HESI MED SURG 2026/2027
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS LATEST UPDATE
1. A client with chronic heart failure is prescribed digoxin. Which assessment finding should
the nurse prioritize as a sign of toxicity?
A. Heart rate of 88 beats per minute
B. Increased appetite and weight gain
C. Blurred vision with yellow-green halos
D. Increased urinary output
Answer: C
Conceptual Explanation: Visual disturbances, such as yellow-green halos, along with
nausea and bradycardia, are classic signs of digoxin toxicity.
2. A client’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 55, HCO3 26. How should the
nurse interpret these findings?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
,Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45
indicates a respiratory cause.
3. A client with a T6 spinal cord injury reports a pounding headache and has a blood pressure
of 190/100 mmHg. What is the priority nursing action?
A. Administer PRN pain medication
B. Check for bladder distension
C. Place the client in a supine position
D. Document the findings in the chart
Answer: B
Conceptual Explanation: These are signs of autonomic dysreflexia. The priority is to
identify and remove the stimulus, often a full bladder or impacted bowel, while sitting the
patient up.
4. Which clinical manifestation differentiates Hyperosmolar Hyperglycemic Nonketotic
Syndrome (HHNS) from Diabetic Ketoacidosis (DKA)?
A. Blood glucose level above 250 mg/dL
B. Altered mental status
C. Excessive thirst and urination
D. Absence of significant ketosis
, Answer: D
Conceptual Explanation: HHNS is characterized by extreme hyperglycemia without the
significant ketosis and acidosis found in DKA.
5. The nurse is triaging victims of a mass casualty event. Which client should be assigned a
‘red’ tag?
A. A client with a simple fracture of the arm
B. A client with minor lacerations who is walking around
C. A client who is unresponsive with a massive head injury and no pulse
D. A client with an open pneumothorax and respiratory distress
Answer: D
Conceptual Explanation: Red tags are for immediate threats to life that are treatable, such
as airway or breathing issues.
6. During surgery, a client develops muscle rigidity and a temperature of 104°F (40°C). Which
medication should the nurse prepare to administer?
A. Naloxone
B. Atropine
C. Pancuronium
D. Dantrolene sodium
Answer: D
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS LATEST UPDATE
1. A client with chronic heart failure is prescribed digoxin. Which assessment finding should
the nurse prioritize as a sign of toxicity?
A. Heart rate of 88 beats per minute
B. Increased appetite and weight gain
C. Blurred vision with yellow-green halos
D. Increased urinary output
Answer: C
Conceptual Explanation: Visual disturbances, such as yellow-green halos, along with
nausea and bradycardia, are classic signs of digoxin toxicity.
2. A client’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 55, HCO3 26. How should the
nurse interpret these findings?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
,Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45
indicates a respiratory cause.
3. A client with a T6 spinal cord injury reports a pounding headache and has a blood pressure
of 190/100 mmHg. What is the priority nursing action?
A. Administer PRN pain medication
B. Check for bladder distension
C. Place the client in a supine position
D. Document the findings in the chart
Answer: B
Conceptual Explanation: These are signs of autonomic dysreflexia. The priority is to
identify and remove the stimulus, often a full bladder or impacted bowel, while sitting the
patient up.
4. Which clinical manifestation differentiates Hyperosmolar Hyperglycemic Nonketotic
Syndrome (HHNS) from Diabetic Ketoacidosis (DKA)?
A. Blood glucose level above 250 mg/dL
B. Altered mental status
C. Excessive thirst and urination
D. Absence of significant ketosis
, Answer: D
Conceptual Explanation: HHNS is characterized by extreme hyperglycemia without the
significant ketosis and acidosis found in DKA.
5. The nurse is triaging victims of a mass casualty event. Which client should be assigned a
‘red’ tag?
A. A client with a simple fracture of the arm
B. A client with minor lacerations who is walking around
C. A client who is unresponsive with a massive head injury and no pulse
D. A client with an open pneumothorax and respiratory distress
Answer: D
Conceptual Explanation: Red tags are for immediate threats to life that are treatable, such
as airway or breathing issues.
6. During surgery, a client develops muscle rigidity and a temperature of 104°F (40°C). Which
medication should the nurse prepare to administer?
A. Naloxone
B. Atropine
C. Pancuronium
D. Dantrolene sodium
Answer: D
