HESI SPECIALTY · MEDICAL-SURGICAL NURSING
EVOLVE ELSEVIER HESI MED SURG 2026/2027
ACTUAL EXAM WITH REAL EXAM QUESTIONS AND A+
CORRECT ANSWERS WITH WELL-ELABORATED
RATIONALES | EVOLVE HESI MEDICAL SURGICAL
LATEST EXAM 2026/2027 (BRAND NEW!!)
Evolve Elsevier · HESI Medical-Surgical Specialty Exam
A+ QUESTIONS 5 SECTIONS 100%
VERIFIED COVERED RATIONALES
CATEGORIES
■ Cardiovascular & Respiratory Disorders
■ Gastrointestinal, Endocrine & Renal Disorders
■ Neurologic, Musculoskeletal & Sensory Disorders
■ Hematologic, Oncologic & Immune Disorders
■ Perioperative, Fluid/Electrolyte & Complex Care
STUVIAACTUALEXAM
Passing Score: 80% · Application / Analysis Level · Aligned to HESI Med-Surg Blueprint
, SECTION 1: CARDIOVASCULAR & RESPIRATORY DISORDERS
Q1. A client with acute decompensated heart failure has crackles in both lung bases, SpO2 88% on room air, and increasing dyspnea. The
nurse’s priority action is to
A. Administer oxygen and elevate the head of the bed
B. Encourage ambulation to the chair
C. Offer oral fluids to thin secretions
D. Obtain a 12-lead ECG only after the client is comfortable
Correct Answer: A
Rationale: Airway and oxygenation take priority; upright positioning and supplemental oxygen reduce work of breathing and improve saturation.
Q2. A client receiving IV heparin for a pulmonary embolism has an aPTT of 110 seconds (therapeutic range 60–80). The nurse should
A. Continue the current infusion rate
B. Increase the rate by 2 mL/hr
C. Hold the infusion and notify the provider; prepare for possible protamine if ordered
D. Administer an extra bolus of heparin
Correct Answer: C
Rationale: aPTT well above the therapeutic range indicates excessive anticoagulation; the infusion is held and the provider is notified.
Q3. A client with COPD is receiving oxygen at 4 L/min by nasal cannula and becomes lethargic with a rising PaCO2. The nurse recognizes
that
A. Higher oxygen is always safer in COPD
B. Excessive oxygen can blunt hypoxic drive in some COPD clients; the rate may need adjustment per orders
C. Lethargy is unrelated to oxygen therapy
D. The client needs immediate intubation without assessment
Correct Answer: B
Rationale: Some clients with chronic hypercapnia rely on hypoxic drive; excessive O2 can worsen CO2 retention and cause somnolence.
Q4. A post-MI client develops sudden chest pain, a new holosystolic murmur, and hypotension. The nurse suspects
A. Uncomplicated angina
B. Expected pericarditis only
C. Anxiety without further evaluation
D. Possible papillary muscle rupture or ventricular septal defect requiring immediate notification of the provider
Correct Answer: D
Rationale: New murmur with hemodynamic instability after MI suggests mechanical complication and is an emergency.
Q5. A client with atrial fibrillation is prescribed warfarin. The nurse emphasizes that the client should
A. Maintain a consistent intake of vitamin K–rich foods and keep all INR appointments
B. Eat large amounts of kale daily without monitoring
C. Double the dose if a dose is missed
D. Stop warfarin if minor bruising occurs without contacting the provider
Correct Answer: A
Rationale: Consistent vitamin K intake and regular INR monitoring are essential for safe anticoagulation.
Q6. A client with pneumonia has a temperature of 38.9°C (102°F), productive cough, and SpO2 91%. Priority nursing interventions include
A. Restricting fluids and keeping the client flat
B. Withholding antipyretics to monitor the fever curve only
C. Oxygen therapy as ordered, hydration, pulmonary hygiene, and antibiotic administration
D. Encouraging bed rest without turning
Correct Answer: C
Rationale: Oxygenation, fluid balance, secretion clearance, and timely antibiotics are core pneumonia interventions.
Q7. A client develops acute shortness of breath and chest pain after a long bone fracture. The nurse’s first action is to
A. Ambulate the client immediately
B. Apply oxygen, place the client in high Fowler’s, and notify the provider of possible fat embolism
C. Massage the fracture site
D. Give a fluid bolus without assessment
Correct Answer: B
Rationale: Suspected fat embolism requires oxygen, positioning, and rapid provider notification.
HESI Med-Surg 2026/2027 · Page 2
EVOLVE ELSEVIER HESI MED SURG 2026/2027
ACTUAL EXAM WITH REAL EXAM QUESTIONS AND A+
CORRECT ANSWERS WITH WELL-ELABORATED
RATIONALES | EVOLVE HESI MEDICAL SURGICAL
LATEST EXAM 2026/2027 (BRAND NEW!!)
Evolve Elsevier · HESI Medical-Surgical Specialty Exam
A+ QUESTIONS 5 SECTIONS 100%
VERIFIED COVERED RATIONALES
CATEGORIES
■ Cardiovascular & Respiratory Disorders
■ Gastrointestinal, Endocrine & Renal Disorders
■ Neurologic, Musculoskeletal & Sensory Disorders
■ Hematologic, Oncologic & Immune Disorders
■ Perioperative, Fluid/Electrolyte & Complex Care
STUVIAACTUALEXAM
Passing Score: 80% · Application / Analysis Level · Aligned to HESI Med-Surg Blueprint
, SECTION 1: CARDIOVASCULAR & RESPIRATORY DISORDERS
Q1. A client with acute decompensated heart failure has crackles in both lung bases, SpO2 88% on room air, and increasing dyspnea. The
nurse’s priority action is to
A. Administer oxygen and elevate the head of the bed
B. Encourage ambulation to the chair
C. Offer oral fluids to thin secretions
D. Obtain a 12-lead ECG only after the client is comfortable
Correct Answer: A
Rationale: Airway and oxygenation take priority; upright positioning and supplemental oxygen reduce work of breathing and improve saturation.
Q2. A client receiving IV heparin for a pulmonary embolism has an aPTT of 110 seconds (therapeutic range 60–80). The nurse should
A. Continue the current infusion rate
B. Increase the rate by 2 mL/hr
C. Hold the infusion and notify the provider; prepare for possible protamine if ordered
D. Administer an extra bolus of heparin
Correct Answer: C
Rationale: aPTT well above the therapeutic range indicates excessive anticoagulation; the infusion is held and the provider is notified.
Q3. A client with COPD is receiving oxygen at 4 L/min by nasal cannula and becomes lethargic with a rising PaCO2. The nurse recognizes
that
A. Higher oxygen is always safer in COPD
B. Excessive oxygen can blunt hypoxic drive in some COPD clients; the rate may need adjustment per orders
C. Lethargy is unrelated to oxygen therapy
D. The client needs immediate intubation without assessment
Correct Answer: B
Rationale: Some clients with chronic hypercapnia rely on hypoxic drive; excessive O2 can worsen CO2 retention and cause somnolence.
Q4. A post-MI client develops sudden chest pain, a new holosystolic murmur, and hypotension. The nurse suspects
A. Uncomplicated angina
B. Expected pericarditis only
C. Anxiety without further evaluation
D. Possible papillary muscle rupture or ventricular septal defect requiring immediate notification of the provider
Correct Answer: D
Rationale: New murmur with hemodynamic instability after MI suggests mechanical complication and is an emergency.
Q5. A client with atrial fibrillation is prescribed warfarin. The nurse emphasizes that the client should
A. Maintain a consistent intake of vitamin K–rich foods and keep all INR appointments
B. Eat large amounts of kale daily without monitoring
C. Double the dose if a dose is missed
D. Stop warfarin if minor bruising occurs without contacting the provider
Correct Answer: A
Rationale: Consistent vitamin K intake and regular INR monitoring are essential for safe anticoagulation.
Q6. A client with pneumonia has a temperature of 38.9°C (102°F), productive cough, and SpO2 91%. Priority nursing interventions include
A. Restricting fluids and keeping the client flat
B. Withholding antipyretics to monitor the fever curve only
C. Oxygen therapy as ordered, hydration, pulmonary hygiene, and antibiotic administration
D. Encouraging bed rest without turning
Correct Answer: C
Rationale: Oxygenation, fluid balance, secretion clearance, and timely antibiotics are core pneumonia interventions.
Q7. A client develops acute shortness of breath and chest pain after a long bone fracture. The nurse’s first action is to
A. Ambulate the client immediately
B. Apply oxygen, place the client in high Fowler’s, and notify the provider of possible fat embolism
C. Massage the fracture site
D. Give a fluid bolus without assessment
Correct Answer: B
Rationale: Suspected fat embolism requires oxygen, positioning, and rapid provider notification.
HESI Med-Surg 2026/2027 · Page 2
