,Med Surg HESI Exams V1 & V2 | 2026/2027 Updated full 400 Q&A | 200
Actual Exam Questions in Each version with Answers & Detailed Rationales
Table of Contents
HESI Med Surg Exams V1 ................................................................................................................................2
HESI Med Surg Exams V2 .............................................................................................................. 47
HESI Med Surg Exams V1
1. The nurse obtains a fingerstick glucose level utilizing bedside lancet/glucose meter equipment
from a client with prescribed sliding scale insulin protocol. The meter indicates 56 mg/dl (3.12
mmol/l). At this time which intervention should the nurse implement first?
A) Collect a blood specimen by venipuncture to send to the laboratory for serum glucose analysis.
B) Prepare the prescribed dose of rapid acting insulin from the sliding scale instructions.
C) Give the client six ounces of non-diet soda or juice.
Correct Answer: C) Give the client six ounces of non-diet soda or juice.
Rationale: This question tests knowledge of hypoglycemia management. A fingerstick glucose of 56
mg/dL is below the normal range of 70 to 110 mg/dL and indicates hypoglycemia, which is a medical
emergency because glucose is the brain's primary fuel source and prolonged hypoglycemia can cause
seizures, coma, and death. The nurse's first action must be to treat the hypoglycemia immediately by
administering a fast-acting source of glucose, such as 15 to 20 grams of a simple carbohydrate like six
ounces of non-diet soda or juice, glucose tablets, or hard candy. The detailed rationale should explain
that insulin would worsen the hypoglycemia and should never be administered when glucose is low, and
that venipuncture for serum glucose analysis, while useful for confirmation, delays treatment and is not
the priority. The nurse should recheck the glucose in 15 minutes, repeat the treatment if the glucose
remains below 70 mg/dL, and once the client is stable, provide a snack containing protein and complex
carbohydrates to prevent recurrence. If the client is unresponsive or unable to swallow, glucagon IM or
IV dextrose should be administered.
2. To achieve maximum mobility and independence for a client with multiple sclerosis (MS), which
intervention is most important for the nurse to implement?
A) Provide a walker for ambulation
B) Frequently assist the client to the bathroom
C) Apply alternating patches over eyes
,D) Teach strengthening exercises
Correct Answer: D) Teach strengthening exercises
Rationale: This question tests knowledge of nursing interventions for multiple sclerosis. MS is a chronic
autoimmune demyelinating disease of the central nervous system that causes progressive muscle
weakness, spasticity, fatigue, and sensory disturbances. The nurse's most important intervention to
promote maximum mobility and independence is to teach strengthening exercises, which help maintain
muscle strength, prevent atrophy and contractures, and preserve the client's ability to perform activities
of daily living independently. The detailed rationale should explain that strengthening exercises are
preferable to providing a walker or frequently assisting with toileting, because these passive
interventions foster dependence, while active exercise promotes independence. Alternating patches
over the eyes is used for diplopia (double vision) and does not address mobility. The nurse should also
teach energy conservation techniques, pacing activities, and the importance of avoiding overheating,
which can worsen symptoms (Uhthoff's sign).
3. A client is admitted to the hospital with symptoms consistent with a right hemisphere stroke.
Which neurovascular assessment requires immediate intervention by the nurse?
A) Pupillary changes to ipsilateral dilation
B) Orientation to person and place only
C) Left-sided drooping and dysphagia
D) Unequal bilateral hand grip strengths
Correct Answer: C) Left-sided drooping and dysphagia
Rationale: This question tests knowledge of stroke assessment and airway safety. A right hemisphere
stroke typically causes left-sided weakness and sensory deficits because the motor and sensory pathways
cross in the brainstem. Dysphagia, or difficulty swallowing, is a serious complication that places the client
at risk for aspiration pneumonia, airway obstruction, and death, and it requires immediate intervention
by the nurse. The detailed rationale should explain that the nurse must keep the client NPO until a
formal swallowing evaluation is performed, position the client upright during meals, and implement
aspiration precautions. Left-sided facial drooping is consistent with the stroke and is not immediately life-
threatening, but the combination of facial drooping and dysphagia indicates cranial nerve involvement
that impairs swallowing, making this the priority. Pupillary changes and unequal hand grips are
important assessments but do not require immediate intervention unless accompanied by other signs of
herniation.
4. The nurse is teaching a client with glomerulonephritis about self care. Which dietary
recommendations should the nurse encourage the client to follow?
A) Limit oral fluid intake to 500 ml per day
B) Restrict protein intake by limiting meats and other high-protein foods
, C) Increase intake of potassium-rich foods such as bananas and cantaloupe
D) Increase intake of high fiber foods such as bran cereal
Correct Answer: B) Restrict protein intake by limiting meats and other high-protein foods
Rationale: This question tests knowledge of dietary management for glomerulonephritis.
Glomerulonephritis is inflammation of the glomeruli that impairs the kidney's ability to filter waste
products, and it can lead to acute kidney injury with azotemia, fluid retention, and electrolyte
imbalances. The nurse should teach the client to restrict protein intake because protein metabolism
produces urea and other nitrogenous wastes that the damaged kidneys cannot adequately excrete, and
reducing protein intake decreases the workload on the kidneys. The detailed rationale should explain
that fluid restriction may be necessary but is typically individualized based on urine output and daily
weight, not fixed at 500 mL; potassium-rich foods may need to be restricted rather than increased if
hyperkalemia is present; and high-fiber foods are generally beneficial for bowel regularity but are not
specific to glomerulonephritis. The nurse should also teach the client to restrict sodium to manage
edema and hypertension, monitor daily weights, and report signs of worsening renal function.
5. The nurse is caring for a client with Herpes zoster who reports painful, red, blisters that align
from the back along the chest's curvature to the anterior chest. Which intervention is the
highest priority for the nurse?
A) Place the client on contact precautions
B) Administer antiviral medications
C) Place wet compresses to ruptured vesicles
D) Administer narcotic analgesics
Correct Answer: B) Administer antiviral medications
Rationale: This question tests knowledge of herpes zoster treatment priorities. Herpes zoster (shingles) is
caused by reactivation of the varicella-zoster virus, and it presents with a painful, unilateral vesicular
rash in a dermatomal distribution. Antiviral medications such as acyclovir, valacyclovir, or famciclovir are
the highest priority intervention because they inhibit viral replication, shorten the duration and severity
of the illness, reduce the risk of postherpetic neuralgia, and prevent dissemination, but they are most
effective when started within 72 hours of rash onset. The detailed rationale should explain that contact
precautions are implemented for clients with disseminated herpes zoster or until lesions are crusted, but
for localized zoster, standard precautions are sufficient; wet compresses and narcotic analgesics provide
symptomatic relief but do not treat the underlying viral infection. The nurse should also teach the client
to keep the rash covered, avoid contact with pregnant women and immunocompromised individuals,
and report signs of bacterial superinfection.
6. A young adult who suffered a severe brain injury in an automobile collision has been
mechanically ventilated for the past three days and has no spontaneous respiratory effort. After
serial electroencephalograms (EEG) reveal no brain activity, the healthcare provider discusses
Actual Exam Questions in Each version with Answers & Detailed Rationales
Table of Contents
HESI Med Surg Exams V1 ................................................................................................................................2
HESI Med Surg Exams V2 .............................................................................................................. 47
HESI Med Surg Exams V1
1. The nurse obtains a fingerstick glucose level utilizing bedside lancet/glucose meter equipment
from a client with prescribed sliding scale insulin protocol. The meter indicates 56 mg/dl (3.12
mmol/l). At this time which intervention should the nurse implement first?
A) Collect a blood specimen by venipuncture to send to the laboratory for serum glucose analysis.
B) Prepare the prescribed dose of rapid acting insulin from the sliding scale instructions.
C) Give the client six ounces of non-diet soda or juice.
Correct Answer: C) Give the client six ounces of non-diet soda or juice.
Rationale: This question tests knowledge of hypoglycemia management. A fingerstick glucose of 56
mg/dL is below the normal range of 70 to 110 mg/dL and indicates hypoglycemia, which is a medical
emergency because glucose is the brain's primary fuel source and prolonged hypoglycemia can cause
seizures, coma, and death. The nurse's first action must be to treat the hypoglycemia immediately by
administering a fast-acting source of glucose, such as 15 to 20 grams of a simple carbohydrate like six
ounces of non-diet soda or juice, glucose tablets, or hard candy. The detailed rationale should explain
that insulin would worsen the hypoglycemia and should never be administered when glucose is low, and
that venipuncture for serum glucose analysis, while useful for confirmation, delays treatment and is not
the priority. The nurse should recheck the glucose in 15 minutes, repeat the treatment if the glucose
remains below 70 mg/dL, and once the client is stable, provide a snack containing protein and complex
carbohydrates to prevent recurrence. If the client is unresponsive or unable to swallow, glucagon IM or
IV dextrose should be administered.
2. To achieve maximum mobility and independence for a client with multiple sclerosis (MS), which
intervention is most important for the nurse to implement?
A) Provide a walker for ambulation
B) Frequently assist the client to the bathroom
C) Apply alternating patches over eyes
,D) Teach strengthening exercises
Correct Answer: D) Teach strengthening exercises
Rationale: This question tests knowledge of nursing interventions for multiple sclerosis. MS is a chronic
autoimmune demyelinating disease of the central nervous system that causes progressive muscle
weakness, spasticity, fatigue, and sensory disturbances. The nurse's most important intervention to
promote maximum mobility and independence is to teach strengthening exercises, which help maintain
muscle strength, prevent atrophy and contractures, and preserve the client's ability to perform activities
of daily living independently. The detailed rationale should explain that strengthening exercises are
preferable to providing a walker or frequently assisting with toileting, because these passive
interventions foster dependence, while active exercise promotes independence. Alternating patches
over the eyes is used for diplopia (double vision) and does not address mobility. The nurse should also
teach energy conservation techniques, pacing activities, and the importance of avoiding overheating,
which can worsen symptoms (Uhthoff's sign).
3. A client is admitted to the hospital with symptoms consistent with a right hemisphere stroke.
Which neurovascular assessment requires immediate intervention by the nurse?
A) Pupillary changes to ipsilateral dilation
B) Orientation to person and place only
C) Left-sided drooping and dysphagia
D) Unequal bilateral hand grip strengths
Correct Answer: C) Left-sided drooping and dysphagia
Rationale: This question tests knowledge of stroke assessment and airway safety. A right hemisphere
stroke typically causes left-sided weakness and sensory deficits because the motor and sensory pathways
cross in the brainstem. Dysphagia, or difficulty swallowing, is a serious complication that places the client
at risk for aspiration pneumonia, airway obstruction, and death, and it requires immediate intervention
by the nurse. The detailed rationale should explain that the nurse must keep the client NPO until a
formal swallowing evaluation is performed, position the client upright during meals, and implement
aspiration precautions. Left-sided facial drooping is consistent with the stroke and is not immediately life-
threatening, but the combination of facial drooping and dysphagia indicates cranial nerve involvement
that impairs swallowing, making this the priority. Pupillary changes and unequal hand grips are
important assessments but do not require immediate intervention unless accompanied by other signs of
herniation.
4. The nurse is teaching a client with glomerulonephritis about self care. Which dietary
recommendations should the nurse encourage the client to follow?
A) Limit oral fluid intake to 500 ml per day
B) Restrict protein intake by limiting meats and other high-protein foods
, C) Increase intake of potassium-rich foods such as bananas and cantaloupe
D) Increase intake of high fiber foods such as bran cereal
Correct Answer: B) Restrict protein intake by limiting meats and other high-protein foods
Rationale: This question tests knowledge of dietary management for glomerulonephritis.
Glomerulonephritis is inflammation of the glomeruli that impairs the kidney's ability to filter waste
products, and it can lead to acute kidney injury with azotemia, fluid retention, and electrolyte
imbalances. The nurse should teach the client to restrict protein intake because protein metabolism
produces urea and other nitrogenous wastes that the damaged kidneys cannot adequately excrete, and
reducing protein intake decreases the workload on the kidneys. The detailed rationale should explain
that fluid restriction may be necessary but is typically individualized based on urine output and daily
weight, not fixed at 500 mL; potassium-rich foods may need to be restricted rather than increased if
hyperkalemia is present; and high-fiber foods are generally beneficial for bowel regularity but are not
specific to glomerulonephritis. The nurse should also teach the client to restrict sodium to manage
edema and hypertension, monitor daily weights, and report signs of worsening renal function.
5. The nurse is caring for a client with Herpes zoster who reports painful, red, blisters that align
from the back along the chest's curvature to the anterior chest. Which intervention is the
highest priority for the nurse?
A) Place the client on contact precautions
B) Administer antiviral medications
C) Place wet compresses to ruptured vesicles
D) Administer narcotic analgesics
Correct Answer: B) Administer antiviral medications
Rationale: This question tests knowledge of herpes zoster treatment priorities. Herpes zoster (shingles) is
caused by reactivation of the varicella-zoster virus, and it presents with a painful, unilateral vesicular
rash in a dermatomal distribution. Antiviral medications such as acyclovir, valacyclovir, or famciclovir are
the highest priority intervention because they inhibit viral replication, shorten the duration and severity
of the illness, reduce the risk of postherpetic neuralgia, and prevent dissemination, but they are most
effective when started within 72 hours of rash onset. The detailed rationale should explain that contact
precautions are implemented for clients with disseminated herpes zoster or until lesions are crusted, but
for localized zoster, standard precautions are sufficient; wet compresses and narcotic analgesics provide
symptomatic relief but do not treat the underlying viral infection. The nurse should also teach the client
to keep the rash covered, avoid contact with pregnant women and immunocompromised individuals,
and report signs of bacterial superinfection.
6. A young adult who suffered a severe brain injury in an automobile collision has been
mechanically ventilated for the past three days and has no spontaneous respiratory effort. After
serial electroencephalograms (EEG) reveal no brain activity, the healthcare provider discusses
