HESI Entrance Exam 2026 Complete Medical Terminology,
Anatomy & Nursing Fundamentals Questions and Answers
with Expert Solutions - 120 Questions with Answers
Page 1
,Q1. In a patient with chronic systolic heart failure, which compensatory
neurohormonal mechanism is initially beneficial but ultimately contributes to disease
progression, and is a primary target for beta-blocker therapy?
A. Activation of the renin-angiotensin-aldosterone system (RAAS)
B. Release of atrial natriuretic peptide (ANP)
C. Upregulation of beta-1 adrenergic receptors
D. Increased vagal tone
Correct Answer: A. Activation of the renin-angiotensin-aldosterone system (RAAS)
Rationale: In chronic systolic heart failure, sustained RAAS activation causes
vasoconstriction, sodium retention, and adverse cardiac remodeling, worsening the
condition. Beta-blockers mitigate the harmful effects of sympathetic activation, not directly
RAAS, but the question asks for the mechanism that is initially compensatory but
ultimately harmful-RAAS. ANP is compensatory but counteracts RAAS; beta-receptor
downregulation occurs, not upregulation; vagal tone is decreased.
Why Wrong:
B - ANP is compensatory and counteracts RAAS, not a primary target of
beta-blockers.
C - Beta-1 receptors are downregulated in heart failure, not upregulated.
D - Vagal tone is decreased in heart failure, not increased, and is not a target of
beta-blockers.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 22
Q2. Which anatomical structure is most likely to be injured during a mid-shaft
humerus fracture, leading to wrist drop?
A. Median nerve
B. Radial nerve
C. Ulnar nerve
D. Musculocutaneous nerve
Correct Answer: B. Radial nerve
Rationale: The radial nerve travels in the radial groove of the humerus and is commonly
injured in mid-shaft fractures, causing wrist drop due to paralysis of the extensor muscles.
The median nerve is more associated with carpal tunnel syndrome; ulnar nerve injury
causes claw hand; musculocutaneous nerve injury affects elbow flexion.
Why Wrong:
A - Median nerve injury causes thenar wasting and 'ape hand', not wrist drop.
C - Ulnar nerve injury causes claw hand and ulnar deviation, not wrist drop.
D - Musculocutaneous nerve injury affects biceps and brachialis, not wrist extensors.
Reference: Moore, K.L. (2026). Clinically Oriented Anatomy, 9th Ed., Ch. 5
Page 2
,Q3. A patient with a severe asthma exacerbation has a PaCO2 of 48 mmHg. Which
acid-base disturbance is present?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Metabolic alkalosis
Correct Answer: C. Respiratory acidosis
Rationale: In a severe asthma exacerbation, airway obstruction leads to hypoventilation
and CO2 retention, causing respiratory acidosis (PaCO2 > 45 mmHg). Respiratory
alkalosis would show low PaCO2; metabolic acidosis would show low bicarbonate;
metabolic alkalosis would show high bicarbonate.
Why Wrong:
A - Respiratory alkalosis is due to hyperventilation, causing low PaCO2.
B - Metabolic acidosis is a primary bicarbonate deficit, not elevated PaCO2.
D - Metabolic alkalosis is a primary bicarbonate excess, not elevated PaCO2.
Reference: Huether, S.E. (2026). Pathophysiology, 8th Ed., Ch. 8
Q4. Which medication is contraindicated in a patient with a history of angioedema
and is an ACE inhibitor?
A. Lisinopril
B. Losartan
C. Amlodipine
D. Hydrochlorothiazide
Correct Answer: A. Lisinopril
Rationale: ACE inhibitors like lisinopril are contraindicated in patients with a history of
angioedema because they increase bradykinin levels, which can precipitate angioedema.
Losartan is an ARB and less likely to cause angioedema; amlodipine is a calcium channel
blocker; hydrochlorothiazide is a thiazide diuretic.
Why Wrong:
B - Losartan is an ARB, not an ACE inhibitor, and has a lower risk of angioedema.
C - Amlodipine is a calcium channel blocker, not an ACE inhibitor.
D - Hydrochlorothiazide is a diuretic, not an ACE inhibitor.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 24
Q5. Which nursing intervention is most appropriate to prevent ventilator-associated
pneumonia (VAP) in a mechanically ventilated patient?
A. Elevate the head of the bed to 30-45 degrees
B. Suction the endotracheal tube every 2 hours
Page 3
, C. Change the ventilator circuit daily
D. Administer prophylactic antibiotics
Correct Answer: A. Elevate the head of the bed to 30-45 degrees
Rationale: Elevating the head of the bed to 30-45 degrees is a key evidence-based
intervention to prevent VAP by reducing aspiration of gastric contents. Routine suctioning
is not scheduled; ventilator circuits should be changed only when visibly soiled;
prophylactic antibiotics are not recommended due to resistance.
Why Wrong:
B - Routine suctioning is not recommended; it should be as needed.
C - Changing circuits daily is not recommended; it increases risk and cost.
D - Prophylactic antibiotics are not effective and may increase resistance.
Reference: Potter, P.A. (2026). Fundamentals of Nursing, 11th Ed., Ch. 39
Q6. A patient has a blood glucose of 350 mg/dL, urine ketones positive, and arterial
pH 7.25. Which condition is most likely?
A. Hyperosmolar hyperglycemic state (HHS)
B. Diabetic ketoacidosis (DKA)
C. Lactic acidosis
D. Alcoholic ketoacidosis
Correct Answer: B. Diabetic ketoacidosis (DKA)
Rationale: The combination of hyperglycemia, ketonuria, and metabolic acidosis (pH
<7.3) is classic for DKA. HHS typically has glucose >600 mg/dL without significant
ketosis; lactic acidosis is associated with tissue hypoxia; alcoholic ketoacidosis occurs in
chronic alcoholics with normal glucose.
Why Wrong:
A - HHS has extreme hyperglycemia but minimal ketosis and no severe acidosis.
C - Lactic acidosis is due to lactate accumulation, not ketones.
D - Alcoholic ketoacidosis typically has low or normal glucose.
Reference: American Diabetes Association. (2026). Standards of Care in Diabetes,
Diabetes Care
Q7. Which medical term describes the surgical repair of a joint?
A. Arthrodesis
B. Arthroplasty
C. Arthrocentesis
D. Arthroscopy
Correct Answer: B. Arthroplasty
Page 4
Anatomy & Nursing Fundamentals Questions and Answers
with Expert Solutions - 120 Questions with Answers
Page 1
,Q1. In a patient with chronic systolic heart failure, which compensatory
neurohormonal mechanism is initially beneficial but ultimately contributes to disease
progression, and is a primary target for beta-blocker therapy?
A. Activation of the renin-angiotensin-aldosterone system (RAAS)
B. Release of atrial natriuretic peptide (ANP)
C. Upregulation of beta-1 adrenergic receptors
D. Increased vagal tone
Correct Answer: A. Activation of the renin-angiotensin-aldosterone system (RAAS)
Rationale: In chronic systolic heart failure, sustained RAAS activation causes
vasoconstriction, sodium retention, and adverse cardiac remodeling, worsening the
condition. Beta-blockers mitigate the harmful effects of sympathetic activation, not directly
RAAS, but the question asks for the mechanism that is initially compensatory but
ultimately harmful-RAAS. ANP is compensatory but counteracts RAAS; beta-receptor
downregulation occurs, not upregulation; vagal tone is decreased.
Why Wrong:
B - ANP is compensatory and counteracts RAAS, not a primary target of
beta-blockers.
C - Beta-1 receptors are downregulated in heart failure, not upregulated.
D - Vagal tone is decreased in heart failure, not increased, and is not a target of
beta-blockers.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 22
Q2. Which anatomical structure is most likely to be injured during a mid-shaft
humerus fracture, leading to wrist drop?
A. Median nerve
B. Radial nerve
C. Ulnar nerve
D. Musculocutaneous nerve
Correct Answer: B. Radial nerve
Rationale: The radial nerve travels in the radial groove of the humerus and is commonly
injured in mid-shaft fractures, causing wrist drop due to paralysis of the extensor muscles.
The median nerve is more associated with carpal tunnel syndrome; ulnar nerve injury
causes claw hand; musculocutaneous nerve injury affects elbow flexion.
Why Wrong:
A - Median nerve injury causes thenar wasting and 'ape hand', not wrist drop.
C - Ulnar nerve injury causes claw hand and ulnar deviation, not wrist drop.
D - Musculocutaneous nerve injury affects biceps and brachialis, not wrist extensors.
Reference: Moore, K.L. (2026). Clinically Oriented Anatomy, 9th Ed., Ch. 5
Page 2
,Q3. A patient with a severe asthma exacerbation has a PaCO2 of 48 mmHg. Which
acid-base disturbance is present?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Metabolic alkalosis
Correct Answer: C. Respiratory acidosis
Rationale: In a severe asthma exacerbation, airway obstruction leads to hypoventilation
and CO2 retention, causing respiratory acidosis (PaCO2 > 45 mmHg). Respiratory
alkalosis would show low PaCO2; metabolic acidosis would show low bicarbonate;
metabolic alkalosis would show high bicarbonate.
Why Wrong:
A - Respiratory alkalosis is due to hyperventilation, causing low PaCO2.
B - Metabolic acidosis is a primary bicarbonate deficit, not elevated PaCO2.
D - Metabolic alkalosis is a primary bicarbonate excess, not elevated PaCO2.
Reference: Huether, S.E. (2026). Pathophysiology, 8th Ed., Ch. 8
Q4. Which medication is contraindicated in a patient with a history of angioedema
and is an ACE inhibitor?
A. Lisinopril
B. Losartan
C. Amlodipine
D. Hydrochlorothiazide
Correct Answer: A. Lisinopril
Rationale: ACE inhibitors like lisinopril are contraindicated in patients with a history of
angioedema because they increase bradykinin levels, which can precipitate angioedema.
Losartan is an ARB and less likely to cause angioedema; amlodipine is a calcium channel
blocker; hydrochlorothiazide is a thiazide diuretic.
Why Wrong:
B - Losartan is an ARB, not an ACE inhibitor, and has a lower risk of angioedema.
C - Amlodipine is a calcium channel blocker, not an ACE inhibitor.
D - Hydrochlorothiazide is a diuretic, not an ACE inhibitor.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 24
Q5. Which nursing intervention is most appropriate to prevent ventilator-associated
pneumonia (VAP) in a mechanically ventilated patient?
A. Elevate the head of the bed to 30-45 degrees
B. Suction the endotracheal tube every 2 hours
Page 3
, C. Change the ventilator circuit daily
D. Administer prophylactic antibiotics
Correct Answer: A. Elevate the head of the bed to 30-45 degrees
Rationale: Elevating the head of the bed to 30-45 degrees is a key evidence-based
intervention to prevent VAP by reducing aspiration of gastric contents. Routine suctioning
is not scheduled; ventilator circuits should be changed only when visibly soiled;
prophylactic antibiotics are not recommended due to resistance.
Why Wrong:
B - Routine suctioning is not recommended; it should be as needed.
C - Changing circuits daily is not recommended; it increases risk and cost.
D - Prophylactic antibiotics are not effective and may increase resistance.
Reference: Potter, P.A. (2026). Fundamentals of Nursing, 11th Ed., Ch. 39
Q6. A patient has a blood glucose of 350 mg/dL, urine ketones positive, and arterial
pH 7.25. Which condition is most likely?
A. Hyperosmolar hyperglycemic state (HHS)
B. Diabetic ketoacidosis (DKA)
C. Lactic acidosis
D. Alcoholic ketoacidosis
Correct Answer: B. Diabetic ketoacidosis (DKA)
Rationale: The combination of hyperglycemia, ketonuria, and metabolic acidosis (pH
<7.3) is classic for DKA. HHS typically has glucose >600 mg/dL without significant
ketosis; lactic acidosis is associated with tissue hypoxia; alcoholic ketoacidosis occurs in
chronic alcoholics with normal glucose.
Why Wrong:
A - HHS has extreme hyperglycemia but minimal ketosis and no severe acidosis.
C - Lactic acidosis is due to lactate accumulation, not ketones.
D - Alcoholic ketoacidosis typically has low or normal glucose.
Reference: American Diabetes Association. (2026). Standards of Care in Diabetes,
Diabetes Care
Q7. Which medical term describes the surgical repair of a joint?
A. Arthrodesis
B. Arthroplasty
C. Arthrocentesis
D. Arthroscopy
Correct Answer: B. Arthroplasty
Page 4
