1
HESI Med-Surg RN Custom
Exam for Med Surg II
(2025/2026) – Verified Q&As
with Images | Graded A+
1. A client with heart failure has jugular vein distention (JVD). What should the nurse
prioritize?
a) Administer oxygen at 4 L/min
b) Notify the healthcare provider
c) Encourage fluid intake
d) Place in a supine position
Rationale: JVD indicates worsening fluid overload in heart failure, requiring immediate
provider notification for intervention, per HESI Med -Surg standards for critical
assessment.
2. Image Placeholder: Chest X-ray showing bilateral infiltrates.
A client’s chest X-ray shows bilateral infiltrates. What condition should the nurse
suspect?
a) Pneumothorax
b) Pulmonary edema
c) Chronic bronchitis
d) Asthma
Rationale: Bilateral infiltrates on a chest X-ray suggest fluid in the lungs, characteristic
of pulmonary edema, often linked to heart failure, per HESI Med -Surg diagnostic
standards.
3. A client with diabetic ketoacidosis (DKA) has a blood glucose of 600 mg/dL. What is
the priority intervention?
a) Administer oral glucose
b) Initiate IV insulin as prescribed
c) Restrict all fluids
d) Encourage ambulation
Rationale: IV insulin corrects hyperglycemia in DKA, a critical intervention to prevent
further acidosis, per HESI Med-Surg endocrine standards.
4. What should the nurse teach a client with COPD about pursed-lip breathing?
a) Inhale deeply through the mouth
b) Exhale slowly through pursed lips
c) Hold breath for 10 seconds
, 2
d) Breathe rapidly through the nose
Rationale: Pursed-lip breathing prolongs exhalation, reducing air trapping in COPD, per
HESI Med-Surg patient teaching standards.
5. A client with acute pancreatitis reports severe epigastric pain. What should the
nurse do first?
a) Encourage oral fluids
b) Administer analgesics as prescribed
c) Position supine
d) Restrict all movement
Rationale: Pain management is a priority in acute pancreatitis to improve comfort and
reduce stress, per HESI Med-Surg acute care standards.
6. Image Placeholder: ECG strip showing ST elevation.
An ECG shows ST elevation in leads V1–V4. What should the nurse suspect?
a) Atrial fibrillation
b) Acute myocardial infarction
c) Pericarditis
d) Ventricular tachycardia
Rationale: ST elevation in anterior leads (V1–V4) indicates an acute myocardial
infarction, requiring urgent intervention, per HESI Med -Surg cardiovascular standards.
7. A client with a new colostomy asks about dietary restrictions. What should the
nurse teach?
a) Avoid all fiber
b) Eat small, frequent meals and chew thoroughly
c) Restrict protein intake
d) Limit fluid intake
Rationale: Small, frequent meals and thorough chewing prevent blockages and promote
stoma function, per HESI Med-Surg patient teaching standards.
8. A client with pneumonia has a temperature of 102.4°F. What should the nurse do
first?
a) Restrict fluids
b) Administer antipyretics as prescribed
c) Encourage coughing
d) Limit oxygen therapy
Rationale: Antipyretics reduce fever and improve comfort in pneumonia, a priority
intervention, per HESI Med-Surg infection standards.
9. Which finding in a client with cirrhosis indicates worsening portal hypertension?
a) Decreased heart rate
b) Esophageal varices
c) Normal blood pressure
d) Clear lung sounds
Rationale: Esophageal varices result from increased portal vein pressure, a complication
of cirrhosis, per HESI Med-Surg hepatic standards.
10. Image Placeholder: Skin assessment showing stage II pressure ulcer.
A client has a stage II pressure ulcer. What should the nurse prioritize?
a) Apply heat therapy
b) Keep the area clean and moist
HESI Med-Surg RN Custom
Exam for Med Surg II
(2025/2026) – Verified Q&As
with Images | Graded A+
1. A client with heart failure has jugular vein distention (JVD). What should the nurse
prioritize?
a) Administer oxygen at 4 L/min
b) Notify the healthcare provider
c) Encourage fluid intake
d) Place in a supine position
Rationale: JVD indicates worsening fluid overload in heart failure, requiring immediate
provider notification for intervention, per HESI Med -Surg standards for critical
assessment.
2. Image Placeholder: Chest X-ray showing bilateral infiltrates.
A client’s chest X-ray shows bilateral infiltrates. What condition should the nurse
suspect?
a) Pneumothorax
b) Pulmonary edema
c) Chronic bronchitis
d) Asthma
Rationale: Bilateral infiltrates on a chest X-ray suggest fluid in the lungs, characteristic
of pulmonary edema, often linked to heart failure, per HESI Med -Surg diagnostic
standards.
3. A client with diabetic ketoacidosis (DKA) has a blood glucose of 600 mg/dL. What is
the priority intervention?
a) Administer oral glucose
b) Initiate IV insulin as prescribed
c) Restrict all fluids
d) Encourage ambulation
Rationale: IV insulin corrects hyperglycemia in DKA, a critical intervention to prevent
further acidosis, per HESI Med-Surg endocrine standards.
4. What should the nurse teach a client with COPD about pursed-lip breathing?
a) Inhale deeply through the mouth
b) Exhale slowly through pursed lips
c) Hold breath for 10 seconds
, 2
d) Breathe rapidly through the nose
Rationale: Pursed-lip breathing prolongs exhalation, reducing air trapping in COPD, per
HESI Med-Surg patient teaching standards.
5. A client with acute pancreatitis reports severe epigastric pain. What should the
nurse do first?
a) Encourage oral fluids
b) Administer analgesics as prescribed
c) Position supine
d) Restrict all movement
Rationale: Pain management is a priority in acute pancreatitis to improve comfort and
reduce stress, per HESI Med-Surg acute care standards.
6. Image Placeholder: ECG strip showing ST elevation.
An ECG shows ST elevation in leads V1–V4. What should the nurse suspect?
a) Atrial fibrillation
b) Acute myocardial infarction
c) Pericarditis
d) Ventricular tachycardia
Rationale: ST elevation in anterior leads (V1–V4) indicates an acute myocardial
infarction, requiring urgent intervention, per HESI Med -Surg cardiovascular standards.
7. A client with a new colostomy asks about dietary restrictions. What should the
nurse teach?
a) Avoid all fiber
b) Eat small, frequent meals and chew thoroughly
c) Restrict protein intake
d) Limit fluid intake
Rationale: Small, frequent meals and thorough chewing prevent blockages and promote
stoma function, per HESI Med-Surg patient teaching standards.
8. A client with pneumonia has a temperature of 102.4°F. What should the nurse do
first?
a) Restrict fluids
b) Administer antipyretics as prescribed
c) Encourage coughing
d) Limit oxygen therapy
Rationale: Antipyretics reduce fever and improve comfort in pneumonia, a priority
intervention, per HESI Med-Surg infection standards.
9. Which finding in a client with cirrhosis indicates worsening portal hypertension?
a) Decreased heart rate
b) Esophageal varices
c) Normal blood pressure
d) Clear lung sounds
Rationale: Esophageal varices result from increased portal vein pressure, a complication
of cirrhosis, per HESI Med-Surg hepatic standards.
10. Image Placeholder: Skin assessment showing stage II pressure ulcer.
A client has a stage II pressure ulcer. What should the nurse prioritize?
a) Apply heat therapy
b) Keep the area clean and moist
