1
HESI RN MED-SURG TEST BANK - ACTUAL EXAM
2026/2027 | EXPERT VERIFIED | NGN-STYLE | MULTIPLE-
CHOICE | 200 VERIFIED Q&A | COMPLETE RATIONALES |
PASS GUARANTEED - A+ GRADED
EXAM OVERVIEW
This HESI RN Med-Surg Test Bank is a comprehensive resource featuring 200 questions covering all body
systems with NGN-style integration. It includes detailed answer explanations, pharmacology prioritization,
and clinical judgment scenarios aligned with Elsevier Evolve HESI testing standards and the NCSBN Clinical
Judgment Measurement Model.
QUESTION 1
A client with heart failure is prescribed furosemide (Lasix) and digoxin. Which laboratory value is most
important for the nurse to monitor?
A) Serum potassium
B) Serum sodium
C) Serum calcium
D) Serum magnesium
Correct Answer: A
Rationale: Furosemide causes potassium loss, leading to hypokalemia. Hypokalemia increases the risk of
digoxin toxicity. Monitoring serum potassium is essential to prevent cardiac arrhythmias.
QUESTION 2
A client with a history of myocardial infarction is prescribed aspirin and clopidogrel. The nurse should
monitor for which adverse effect?
A) Bleeding
B) Hypertension
C) Hyperglycemia
D) Tachycardia
,2
Correct Answer: A
Rationale: Aspirin and clopidogrel are antiplatelet agents that increase the risk of bleeding. The nurse should
monitor for signs of bleeding (e.g., bruising, petechiae, bleeding gums, hematuria).
QUESTION 3
A client with COPD is receiving oxygen at 2 L/min via nasal cannula. Which assessment finding indicates the
client is tolerating the oxygen therapy?
A) Respiratory rate of 28 breaths/min
B) SpO2 of 92%
C) Heart rate of 100 bpm
D) PaCO2 of 55 mmHg
Correct Answer: B
Rationale: In COPD, oxygen therapy is titrated to maintain SpO2 ≥-90%.
88 An SpO2 of 92% indicates
adequate oxygenation. Tachypnea (A), tachycardia (C), and elevated PaCO2 (D) may indicate inadequate
response or CO2 retention.
QUESTION 4
A client with pneumonia is prescribed levofloxacin. Which teaching should the nurse include?
A) Take the medication with dairy products
B) Avoid sun exposure
C) Take the medication on an empty stomach
D) This medication will cause orange urine
Correct Answer: B
Rationale: Levofloxacin is a fluoroquinolone that can cause photosensitivity. Clients should avoid sun
exposure and use sunscreen. It should be taken with or without food (A). Orange urine (D) is caused by
rifampin.
QUESTION 5
A client with a pulmonary embolism is receiving heparin IV. Which laboratory value indicates the therapy is
therapeutic?
,3
A) aPTT of 45 seconds
B) aPTT of 65 seconds
C) aPTT of 35 seconds
D) INR of 3.0
Correct Answer: B
Rationale: The therapeutic aPTT for heparin is 1.5-2.5 times the normal control value (typically 60-90
seconds). An aPTT of 45 seconds (A) is below therapeutic range. INR (D) is used for warfarin, not heparin.
QUESTION 6
A client with a chest tube has continuous bubbling in the water-seal chamber. Which action should the nurse
take?
A) Clamp the chest tube
B) Notify the healthcare provider
C) Continue to monitor
D) Increase suction pressure
Correct Answer: B
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak. The healthcare provider
should be notified. Clamping the chest tube (A) can cause tension pneumothorax.
QUESTION 7
A client with a tracheostomy has thick secretions. Which intervention should the nurse implement first?
A) Instill normal saline into the tracheostomy
B) Increase fluid intake
C) Perform deep suctioning every hour
D) Change the tracheostomy tube
Correct Answer: B
Rationale: Increasing fluid intake (if not contraindicated) helps thin secretions. Instilling normal saline (A) is
no longer recommended. Suctioning should be performed on an as-needed basis (C).
, 4
QUESTION 8
A client with a head injury has an ICP of 28 mmHg. Which action should the nurse take first?
A) Administer mannitol as prescribed
B) Elevate the head of the bed to 30 degrees
C) Notify the healthcare provider
D) Increase the rate of IV fluids
Correct Answer: B
Rationale: The initial nursing action for elevated ICP is to elevate the head of the bed to 30 degrees to promote
venous drainage and reduce ICP. If ICP remains elevated, the healthcare provider should be notified (C), and
medications (mannitol, hypertonic saline) may be administered (A).
QUESTION 9
A client with a spinal cord injury above T6 develops severe hypertension, bradycardia, and headache. This
condition is known as:
A) Spinal shock
B) Neurogenic shock
C) Autonomic dysreflexia
D) Cauda equina syndrome
Correct Answer: C
Rationale: Autonomic dysreflexia is a life-threatening emergency that occurs in clients with spinal cord
injuries at T6 or above. It is triggered by a noxious stimulus below the level of injury (e.g., full bladder, fecal
impaction) and causes severe hypertension, bradycardia, and headache.
QUESTION 10
A client with a spinal cord injury above T6 develops autonomic dysreflexia. Which is the priority
intervention?
A) Lower the head of the bed
B) Administer antihypertensive medication
C) Identify and remove the triggering stimulus
D) Administer oxygen
HESI RN MED-SURG TEST BANK - ACTUAL EXAM
2026/2027 | EXPERT VERIFIED | NGN-STYLE | MULTIPLE-
CHOICE | 200 VERIFIED Q&A | COMPLETE RATIONALES |
PASS GUARANTEED - A+ GRADED
EXAM OVERVIEW
This HESI RN Med-Surg Test Bank is a comprehensive resource featuring 200 questions covering all body
systems with NGN-style integration. It includes detailed answer explanations, pharmacology prioritization,
and clinical judgment scenarios aligned with Elsevier Evolve HESI testing standards and the NCSBN Clinical
Judgment Measurement Model.
QUESTION 1
A client with heart failure is prescribed furosemide (Lasix) and digoxin. Which laboratory value is most
important for the nurse to monitor?
A) Serum potassium
B) Serum sodium
C) Serum calcium
D) Serum magnesium
Correct Answer: A
Rationale: Furosemide causes potassium loss, leading to hypokalemia. Hypokalemia increases the risk of
digoxin toxicity. Monitoring serum potassium is essential to prevent cardiac arrhythmias.
QUESTION 2
A client with a history of myocardial infarction is prescribed aspirin and clopidogrel. The nurse should
monitor for which adverse effect?
A) Bleeding
B) Hypertension
C) Hyperglycemia
D) Tachycardia
,2
Correct Answer: A
Rationale: Aspirin and clopidogrel are antiplatelet agents that increase the risk of bleeding. The nurse should
monitor for signs of bleeding (e.g., bruising, petechiae, bleeding gums, hematuria).
QUESTION 3
A client with COPD is receiving oxygen at 2 L/min via nasal cannula. Which assessment finding indicates the
client is tolerating the oxygen therapy?
A) Respiratory rate of 28 breaths/min
B) SpO2 of 92%
C) Heart rate of 100 bpm
D) PaCO2 of 55 mmHg
Correct Answer: B
Rationale: In COPD, oxygen therapy is titrated to maintain SpO2 ≥-90%.
88 An SpO2 of 92% indicates
adequate oxygenation. Tachypnea (A), tachycardia (C), and elevated PaCO2 (D) may indicate inadequate
response or CO2 retention.
QUESTION 4
A client with pneumonia is prescribed levofloxacin. Which teaching should the nurse include?
A) Take the medication with dairy products
B) Avoid sun exposure
C) Take the medication on an empty stomach
D) This medication will cause orange urine
Correct Answer: B
Rationale: Levofloxacin is a fluoroquinolone that can cause photosensitivity. Clients should avoid sun
exposure and use sunscreen. It should be taken with or without food (A). Orange urine (D) is caused by
rifampin.
QUESTION 5
A client with a pulmonary embolism is receiving heparin IV. Which laboratory value indicates the therapy is
therapeutic?
,3
A) aPTT of 45 seconds
B) aPTT of 65 seconds
C) aPTT of 35 seconds
D) INR of 3.0
Correct Answer: B
Rationale: The therapeutic aPTT for heparin is 1.5-2.5 times the normal control value (typically 60-90
seconds). An aPTT of 45 seconds (A) is below therapeutic range. INR (D) is used for warfarin, not heparin.
QUESTION 6
A client with a chest tube has continuous bubbling in the water-seal chamber. Which action should the nurse
take?
A) Clamp the chest tube
B) Notify the healthcare provider
C) Continue to monitor
D) Increase suction pressure
Correct Answer: B
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak. The healthcare provider
should be notified. Clamping the chest tube (A) can cause tension pneumothorax.
QUESTION 7
A client with a tracheostomy has thick secretions. Which intervention should the nurse implement first?
A) Instill normal saline into the tracheostomy
B) Increase fluid intake
C) Perform deep suctioning every hour
D) Change the tracheostomy tube
Correct Answer: B
Rationale: Increasing fluid intake (if not contraindicated) helps thin secretions. Instilling normal saline (A) is
no longer recommended. Suctioning should be performed on an as-needed basis (C).
, 4
QUESTION 8
A client with a head injury has an ICP of 28 mmHg. Which action should the nurse take first?
A) Administer mannitol as prescribed
B) Elevate the head of the bed to 30 degrees
C) Notify the healthcare provider
D) Increase the rate of IV fluids
Correct Answer: B
Rationale: The initial nursing action for elevated ICP is to elevate the head of the bed to 30 degrees to promote
venous drainage and reduce ICP. If ICP remains elevated, the healthcare provider should be notified (C), and
medications (mannitol, hypertonic saline) may be administered (A).
QUESTION 9
A client with a spinal cord injury above T6 develops severe hypertension, bradycardia, and headache. This
condition is known as:
A) Spinal shock
B) Neurogenic shock
C) Autonomic dysreflexia
D) Cauda equina syndrome
Correct Answer: C
Rationale: Autonomic dysreflexia is a life-threatening emergency that occurs in clients with spinal cord
injuries at T6 or above. It is triggered by a noxious stimulus below the level of injury (e.g., full bladder, fecal
impaction) and causes severe hypertension, bradycardia, and headache.
QUESTION 10
A client with a spinal cord injury above T6 develops autonomic dysreflexia. Which is the priority
intervention?
A) Lower the head of the bed
B) Administer antihypertensive medication
C) Identify and remove the triggering stimulus
D) Administer oxygen
