HESI Med-Surg RN Custom Exam for
Med Surg II (2025/2026) – Verified
Q&As with Images | Graded A+
Multiple-Choice Questions (1–50)
Question 1: A client with atrial fibrillation shows an irregular rhythm on an ECG strip (image:
ECG with irregular R-R intervals). Which treatment should the nurse anticipate?
A) Administer lidocaine 75 mg IV push
B) Perform synchronized cardioversion
C) Defibrillate immediately
D) Administer atropine 0.4 mg IV push
Answer: B) Perform synchronized cardioversion
Rationale: Synchronized cardioversion is the treatment of choice for uncontrolled atrial
fibrillation to restore sinus rhythm. Lidocaine (A) is for ventricular dysrhythmias, defibrillation
(C) is for ventricular fibrillation, and atropine (D) is for bradycardia.
Question 2: A client post-myocardial infarction reports chest pain (image: client clutching
chest). What is the nurse’s first action?
A) Administer aspirin
B) Notify the healthcare provider
C) Administer oxygen
D) Obtain an ECG
Answer: C) Administer oxygen
Rationale: Oxygen improves myocardial oxygenation in post-MI chest pain, prioritizing patient
safety. Aspirin (A) and ECG (D) are secondary, and notifying the provider (B) follows initial
intervention.
Question 3: A client with acute kidney injury (AKI) has a potassium level of 6.2 mEq/L. Which
medication should the nurse anticipate?
A) Furosemide
B) Sodium bicarbonate
C) Insulin and glucose
D) Spironolactone
Answer: C) Insulin and glucose
Rationale: Insulin and glucose shift potassium into cells, treating hyperkalemia in AKI.
Furosemide (A) may worsen dehydration, sodium bicarbonate (B) is for acidosis, and
spironolactone (D) increases potassium.
Question 4: A client with diabetic ketoacidosis (DKA) is admitted (image: lab results showing
pH 7.25, glucose 450 mg/dL). What is the priority nursing action?
, A) Administer insulin infusion
B) Give oral glucose
C) Restrict fluids
D) Administer potassium supplements
Answer: A) Administer insulin infusion
Rationale: Insulin corrects hyperglycemia and acidosis in DKA. Oral glucose (B) is
contraindicated, fluids (C) are needed, and potassium (D) requires monitoring first.
Question 5: Which EHR component is critical for documenting a client’s fall risk assessment in
a nursing home?
A) Billing records
B) Nursing notes
C) Social history
D) Insurance details
Answer: B) Nursing notes
Rationale: Nursing notes document fall risk assessments, ensuring care continuity for older
adults. Other options are unrelated to clinical documentation.
Question 6: A client with COPD reports shortness of breath (image: client using pursed-lip
breathing). Which intervention should the nurse implement first?
A) Administer albuterol nebulizer
B) Check oxygen saturation
C) Place in supine position
D) Administer morphine
Answer: B) Check oxygen saturation
Rationale: Checking oxygen saturation assesses hypoxia severity in COPD exacerbation.
Albuterol (A) follows assessment, supine position (C) worsens breathing, and morphine (D) is
not first-line.
Question 7: A nurse notices a medication error in an older adult’s EHR. What is the correct
action?
A) Delete the error
B) Document the correction with a note
C) Notify the patient directly
D) Ignore the error
Answer: B) Document the correction with a note
Rationale: Documenting corrections with a note maintains EHR integrity, critical for older
adults’ safety.
Question 8: A client with heart failure is prescribed furosemide. Which electrolyte imbalance
should the nurse monitor? (image: lab results panel)
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hyponatremia
Answer: B) Hypokalemia
Med Surg II (2025/2026) – Verified
Q&As with Images | Graded A+
Multiple-Choice Questions (1–50)
Question 1: A client with atrial fibrillation shows an irregular rhythm on an ECG strip (image:
ECG with irregular R-R intervals). Which treatment should the nurse anticipate?
A) Administer lidocaine 75 mg IV push
B) Perform synchronized cardioversion
C) Defibrillate immediately
D) Administer atropine 0.4 mg IV push
Answer: B) Perform synchronized cardioversion
Rationale: Synchronized cardioversion is the treatment of choice for uncontrolled atrial
fibrillation to restore sinus rhythm. Lidocaine (A) is for ventricular dysrhythmias, defibrillation
(C) is for ventricular fibrillation, and atropine (D) is for bradycardia.
Question 2: A client post-myocardial infarction reports chest pain (image: client clutching
chest). What is the nurse’s first action?
A) Administer aspirin
B) Notify the healthcare provider
C) Administer oxygen
D) Obtain an ECG
Answer: C) Administer oxygen
Rationale: Oxygen improves myocardial oxygenation in post-MI chest pain, prioritizing patient
safety. Aspirin (A) and ECG (D) are secondary, and notifying the provider (B) follows initial
intervention.
Question 3: A client with acute kidney injury (AKI) has a potassium level of 6.2 mEq/L. Which
medication should the nurse anticipate?
A) Furosemide
B) Sodium bicarbonate
C) Insulin and glucose
D) Spironolactone
Answer: C) Insulin and glucose
Rationale: Insulin and glucose shift potassium into cells, treating hyperkalemia in AKI.
Furosemide (A) may worsen dehydration, sodium bicarbonate (B) is for acidosis, and
spironolactone (D) increases potassium.
Question 4: A client with diabetic ketoacidosis (DKA) is admitted (image: lab results showing
pH 7.25, glucose 450 mg/dL). What is the priority nursing action?
, A) Administer insulin infusion
B) Give oral glucose
C) Restrict fluids
D) Administer potassium supplements
Answer: A) Administer insulin infusion
Rationale: Insulin corrects hyperglycemia and acidosis in DKA. Oral glucose (B) is
contraindicated, fluids (C) are needed, and potassium (D) requires monitoring first.
Question 5: Which EHR component is critical for documenting a client’s fall risk assessment in
a nursing home?
A) Billing records
B) Nursing notes
C) Social history
D) Insurance details
Answer: B) Nursing notes
Rationale: Nursing notes document fall risk assessments, ensuring care continuity for older
adults. Other options are unrelated to clinical documentation.
Question 6: A client with COPD reports shortness of breath (image: client using pursed-lip
breathing). Which intervention should the nurse implement first?
A) Administer albuterol nebulizer
B) Check oxygen saturation
C) Place in supine position
D) Administer morphine
Answer: B) Check oxygen saturation
Rationale: Checking oxygen saturation assesses hypoxia severity in COPD exacerbation.
Albuterol (A) follows assessment, supine position (C) worsens breathing, and morphine (D) is
not first-line.
Question 7: A nurse notices a medication error in an older adult’s EHR. What is the correct
action?
A) Delete the error
B) Document the correction with a note
C) Notify the patient directly
D) Ignore the error
Answer: B) Document the correction with a note
Rationale: Documenting corrections with a note maintains EHR integrity, critical for older
adults’ safety.
Question 8: A client with heart failure is prescribed furosemide. Which electrolyte imbalance
should the nurse monitor? (image: lab results panel)
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hyponatremia
Answer: B) Hypokalemia
