HESI Medical-Surgical Nursing
MED SURG HESI V1
Questions & Answers — Verified Answers
Most Comprehensive Edition ·
155 Comprehensive Questions & Verified Answers
Aligned with HESI V1 Blueprint & NCLEX Standards
Nursing Education Series
,HESI Medical-Surgical Nursing V1 — Verified Answers
Exam Overview
Purpose: This 155-item HESI Medical-Surgical Nursing V1 certification preparation exam evaluates competency
mastery across the 2026/2027 HESI V1 blueprint. Items comprehensively cover perioperative care, cardiovascular,
respiratory, neurological, endocrine, renal, gastrointestinal, musculoskeletal/integumentary/oncologic, and
emergency/critical care disorders. Each item includes a 2-3 sentence rationale citing evidence-based medical-surgical
nursing practice, pathophysiologic mechanisms, and HESI-specific test-taking strategies.
Structure: The exam is organized into nine competency-labeled sections weighted toward cardiovascular,
respiratory, and endocrine content as commonly tested in HESI V1. Approximately 80% of items are scenario-based
NCLEX-style questions ("Which client should the nurse assess FIRST?", "Which finding requires IMMEDIATE
follow-up?"), and 20% are direct recall. Recommended administration time: 240 minutes. Pre-test readiness
benchmark: 80% correct.
# Section Item Range Items
1 Section 1: Perioperative Nursing and Surgical Care Q1–Q17 17
2 Section 2: Cardiovascular Disorders and Management Q18–Q37 20
3 Section 3: Respiratory Disorders and Management Q38–Q56 19
4 Section 4: Neurological Disorders and Management Q57–Q75 19
5 Section 5: Endocrine and Metabolic Disorders Q76–Q93 18
6 Section 6: Renal and Genitourinary Disorders Q94–Q110 17
7 Section 7: Gastrointestinal and Hepatobiliary Disorders Q111–Q129 19
8 Section 8: Musculoskeletal, Integumentary, and Oncologic Disorders Q130–Q143 14
9 Section 9: Emergency, Critical Care, and Fluid/Electrolyte Management Q144–Q155 12
TOTAL 155
How to use this exam: Attempt each item without external references. Review every rationale — even for items
answered correctly — to confirm competency mastery. For missed items, identify the disease process, assessment
priority, laboratory interpretation, or pharmacologic principle that caused the error and re-study that medical-surgical
concept before retaking the HESI V1 examination.
Nursing Education Series Page 2
,HESI Medical-Surgical Nursing V1 — Verified Answers
SECTION 1
Section 1: Perioperative Nursing and Surgical Care
Preoperative, Intraoperative, Postoperative, and Anesthesia
Q1: The nurse is preparing a client for surgery. The client reports taking 81 mg aspirin daily for cardiac
prophylaxis. Which action should the nurse take FIRST?
A. Administer the aspirin as scheduled
B. Notify the surgeon of the aspirin use immediately [CORRECT]
C. Hold the aspirin for one dose only
D. Document the finding and continue with preparation
Correct Answer: B. Notify the surgeon of the aspirin use immediately
Rationale: Aspirin inhibits platelet aggregation and increases bleeding risk during and after surgery. The surgeon must be notified
immediately to determine whether to delay surgery or proceed with awareness of increased bleeding risk. Holding for one dose is
insufficient; documentation alone is unsafe.
Q2: A client is scheduled for general anesthesia. Which preoperative assessment finding requires IMMEDIATE
follow-up by the nurse?
A. Heart rate 72 bpm and regular
B. Blood pressure 138/86 mmHg
C. Potassium level 3.0 mEq/L [CORRECT]
D. Hemoglobin 13.5 g/dL
Correct Answer: C. Potassium level 3.0 mEq/L
Rationale: Hypokalemia (K+ 3.0 mEq/L) increases the risk of cardiac dysrhythmias, especially under general anesthesia. The
surgeon and anesthesia provider must be notified for correction prior to surgery. The other findings are within acceptable or
mildly elevated ranges that do not require urgent intervention.
Q3: The nurse is teaching a client about postoperative deep breathing exercises. Which statement by the client
indicates that teaching has been EFFECTIVE?
A. "I will take shallow breaths to avoid pain."
B. "I will inhale deeply through my nose, hold for 3 seconds, and exhale slowly through pursed lips."
[CORRECT]
C. "I will do these exercises only when I feel short of breath."
D. "I will breathe normally and rely on the incentive spirometer alone."
Correct Answer: B. "I will inhale deeply through my nose, hold for 3 seconds, and
exhale slowly through pursed lips."
Rationale: Deep breathing with inhale through nose, brief hold, and slow pursed-lip exhale promotes alveolar expansion and
prevents atelectasis. Shallow breaths and relying on incentive spirometry alone are insufficient. Performing exercises only when
symptomatic misses the preventive purpose.
Nursing Education Series Page 3
, HESI Medical-Surgical Nursing V1 — Verified Answers
Q4: A postoperative client reports sudden chest pain and shortness of breath on the second postoperative day. The
client's pulse oximetry shows 88% on room air. Which complication should the nurse SUSPECT?
A. Atelectasis
B. Pulmonary embolism (PE) [CORRECT]
C. Wound dehiscence
D. Paralytic ileus
Correct Answer: B. Pulmonary embolism (PE)
Rationale: Sudden chest pain, dyspnea, and hypoxia on postoperative day 2 are classic for pulmonary embolism, a
life-threatening complication. Atelectasis is more gradual; wound dehiscence is visible at the incision; paralytic ileus affects the
abdomen. PE requires immediate oxygen and provider notification.
Q5: Which client is at GREATEST risk for developing postoperative deep vein thrombosis (DVT)?
A. A 35-year-old client who underwent a 30-minute laparoscopic appendectomy
B. A 78-year-old client undergoing hip replacement surgery who has a history of heart failure [CORRECT]
C. A 50-year-old client scheduled for cataract surgery under local anesthesia
D. A 45-year-old client undergoing a 1-hour hernia repair with early ambulation
Correct Answer: B. A 78-year-old client undergoing hip replacement surgery who has a
history of heart failure
Rationale: Advanced age, major orthopedic surgery (hip replacement), and heart failure all increase DVT risk through Virchow's
triad: venous stasis, endothelial injury, and hypercoagulability. The other clients have lower risk due to shorter procedures, local
anesthesia, or early ambulation.
Q6: A client who received general anesthesia is admitted to the postanesthesia care unit (PACU). Which assessment
is the PRIORITY during the immediate postoperative period?
A. Surgical site dressing check
B. Airway patency and oxygen saturation [CORRECT]
C. Pain level using a 0-10 scale
D. Ability to move all extremities
Correct Answer: B. Airway patency and oxygen saturation
Rationale: In the immediate postoperative period, airway patency and oxygen saturation are the priority (ABC framework)
because anesthesia depresses respirations and the airway may be obstructed by secretions or residual anesthesia. The other
assessments are important but secondary to airway and breathing.
Q7: A client is recovering from spinal anesthesia after a lower abdominal surgery. Which finding requires
IMMEDIATE intervention by the nurse?
A. Blood pressure 110/70 mmHg
B. Client reports feeling sensation returning to the legs at 4 hours postoperative
C. Respiratory rate 24 breaths per minute [CORRECT]
D. Urine output 30 mL/hr
Correct Answer: C. Respiratory rate 24 breaths per minute
Rationale: A respiratory rate of 24 breaths/min in the recovery from spinal anesthesia may indicate ascending spinal block or
respiratory compromise requiring immediate intervention. Spinal anesthesia can cause respiratory depression if the block rises.
The other findings are acceptable or expected.
Nursing Education Series Page 4
MED SURG HESI V1
Questions & Answers — Verified Answers
Most Comprehensive Edition ·
155 Comprehensive Questions & Verified Answers
Aligned with HESI V1 Blueprint & NCLEX Standards
Nursing Education Series
,HESI Medical-Surgical Nursing V1 — Verified Answers
Exam Overview
Purpose: This 155-item HESI Medical-Surgical Nursing V1 certification preparation exam evaluates competency
mastery across the 2026/2027 HESI V1 blueprint. Items comprehensively cover perioperative care, cardiovascular,
respiratory, neurological, endocrine, renal, gastrointestinal, musculoskeletal/integumentary/oncologic, and
emergency/critical care disorders. Each item includes a 2-3 sentence rationale citing evidence-based medical-surgical
nursing practice, pathophysiologic mechanisms, and HESI-specific test-taking strategies.
Structure: The exam is organized into nine competency-labeled sections weighted toward cardiovascular,
respiratory, and endocrine content as commonly tested in HESI V1. Approximately 80% of items are scenario-based
NCLEX-style questions ("Which client should the nurse assess FIRST?", "Which finding requires IMMEDIATE
follow-up?"), and 20% are direct recall. Recommended administration time: 240 minutes. Pre-test readiness
benchmark: 80% correct.
# Section Item Range Items
1 Section 1: Perioperative Nursing and Surgical Care Q1–Q17 17
2 Section 2: Cardiovascular Disorders and Management Q18–Q37 20
3 Section 3: Respiratory Disorders and Management Q38–Q56 19
4 Section 4: Neurological Disorders and Management Q57–Q75 19
5 Section 5: Endocrine and Metabolic Disorders Q76–Q93 18
6 Section 6: Renal and Genitourinary Disorders Q94–Q110 17
7 Section 7: Gastrointestinal and Hepatobiliary Disorders Q111–Q129 19
8 Section 8: Musculoskeletal, Integumentary, and Oncologic Disorders Q130–Q143 14
9 Section 9: Emergency, Critical Care, and Fluid/Electrolyte Management Q144–Q155 12
TOTAL 155
How to use this exam: Attempt each item without external references. Review every rationale — even for items
answered correctly — to confirm competency mastery. For missed items, identify the disease process, assessment
priority, laboratory interpretation, or pharmacologic principle that caused the error and re-study that medical-surgical
concept before retaking the HESI V1 examination.
Nursing Education Series Page 2
,HESI Medical-Surgical Nursing V1 — Verified Answers
SECTION 1
Section 1: Perioperative Nursing and Surgical Care
Preoperative, Intraoperative, Postoperative, and Anesthesia
Q1: The nurse is preparing a client for surgery. The client reports taking 81 mg aspirin daily for cardiac
prophylaxis. Which action should the nurse take FIRST?
A. Administer the aspirin as scheduled
B. Notify the surgeon of the aspirin use immediately [CORRECT]
C. Hold the aspirin for one dose only
D. Document the finding and continue with preparation
Correct Answer: B. Notify the surgeon of the aspirin use immediately
Rationale: Aspirin inhibits platelet aggregation and increases bleeding risk during and after surgery. The surgeon must be notified
immediately to determine whether to delay surgery or proceed with awareness of increased bleeding risk. Holding for one dose is
insufficient; documentation alone is unsafe.
Q2: A client is scheduled for general anesthesia. Which preoperative assessment finding requires IMMEDIATE
follow-up by the nurse?
A. Heart rate 72 bpm and regular
B. Blood pressure 138/86 mmHg
C. Potassium level 3.0 mEq/L [CORRECT]
D. Hemoglobin 13.5 g/dL
Correct Answer: C. Potassium level 3.0 mEq/L
Rationale: Hypokalemia (K+ 3.0 mEq/L) increases the risk of cardiac dysrhythmias, especially under general anesthesia. The
surgeon and anesthesia provider must be notified for correction prior to surgery. The other findings are within acceptable or
mildly elevated ranges that do not require urgent intervention.
Q3: The nurse is teaching a client about postoperative deep breathing exercises. Which statement by the client
indicates that teaching has been EFFECTIVE?
A. "I will take shallow breaths to avoid pain."
B. "I will inhale deeply through my nose, hold for 3 seconds, and exhale slowly through pursed lips."
[CORRECT]
C. "I will do these exercises only when I feel short of breath."
D. "I will breathe normally and rely on the incentive spirometer alone."
Correct Answer: B. "I will inhale deeply through my nose, hold for 3 seconds, and
exhale slowly through pursed lips."
Rationale: Deep breathing with inhale through nose, brief hold, and slow pursed-lip exhale promotes alveolar expansion and
prevents atelectasis. Shallow breaths and relying on incentive spirometry alone are insufficient. Performing exercises only when
symptomatic misses the preventive purpose.
Nursing Education Series Page 3
, HESI Medical-Surgical Nursing V1 — Verified Answers
Q4: A postoperative client reports sudden chest pain and shortness of breath on the second postoperative day. The
client's pulse oximetry shows 88% on room air. Which complication should the nurse SUSPECT?
A. Atelectasis
B. Pulmonary embolism (PE) [CORRECT]
C. Wound dehiscence
D. Paralytic ileus
Correct Answer: B. Pulmonary embolism (PE)
Rationale: Sudden chest pain, dyspnea, and hypoxia on postoperative day 2 are classic for pulmonary embolism, a
life-threatening complication. Atelectasis is more gradual; wound dehiscence is visible at the incision; paralytic ileus affects the
abdomen. PE requires immediate oxygen and provider notification.
Q5: Which client is at GREATEST risk for developing postoperative deep vein thrombosis (DVT)?
A. A 35-year-old client who underwent a 30-minute laparoscopic appendectomy
B. A 78-year-old client undergoing hip replacement surgery who has a history of heart failure [CORRECT]
C. A 50-year-old client scheduled for cataract surgery under local anesthesia
D. A 45-year-old client undergoing a 1-hour hernia repair with early ambulation
Correct Answer: B. A 78-year-old client undergoing hip replacement surgery who has a
history of heart failure
Rationale: Advanced age, major orthopedic surgery (hip replacement), and heart failure all increase DVT risk through Virchow's
triad: venous stasis, endothelial injury, and hypercoagulability. The other clients have lower risk due to shorter procedures, local
anesthesia, or early ambulation.
Q6: A client who received general anesthesia is admitted to the postanesthesia care unit (PACU). Which assessment
is the PRIORITY during the immediate postoperative period?
A. Surgical site dressing check
B. Airway patency and oxygen saturation [CORRECT]
C. Pain level using a 0-10 scale
D. Ability to move all extremities
Correct Answer: B. Airway patency and oxygen saturation
Rationale: In the immediate postoperative period, airway patency and oxygen saturation are the priority (ABC framework)
because anesthesia depresses respirations and the airway may be obstructed by secretions or residual anesthesia. The other
assessments are important but secondary to airway and breathing.
Q7: A client is recovering from spinal anesthesia after a lower abdominal surgery. Which finding requires
IMMEDIATE intervention by the nurse?
A. Blood pressure 110/70 mmHg
B. Client reports feeling sensation returning to the legs at 4 hours postoperative
C. Respiratory rate 24 breaths per minute [CORRECT]
D. Urine output 30 mL/hr
Correct Answer: C. Respiratory rate 24 breaths per minute
Rationale: A respiratory rate of 24 breaths/min in the recovery from spinal anesthesia may indicate ascending spinal block or
respiratory compromise requiring immediate intervention. Spinal anesthesia can cause respiratory depression if the block rises.
The other findings are acceptable or expected.
Nursing Education Series Page 4
