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HESI MED-SURG RN CUSTOM EXAM PRACTICE
QUESTIONS - LATEST 2026/2027 | EXPERT VERIFIED |
NGN-STYLE | MULTIPLE-CHOICE | 150 VERIFIED Q&A |
COMPLETE RATIONALES | PASS GUARANTEED - A+
GRADED
EXAM OVERVIEW
This HESI Med-Surg RN Custom Exam Practice Questions set focuses on core Med-Surg II content including
endocrine, cardiac, respiratory, gastrointestinal, renal, and neurological disorders. It features NGN-style
clinical judgment questions, pharmacology prioritization, and detailed rationales based on Elsevier Evolve
HESI testing standards.
QUESTION 1
A nurse is assessing a client with hyperthyroidism. Which finding is most consistent with this diagnosis?
A) Weight gain and cold intolerance
B) Bradycardia and constipation
C) Tachycardia and heat intolerance
D) Lethargy and dry skin
Correct Answer: C
Rationale: Hyperthyroidism is characterized by increased metabolism, causing tachycardia, heat intolerance,
weight loss, and diaphoresis. Weight gain (A), bradycardia (B), and lethargy (D) are associated with
hypothyroidism.
QUESTION 2
A client with hypothyroidism is prescribed levothyroxine. Which statement indicates the client understands
the medication?
A) "I should take this medication with food to prevent stomach upset."
B) "I should take this medication on an empty stomach, 30-60 minutes before breakfast."
C) "I should stop taking this medication if I feel better."
D) "I can take this medication with calcium supplements."
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Correct Answer: B
Rationale: Levothyroxine should be taken on an empty stomach, 30-60 minutes before breakfast, to optimize
absorption. Taking it with food (A) or calcium (D) decreases absorption. It should not be stopped abruptly
(C).
QUESTION 3
A client with diabetes is experiencing diabetic ketoacidosis (DKA). Which finding is most consistent with
DKA?
A) Blood glucose of 180 mg/dL and pH of 7.40
B) Blood glucose of 450 mg/dL, pH of 7.25, and positive serum ketones
C) Blood glucose of 120 mg/dL and pH of 7.35
D) Blood glucose of 350 mg/dL, pH of 7.50, and negative serum ketones
Correct Answer: B
Rationale: DKA is characterized by severe hyperglycemia (>250 mg/dL), metabolic acidosis (pH <7.30), and
positive serum ketones. Blood glucose of 180 (A) is not severe. pH of 7.50 (D) indicates alkalosis, not acidosis.
Negative ketones (D) rule out DKA.
QUESTION 4
A client with diabetes is experiencing hyperosmolar hyperglycemic state (HHS). Which finding distinguishes
HHS from DKA?
A) Blood glucose >600 mg/dL and no significant ketosis
B) Blood glucose >250 mg/dL and positive ketones
C) pH <7.30 and bicarbonate <18 mEq/L
D) Kussmaul respirations
Correct Answer: A
Rationale: HHS is characterized by severe hyperglycemia (>600 mg/dL), hyperosmolality, and no significant
ketosis. DKA (B, C, D) includes positive ketones, metabolic acidosis, and Kussmaul respirations.
QUESTION 5
A client with diabetes is prescribed metformin. Which teaching should the nurse include?
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A) "Take this medication with food to prevent gastrointestinal upset."
B) "Take this medication on an empty stomach for best absorption."
C) "This medication may cause hypoglycemia."
D) "This medication is safe to take with alcohol."
Correct Answer: A
Rationale: Metformin should be taken with food to reduce gastrointestinal side effects (nausea, diarrhea). It
does not typically cause hypoglycemia (C) when used alone. Alcohol should be avoided or limited (D) due to
the risk of lactic acidosis.
QUESTION 6
A client with diabetes is prescribed insulin lispro (Humalog). When should the nurse administer this
medication?
A) 30 minutes before meals
B) 15 minutes before meals or immediately after meals
C) 1 hour before meals
D) At bedtime only
Correct Answer: B
Rationale: Insulin lispro is a rapid-acting insulin with an onset of 10-15 minutes. It should be given 15
minutes before meals or immediately after meals. Regular insulin (A) is given 30 minutes before meals. NPH
(C) is given 1 hour before meals.
QUESTION 7
A client with diabetes is prescribed insulin glargine (Lantus). Which statement indicates the client
understands the medication?
A) "I should take this insulin before meals."
B) "I should take this insulin once daily at bedtime."
C) "I should mix this insulin with regular insulin."
D) "This insulin will peak in 2-4 hours."
Correct Answer: B
, 4
Rationale: Insulin glargine is a long-acting insulin taken once daily at bedtime. It should not be mixed with
other insulins (C). It has no pronounced peak (D). Regular insulin (A) is taken before meals.
QUESTION 8
A client with diabetes is experiencing hypoglycemia. Which symptom would the nurse expect?
A) Polyuria
B) Polydipsia
C) Diaphoresis and tremors
D) Kussmaul respirations
Correct Answer: C
Rationale: Diaphoresis and tremors are classic signs of hypoglycemia, caused by catecholamine release.
Polyuria (A) and polydipsia (B) indicate hyperglycemia. Kussmaul respirations (D) indicate metabolic
acidosis.
QUESTION 9
A client with diabetes is experiencing hyperglycemia. Which symptom would the nurse expect?
A) Diaphoresis
B) Tremors
C) Polyuria and polydipsia
D) Confusion
Correct Answer: C
Rationale: Polyuria and polydipsia are classic signs of hyperglycemia, caused by osmotic diuresis. Diaphoresis
(A), tremors (B), and confusion (D) indicate hypoglycemia.
QUESTION 10
A client with diabetes is prescribed an ACE inhibitor. Which is the expected effect of this medication?
A) Decreased heart rate
B) Decreased blood pressure
C) Decreased blood glucose
D) Decreased urine output
HESI MED-SURG RN CUSTOM EXAM PRACTICE
QUESTIONS - LATEST 2026/2027 | EXPERT VERIFIED |
NGN-STYLE | MULTIPLE-CHOICE | 150 VERIFIED Q&A |
COMPLETE RATIONALES | PASS GUARANTEED - A+
GRADED
EXAM OVERVIEW
This HESI Med-Surg RN Custom Exam Practice Questions set focuses on core Med-Surg II content including
endocrine, cardiac, respiratory, gastrointestinal, renal, and neurological disorders. It features NGN-style
clinical judgment questions, pharmacology prioritization, and detailed rationales based on Elsevier Evolve
HESI testing standards.
QUESTION 1
A nurse is assessing a client with hyperthyroidism. Which finding is most consistent with this diagnosis?
A) Weight gain and cold intolerance
B) Bradycardia and constipation
C) Tachycardia and heat intolerance
D) Lethargy and dry skin
Correct Answer: C
Rationale: Hyperthyroidism is characterized by increased metabolism, causing tachycardia, heat intolerance,
weight loss, and diaphoresis. Weight gain (A), bradycardia (B), and lethargy (D) are associated with
hypothyroidism.
QUESTION 2
A client with hypothyroidism is prescribed levothyroxine. Which statement indicates the client understands
the medication?
A) "I should take this medication with food to prevent stomach upset."
B) "I should take this medication on an empty stomach, 30-60 minutes before breakfast."
C) "I should stop taking this medication if I feel better."
D) "I can take this medication with calcium supplements."
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Correct Answer: B
Rationale: Levothyroxine should be taken on an empty stomach, 30-60 minutes before breakfast, to optimize
absorption. Taking it with food (A) or calcium (D) decreases absorption. It should not be stopped abruptly
(C).
QUESTION 3
A client with diabetes is experiencing diabetic ketoacidosis (DKA). Which finding is most consistent with
DKA?
A) Blood glucose of 180 mg/dL and pH of 7.40
B) Blood glucose of 450 mg/dL, pH of 7.25, and positive serum ketones
C) Blood glucose of 120 mg/dL and pH of 7.35
D) Blood glucose of 350 mg/dL, pH of 7.50, and negative serum ketones
Correct Answer: B
Rationale: DKA is characterized by severe hyperglycemia (>250 mg/dL), metabolic acidosis (pH <7.30), and
positive serum ketones. Blood glucose of 180 (A) is not severe. pH of 7.50 (D) indicates alkalosis, not acidosis.
Negative ketones (D) rule out DKA.
QUESTION 4
A client with diabetes is experiencing hyperosmolar hyperglycemic state (HHS). Which finding distinguishes
HHS from DKA?
A) Blood glucose >600 mg/dL and no significant ketosis
B) Blood glucose >250 mg/dL and positive ketones
C) pH <7.30 and bicarbonate <18 mEq/L
D) Kussmaul respirations
Correct Answer: A
Rationale: HHS is characterized by severe hyperglycemia (>600 mg/dL), hyperosmolality, and no significant
ketosis. DKA (B, C, D) includes positive ketones, metabolic acidosis, and Kussmaul respirations.
QUESTION 5
A client with diabetes is prescribed metformin. Which teaching should the nurse include?
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A) "Take this medication with food to prevent gastrointestinal upset."
B) "Take this medication on an empty stomach for best absorption."
C) "This medication may cause hypoglycemia."
D) "This medication is safe to take with alcohol."
Correct Answer: A
Rationale: Metformin should be taken with food to reduce gastrointestinal side effects (nausea, diarrhea). It
does not typically cause hypoglycemia (C) when used alone. Alcohol should be avoided or limited (D) due to
the risk of lactic acidosis.
QUESTION 6
A client with diabetes is prescribed insulin lispro (Humalog). When should the nurse administer this
medication?
A) 30 minutes before meals
B) 15 minutes before meals or immediately after meals
C) 1 hour before meals
D) At bedtime only
Correct Answer: B
Rationale: Insulin lispro is a rapid-acting insulin with an onset of 10-15 minutes. It should be given 15
minutes before meals or immediately after meals. Regular insulin (A) is given 30 minutes before meals. NPH
(C) is given 1 hour before meals.
QUESTION 7
A client with diabetes is prescribed insulin glargine (Lantus). Which statement indicates the client
understands the medication?
A) "I should take this insulin before meals."
B) "I should take this insulin once daily at bedtime."
C) "I should mix this insulin with regular insulin."
D) "This insulin will peak in 2-4 hours."
Correct Answer: B
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Rationale: Insulin glargine is a long-acting insulin taken once daily at bedtime. It should not be mixed with
other insulins (C). It has no pronounced peak (D). Regular insulin (A) is taken before meals.
QUESTION 8
A client with diabetes is experiencing hypoglycemia. Which symptom would the nurse expect?
A) Polyuria
B) Polydipsia
C) Diaphoresis and tremors
D) Kussmaul respirations
Correct Answer: C
Rationale: Diaphoresis and tremors are classic signs of hypoglycemia, caused by catecholamine release.
Polyuria (A) and polydipsia (B) indicate hyperglycemia. Kussmaul respirations (D) indicate metabolic
acidosis.
QUESTION 9
A client with diabetes is experiencing hyperglycemia. Which symptom would the nurse expect?
A) Diaphoresis
B) Tremors
C) Polyuria and polydipsia
D) Confusion
Correct Answer: C
Rationale: Polyuria and polydipsia are classic signs of hyperglycemia, caused by osmotic diuresis. Diaphoresis
(A), tremors (B), and confusion (D) indicate hypoglycemia.
QUESTION 10
A client with diabetes is prescribed an ACE inhibitor. Which is the expected effect of this medication?
A) Decreased heart rate
B) Decreased blood pressure
C) Decreased blood glucose
D) Decreased urine output
