HESI Med-Surg Assessment Test Bank
Complete Practice Test Bank — 500 Exam-Style Questions with Verified Answers & Detailed
Rationales
Table of Contents
1. Exam Overview … 1
2. Domain 1: Cardiovascular and Hematologic Nursing … 3
- Questions 1–70
3. Domain 2: Respiratory System Care … 18
- Questions 71–130
4. Domain 3: Gastrointestinal and Nutritional Disorders … 33
- Questions 131–190
5. Domain 4: Endocrine and Metabolic Conditions … 49
- Questions 191–250
6. Domain 5: Renal, Urinary, and Reproductive Health … 65
- Questions 251–310
7. Domain 6: Neurologic and Sensory System Nursing … 81
- Questions 311–370
8. Domain 7: Musculoskeletal Management … 97
- Questions 371–420
9. Domain 8: Immunologic and Infectious Disease Care … 111
- Questions 421–460
10. Domain 9: Perioperative and Emergency Nursing … 123
- Questions 461–500
---
,Exam Overview
Examination: HESI Medical-Surgical Nursing Specialty Exam
Publisher: Elsevier
Format: Multiple-choice and Next Generation NCLEX (NGN) style questions
Total Questions: Varies by version (typically 55–150 scored questions)
Time Allowed: Varies by exam version
Passing Standard: HESI Conversion Score of 900+ (recommended); scores of 850–899 are
acceptable for most programs
Core Domains & Weightings:
| Domain | Weight | Key Topics |
|--------|--------|------------|
| Management of Care | 12–15% | Delegation, Prioritization, Advocacy, Continuity of Care |
| Safety and Infection Control | 10–12% | Precautions, Injury Prevention, Emergency
Response |
| Basic Care and Comfort | 10–12% | ADLs, Mobility, Nutrition, Elimination, Rest |
| Pharmacological and Parenteral Therapies | 12–15% | Medication Administration, IV
Therapy, Blood Products |
| Reduction of Risk Potential | 12–15% | Lab Values, Diagnostic Tests, Potential
Complications |
| Physiological Adaptation | 20–25% | Acute and Chronic Illness Management |
| Health Promotion and Maintenance | 8–10% | Screening, Disease Prevention, Lifestyle |
| Psychosocial Integrity | 8–10% | Coping, Grief, Mental Health, Crisis Intervention |
Content Areas Covered:
- Cardiovascular and Hematologic Nursing
,- Respiratory System Care
- Gastrointestinal and Nutritional Disorders
- Endocrine and Metabolic Conditions
- Renal, Urinary, and Reproductive Health
- Neurologic and Sensory System Nursing
- Musculoskeletal Management
- Immunologic and Infectious Disease Care
- Perioperative and Emergency Nursing
---
DOMAIN 1: CARDIOVASCULAR AND HEMATOLOGIC NURSING
Questions 1–70
---
Question 1. A client with heart failure is prescribed furosemide 40 mg IV push. Which
assessment finding requires immediate intervention?
A) Blood pressure 98/60 mm Hg
B) Potassium level 2.8 mEq/L
C) Urine output 50 mL/hr
D) Respiratory rate 22 breaths/min
Answer: B
Explanation: A potassium level of 2.8 mEq/L is critically low (normal range: 3.5–5.0 mEq/L).
Furosemide is a loop diuretic that causes potassium loss, increasing the risk for fatal
, dysrhythmias such as ventricular tachycardia and ventricular fibrillation. The nurse should
withhold the dose, notify the provider, and prepare to administer potassium replacement.
---
Question 2. A nurse is caring for a client who had a myocardial infarction 24 hours ago.
Which laboratory value should the nurse monitor most closely?
A) Serum potassium
B) Troponin I
C) BNP
D) D-dimer
Answer: B
Explanation: Troponin I is the most specific and sensitive cardiac marker for myocardial
infarction. It rises within 3–12 hours after onset of chest pain and peaks at 24–48 hours.
Troponin levels help confirm the diagnosis and estimate infarct size.
---
Question 3. A client is admitted with atrial fibrillation and a ventricular rate of 148
beats/min. The client is diaphoretic and reports palpitations. Which intervention should the
nurse anticipate first?
A) Administration of IV diltiazem
B) Synchronized cardioversion
C) Administration of IV amiodarone
D) Vagal maneuver
Complete Practice Test Bank — 500 Exam-Style Questions with Verified Answers & Detailed
Rationales
Table of Contents
1. Exam Overview … 1
2. Domain 1: Cardiovascular and Hematologic Nursing … 3
- Questions 1–70
3. Domain 2: Respiratory System Care … 18
- Questions 71–130
4. Domain 3: Gastrointestinal and Nutritional Disorders … 33
- Questions 131–190
5. Domain 4: Endocrine and Metabolic Conditions … 49
- Questions 191–250
6. Domain 5: Renal, Urinary, and Reproductive Health … 65
- Questions 251–310
7. Domain 6: Neurologic and Sensory System Nursing … 81
- Questions 311–370
8. Domain 7: Musculoskeletal Management … 97
- Questions 371–420
9. Domain 8: Immunologic and Infectious Disease Care … 111
- Questions 421–460
10. Domain 9: Perioperative and Emergency Nursing … 123
- Questions 461–500
---
,Exam Overview
Examination: HESI Medical-Surgical Nursing Specialty Exam
Publisher: Elsevier
Format: Multiple-choice and Next Generation NCLEX (NGN) style questions
Total Questions: Varies by version (typically 55–150 scored questions)
Time Allowed: Varies by exam version
Passing Standard: HESI Conversion Score of 900+ (recommended); scores of 850–899 are
acceptable for most programs
Core Domains & Weightings:
| Domain | Weight | Key Topics |
|--------|--------|------------|
| Management of Care | 12–15% | Delegation, Prioritization, Advocacy, Continuity of Care |
| Safety and Infection Control | 10–12% | Precautions, Injury Prevention, Emergency
Response |
| Basic Care and Comfort | 10–12% | ADLs, Mobility, Nutrition, Elimination, Rest |
| Pharmacological and Parenteral Therapies | 12–15% | Medication Administration, IV
Therapy, Blood Products |
| Reduction of Risk Potential | 12–15% | Lab Values, Diagnostic Tests, Potential
Complications |
| Physiological Adaptation | 20–25% | Acute and Chronic Illness Management |
| Health Promotion and Maintenance | 8–10% | Screening, Disease Prevention, Lifestyle |
| Psychosocial Integrity | 8–10% | Coping, Grief, Mental Health, Crisis Intervention |
Content Areas Covered:
- Cardiovascular and Hematologic Nursing
,- Respiratory System Care
- Gastrointestinal and Nutritional Disorders
- Endocrine and Metabolic Conditions
- Renal, Urinary, and Reproductive Health
- Neurologic and Sensory System Nursing
- Musculoskeletal Management
- Immunologic and Infectious Disease Care
- Perioperative and Emergency Nursing
---
DOMAIN 1: CARDIOVASCULAR AND HEMATOLOGIC NURSING
Questions 1–70
---
Question 1. A client with heart failure is prescribed furosemide 40 mg IV push. Which
assessment finding requires immediate intervention?
A) Blood pressure 98/60 mm Hg
B) Potassium level 2.8 mEq/L
C) Urine output 50 mL/hr
D) Respiratory rate 22 breaths/min
Answer: B
Explanation: A potassium level of 2.8 mEq/L is critically low (normal range: 3.5–5.0 mEq/L).
Furosemide is a loop diuretic that causes potassium loss, increasing the risk for fatal
, dysrhythmias such as ventricular tachycardia and ventricular fibrillation. The nurse should
withhold the dose, notify the provider, and prepare to administer potassium replacement.
---
Question 2. A nurse is caring for a client who had a myocardial infarction 24 hours ago.
Which laboratory value should the nurse monitor most closely?
A) Serum potassium
B) Troponin I
C) BNP
D) D-dimer
Answer: B
Explanation: Troponin I is the most specific and sensitive cardiac marker for myocardial
infarction. It rises within 3–12 hours after onset of chest pain and peaks at 24–48 hours.
Troponin levels help confirm the diagnosis and estimate infarct size.
---
Question 3. A client is admitted with atrial fibrillation and a ventricular rate of 148
beats/min. The client is diaphoretic and reports palpitations. Which intervention should the
nurse anticipate first?
A) Administration of IV diltiazem
B) Synchronized cardioversion
C) Administration of IV amiodarone
D) Vagal maneuver
