VERIFIED ANSWERS | 2026/2027 EVIDENCE-BASED UPDATES
MED SURG HESI V1
Medical-Surgical Nursing Exam
Questions and Answers
(2026/2027)
Verified Answers
Total Questions 120
Sections 8
Cognitive Mix 30% Recall | 50% Application | 20% Analysis
Question Style 75% Scenario-Based | 25% Direct Recall
Format Multiple Choice (4 options, single best answer)
Coverage Comprehensive Medical-Surgical Body Systems
,MED SURG HESI V1 - Medical-Surgical Nursing Questions and Answers (2026/2027) | Verified Answers
Aligned with HESI Medical-Surgical Nursing V1 Exam Standards
Evidence-Based Medical-Surgical Nursing Practice (2026-2027)
MED SURG HESI V1 - Questions and Answers (2026/2027) - Verified Answers Page 2
,MED SURG HESI V1 - Medical-Surgical Nursing Questions and Answers (2026/2027) | Verified Answers
Exam Structure & Table of Contents
This 120-question exam covers all body systems tested in the HESI Medical-Surgical Nursing V1
specialty examination. Each question includes a verified correct answer and a detailed rationale
explaining the pathophysiologic basis, assessment findings, nursing interventions, and safety
priorities. Content reflects 2026/2027 evidence-based medical-surgical nursing practice
including current Surviving Sepsis guidelines, ACS STEMI/NSTEMI management, oncology
emergencies, transfusion safety, and high-alert medication protocols.
Section Questions Content Domain
Section 1 Q1 - Q14 Perioperative Nursing Care (Preoperative, Intraoperative, Postoperative, & Complications)
Section 2 Q15 - Q28 Fluid, Electrolyte, and Acid-Base Balance (Imbalances, IV Therapy, & ABG Interpretation)
Section 3 Q29 - Q46 Cardiovascular Disorders (HTN, CAD, MI, Heart Failure, & Dysrhythmias)
Section 4 Q47 - Q60 Hematologic and Oncologic Disorders (Anemia, Coagulopathies, Transfusions, & Cancer Care)
Section 5 Q61 - Q76 Respiratory Disorders (Pneumonia, COPD, Asthma, PE, & Chest Tubes)
Section 6 Q77 - Q90 Neurological Disorders (Stroke, TBI, Seizures, & Increased ICP)
Section 7 Q91 - Q108 Renal, Endocrine, and Gastrointestinal Disorders (AKI, CKD, Diabetes, Thyroid, GI Bleeding, & Liv
Section 8 Q109 - Q120 Musculoskeletal, Integumentary, and Emergency Care (Fractures, Wounds, Shock, & Sepsis)
Cognitive Level Distribution: Questions are calibrated to Bloom's taxonomy for
medical-surgical nursing competency - approximately 30% test recall of pathophysiology,
medications, and assessment findings; 50% require application to clinical scenarios and
prioritization; 20% demand analysis of complex situations and clinical judgment. This
distribution mirrors the rigor of the HESI Medical-Surgical V1 specialty examination.
How to Use This Exam: Each question presents a clinical scenario or direct knowledge question
followed by four options. The correct option is marked [CORRECT] in bold green. A detailed
rationale follows each question, explaining why the correct answer is right and why the
distractors are wrong - with reference to pathophysiological basis, assessment findings, nursing
interventions, and safety priorities. Use this exam for HESI preparation, NCLEX readiness, and
clinical judgment development.
MED SURG HESI V1 - Questions and Answers (2026/2027) - Verified Answers Page 3
, MED SURG HESI V1 - Medical-Surgical Nursing Questions and Answers (2026/2027) | Verified Answers
SECTION 1: Perioperative Nursing Care
Q1: A client is scheduled for an elective cholecystectomy in the morning. While reviewing the
preoperative orders, the nurse notes the client took 81 mg aspirin daily including this morning.
Which action should the nurse take FIRST?
A. Administer the prescribed preoperative IV antibiotic and notify the surgeon after surgery
B. Notify the surgeon immediately, document the finding, and anticipate possible postponement
of surgery due to increased bleeding risk [CORRECT]
C. Administer vitamin K intramuscularly to reverse the aspirin effect
D. Continue with routine preoperative preparation; low-dose aspirin does not affect surgical
bleeding
Correct Answer: B
Rationale: Aspirin irreversibly inhibits platelet aggregation for the life of the platelet (7-10 days),
increasing intraoperative bleeding risk. The surgeon must be notified immediately as surgery may need
to be postponed. Antibiotics can wait until bleeding risk is clarified. Vitamin K reverses warfarin, not
aspirin. Even low-dose aspirin affects bleeding. This is a high-alert preoperative medication
reconciliation finding.
Q2: A client arrives at the preoperative holding area for a scheduled colectomy. The client
signed the consent form 2 hours ago but now states, 'I'm not sure I want to go through with this.'
What is the nurse's BEST response?
A. Reassure the client that preoperative anxiety is normal and proceed with transfer to the OR
B. Notify the surgeon immediately; the client has the right to refuse consent at any time before
surgery begins [CORRECT]
C. Remind the client that the consent form is legally binding and surgery must proceed
D. Administer the prescribed preoperative anxiolytic to reduce anxiety before continuing
Correct Answer: B
Rationale: Informed consent can be withdrawn at any time prior to the start of the procedure. The
nurse must immediately notify the surgeon so the surgeon can address the client's concerns. Forcing
surgery after consent withdrawal constitutes battery. Anxiolytics do not resolve consent concerns and
may impair judgment. Documentation of the client's statement and notification of the surgeon is
essential.
MED SURG HESI V1 - Questions and Answers (2026/2027) - Verified Answers Page 4
MED SURG HESI V1
Medical-Surgical Nursing Exam
Questions and Answers
(2026/2027)
Verified Answers
Total Questions 120
Sections 8
Cognitive Mix 30% Recall | 50% Application | 20% Analysis
Question Style 75% Scenario-Based | 25% Direct Recall
Format Multiple Choice (4 options, single best answer)
Coverage Comprehensive Medical-Surgical Body Systems
,MED SURG HESI V1 - Medical-Surgical Nursing Questions and Answers (2026/2027) | Verified Answers
Aligned with HESI Medical-Surgical Nursing V1 Exam Standards
Evidence-Based Medical-Surgical Nursing Practice (2026-2027)
MED SURG HESI V1 - Questions and Answers (2026/2027) - Verified Answers Page 2
,MED SURG HESI V1 - Medical-Surgical Nursing Questions and Answers (2026/2027) | Verified Answers
Exam Structure & Table of Contents
This 120-question exam covers all body systems tested in the HESI Medical-Surgical Nursing V1
specialty examination. Each question includes a verified correct answer and a detailed rationale
explaining the pathophysiologic basis, assessment findings, nursing interventions, and safety
priorities. Content reflects 2026/2027 evidence-based medical-surgical nursing practice
including current Surviving Sepsis guidelines, ACS STEMI/NSTEMI management, oncology
emergencies, transfusion safety, and high-alert medication protocols.
Section Questions Content Domain
Section 1 Q1 - Q14 Perioperative Nursing Care (Preoperative, Intraoperative, Postoperative, & Complications)
Section 2 Q15 - Q28 Fluid, Electrolyte, and Acid-Base Balance (Imbalances, IV Therapy, & ABG Interpretation)
Section 3 Q29 - Q46 Cardiovascular Disorders (HTN, CAD, MI, Heart Failure, & Dysrhythmias)
Section 4 Q47 - Q60 Hematologic and Oncologic Disorders (Anemia, Coagulopathies, Transfusions, & Cancer Care)
Section 5 Q61 - Q76 Respiratory Disorders (Pneumonia, COPD, Asthma, PE, & Chest Tubes)
Section 6 Q77 - Q90 Neurological Disorders (Stroke, TBI, Seizures, & Increased ICP)
Section 7 Q91 - Q108 Renal, Endocrine, and Gastrointestinal Disorders (AKI, CKD, Diabetes, Thyroid, GI Bleeding, & Liv
Section 8 Q109 - Q120 Musculoskeletal, Integumentary, and Emergency Care (Fractures, Wounds, Shock, & Sepsis)
Cognitive Level Distribution: Questions are calibrated to Bloom's taxonomy for
medical-surgical nursing competency - approximately 30% test recall of pathophysiology,
medications, and assessment findings; 50% require application to clinical scenarios and
prioritization; 20% demand analysis of complex situations and clinical judgment. This
distribution mirrors the rigor of the HESI Medical-Surgical V1 specialty examination.
How to Use This Exam: Each question presents a clinical scenario or direct knowledge question
followed by four options. The correct option is marked [CORRECT] in bold green. A detailed
rationale follows each question, explaining why the correct answer is right and why the
distractors are wrong - with reference to pathophysiological basis, assessment findings, nursing
interventions, and safety priorities. Use this exam for HESI preparation, NCLEX readiness, and
clinical judgment development.
MED SURG HESI V1 - Questions and Answers (2026/2027) - Verified Answers Page 3
, MED SURG HESI V1 - Medical-Surgical Nursing Questions and Answers (2026/2027) | Verified Answers
SECTION 1: Perioperative Nursing Care
Q1: A client is scheduled for an elective cholecystectomy in the morning. While reviewing the
preoperative orders, the nurse notes the client took 81 mg aspirin daily including this morning.
Which action should the nurse take FIRST?
A. Administer the prescribed preoperative IV antibiotic and notify the surgeon after surgery
B. Notify the surgeon immediately, document the finding, and anticipate possible postponement
of surgery due to increased bleeding risk [CORRECT]
C. Administer vitamin K intramuscularly to reverse the aspirin effect
D. Continue with routine preoperative preparation; low-dose aspirin does not affect surgical
bleeding
Correct Answer: B
Rationale: Aspirin irreversibly inhibits platelet aggregation for the life of the platelet (7-10 days),
increasing intraoperative bleeding risk. The surgeon must be notified immediately as surgery may need
to be postponed. Antibiotics can wait until bleeding risk is clarified. Vitamin K reverses warfarin, not
aspirin. Even low-dose aspirin affects bleeding. This is a high-alert preoperative medication
reconciliation finding.
Q2: A client arrives at the preoperative holding area for a scheduled colectomy. The client
signed the consent form 2 hours ago but now states, 'I'm not sure I want to go through with this.'
What is the nurse's BEST response?
A. Reassure the client that preoperative anxiety is normal and proceed with transfer to the OR
B. Notify the surgeon immediately; the client has the right to refuse consent at any time before
surgery begins [CORRECT]
C. Remind the client that the consent form is legally binding and surgery must proceed
D. Administer the prescribed preoperative anxiolytic to reduce anxiety before continuing
Correct Answer: B
Rationale: Informed consent can be withdrawn at any time prior to the start of the procedure. The
nurse must immediately notify the surgeon so the surgeon can address the client's concerns. Forcing
surgery after consent withdrawal constitutes battery. Anxiolytics do not resolve consent concerns and
may impair judgment. Documentation of the client's statement and notification of the surgeon is
essential.
MED SURG HESI V1 - Questions and Answers (2026/2027) - Verified Answers Page 4
