HESI Med-Surg Exam (Latest 2026
Update) Practice Questions and
Answers
1. Which assessment is most important for the nurse to
perform on a client who is hospitalized for Guillain-Barré
syndrome that is rapidly progressing?
A. Respiratory effort.
B. Unsteady gait.
C. Intensity of pain.
D. Ability to eat.
Answer: A. Respiratory effort.
Rationale: Guillain-Barré syndrome causes paralysis or
weakness that typically starts at the feet and progresses
upwards. As the condition progresses, the nurse must
ensure that the client is able to breathe effectively.
Reference: Heuther, Understanding Pathophysiology, 6th ed.
p. 412
2. A male client comes into the clinic with a history of penile
discharge with painful, burning urination. Which action
should the nurse implement?
A. Collect a culture of the penile discharge.
B. Palpate the inguinal lymph nodes gently.
C. Observe for scrotal swelling and redness.
D. Express the discharge to determine color.
Answer: A. Collect a culture of the penile discharge.
Rationale: Penile discharge with painful urination is
commonly associated with gonorrhea. The nurse should
collect a culture of the penile discharge to determine the
cause of these symptoms. The cause must be determined or
confirmed through culture to identify the organism and
ensure effective treatment.
Reference: Jarvis Physical Examination and Health
Assessment, 6th edition
1
,3. A client with history of atrial fibrillation is admitted to the
telemetry unit with sudden onset of shortness of breath.
The nurse observes a new irregular heart rhythm and should
perform which assessment at this time?
A. Check for a pulse deficit.
B. Palpate the apical impulse.
C. Inspect jugular vein pulse.
D. Examine for a carotid bruit.
Answer: A. Check for a pulse deficit.
Rationale: A client with a past history of atrial fibrillation
may return to that rhythm. Any signs of atrial fibrillation,
such as sudden onset shortness of breath, requires further
investigation. The nurse should assess this client for a pulse
deficit because this condition occurs with atrial fibrillation.
4. Which client should be further assessed for an ectopic
pregnancy?
A. A 24-year-old with shoulder and lower abdominal quadrant pain.
B. A 33-year-old with intermittent lower abdominal cramping.
C. A 20-year-old with fever and right lower abdominal colic.
D. A 40-year-old with jaundice and right lower abdominal pain.
Answer: A. A 24-year-old with shoulder and lower abdominal
quadrant pain.
Rationale: A 24-year-old with sudden onset of lower
abdominal quadrant pain should be assessed for an ectopic
pregnancy. The pain can also be referred to the shoulder
and may be associated with vaginal bleeding.
Reference: Health Assessment for Nursing Practice, Wilson
and Giddens, p. 269
5. Which dietary assessment finding is most important for
the nurse to address when caring for a client with diabetic
nephropathy?
A. Drinks a six pack of beer every day.
B. Enjoys a hamburger once a month.
C. Eats fortified breakfast cereal daily.
D. Consumes beans and rice every day.
Answer: A. Drinks a six pack of beer every day.
2
,Rationale: Drinking six beers every day is the dietary
assessment finding most important for the nurse to address
when caring for a client with diabetic nephropathy. The
usual can of beer is 12 ounces (355 mL). Clients with
diabetes are recommended to drink no more than 12 ounces
of beer per day because beer contains carbohydrates that
can create unhealthy fluctuations in blood glucose and
promote poor glucose control. Nephropathy is exacerbated
by poor blood glucose control.
6. Which assessment finding is of greatest concern to the
nurse who is caring for a client with stomatitis?
A. Cough brought on by swallowing.
B. Sore throat caused by speaking.
C. Painful and dry oral cavity.
D. Unintended weight loss.
Answer: A. Cough brought on by swallowing.
Rationale: A cough brought on by swallowing is a sign of
dysphagia, which is a finding of particular concern in a client
with stomatitis. Dysphagia can cause numerous problems,
including airway obstruction, and should be reported to the
healthcare provider immediately.
Reference: Ignatavicius, (2016). Medical-surgical nursing:
Patient-centered collaborative care, eighth edition, Ch. 53,
p. 1100.
7. The nurse is teaching a client diagnosed with peripheral
arterial disease. Which genitourinary system complication
should the nurse include in the teaching?
A. Altered sexual response.
B. Sterility.
C. Urinary incontinence.
D. Decreased pelvic muscle tone.
Answer: A. Altered sexual response.
Rationale: Peripheral arterial disease (PAD) is a
cardiovascular condition characterized by narrowing of the
arteries and reduced blood flow to the extremities. PAD is
known to alter the blood flow to the male's penis and is
associated with erectile dysfunction in men.
3
, Reference: Ignatavicius., (2016). Medical-surgical nursing:
Patient-centered collaborative care, eighth edition, Ch. 69,
p. 1452.
8. A 40-year-old female client has a history of smoking.
Which finding should the nurse identify as a risk factor for
myocardial infarction?
A. Oral contraceptives.
B. Senile osteopenia.
C. Levothyroxine therapy.
D. Pernicious anemia.
Answer: A. Oral contraceptives.
Rationale: Women older than 35 years old who smoke and
take oral contraceptives have an increased risk of
myocardial infarction or stroke.
Reference: Ignatavicius, (2013). Medical-surgical nursing:
Patient-centered collaborative care, 7th ed., Ch. 35, p. 694.
9. A client has been told that there is cataract formation
over both eyes. Which finding should the nurse expect when
assessing the client?
A. Decreased color perception.
B. Presence of floaters.
C. Loss of central vision.
D. Reduced peripheral vision.
Answer: A. Decreased color perception.
Rationale: Decreased color perception occurs with cataract
formation. Cataract formation is also associated with blurred
vision and a global loss of vision so gradual that the client
may not be aware of it.
Reference: Ignatavicius, (2016). Medical-surgical nursing:
Patient-centered collaborative care, eighth edition, Ch. 47.
10. Which assessment finding should most concern the
nurse who is monitoring a client two hours after a
thoracentesis?
4
Update) Practice Questions and
Answers
1. Which assessment is most important for the nurse to
perform on a client who is hospitalized for Guillain-Barré
syndrome that is rapidly progressing?
A. Respiratory effort.
B. Unsteady gait.
C. Intensity of pain.
D. Ability to eat.
Answer: A. Respiratory effort.
Rationale: Guillain-Barré syndrome causes paralysis or
weakness that typically starts at the feet and progresses
upwards. As the condition progresses, the nurse must
ensure that the client is able to breathe effectively.
Reference: Heuther, Understanding Pathophysiology, 6th ed.
p. 412
2. A male client comes into the clinic with a history of penile
discharge with painful, burning urination. Which action
should the nurse implement?
A. Collect a culture of the penile discharge.
B. Palpate the inguinal lymph nodes gently.
C. Observe for scrotal swelling and redness.
D. Express the discharge to determine color.
Answer: A. Collect a culture of the penile discharge.
Rationale: Penile discharge with painful urination is
commonly associated with gonorrhea. The nurse should
collect a culture of the penile discharge to determine the
cause of these symptoms. The cause must be determined or
confirmed through culture to identify the organism and
ensure effective treatment.
Reference: Jarvis Physical Examination and Health
Assessment, 6th edition
1
,3. A client with history of atrial fibrillation is admitted to the
telemetry unit with sudden onset of shortness of breath.
The nurse observes a new irregular heart rhythm and should
perform which assessment at this time?
A. Check for a pulse deficit.
B. Palpate the apical impulse.
C. Inspect jugular vein pulse.
D. Examine for a carotid bruit.
Answer: A. Check for a pulse deficit.
Rationale: A client with a past history of atrial fibrillation
may return to that rhythm. Any signs of atrial fibrillation,
such as sudden onset shortness of breath, requires further
investigation. The nurse should assess this client for a pulse
deficit because this condition occurs with atrial fibrillation.
4. Which client should be further assessed for an ectopic
pregnancy?
A. A 24-year-old with shoulder and lower abdominal quadrant pain.
B. A 33-year-old with intermittent lower abdominal cramping.
C. A 20-year-old with fever and right lower abdominal colic.
D. A 40-year-old with jaundice and right lower abdominal pain.
Answer: A. A 24-year-old with shoulder and lower abdominal
quadrant pain.
Rationale: A 24-year-old with sudden onset of lower
abdominal quadrant pain should be assessed for an ectopic
pregnancy. The pain can also be referred to the shoulder
and may be associated with vaginal bleeding.
Reference: Health Assessment for Nursing Practice, Wilson
and Giddens, p. 269
5. Which dietary assessment finding is most important for
the nurse to address when caring for a client with diabetic
nephropathy?
A. Drinks a six pack of beer every day.
B. Enjoys a hamburger once a month.
C. Eats fortified breakfast cereal daily.
D. Consumes beans and rice every day.
Answer: A. Drinks a six pack of beer every day.
2
,Rationale: Drinking six beers every day is the dietary
assessment finding most important for the nurse to address
when caring for a client with diabetic nephropathy. The
usual can of beer is 12 ounces (355 mL). Clients with
diabetes are recommended to drink no more than 12 ounces
of beer per day because beer contains carbohydrates that
can create unhealthy fluctuations in blood glucose and
promote poor glucose control. Nephropathy is exacerbated
by poor blood glucose control.
6. Which assessment finding is of greatest concern to the
nurse who is caring for a client with stomatitis?
A. Cough brought on by swallowing.
B. Sore throat caused by speaking.
C. Painful and dry oral cavity.
D. Unintended weight loss.
Answer: A. Cough brought on by swallowing.
Rationale: A cough brought on by swallowing is a sign of
dysphagia, which is a finding of particular concern in a client
with stomatitis. Dysphagia can cause numerous problems,
including airway obstruction, and should be reported to the
healthcare provider immediately.
Reference: Ignatavicius, (2016). Medical-surgical nursing:
Patient-centered collaborative care, eighth edition, Ch. 53,
p. 1100.
7. The nurse is teaching a client diagnosed with peripheral
arterial disease. Which genitourinary system complication
should the nurse include in the teaching?
A. Altered sexual response.
B. Sterility.
C. Urinary incontinence.
D. Decreased pelvic muscle tone.
Answer: A. Altered sexual response.
Rationale: Peripheral arterial disease (PAD) is a
cardiovascular condition characterized by narrowing of the
arteries and reduced blood flow to the extremities. PAD is
known to alter the blood flow to the male's penis and is
associated with erectile dysfunction in men.
3
, Reference: Ignatavicius., (2016). Medical-surgical nursing:
Patient-centered collaborative care, eighth edition, Ch. 69,
p. 1452.
8. A 40-year-old female client has a history of smoking.
Which finding should the nurse identify as a risk factor for
myocardial infarction?
A. Oral contraceptives.
B. Senile osteopenia.
C. Levothyroxine therapy.
D. Pernicious anemia.
Answer: A. Oral contraceptives.
Rationale: Women older than 35 years old who smoke and
take oral contraceptives have an increased risk of
myocardial infarction or stroke.
Reference: Ignatavicius, (2013). Medical-surgical nursing:
Patient-centered collaborative care, 7th ed., Ch. 35, p. 694.
9. A client has been told that there is cataract formation
over both eyes. Which finding should the nurse expect when
assessing the client?
A. Decreased color perception.
B. Presence of floaters.
C. Loss of central vision.
D. Reduced peripheral vision.
Answer: A. Decreased color perception.
Rationale: Decreased color perception occurs with cataract
formation. Cataract formation is also associated with blurred
vision and a global loss of vision so gradual that the client
may not be aware of it.
Reference: Ignatavicius, (2016). Medical-surgical nursing:
Patient-centered collaborative care, eighth edition, Ch. 47.
10. Which assessment finding should most concern the
nurse who is monitoring a client two hours after a
thoracentesis?
4
