HESI MED-SURG • MEDICAL-SURGICAL NURSING
EVOLVE ELSEVIER HESI MED SURG 2026/2027
ACTUAL EXAM WITH REAL EXAM QUESTIONS
AND CORRECT ANSWERS WITH WELL-ELABORATED
RATIONALES | EVOLVE HESI MEDICAL SURGICAL
LATEST EXAM 2026/2027 (BRAND NEW!!) —
A+
2026/2027 Official Exam
Official-Style Medical-Surgical Nursing Examination • Passing Score 80%
A+ QUESTIONS 5 SECTIONS 100%
VERIFIED BALANCED RATIONALES
CATEGORIES
Cardiovascular & Respiratory Disorders
Fluid, Electrolyte, Acid-Base & Renal
Endocrine, Gastrointestinal & Neurological
Perioperative, Pain & Immune/Oncology
Musculoskeletal, Integumentary & Emergency/Critical Care
EXAM FORMAT & SCORING
• Question Format: Multiple-choice (A–D) | 1 mark per question
• Total Marks: 50 | Passing Score: 80% (40/50)
• Difficulty: Advanced Medical-Surgical Nursing — Application & Analysis
• High-yield HESI med-surg topics prioritized for clinical readiness
• Answer Distribution: Balanced A/B/C/D | Full item-specific rationales
• Brand: STUVIAACTUALEXAM | Year: 2026/2027 | Evolve HESI aligned
STUVIAACTUALEXAM
, SECTION: CARDIOVASCULAR & RESPIRATORY DISORDERS
Q1. A client with acute decompensated heart failure is receiving continuous IV furosemide. The nurse notes a 1.2 kg weight gain
over 24 hours, crackles in both lung bases, and an oxygen saturation of 90% on 2 L nasal cannula. The most appropriate
immediate nursing action is to notify the provider and prepare for possible escalation of respiratory support while continuing to
monitor fluid balance.
A. Elevate the head of the bed, apply oxygen as ordered, and report the findings promptly
B. Decrease the furosemide rate because the client is losing too much fluid
C. Encourage oral fluid intake to correct presumed dehydration
D. Document the findings as expected for the diagnosis and reassess in four hours
Correct Answer: A
Rationale: Weight gain, persistent crackles, and declining saturation indicate ongoing fluid overload and impaired gas exchange. Positioning,
supplemental oxygen, and timely communication support oxygenation while the treatment plan is adjusted.
Q2. A client admitted with an ST-elevation myocardial infarction received fibrinolytic therapy 90 minutes ago. The nurse observes
frequent premature ventricular complexes and a short run of non-sustained ventricular tachycardia. The client remains alert with a
blood pressure of 118/72 mm Hg. The priority action is continuous cardiac monitoring and readiness to manage life-threatening
dysrhythmias according to ACLS protocols.
A. Administer a fluid bolus to increase preload
B. Maintain continuous monitoring and have emergency equipment immediately available
C. Ambulate the client to reduce anxiety-related ectopy
D. Discontinue cardiac monitoring because the client is hemodynamically stable
Correct Answer: B
Rationale: Reperfusion can trigger reperfusion arrhythmias. Even when the client is currently stable, continuous monitoring and preparedness for
deterioration are essential after fibrinolysis.
Q3. A client with COPD is receiving oxygen at 2 L/min via nasal cannula. Arterial blood gas results show pH 7.34, PaCO■ 58 mm
Hg, PaO■ 62 mm Hg, and HCO■■ 30 mEq/L. The nurse interprets these values as compensated respiratory acidosis with mild
hypoxemia and continues cautious oxygen therapy while monitoring for CO■ retention.
A. Acute uncompensated metabolic acidosis requiring immediate bicarbonate
B. Acute respiratory alkalosis from hyperventilation
C. Chronic respiratory acidosis with renal compensation and acceptable oxygenation for this client
D. Normal acid-base balance with no need for further assessment
Correct Answer: C
Rationale: Elevated PaCO■ with elevated HCO■■ and near-normal pH indicates chronic CO■ retention with renal compensation, common in
COPD. Oxygen is titrated carefully to avoid suppressing hypoxic drive.
Q4. A client develops sudden dyspnea, chest pain, and restlessness on the second postoperative day after abdominal surgery.
Heart rate is 122, respiratory rate 28, and SpO■ 88% on room air. The nurse’s first action is to apply oxygen and place the client in
high Fowler’s position while activating the rapid-response process for suspected pulmonary embolism.
A. Encourage the client to ambulate to improve circulation
B. Administer a prn sedative to reduce anxiety
C. Wait 15 minutes and reassess vital signs before intervening
D. Administer oxygen, position upright, and obtain immediate assistance
Correct Answer: D
Rationale: Sudden respiratory distress after surgery raises suspicion for pulmonary embolism. Immediate oxygenation, upright positioning, and
rapid clinical support are the priority.
Q5. A client with atrial fibrillation is started on warfarin. The nurse reinforces that the client must have regular INR monitoring and
report signs of bleeding. The therapeutic INR range for most clients with atrial fibrillation is 2.0–3.0, and consistent vitamin K intake
is important for stable dosing.
A. Maintain a consistent diet and keep scheduled INR appointments to stay in the 2–3 range
B. INR does not need to be checked once the dose is stable
C. Double the warfarin dose if a single dose is missed
D. Stop warfarin three days before any dental cleaning without notifying the provider
Correct Answer: A
Rationale: Warfarin requires ongoing INR monitoring. Consistency in diet (vitamin K) and adherence to the prescribed regimen keep
anticoagulation in the therapeutic window and reduce both clotting and bleeding risk.
Page 1 of 10 | STUVIAACTUALEXAM
EVOLVE ELSEVIER HESI MED SURG 2026/2027
ACTUAL EXAM WITH REAL EXAM QUESTIONS
AND CORRECT ANSWERS WITH WELL-ELABORATED
RATIONALES | EVOLVE HESI MEDICAL SURGICAL
LATEST EXAM 2026/2027 (BRAND NEW!!) —
A+
2026/2027 Official Exam
Official-Style Medical-Surgical Nursing Examination • Passing Score 80%
A+ QUESTIONS 5 SECTIONS 100%
VERIFIED BALANCED RATIONALES
CATEGORIES
Cardiovascular & Respiratory Disorders
Fluid, Electrolyte, Acid-Base & Renal
Endocrine, Gastrointestinal & Neurological
Perioperative, Pain & Immune/Oncology
Musculoskeletal, Integumentary & Emergency/Critical Care
EXAM FORMAT & SCORING
• Question Format: Multiple-choice (A–D) | 1 mark per question
• Total Marks: 50 | Passing Score: 80% (40/50)
• Difficulty: Advanced Medical-Surgical Nursing — Application & Analysis
• High-yield HESI med-surg topics prioritized for clinical readiness
• Answer Distribution: Balanced A/B/C/D | Full item-specific rationales
• Brand: STUVIAACTUALEXAM | Year: 2026/2027 | Evolve HESI aligned
STUVIAACTUALEXAM
, SECTION: CARDIOVASCULAR & RESPIRATORY DISORDERS
Q1. A client with acute decompensated heart failure is receiving continuous IV furosemide. The nurse notes a 1.2 kg weight gain
over 24 hours, crackles in both lung bases, and an oxygen saturation of 90% on 2 L nasal cannula. The most appropriate
immediate nursing action is to notify the provider and prepare for possible escalation of respiratory support while continuing to
monitor fluid balance.
A. Elevate the head of the bed, apply oxygen as ordered, and report the findings promptly
B. Decrease the furosemide rate because the client is losing too much fluid
C. Encourage oral fluid intake to correct presumed dehydration
D. Document the findings as expected for the diagnosis and reassess in four hours
Correct Answer: A
Rationale: Weight gain, persistent crackles, and declining saturation indicate ongoing fluid overload and impaired gas exchange. Positioning,
supplemental oxygen, and timely communication support oxygenation while the treatment plan is adjusted.
Q2. A client admitted with an ST-elevation myocardial infarction received fibrinolytic therapy 90 minutes ago. The nurse observes
frequent premature ventricular complexes and a short run of non-sustained ventricular tachycardia. The client remains alert with a
blood pressure of 118/72 mm Hg. The priority action is continuous cardiac monitoring and readiness to manage life-threatening
dysrhythmias according to ACLS protocols.
A. Administer a fluid bolus to increase preload
B. Maintain continuous monitoring and have emergency equipment immediately available
C. Ambulate the client to reduce anxiety-related ectopy
D. Discontinue cardiac monitoring because the client is hemodynamically stable
Correct Answer: B
Rationale: Reperfusion can trigger reperfusion arrhythmias. Even when the client is currently stable, continuous monitoring and preparedness for
deterioration are essential after fibrinolysis.
Q3. A client with COPD is receiving oxygen at 2 L/min via nasal cannula. Arterial blood gas results show pH 7.34, PaCO■ 58 mm
Hg, PaO■ 62 mm Hg, and HCO■■ 30 mEq/L. The nurse interprets these values as compensated respiratory acidosis with mild
hypoxemia and continues cautious oxygen therapy while monitoring for CO■ retention.
A. Acute uncompensated metabolic acidosis requiring immediate bicarbonate
B. Acute respiratory alkalosis from hyperventilation
C. Chronic respiratory acidosis with renal compensation and acceptable oxygenation for this client
D. Normal acid-base balance with no need for further assessment
Correct Answer: C
Rationale: Elevated PaCO■ with elevated HCO■■ and near-normal pH indicates chronic CO■ retention with renal compensation, common in
COPD. Oxygen is titrated carefully to avoid suppressing hypoxic drive.
Q4. A client develops sudden dyspnea, chest pain, and restlessness on the second postoperative day after abdominal surgery.
Heart rate is 122, respiratory rate 28, and SpO■ 88% on room air. The nurse’s first action is to apply oxygen and place the client in
high Fowler’s position while activating the rapid-response process for suspected pulmonary embolism.
A. Encourage the client to ambulate to improve circulation
B. Administer a prn sedative to reduce anxiety
C. Wait 15 minutes and reassess vital signs before intervening
D. Administer oxygen, position upright, and obtain immediate assistance
Correct Answer: D
Rationale: Sudden respiratory distress after surgery raises suspicion for pulmonary embolism. Immediate oxygenation, upright positioning, and
rapid clinical support are the priority.
Q5. A client with atrial fibrillation is started on warfarin. The nurse reinforces that the client must have regular INR monitoring and
report signs of bleeding. The therapeutic INR range for most clients with atrial fibrillation is 2.0–3.0, and consistent vitamin K intake
is important for stable dosing.
A. Maintain a consistent diet and keep scheduled INR appointments to stay in the 2–3 range
B. INR does not need to be checked once the dose is stable
C. Double the warfarin dose if a single dose is missed
D. Stop warfarin three days before any dental cleaning without notifying the provider
Correct Answer: A
Rationale: Warfarin requires ongoing INR monitoring. Consistency in diet (vitamin K) and adherence to the prescribed regimen keep
anticoagulation in the therapeutic window and reduce both clotting and bleeding risk.
Page 1 of 10 | STUVIAACTUALEXAM
