1
HESI Med Surg V1 Exit Exam 2025 –
Real Exam Questions | Verified Expert
Answers | 100% Graded A+ and
Updated
The following 100 multiple-choice questions (MCQs) are designed for the HESI Medical-
Surgical V1 Exit Exam 2025, aligned with the HESI Medical-Surgical curriculum. Each question
includes four answer options (A–D), with the correct answer highlighted in blue, followed by an
expert-verified rationale. The questions cover key areas such as cardiovascular, respiratory,
gastrointestinal, neurological, endocrine, renal, musculoskeletal, and integumentary systems, as
well as perioperative care, fluid and electrolyte balance, and emergency nursing. These questions
are updated to reflect current evidence-based practice and clinical standards for 2025.
1. A client with acute myocardial infarction (MI) is receiving thrombolytic therapy.
Which finding indicates the therapy is effective?
A. Increased chest pain
B. Return of ST-segment elevation to baseline
C. Elevated troponin levels
D. Decreased blood pressure
Correct Answer: B. Return of ST-segment elevation to baseline
Rationale: Thrombolytic therapy aims to dissolve clots and restore coronary blood flow,
indicated by the return of ST-segment elevation to baseline (B) on ECG, signaling
reperfusion. Increased chest pain (A) suggests ongoing ischemia, elevated troponins (C)
indicate myocardial damage but not therapy success, and decreased blood pressure (D) is
not a direct indicator. HESI Alignment: Assessing thrombolytic therapy outcomes is
critical in MI management.
2. A client with chronic obstructive pulmonary disease (COPD) is experiencing
dyspnea. Which position should the nurse assist the client into?
A. Supine
B. Prone
C. High Fowler’s
D. Trendelenburg
Correct Answer: C. High Fowler’s
Rationale: High Fowler’s position (C) maximizes lung expansion and eases breathing in
COPD. Supine (A) and prone (B) positions restrict lung expansion, and Trendelenburg
(D) is inappropriate for respiratory distress. HESI Alignment: Positioning enhances
respiratory function in COPD.
3. A client with type 2 diabetes mellitus reports nausea and vomiting. Which
laboratory value should the nurse prioritize?
, 2
A. Serum potassium
B. Blood glucose
C. Serum creatinine
D. White blood cell count
Correct Answer: B. Blood glucose
Rationale: Nausea and vomiting in diabetes (B) may indicate hyperglycemia or diabetic
ketoacidosis, requiring immediate glucose assessment. Potassium (A), creatinine (C), and
white blood cells (D) are secondary unless specific symptoms suggest otherwise. HESI
Alignment: Glucose monitoring is critical in diabetic emergencies.
4. A client is postoperative day 1 after a total hip replacement. Which assessment
finding requires immediate action?
A. Pain at the surgical site
B. Swelling in the operative leg
C. Capillary refill of 2 seconds
D. Warmth at the incision site
Correct Answer: B. Swelling in the operative leg
Rationale: Swelling in the operative leg (B) may indicate deep vein thrombosis (DVT), a
serious complication requiring immediate intervention. Pain (A) and warmth (D) are
expected, and capillary refill of 2 seconds (C) is normal. HESI Alignment: Early
detection of DVT prevents complications in postoperative care.
5. A client with heart failure is prescribed furosemide. Which electrolyte imbalance
should the nurse monitor for?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: B. Hypokalemia
Rationale: Furosemide, a loop diuretic, causes potassium loss, leading to hypokalemia
(B). Hyperkalemia (A), hypernatremia (C), and hypocalcemia (D) are less common.
HESI Alignment: Electrolyte monitoring is essential in heart failure management.
6. A client with pneumonia reports a productive cough. Which intervention should the
nurse prioritize?
A. Restrict fluid intake
B. Encourage deep breathing and coughing
C. Administer an antitussive
D. Place in a prone position
Correct Answer: B. Encourage deep breathing and coughing
Rationale: Deep breathing and coughing (B) promote airway clearance in pneumonia.
Restricting fluids (A) risks dehydration, antitussives (C) suppress productive coughs, and
prone positioning (D) is not indicated. HESI Alignment: Airway clearance is a priority
in respiratory infections.
7. A client with chronic kidney disease (CKD) is on hemodialysis. Which dietary
restriction should the nurse reinforce?
A. Low-protein diet
B. Low-potassium diet
C. High-sodium diet
, 3
D. High-calcium diet
Correct Answer: B. Low-potassium diet
Rationale: CKD patients on hemodialysis require a low-potassium diet (B) to prevent
hyperkalemia due to impaired potassium excretion. Low-protein (A) is not always
indicated, and high-sodium (C) or high-calcium (D) diets are inappropriate. HESI
Alignment: Dietary management is key in CKD.
8. A client with a traumatic brain injury has increased intracranial pressure (ICP).
Which nursing action is the priority?
A. Elevate the head of the bed to 30 degrees
B. Administer a loop diuretic
C. Encourage coughing
D. Keep the head in a neutral position
Correct Answer: A. Elevate the head of the bed to 30 degrees
Rationale: Elevating the head to 30 degrees (A) promotes venous drainage and reduces
ICP. Diuretics (B) are secondary, coughing (C) increases ICP, and neutral head position
(D) is less effective. HESI Alignment: Reducing ICP is critical in neurological care.
9. A client with peptic ulcer disease reports epigastric pain. Which medication should
the nurse expect to administer?
A. Ibuprofen
B. Omeprazole
C. Aspirin
D. Acetaminophen
Correct Answer: B. Omeprazole
Rationale: Omeprazole (B), a proton pump inhibitor, reduces acid production and
promotes ulcer healing. Ibuprofen (A) and aspirin (C) worsen ulcers, and acetaminophen
(D) does not address acid. HESI Alignment: Acid suppression is key in peptic ulcer
disease.
10. A client with atrial fibrillation is prescribed warfarin. Which laboratory value
should the nurse monitor?
A. Platelet count
B. International normalized ratio (INR)
C. Serum potassium
D. Blood glucose
Correct Answer: B. International normalized ratio (INR)
Rationale: INR (B) monitors warfarin’s anticoagulant effect to ensure therapeutic levels
(2–3 for atrial fibrillation). Platelet count (A), potassium (C), and glucose (D) are not
directly affected. HESI Alignment: Anticoagulant monitoring prevents complications.
11. A client with acute pancreatitis reports severe abdominal pain. Which position
should the nurse encourage?
A. Supine with legs elevated
B. Side-lying with knees flexed
C. Prone
D. High Fowler’s
Correct Answer: B. Side-lying with knees flexed
Rationale: Side-lying with knees flexed (B) reduces pancreatic stimulation and eases
HESI Med Surg V1 Exit Exam 2025 –
Real Exam Questions | Verified Expert
Answers | 100% Graded A+ and
Updated
The following 100 multiple-choice questions (MCQs) are designed for the HESI Medical-
Surgical V1 Exit Exam 2025, aligned with the HESI Medical-Surgical curriculum. Each question
includes four answer options (A–D), with the correct answer highlighted in blue, followed by an
expert-verified rationale. The questions cover key areas such as cardiovascular, respiratory,
gastrointestinal, neurological, endocrine, renal, musculoskeletal, and integumentary systems, as
well as perioperative care, fluid and electrolyte balance, and emergency nursing. These questions
are updated to reflect current evidence-based practice and clinical standards for 2025.
1. A client with acute myocardial infarction (MI) is receiving thrombolytic therapy.
Which finding indicates the therapy is effective?
A. Increased chest pain
B. Return of ST-segment elevation to baseline
C. Elevated troponin levels
D. Decreased blood pressure
Correct Answer: B. Return of ST-segment elevation to baseline
Rationale: Thrombolytic therapy aims to dissolve clots and restore coronary blood flow,
indicated by the return of ST-segment elevation to baseline (B) on ECG, signaling
reperfusion. Increased chest pain (A) suggests ongoing ischemia, elevated troponins (C)
indicate myocardial damage but not therapy success, and decreased blood pressure (D) is
not a direct indicator. HESI Alignment: Assessing thrombolytic therapy outcomes is
critical in MI management.
2. A client with chronic obstructive pulmonary disease (COPD) is experiencing
dyspnea. Which position should the nurse assist the client into?
A. Supine
B. Prone
C. High Fowler’s
D. Trendelenburg
Correct Answer: C. High Fowler’s
Rationale: High Fowler’s position (C) maximizes lung expansion and eases breathing in
COPD. Supine (A) and prone (B) positions restrict lung expansion, and Trendelenburg
(D) is inappropriate for respiratory distress. HESI Alignment: Positioning enhances
respiratory function in COPD.
3. A client with type 2 diabetes mellitus reports nausea and vomiting. Which
laboratory value should the nurse prioritize?
, 2
A. Serum potassium
B. Blood glucose
C. Serum creatinine
D. White blood cell count
Correct Answer: B. Blood glucose
Rationale: Nausea and vomiting in diabetes (B) may indicate hyperglycemia or diabetic
ketoacidosis, requiring immediate glucose assessment. Potassium (A), creatinine (C), and
white blood cells (D) are secondary unless specific symptoms suggest otherwise. HESI
Alignment: Glucose monitoring is critical in diabetic emergencies.
4. A client is postoperative day 1 after a total hip replacement. Which assessment
finding requires immediate action?
A. Pain at the surgical site
B. Swelling in the operative leg
C. Capillary refill of 2 seconds
D. Warmth at the incision site
Correct Answer: B. Swelling in the operative leg
Rationale: Swelling in the operative leg (B) may indicate deep vein thrombosis (DVT), a
serious complication requiring immediate intervention. Pain (A) and warmth (D) are
expected, and capillary refill of 2 seconds (C) is normal. HESI Alignment: Early
detection of DVT prevents complications in postoperative care.
5. A client with heart failure is prescribed furosemide. Which electrolyte imbalance
should the nurse monitor for?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: B. Hypokalemia
Rationale: Furosemide, a loop diuretic, causes potassium loss, leading to hypokalemia
(B). Hyperkalemia (A), hypernatremia (C), and hypocalcemia (D) are less common.
HESI Alignment: Electrolyte monitoring is essential in heart failure management.
6. A client with pneumonia reports a productive cough. Which intervention should the
nurse prioritize?
A. Restrict fluid intake
B. Encourage deep breathing and coughing
C. Administer an antitussive
D. Place in a prone position
Correct Answer: B. Encourage deep breathing and coughing
Rationale: Deep breathing and coughing (B) promote airway clearance in pneumonia.
Restricting fluids (A) risks dehydration, antitussives (C) suppress productive coughs, and
prone positioning (D) is not indicated. HESI Alignment: Airway clearance is a priority
in respiratory infections.
7. A client with chronic kidney disease (CKD) is on hemodialysis. Which dietary
restriction should the nurse reinforce?
A. Low-protein diet
B. Low-potassium diet
C. High-sodium diet
, 3
D. High-calcium diet
Correct Answer: B. Low-potassium diet
Rationale: CKD patients on hemodialysis require a low-potassium diet (B) to prevent
hyperkalemia due to impaired potassium excretion. Low-protein (A) is not always
indicated, and high-sodium (C) or high-calcium (D) diets are inappropriate. HESI
Alignment: Dietary management is key in CKD.
8. A client with a traumatic brain injury has increased intracranial pressure (ICP).
Which nursing action is the priority?
A. Elevate the head of the bed to 30 degrees
B. Administer a loop diuretic
C. Encourage coughing
D. Keep the head in a neutral position
Correct Answer: A. Elevate the head of the bed to 30 degrees
Rationale: Elevating the head to 30 degrees (A) promotes venous drainage and reduces
ICP. Diuretics (B) are secondary, coughing (C) increases ICP, and neutral head position
(D) is less effective. HESI Alignment: Reducing ICP is critical in neurological care.
9. A client with peptic ulcer disease reports epigastric pain. Which medication should
the nurse expect to administer?
A. Ibuprofen
B. Omeprazole
C. Aspirin
D. Acetaminophen
Correct Answer: B. Omeprazole
Rationale: Omeprazole (B), a proton pump inhibitor, reduces acid production and
promotes ulcer healing. Ibuprofen (A) and aspirin (C) worsen ulcers, and acetaminophen
(D) does not address acid. HESI Alignment: Acid suppression is key in peptic ulcer
disease.
10. A client with atrial fibrillation is prescribed warfarin. Which laboratory value
should the nurse monitor?
A. Platelet count
B. International normalized ratio (INR)
C. Serum potassium
D. Blood glucose
Correct Answer: B. International normalized ratio (INR)
Rationale: INR (B) monitors warfarin’s anticoagulant effect to ensure therapeutic levels
(2–3 for atrial fibrillation). Platelet count (A), potassium (C), and glucose (D) are not
directly affected. HESI Alignment: Anticoagulant monitoring prevents complications.
11. A client with acute pancreatitis reports severe abdominal pain. Which position
should the nurse encourage?
A. Supine with legs elevated
B. Side-lying with knees flexed
C. Prone
D. High Fowler’s
Correct Answer: B. Side-lying with knees flexed
Rationale: Side-lying with knees flexed (B) reduces pancreatic stimulation and eases
