HESI Medical-Surgical Nursing Practice
Exam Questions and Correct Answers
(Verified Answers) Plus Rationale 2027
Q&A| Instant Download Pdf
1. A client with heart failure reports increasing shortness of breath
and difficulty breathing when lying flat. Which assessment finding
should the nurse expect?
a. Decreased jugular venous pressure
b. Bilateral crackles
c. Bradycardia
d. Dry mucous membranes
Answer: b. Bilateral crackles
Rationale: Heart failure can cause pulmonary congestion when the
heart cannot effectively pump blood forward. Fluid accumulates in the
lungs, producing crackles and symptoms such as dyspnea and
,orthopnea. Increased jugular venous pressure and peripheral edema
may also occur.
2. A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen therapy. Which nursing action is most
appropriate?
a. Administer oxygen at the highest possible flow rate
b. Maintain oxygen at the prescribed low-flow rate
c. Discontinue oxygen when the client becomes dyspneic
d. Encourage the client to breathe rapidly
Answer: b. Maintain oxygen at the prescribed low-flow rate
Rationale: Clients with COPD may require carefully titrated oxygen
therapy. The nurse should administer oxygen at the prescribed rate and
monitor oxygen saturation, respiratory status, and level of
consciousness. Excessive oxygen administration can worsen carbon
dioxide retention in some patients.
3. A client with diabetes mellitus is awake, confused, diaphoretic,
and trembling. The blood glucose level is 48 mg/dL. What should
the nurse do first?
a. Administer regular insulin
b. Give 15 g of rapid-acting carbohydrate
,c. Start an IV infusion of normal saline
d. Administer glucagon immediately
Answer: b. Give 15 g of rapid-acting carbohydrate
Rationale: The client has symptomatic hypoglycemia and is conscious
and able to swallow. The immediate treatment is approximately 15 g of
rapidly absorbed carbohydrate, followed by reassessment of blood
glucose. Glucagon is generally reserved for severe hypoglycemia when
the client cannot safely take oral carbohydrates.
4. A client is admitted with a suspected myocardial infarction. Which
laboratory test is most specific for myocardial injury?
a. Serum sodium
b. Troponin
c. Hemoglobin
d. Amylase
Answer: b. Troponin
Rationale: Cardiac troponins are highly specific markers of myocardial
injury and are central to the evaluation of acute coronary syndromes.
Troponin levels typically rise after myocardial cell injury and can remain
elevated for several days.
, 5. A client taking warfarin has an international normalized ratio (INR)
of 5.8. Which action should the nurse anticipate?
a. Administer the next dose as scheduled
b. Encourage foods high in vitamin K immediately
c. Hold the medication and notify the healthcare provider
d. Administer aspirin
Answer: c. Hold the medication and notify the healthcare provider
Rationale: An INR of 5.8 represents excessive anticoagulation and
increases bleeding risk. The nurse should hold warfarin and notify the
healthcare provider for further management. Treatment depends on the
INR, presence of bleeding, and overall clinical condition.
6. A client with pneumonia has a respiratory rate of 30/min, oxygen
saturation of 88%, and increasing confusion. Which action has the
highest priority?
a. Encourage oral fluids
b. Apply supplemental oxygen as prescribed
c. Obtain a sputum specimen
d. Teach coughing exercises
Answer: b. Apply supplemental oxygen as prescribed
Exam Questions and Correct Answers
(Verified Answers) Plus Rationale 2027
Q&A| Instant Download Pdf
1. A client with heart failure reports increasing shortness of breath
and difficulty breathing when lying flat. Which assessment finding
should the nurse expect?
a. Decreased jugular venous pressure
b. Bilateral crackles
c. Bradycardia
d. Dry mucous membranes
Answer: b. Bilateral crackles
Rationale: Heart failure can cause pulmonary congestion when the
heart cannot effectively pump blood forward. Fluid accumulates in the
lungs, producing crackles and symptoms such as dyspnea and
,orthopnea. Increased jugular venous pressure and peripheral edema
may also occur.
2. A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen therapy. Which nursing action is most
appropriate?
a. Administer oxygen at the highest possible flow rate
b. Maintain oxygen at the prescribed low-flow rate
c. Discontinue oxygen when the client becomes dyspneic
d. Encourage the client to breathe rapidly
Answer: b. Maintain oxygen at the prescribed low-flow rate
Rationale: Clients with COPD may require carefully titrated oxygen
therapy. The nurse should administer oxygen at the prescribed rate and
monitor oxygen saturation, respiratory status, and level of
consciousness. Excessive oxygen administration can worsen carbon
dioxide retention in some patients.
3. A client with diabetes mellitus is awake, confused, diaphoretic,
and trembling. The blood glucose level is 48 mg/dL. What should
the nurse do first?
a. Administer regular insulin
b. Give 15 g of rapid-acting carbohydrate
,c. Start an IV infusion of normal saline
d. Administer glucagon immediately
Answer: b. Give 15 g of rapid-acting carbohydrate
Rationale: The client has symptomatic hypoglycemia and is conscious
and able to swallow. The immediate treatment is approximately 15 g of
rapidly absorbed carbohydrate, followed by reassessment of blood
glucose. Glucagon is generally reserved for severe hypoglycemia when
the client cannot safely take oral carbohydrates.
4. A client is admitted with a suspected myocardial infarction. Which
laboratory test is most specific for myocardial injury?
a. Serum sodium
b. Troponin
c. Hemoglobin
d. Amylase
Answer: b. Troponin
Rationale: Cardiac troponins are highly specific markers of myocardial
injury and are central to the evaluation of acute coronary syndromes.
Troponin levels typically rise after myocardial cell injury and can remain
elevated for several days.
, 5. A client taking warfarin has an international normalized ratio (INR)
of 5.8. Which action should the nurse anticipate?
a. Administer the next dose as scheduled
b. Encourage foods high in vitamin K immediately
c. Hold the medication and notify the healthcare provider
d. Administer aspirin
Answer: c. Hold the medication and notify the healthcare provider
Rationale: An INR of 5.8 represents excessive anticoagulation and
increases bleeding risk. The nurse should hold warfarin and notify the
healthcare provider for further management. Treatment depends on the
INR, presence of bleeding, and overall clinical condition.
6. A client with pneumonia has a respiratory rate of 30/min, oxygen
saturation of 88%, and increasing confusion. Which action has the
highest priority?
a. Encourage oral fluids
b. Apply supplemental oxygen as prescribed
c. Obtain a sputum specimen
d. Teach coughing exercises
Answer: b. Apply supplemental oxygen as prescribed
