HESI Med Surg Exam Part 2 (Latest
2026/2027 Update) Complete Q&A
with Verified Answers and Detailed
Rationales Cardiovascular,
HESI Med Surg Exam Part 2 (Latest | Comprehensive Examination
HESI Med Surg Exam Part 2 (Latest 2026/2027 Update)
Complete Q&A with Verified Answers and Detailed
Rationales Cardiovascular, Respiratory, Renal, Endocrine,
INTRODUCTION
This document is an important and very helpful preparation
resource for HESI Med Surg Exam Part 2 (Latest 2026/2027
Update) Complete Q&A with Verified Answers and Detailed
Rationales Cardiovascular, Respiratory, Renal, Endocrine,
Neurological, Emergency Nursing A+ Graded BSN 266. 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 continuous IV
furosemide. Which assessment finding requires immediate intervention?
A. Urine output of 100 mL/hr
B. Serum potassium of 3.1 mEq/L
C. Blood pressure 110/70 mm Hg
D. Weight loss of 1 kg in 24 hours
Correct Answer: B - Serum potassium of 3.1 mEq/L
RATIONALE
Hypokalemia (K+ <3.5 mEq/L) predisposes to lethal dysrhythmias in
heart failure patients on loop diuretics; immediate replacement is
essential. Options A, C, and D reflect expected therapeutic effects or
acceptable parameters.
Question 2
Which arterial blood gas value indicates that a patient with COPD is retaining
carbon dioxide and requires immediate intervention?
A. pH 7.32, PaCO2 58 mm Hg
B. pH 7.45, PaCO2 35 mm Hg
C. pH 7.38, PaCO2 42 mm Hg
D. pH 7.48, PaCO2 30 mm Hg
Correct Answer: A - pH 7.32, PaCO2 58 mm Hg
RATIONALE
A pH <7.35 with PaCO2 >45 mm Hg indicates respiratory acidosis
from CO2 retention, necessitating urgent intervention to improve
ventilation. Options B, C, and D represent alkalosis or normal values.
Page 2
, Question 3
A patient with chronic kidney disease has a glomerular filtration rate of 12
mL/min/1.73 m2. Which medication is contraindicated?
A. Epoetin alfa
B. Metformin
C. Calcium acetate
D. Furosemide
Correct Answer: B - Metformin
RATIONALE
Metformin is contraindicated when GFR <30 mL/min/1.73 m2 due to
increased risk of lactic acidosis. Epoetin alfa, calcium acetate, and
furosemide are commonly used in CKD management.
Question 4
Which finding in a patient with diabetic ketoacidosis indicates that treatment is
effective?
A. Serum glucose 450 mg/dL
B. Serum bicarbonate 12 mEq/L
C. Urine ketones large
D. Serum potassium 4.0 mEq/L
Correct Answer: D - Serum potassium 4.0 mEq/L
RATIONALE
A normal potassium level (4.0 mEq/L) indicates that insulin and fluid
replacement are correcting the acidosis and shifting potassium back
into cells. The other options indicate ongoing hyperglycemia, acidosis,
or ketosis.
Page 3
, Question 5
A patient with a traumatic brain injury has a Glasgow Coma Scale score of 7.
Which nursing action is the priority?
A. Perform oral care every 4 hours
B. Maintain head of bed at 30 degrees
C. Suction the airway every 2 hours
D. Administer mannitol as prescribed
Correct Answer: B - Maintain head of bed at 30 degrees
RATIONALE
Elevating the head of the bed to 30 degrees promotes venous drainage
and reduces intracranial pressure, a priority in severe TBI. Suctioning
can increase ICP; mannitol is given for increased ICP but is not the
immediate priority over positioning.
Question 6
A patient arrives in the emergency department with a tension pneumothorax.
Which intervention should the nurse anticipate?
A. Chest tube insertion at the 5th intercostal space
B. Needle decompression at the 2nd intercostal space
C. Administration of high-flow oxygen
D. Pericardiocentesis
Correct Answer: B - Needle decompression at the 2nd intercostal
space
RATIONALE
Tension pneumothorax requires immediate needle decompression at
the 2nd intercostal space to relieve pressure and prevent
cardiovascular collapse. Chest tube insertion is definitive but not
immediate; pericardiocentesis is for cardiac tamponade.
Page 4
2026/2027 Update) Complete Q&A
with Verified Answers and Detailed
Rationales Cardiovascular,
HESI Med Surg Exam Part 2 (Latest | Comprehensive Examination
HESI Med Surg Exam Part 2 (Latest 2026/2027 Update)
Complete Q&A with Verified Answers and Detailed
Rationales Cardiovascular, Respiratory, Renal, Endocrine,
INTRODUCTION
This document is an important and very helpful preparation
resource for HESI Med Surg Exam Part 2 (Latest 2026/2027
Update) Complete Q&A with Verified Answers and Detailed
Rationales Cardiovascular, Respiratory, Renal, Endocrine,
Neurological, Emergency Nursing A+ Graded BSN 266. 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 continuous IV
furosemide. Which assessment finding requires immediate intervention?
A. Urine output of 100 mL/hr
B. Serum potassium of 3.1 mEq/L
C. Blood pressure 110/70 mm Hg
D. Weight loss of 1 kg in 24 hours
Correct Answer: B - Serum potassium of 3.1 mEq/L
RATIONALE
Hypokalemia (K+ <3.5 mEq/L) predisposes to lethal dysrhythmias in
heart failure patients on loop diuretics; immediate replacement is
essential. Options A, C, and D reflect expected therapeutic effects or
acceptable parameters.
Question 2
Which arterial blood gas value indicates that a patient with COPD is retaining
carbon dioxide and requires immediate intervention?
A. pH 7.32, PaCO2 58 mm Hg
B. pH 7.45, PaCO2 35 mm Hg
C. pH 7.38, PaCO2 42 mm Hg
D. pH 7.48, PaCO2 30 mm Hg
Correct Answer: A - pH 7.32, PaCO2 58 mm Hg
RATIONALE
A pH <7.35 with PaCO2 >45 mm Hg indicates respiratory acidosis
from CO2 retention, necessitating urgent intervention to improve
ventilation. Options B, C, and D represent alkalosis or normal values.
Page 2
, Question 3
A patient with chronic kidney disease has a glomerular filtration rate of 12
mL/min/1.73 m2. Which medication is contraindicated?
A. Epoetin alfa
B. Metformin
C. Calcium acetate
D. Furosemide
Correct Answer: B - Metformin
RATIONALE
Metformin is contraindicated when GFR <30 mL/min/1.73 m2 due to
increased risk of lactic acidosis. Epoetin alfa, calcium acetate, and
furosemide are commonly used in CKD management.
Question 4
Which finding in a patient with diabetic ketoacidosis indicates that treatment is
effective?
A. Serum glucose 450 mg/dL
B. Serum bicarbonate 12 mEq/L
C. Urine ketones large
D. Serum potassium 4.0 mEq/L
Correct Answer: D - Serum potassium 4.0 mEq/L
RATIONALE
A normal potassium level (4.0 mEq/L) indicates that insulin and fluid
replacement are correcting the acidosis and shifting potassium back
into cells. The other options indicate ongoing hyperglycemia, acidosis,
or ketosis.
Page 3
, Question 5
A patient with a traumatic brain injury has a Glasgow Coma Scale score of 7.
Which nursing action is the priority?
A. Perform oral care every 4 hours
B. Maintain head of bed at 30 degrees
C. Suction the airway every 2 hours
D. Administer mannitol as prescribed
Correct Answer: B - Maintain head of bed at 30 degrees
RATIONALE
Elevating the head of the bed to 30 degrees promotes venous drainage
and reduces intracranial pressure, a priority in severe TBI. Suctioning
can increase ICP; mannitol is given for increased ICP but is not the
immediate priority over positioning.
Question 6
A patient arrives in the emergency department with a tension pneumothorax.
Which intervention should the nurse anticipate?
A. Chest tube insertion at the 5th intercostal space
B. Needle decompression at the 2nd intercostal space
C. Administration of high-flow oxygen
D. Pericardiocentesis
Correct Answer: B - Needle decompression at the 2nd intercostal
space
RATIONALE
Tension pneumothorax requires immediate needle decompression at
the 2nd intercostal space to relieve pressure and prevent
cardiovascular collapse. Chest tube insertion is definitive but not
immediate; pericardiocentesis is for cardiac tamponade.
Page 4
