HESI Med Surg Exam (Latest
2026/2027 Update) Complete Q&A
with Verified Answers and Detailed
Rationales Evolve Elsevier Medical
HESI Med Surg Exam (Latest 2026/2027 Update) | Comprehensive
Examination
HESI Med Surg Exam (Latest 2026/2027 Update) Complete
Q&A with Verified Answers and Detailed Rationales Evolve
Elsevier Medical Surgical Nursing Test Bank for RN Exit and
INTRODUCTION
This document is an important and very helpful preparation
resource for HESI Med Surg Exam (Latest 2026/2027 Update)
Complete Q&A with Verified Answers and Detailed Rationales
Evolve Elsevier Medical Surgical Nursing Test Bank for RN
Exit and Specialty Exams A+ Graded. Every item uses a focused
exam stem, four response options, a keyed response, and a clear
rationale, making it easier to understand the subject, spot
distractors, and build real exam confidence.
Page 1
, Question 1
A patient with acute decompensated heart failure is receiving IV furosemide.
Which assessment finding most specifically indicates a clinically significant
adverse effect requiring immediate provider notification?
A. Serum potassium 3.1 mEq/L with new U waves on telemetry
B. Urine output of 90 mL/hr over the past 3 hours
C. Blood pressure decrease from 138/82 to 118/70 mm Hg
D. Serum sodium 134 mEq/L with mild thirst
Correct Answer: A - Serum potassium 3.1 mEq/L with new U
waves on telemetry
RATIONALE
Loop diuretics cause potassium wasting; hypokalemia with U waves
signals increased risk for lethal dysrhythmias and requires immediate
intervention. The other findings are expected therapeutic or mild
effects and do not indicate the same urgency.
Question 2
A patient with type 1 diabetes is found unresponsive with a blood glucose of
42 mg/dL. After IV dextrose administration, which finding best indicates the
treatment has been effective?
A. Blood glucose 110 mg/dL with return of consciousness
B. Blood glucose 78 mg/dL with persistent confusion
C. Serum potassium 4.2 mEq/L
D. Urine ketones negative
Correct Answer: A - Blood glucose 110 mg/dL with return of
consciousness
Page 2
, RATIONALE
Effective treatment of hypoglycemia requires both normalization of
blood glucose and resolution of neurologic symptoms; a glucose of
110 mg/dL with restored consciousness confirms this. Persistent
confusion at 78 mg/dL or isolated lab values do not confirm clinical
recovery.
Question 3
A patient with acute kidney injury (AKI) has a serum potassium of 6.8 mEq/L
and peaked T waves. Which prescribed intervention should the nurse anticipate
as the priority?
A. Administer IV calcium gluconate
B. Administer oral sodium polystyrene sulfonate
C. Initiate continuous renal replacement therapy (CRRT)
D. Administer IV regular insulin with dextrose
Correct Answer: A - Administer IV calcium gluconate
RATIONALE
IV calcium gluconate is given first to stabilize the myocardium and
prevent lethal dysrhythmias from hyperkalemia. Insulin/dextrose and
polystyrene shift or remove potassium but do not immediately protect
the heart; CRRT is definitive but not the first emergency action.
Question 4
A patient is receiving IV heparin for a pulmonary embolism. Which laboratory
result requires immediate action?
A. aPTT 98 seconds (control 30-40) with new hematuria
B. Platelet count 180,000/mm3
C. Hemoglobin 13.2 g/dL
D. INR 1.1
Correct Answer: A - aPTT 98 seconds (control 30-40) with new
Page 3
, hematuria
RATIONALE
A markedly prolonged aPTT with bleeding indicates heparin toxicity
and risk for hemorrhage; the antidote is protamine sulfate. The other
values are within normal limits and do not indicate heparin-induced
complications.
Question 5
A patient with increased intracranial pressure (ICP) from a traumatic brain
injury is being positioned. Which intervention best supports cerebral
perfusion?
A. Keep head of bed at 30 degrees with head in neutral alignment
B. Place in Trendelenburg position
C. Position with head turned to the side
D. Maintain flat supine position
Correct Answer: A - Keep head of bed at 30 degrees with head in
neutral alignment
RATIONALE
Elevating the head of bed 30 degrees with neutral head alignment
promotes venous drainage and reduces ICP while maintaining cerebral
perfusion pressure. Trendelenburg, head rotation, and flat positioning
can increase ICP or impair venous return.
Question 6
A patient with a new ileostomy is at risk for which electrolyte imbalance?
A. Hyponatremia and hypokalemia
B. Hypernatremia and hyperkalemia
C. Hypercalcemia
D. Hyperphosphatemia
Correct Answer: A - Hyponatremia and hypokalemia
Page 4
2026/2027 Update) Complete Q&A
with Verified Answers and Detailed
Rationales Evolve Elsevier Medical
HESI Med Surg Exam (Latest 2026/2027 Update) | Comprehensive
Examination
HESI Med Surg Exam (Latest 2026/2027 Update) Complete
Q&A with Verified Answers and Detailed Rationales Evolve
Elsevier Medical Surgical Nursing Test Bank for RN Exit and
INTRODUCTION
This document is an important and very helpful preparation
resource for HESI Med Surg Exam (Latest 2026/2027 Update)
Complete Q&A with Verified Answers and Detailed Rationales
Evolve Elsevier Medical Surgical Nursing Test Bank for RN
Exit and Specialty Exams A+ Graded. Every item uses a focused
exam stem, four response options, a keyed response, and a clear
rationale, making it easier to understand the subject, spot
distractors, and build real exam confidence.
Page 1
, Question 1
A patient with acute decompensated heart failure is receiving IV furosemide.
Which assessment finding most specifically indicates a clinically significant
adverse effect requiring immediate provider notification?
A. Serum potassium 3.1 mEq/L with new U waves on telemetry
B. Urine output of 90 mL/hr over the past 3 hours
C. Blood pressure decrease from 138/82 to 118/70 mm Hg
D. Serum sodium 134 mEq/L with mild thirst
Correct Answer: A - Serum potassium 3.1 mEq/L with new U
waves on telemetry
RATIONALE
Loop diuretics cause potassium wasting; hypokalemia with U waves
signals increased risk for lethal dysrhythmias and requires immediate
intervention. The other findings are expected therapeutic or mild
effects and do not indicate the same urgency.
Question 2
A patient with type 1 diabetes is found unresponsive with a blood glucose of
42 mg/dL. After IV dextrose administration, which finding best indicates the
treatment has been effective?
A. Blood glucose 110 mg/dL with return of consciousness
B. Blood glucose 78 mg/dL with persistent confusion
C. Serum potassium 4.2 mEq/L
D. Urine ketones negative
Correct Answer: A - Blood glucose 110 mg/dL with return of
consciousness
Page 2
, RATIONALE
Effective treatment of hypoglycemia requires both normalization of
blood glucose and resolution of neurologic symptoms; a glucose of
110 mg/dL with restored consciousness confirms this. Persistent
confusion at 78 mg/dL or isolated lab values do not confirm clinical
recovery.
Question 3
A patient with acute kidney injury (AKI) has a serum potassium of 6.8 mEq/L
and peaked T waves. Which prescribed intervention should the nurse anticipate
as the priority?
A. Administer IV calcium gluconate
B. Administer oral sodium polystyrene sulfonate
C. Initiate continuous renal replacement therapy (CRRT)
D. Administer IV regular insulin with dextrose
Correct Answer: A - Administer IV calcium gluconate
RATIONALE
IV calcium gluconate is given first to stabilize the myocardium and
prevent lethal dysrhythmias from hyperkalemia. Insulin/dextrose and
polystyrene shift or remove potassium but do not immediately protect
the heart; CRRT is definitive but not the first emergency action.
Question 4
A patient is receiving IV heparin for a pulmonary embolism. Which laboratory
result requires immediate action?
A. aPTT 98 seconds (control 30-40) with new hematuria
B. Platelet count 180,000/mm3
C. Hemoglobin 13.2 g/dL
D. INR 1.1
Correct Answer: A - aPTT 98 seconds (control 30-40) with new
Page 3
, hematuria
RATIONALE
A markedly prolonged aPTT with bleeding indicates heparin toxicity
and risk for hemorrhage; the antidote is protamine sulfate. The other
values are within normal limits and do not indicate heparin-induced
complications.
Question 5
A patient with increased intracranial pressure (ICP) from a traumatic brain
injury is being positioned. Which intervention best supports cerebral
perfusion?
A. Keep head of bed at 30 degrees with head in neutral alignment
B. Place in Trendelenburg position
C. Position with head turned to the side
D. Maintain flat supine position
Correct Answer: A - Keep head of bed at 30 degrees with head in
neutral alignment
RATIONALE
Elevating the head of bed 30 degrees with neutral head alignment
promotes venous drainage and reduces ICP while maintaining cerebral
perfusion pressure. Trendelenburg, head rotation, and flat positioning
can increase ICP or impair venous return.
Question 6
A patient with a new ileostomy is at risk for which electrolyte imbalance?
A. Hyponatremia and hypokalemia
B. Hypernatremia and hyperkalemia
C. Hypercalcemia
D. Hyperphosphatemia
Correct Answer: A - Hyponatremia and hypokalemia
Page 4
