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HESI Med-Surg Nursing Test Bank 2025 | High-Yield
NCLEX Practice Qs with Answers & Rationales
1. Cardiac – Heart Failure Monitoring
Question:
A nurse is caring for a client with heart failure. Which finding should be reported to the healthcare
provider immediately?
A. Weight gain of 2 lbs in 24 hours
B. Crackles in lower lung bases
C. Pink, frothy sputum
D. Fatigue with ambulation
✅ Answer: C. Pink, frothy sputum
Rationale:
Pink, frothy sputum indicates pulmonary edema, a life-threatening complication of left-sided heart
failure. Requires immediate intervention.
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2. Respiratory – COPD Oxygen Use
Question:
A client with COPD is receiving oxygen at 4 L/min via nasal cannula. The nurse should monitor for
which complication?
A. Hyperventilation
B. Oxygen toxicity
C. Carbon dioxide retention
D. Pneumothorax
✅ Answer: C. Carbon dioxide retention
Rationale:
Clients with COPD rely on hypoxic drive. High oxygen flow can suppress respirations, leading to
CO₂ retention and respiratory acidosis.
3. Endocrine – Diabetes Sick Day Rule
Question:
Which instruction should the nurse include for a client with diabetes during illness?
A. Stop insulin if not eating
B. Monitor blood glucose every 6 hours
C. Avoid fluids to prevent nausea
D. Check urine for ketones
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✅ Answer: D. Check urine for ketones
Rationale:
During illness, blood glucose can rise even if not eating. Clients should continue insulin, monitor
glucose more frequently, and test for ketones.
4. Neuro – Stroke Priority Assessment
Question:
A client with a suspected stroke arrives in the ED. What is the nurse’s priority assessment?
A. Blood pressure
B. Facial droop
C. Blood glucose level
D. Time of symptom onset
✅ Answer: D. Time of symptom onset
Rationale:
Time of onset is critical for determining eligibility for thrombolytic therapy (tPA), which must be
given within 3–4.5 hours.
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5. Renal – Hemodialysis Complication
Question:
A client receiving hemodialysis complains of headache, nausea, and restlessness. What should the
nurse suspect?
A. Dialysis disequilibrium syndrome
B. Hypoglycemia
C. Air embolism
D. Hyperkalemia
✅ Answer: A. Dialysis disequilibrium syndrome
Rationale:
Dialysis disequilibrium occurs from rapid fluid/electrolyte shifts. Symptoms include headache,
nausea, and confusion.
6. GI – Post-Cholecystectomy Teaching
Question:
Which dietary instruction is most appropriate after a laparoscopic cholecystectomy?
A. Increase fiber intake
B. Follow a high-fat diet
C. Avoid spicy and fatty foods
D. Restrict fluids to 1 liter/day
✅ Answer: C. Avoid spicy and fatty foods
HESI Med-Surg Nursing Test Bank 2025 | High-Yield
NCLEX Practice Qs with Answers & Rationales
1. Cardiac – Heart Failure Monitoring
Question:
A nurse is caring for a client with heart failure. Which finding should be reported to the healthcare
provider immediately?
A. Weight gain of 2 lbs in 24 hours
B. Crackles in lower lung bases
C. Pink, frothy sputum
D. Fatigue with ambulation
✅ Answer: C. Pink, frothy sputum
Rationale:
Pink, frothy sputum indicates pulmonary edema, a life-threatening complication of left-sided heart
failure. Requires immediate intervention.
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2. Respiratory – COPD Oxygen Use
Question:
A client with COPD is receiving oxygen at 4 L/min via nasal cannula. The nurse should monitor for
which complication?
A. Hyperventilation
B. Oxygen toxicity
C. Carbon dioxide retention
D. Pneumothorax
✅ Answer: C. Carbon dioxide retention
Rationale:
Clients with COPD rely on hypoxic drive. High oxygen flow can suppress respirations, leading to
CO₂ retention and respiratory acidosis.
3. Endocrine – Diabetes Sick Day Rule
Question:
Which instruction should the nurse include for a client with diabetes during illness?
A. Stop insulin if not eating
B. Monitor blood glucose every 6 hours
C. Avoid fluids to prevent nausea
D. Check urine for ketones
,3
✅ Answer: D. Check urine for ketones
Rationale:
During illness, blood glucose can rise even if not eating. Clients should continue insulin, monitor
glucose more frequently, and test for ketones.
4. Neuro – Stroke Priority Assessment
Question:
A client with a suspected stroke arrives in the ED. What is the nurse’s priority assessment?
A. Blood pressure
B. Facial droop
C. Blood glucose level
D. Time of symptom onset
✅ Answer: D. Time of symptom onset
Rationale:
Time of onset is critical for determining eligibility for thrombolytic therapy (tPA), which must be
given within 3–4.5 hours.
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5. Renal – Hemodialysis Complication
Question:
A client receiving hemodialysis complains of headache, nausea, and restlessness. What should the
nurse suspect?
A. Dialysis disequilibrium syndrome
B. Hypoglycemia
C. Air embolism
D. Hyperkalemia
✅ Answer: A. Dialysis disequilibrium syndrome
Rationale:
Dialysis disequilibrium occurs from rapid fluid/electrolyte shifts. Symptoms include headache,
nausea, and confusion.
6. GI – Post-Cholecystectomy Teaching
Question:
Which dietary instruction is most appropriate after a laparoscopic cholecystectomy?
A. Increase fiber intake
B. Follow a high-fat diet
C. Avoid spicy and fatty foods
D. Restrict fluids to 1 liter/day
✅ Answer: C. Avoid spicy and fatty foods
