HESI Med Surg Exam
2026 | Medical-Surgical
Nursing Study Guide,
Practice Questions &
Exam Review
|Guaranteed success|
,2. It is most important for the registered nurse (RN) who ANS: A
is working on a medical unit to provide Access of an implanted port is a skill that requires experience and expertise, so
direct supervision in which situation? it is important
a. A graduate nurse needs to access a client's implanted for the RN to supervise a graduate nurse performing this task (A). An
port to start an infusion of experienced nurse
Ringer's Lactate. should be able to start a blood transfusion (B) regardless of the setting, and
b. A postpartum nurse pulled to the unit needs to start should not require
a transfusion of packed direct supervision. The practical nurse should be able to assist with a procedure
red blood cells. such as a
c. A practical nurse is preparing to assist the healthcare lumbar puncture (C) without direct supervision, and the UAP (D) can perform
provider with a lumbar this skill
puncture at the bedside. without direct supervision
d. An unlicensed assistive personnel is preparing to
weigh an obese bedfast
client using a bed scale
In assessing a client with preeclampsia who is receiving ANS: C
magnesium sulfate, the nurse The client is exhibiting symptoms of magnesium sulfate toxicity--decreased
determines that her deep tendon reflexes are 1+; reflexes (normal is
respiratory rate is 12 breaths/minute; +2), a low normal respiratory rate (normal is 12 to 20 breaths/min), a less than
urinary output is 90 ml in 4 hours; magnesium sulfate average
level is 9 mg/dl. Based on these urinary output (30 ml/hour is average), and a low magnesium sulfate level
findings, what intervention should the nurse (normal is 4 to
implement? 8mg/dl). Based on these findings, the nurse should stop the infusion (C). (A) is
a. Continue the magnesium sulfate infusion as contraindicated. (B) would not fully alleviate the magnesium sulfate toxicity
prescribed. symptoms. (D)
b. Decrease the magnesium sulfate infusion by one-half. (the antagonist for magnesium sulfate) would be indicated if the respiratory
c. Stop the magnesium sulfate infusion immediately. rate were less
d. Administer calcium gluconate immediately. than 12 breaths/minute.
A client is on a mechanical ventilator. Which client ANS: A
response indicates that the neuromuscular This medication causes paralysis (A) following intravenous injection. Peak
blocker tubocurarine chloride (Tubarine) is effective? effects persist for
a. The client's expremities are paralyzed. 35 to 60 minutes. (B and C) would not be possible if the medication is effective.
b. The peripheral nerve stimulator causes twitching. The Glasgow
c. The client clinches fist upon command. coma scale is used to evaluate the neurological status of the client and does
d. The client's Glagow Coma Scale score is 14 not evaluate the
effectiveness (D) of this medication.
,5. An elderly female client comes to the clinic for a ANS: B
regular check-up. The client tells the nurse Frequent and/or large doses of acetaminophen can cause an increase in liver
that she has increased her daily doses of enzymes,
acetaminophen (Tylenol) for the past month to indicating possible liver damage (B). If the client reported unusual bleeding, or
control joint pain. Based on this client's comment, what an increase in
previous lab values should the nurse aspirin usage, it would be important for the nurse to assess for increased
compare with today's lab report? bleeding and monitor
a. Look at last quarter's hemoglobin and hematocrit, (A and/or C). (D) is not affected by increases in acetaminophen doses.
expecting an increase today due
to dehydration.
b. Look for an increase in today's LDH compared to the
previous one to assess
for possible liver damage. c. Expect to find an increase
in today's APTT as compared to last quarter's due
to bleeding.
d. Determine if there is a decrease in serum potassium
due to renal compromise.
6. Aspirin is prescribed for a 9-year-old child with ANS: C
rheumatic fever to control the inflammatory Ringing in the ears (tinnitus) (C) is an important sign of aspirin overdosage and
process, promote comfort, and reduce fever. What should be
intervention is most important for the reported immediately. Though a tepid sponge bath may lower the child's
nurse to implement? temperature, the
a. Instruct the parents to hold the aspirin until the child prescription for aspirin should not be held (A). Aspirin should be taken with at
has first had a tepid sponge least eight
bath. ounces of water to completely wash the tablet into the stomach and to help
b. Administer the aspirin with at least two ounces of prevent GI
water or juice. discomfort (B). Yellow halos are associated with Digoxin toxicity, not aspirin (D)
c. Notify the healthcare provider if the child complains
of ringing in the ears.
d. Advise the parents to question the child about seeing
yellow halos around objects
7. Which signs or symptoms are characteristic of an ANS: D
adult client diagnosed with Cushing's The classic picture of Cushing's syndrome in the adult is central-type obesity
syndrome? with thin
a. Husky voice and complaints of hoarseness. extremities (D), along with a "buffalo hump" in the supraclavicular area, heavy
b. Warm, soft, moist, salmon-colored skin. trunk, and
c. Visible swelling of the neck, with no pain. thin fragile skin. The symptoms described in (A) are clinical manifestations of
d. Central-type obesity, with thin extremities. hypothyroidism, and in (B) of hyperthyroidism. (C) may indicate a goiter or a
tumor of the
thyroid gland
, 8. A charge nurse agrees to cover another nurse's ANS: D
assignment during a lunch break. Based on the A pulse oximeter reading of 90% indicates an arterial blood gas of less than 80
status report provided by the nurse who is leaving for to 100 and
lunch, which client should be checked should be assessed immediately (D). (A) is an expected finding. (B) is not an
first by the charge nurse? The client unusual finding.
a. admitted yesterday with diabetec ketoacidosis whose (C) is an expected finding for this client.
blood glucose level
is now 195 mg/dl.
b. with an ileal conduit created two days ago with a
scant amount of blood in
the drainage pouch.
c. post-triple coronary bypass four days ago who has
serosanguinous drainage
in the chest tube.
d. with a pneumothorax secondary to a gunshot wound
with a current pulse
oximeter reading of 90%.
9. An outcome for treatment of peripheral vascular ANS: A
disease is, "The client will have decreased Client behaviors indicating that the expected outcome of, "decreased venous
venous congestion." What client behavior would congestion" has
indicate to the nurse that this outcome has been met would include elevating the legs, increasing walking time, and an
been met? observable
a. Avoids prolonged sitting or standing. decrease in edema of the lower extremities (A). (B and C) would be
b. Avoids trauma and irritation to skin. appropriate for outcomes
c. Wears protective shoes. for, "Attains or maintains tissue integrity." (D) would be an appropriate outcome
d. Quits smoking for,
"Demonstrates an increase in arterial blood supply to extremities."
10. The healthcare provider performs a paracentesis on ANS: D
a client with ascites and 3 liters of fluid Life-threatening complications such as hypovolemia and sepsis can occur
are removed. Which assessment parameter is most following a
critical for the nurse to monitor following paracentesis, and measurement of vital signs (D) will provide assessment data
the procedure? that will help
a. Pedal pulses. detect the occurrence of such complications. (A) might be assessed to check
b. Breath sounds. for circulation in
c. Gag reflex. the lower extremities, but are not indicated for postparacentesis assessment.
d. Vital signs Reduction of (B)
may occur as the result of decreased fluid in the peritoneal cavity, but is a
desired outcome,
not a complication, of this procedure. (C) is not affected by a paracentesis
procedure
11. The nurse is administering sevelamer (RenaGel) ANS: B
during lunch to a client with end stage renal RenaGel is an intestinal phosphate binder and should be taken with meals to
disease (ESRD). The client asks the nurse to bring the prevent
medication later. The nurse should contributing to the hyperphosphatemia (B), associated with ESRD. (A, C, and D)
describe which action of RenaGel as an explanation for are not the
taking it with meals? therapeutic actions of RenaGel
a. Prevents indigestion associated with ingestion of
spicy foods.
b. Binds with phosphorus in foods and prevents
absorption.
c. Promotes stomach emptying and prevents gastric
reflux.
d. Buffers hydrochloric acid and prevents gastric
erosion
2026 | Medical-Surgical
Nursing Study Guide,
Practice Questions &
Exam Review
|Guaranteed success|
,2. It is most important for the registered nurse (RN) who ANS: A
is working on a medical unit to provide Access of an implanted port is a skill that requires experience and expertise, so
direct supervision in which situation? it is important
a. A graduate nurse needs to access a client's implanted for the RN to supervise a graduate nurse performing this task (A). An
port to start an infusion of experienced nurse
Ringer's Lactate. should be able to start a blood transfusion (B) regardless of the setting, and
b. A postpartum nurse pulled to the unit needs to start should not require
a transfusion of packed direct supervision. The practical nurse should be able to assist with a procedure
red blood cells. such as a
c. A practical nurse is preparing to assist the healthcare lumbar puncture (C) without direct supervision, and the UAP (D) can perform
provider with a lumbar this skill
puncture at the bedside. without direct supervision
d. An unlicensed assistive personnel is preparing to
weigh an obese bedfast
client using a bed scale
In assessing a client with preeclampsia who is receiving ANS: C
magnesium sulfate, the nurse The client is exhibiting symptoms of magnesium sulfate toxicity--decreased
determines that her deep tendon reflexes are 1+; reflexes (normal is
respiratory rate is 12 breaths/minute; +2), a low normal respiratory rate (normal is 12 to 20 breaths/min), a less than
urinary output is 90 ml in 4 hours; magnesium sulfate average
level is 9 mg/dl. Based on these urinary output (30 ml/hour is average), and a low magnesium sulfate level
findings, what intervention should the nurse (normal is 4 to
implement? 8mg/dl). Based on these findings, the nurse should stop the infusion (C). (A) is
a. Continue the magnesium sulfate infusion as contraindicated. (B) would not fully alleviate the magnesium sulfate toxicity
prescribed. symptoms. (D)
b. Decrease the magnesium sulfate infusion by one-half. (the antagonist for magnesium sulfate) would be indicated if the respiratory
c. Stop the magnesium sulfate infusion immediately. rate were less
d. Administer calcium gluconate immediately. than 12 breaths/minute.
A client is on a mechanical ventilator. Which client ANS: A
response indicates that the neuromuscular This medication causes paralysis (A) following intravenous injection. Peak
blocker tubocurarine chloride (Tubarine) is effective? effects persist for
a. The client's expremities are paralyzed. 35 to 60 minutes. (B and C) would not be possible if the medication is effective.
b. The peripheral nerve stimulator causes twitching. The Glasgow
c. The client clinches fist upon command. coma scale is used to evaluate the neurological status of the client and does
d. The client's Glagow Coma Scale score is 14 not evaluate the
effectiveness (D) of this medication.
,5. An elderly female client comes to the clinic for a ANS: B
regular check-up. The client tells the nurse Frequent and/or large doses of acetaminophen can cause an increase in liver
that she has increased her daily doses of enzymes,
acetaminophen (Tylenol) for the past month to indicating possible liver damage (B). If the client reported unusual bleeding, or
control joint pain. Based on this client's comment, what an increase in
previous lab values should the nurse aspirin usage, it would be important for the nurse to assess for increased
compare with today's lab report? bleeding and monitor
a. Look at last quarter's hemoglobin and hematocrit, (A and/or C). (D) is not affected by increases in acetaminophen doses.
expecting an increase today due
to dehydration.
b. Look for an increase in today's LDH compared to the
previous one to assess
for possible liver damage. c. Expect to find an increase
in today's APTT as compared to last quarter's due
to bleeding.
d. Determine if there is a decrease in serum potassium
due to renal compromise.
6. Aspirin is prescribed for a 9-year-old child with ANS: C
rheumatic fever to control the inflammatory Ringing in the ears (tinnitus) (C) is an important sign of aspirin overdosage and
process, promote comfort, and reduce fever. What should be
intervention is most important for the reported immediately. Though a tepid sponge bath may lower the child's
nurse to implement? temperature, the
a. Instruct the parents to hold the aspirin until the child prescription for aspirin should not be held (A). Aspirin should be taken with at
has first had a tepid sponge least eight
bath. ounces of water to completely wash the tablet into the stomach and to help
b. Administer the aspirin with at least two ounces of prevent GI
water or juice. discomfort (B). Yellow halos are associated with Digoxin toxicity, not aspirin (D)
c. Notify the healthcare provider if the child complains
of ringing in the ears.
d. Advise the parents to question the child about seeing
yellow halos around objects
7. Which signs or symptoms are characteristic of an ANS: D
adult client diagnosed with Cushing's The classic picture of Cushing's syndrome in the adult is central-type obesity
syndrome? with thin
a. Husky voice and complaints of hoarseness. extremities (D), along with a "buffalo hump" in the supraclavicular area, heavy
b. Warm, soft, moist, salmon-colored skin. trunk, and
c. Visible swelling of the neck, with no pain. thin fragile skin. The symptoms described in (A) are clinical manifestations of
d. Central-type obesity, with thin extremities. hypothyroidism, and in (B) of hyperthyroidism. (C) may indicate a goiter or a
tumor of the
thyroid gland
, 8. A charge nurse agrees to cover another nurse's ANS: D
assignment during a lunch break. Based on the A pulse oximeter reading of 90% indicates an arterial blood gas of less than 80
status report provided by the nurse who is leaving for to 100 and
lunch, which client should be checked should be assessed immediately (D). (A) is an expected finding. (B) is not an
first by the charge nurse? The client unusual finding.
a. admitted yesterday with diabetec ketoacidosis whose (C) is an expected finding for this client.
blood glucose level
is now 195 mg/dl.
b. with an ileal conduit created two days ago with a
scant amount of blood in
the drainage pouch.
c. post-triple coronary bypass four days ago who has
serosanguinous drainage
in the chest tube.
d. with a pneumothorax secondary to a gunshot wound
with a current pulse
oximeter reading of 90%.
9. An outcome for treatment of peripheral vascular ANS: A
disease is, "The client will have decreased Client behaviors indicating that the expected outcome of, "decreased venous
venous congestion." What client behavior would congestion" has
indicate to the nurse that this outcome has been met would include elevating the legs, increasing walking time, and an
been met? observable
a. Avoids prolonged sitting or standing. decrease in edema of the lower extremities (A). (B and C) would be
b. Avoids trauma and irritation to skin. appropriate for outcomes
c. Wears protective shoes. for, "Attains or maintains tissue integrity." (D) would be an appropriate outcome
d. Quits smoking for,
"Demonstrates an increase in arterial blood supply to extremities."
10. The healthcare provider performs a paracentesis on ANS: D
a client with ascites and 3 liters of fluid Life-threatening complications such as hypovolemia and sepsis can occur
are removed. Which assessment parameter is most following a
critical for the nurse to monitor following paracentesis, and measurement of vital signs (D) will provide assessment data
the procedure? that will help
a. Pedal pulses. detect the occurrence of such complications. (A) might be assessed to check
b. Breath sounds. for circulation in
c. Gag reflex. the lower extremities, but are not indicated for postparacentesis assessment.
d. Vital signs Reduction of (B)
may occur as the result of decreased fluid in the peritoneal cavity, but is a
desired outcome,
not a complication, of this procedure. (C) is not affected by a paracentesis
procedure
11. The nurse is administering sevelamer (RenaGel) ANS: B
during lunch to a client with end stage renal RenaGel is an intestinal phosphate binder and should be taken with meals to
disease (ESRD). The client asks the nurse to bring the prevent
medication later. The nurse should contributing to the hyperphosphatemia (B), associated with ESRD. (A, C, and D)
describe which action of RenaGel as an explanation for are not the
taking it with meals? therapeutic actions of RenaGel
a. Prevents indigestion associated with ingestion of
spicy foods.
b. Binds with phosphorus in foods and prevents
absorption.
c. Promotes stomach emptying and prevents gastric
reflux.
d. Buffers hydrochloric acid and prevents gastric
erosion
