HESI RN Med-Surg Comprehensive Exam
2025/2026 | Complete Exam with NGN (Next
Generation NCLEX) Questions & Correct Answers
HESI RN Medical-Surgical Comprehensive Exam | Key Concepts: Adult Health, Complex
Disease Management, Pharmacology, Diagnostic Testing, Priority Nursing Interventions,
Patient Safety, Critical Care, and NGN Case Studies | Expert-Verified Q&A | Clinical &
Exam-Ready
Introduction
This updated 2025/2026 HESI RN Med-Surg Comprehensive Exam resource includes 180 fully
verified questions with 100% correct answers, featuring NGN-style case studies and alternate
item formats. Content covers critical areas of adult health nursing including pathophysiology,
pharmacologic management, diagnostics, evidence-based interventions, safety protocols, and
priority setting. All answers are graded A+ and ensure complete preparation for both HESI and
NGN exam success.
Answer Format
All correct answers are highlighted in bold and green, with rationales that explain nursing
priorities, reinforce clinical reasoning, and strengthen decision-making for NGN readiness.
HESI RN Med-Surg Comprehensive Exam Practice Questions (1–180)
1. A client with chronic kidney disease is experiencing hyperkalemia. Which
food should the nurse instruct the client to avoid?
a) Apples
b) Bananas
c) Carrots
d) Broccoli
b) Bananas
Rationale: Bananas are high in potassium, which should be avoided in hyperkalemia to prevent
cardiac complications.
2. A client is admitted with acute pancreatitis. Which laboratory value is
most indicative of this diagnosis?
a) Elevated serum amylase
b) Decreased white blood cell count
c) Elevated hemoglobin
d) Decreased serum glucose
,a) Elevated serum amylase
Rationale: Elevated serum amylase is a key diagnostic marker for acute pancreatitis.
3. A client with a history of heart failure is prescribed furosemide. Which
electrolyte imbalance should the nurse monitor for?
a) Hyperkalemia
b) Hypokalemia
c) Hypernatremia
d) Hyponatremia
b) Hypokalemia
Rationale: Furosemide, a loop diuretic, causes potassium loss, leading to hypokalemia.
4. A client is receiving heparin therapy. Which laboratory value should the
nurse monitor?
a) INR
b) aPTT
c) PT
d) Platelet count
b) aPTT
Rationale: aPTT is used to monitor heparin therapy, with a therapeutic range of 1.5–2.5 times
baseline.
5. A client with diabetes mellitus is experiencing hypoglycemia. Which
symptom is most indicative?
a) Polyuria
b) Tremors
c) Polydipsia
d) Weight gain
b) Tremors
Rationale: Tremors are a common symptom of hypoglycemia due to sympathetic activation.
6. A client is admitted with a suspected myocardial infarction. Which
enzyme is most specific for diagnosis?
a) CK-MB
b) Troponin I
c) LDH
d) AST
b) Troponin I
Rationale: Troponin I is the most specific marker for myocardial infarction, with high
sensitivity.
7. A client with COPD is experiencing an exacerbation. Which medication
should the nurse expect to administer?
a) Albuterol nebulizer
b) Furosemide
c) Heparin
,d) Insulin
a) Albuterol nebulizer
Rationale: Albuterol, a bronchodilator, is first-line for COPD exacerbations to relieve
bronchospasm.
8. A client is postoperative day 1 after abdominal surgery. Which
assessment finding indicates a complication?
a) Clear lung sounds
b) Absent bowel sounds
c) Urine output of 50 mL/hr
d) Temperature of 98.6°F
b) Absent bowel sounds
Rationale: Absent bowel sounds may indicate paralytic ileus, a common postoperative
complication.
9. A client with a peptic ulcer is prescribed omeprazole. What is the purpose
of this medication?
a) Increase gastric acid production
b) Reduce gastric acid production
c) Coat the stomach lining
d) Kill H. pylori bacteria
b) Reduce gastric acid production
Rationale: Omeprazole, a proton pump inhibitor, reduces gastric acid production to promote
ulcer healing.
10. A client with cirrhosis is experiencing ascites. Which medication should
the nurse expect to administer?
a) Furosemide
b) Spironolactone
c) Mannitol
d) Acetaminophen
b) Spironolactone
Rationale: Spironolactone, a potassium-sparing diuretic, is first-line for ascites in cirrhosis to
reduce fluid retention.
11. A client with atrial fibrillation is prescribed warfarin. Which dietary
recommendation should the nurse provide?
a) Increase intake of leafy green vegetables
b) Maintain consistent intake of vitamin K-rich foods
c) Avoid all dairy products
d) Eliminate carbohydrates
b) Maintain consistent intake of vitamin K-rich foods
Rationale: Warfarin’s anticoagulant effect is influenced by vitamin K. Consistent intake of
vitamin K-rich foods ensures stable INR levels.
, 12. A client with a suspected pulmonary embolism is admitted. Which
diagnostic test should the nurse expect to be ordered?
a) Chest X-ray
b) CT pulmonary angiography
c) ECG
d) ABG analysis
b) CT pulmonary angiography
Rationale: CT pulmonary angiography is the gold standard for diagnosing pulmonary
embolism.
13. A client with type 2 diabetes is prescribed metformin. Which side effect
should the nurse monitor for?
a) Hypoglycemia
b) Lactic acidosis
c) Hyperkalemia
d) Weight gain
b) Lactic acidosis
Rationale: Metformin can rarely cause lactic acidosis, a serious side effect, especially in renal
impairment.
14. A client with a history of stroke presents with dysphagia. Which nursing
intervention is the priority?
a) Administer oral medications
b) Perform a swallow evaluation
c) Encourage fluid intake
d) Place in a high Fowler’s position
b) Perform a swallow evaluation
Rationale: A swallow evaluation is critical to prevent aspiration in clients with dysphagia.
15. A client is receiving chemotherapy and reports nausea. Which
medication should the nurse anticipate?
a) Ondansetron
b) Diphenhydramine
c) Lorazepam
d) Morphine
a) Ondansetron
Rationale: Ondansetron, a 5-HT3 receptor antagonist, is first-line for chemotherapy-induced
nausea.
16. A client with a fractured femur is in traction. Which assessment finding
requires immediate intervention?
a) Pain at the fracture site
b) Numbness in the toes
c) Localized swelling
d) Mild muscle spasms
2025/2026 | Complete Exam with NGN (Next
Generation NCLEX) Questions & Correct Answers
HESI RN Medical-Surgical Comprehensive Exam | Key Concepts: Adult Health, Complex
Disease Management, Pharmacology, Diagnostic Testing, Priority Nursing Interventions,
Patient Safety, Critical Care, and NGN Case Studies | Expert-Verified Q&A | Clinical &
Exam-Ready
Introduction
This updated 2025/2026 HESI RN Med-Surg Comprehensive Exam resource includes 180 fully
verified questions with 100% correct answers, featuring NGN-style case studies and alternate
item formats. Content covers critical areas of adult health nursing including pathophysiology,
pharmacologic management, diagnostics, evidence-based interventions, safety protocols, and
priority setting. All answers are graded A+ and ensure complete preparation for both HESI and
NGN exam success.
Answer Format
All correct answers are highlighted in bold and green, with rationales that explain nursing
priorities, reinforce clinical reasoning, and strengthen decision-making for NGN readiness.
HESI RN Med-Surg Comprehensive Exam Practice Questions (1–180)
1. A client with chronic kidney disease is experiencing hyperkalemia. Which
food should the nurse instruct the client to avoid?
a) Apples
b) Bananas
c) Carrots
d) Broccoli
b) Bananas
Rationale: Bananas are high in potassium, which should be avoided in hyperkalemia to prevent
cardiac complications.
2. A client is admitted with acute pancreatitis. Which laboratory value is
most indicative of this diagnosis?
a) Elevated serum amylase
b) Decreased white blood cell count
c) Elevated hemoglobin
d) Decreased serum glucose
,a) Elevated serum amylase
Rationale: Elevated serum amylase is a key diagnostic marker for acute pancreatitis.
3. A client with a history of heart failure is prescribed furosemide. Which
electrolyte imbalance should the nurse monitor for?
a) Hyperkalemia
b) Hypokalemia
c) Hypernatremia
d) Hyponatremia
b) Hypokalemia
Rationale: Furosemide, a loop diuretic, causes potassium loss, leading to hypokalemia.
4. A client is receiving heparin therapy. Which laboratory value should the
nurse monitor?
a) INR
b) aPTT
c) PT
d) Platelet count
b) aPTT
Rationale: aPTT is used to monitor heparin therapy, with a therapeutic range of 1.5–2.5 times
baseline.
5. A client with diabetes mellitus is experiencing hypoglycemia. Which
symptom is most indicative?
a) Polyuria
b) Tremors
c) Polydipsia
d) Weight gain
b) Tremors
Rationale: Tremors are a common symptom of hypoglycemia due to sympathetic activation.
6. A client is admitted with a suspected myocardial infarction. Which
enzyme is most specific for diagnosis?
a) CK-MB
b) Troponin I
c) LDH
d) AST
b) Troponin I
Rationale: Troponin I is the most specific marker for myocardial infarction, with high
sensitivity.
7. A client with COPD is experiencing an exacerbation. Which medication
should the nurse expect to administer?
a) Albuterol nebulizer
b) Furosemide
c) Heparin
,d) Insulin
a) Albuterol nebulizer
Rationale: Albuterol, a bronchodilator, is first-line for COPD exacerbations to relieve
bronchospasm.
8. A client is postoperative day 1 after abdominal surgery. Which
assessment finding indicates a complication?
a) Clear lung sounds
b) Absent bowel sounds
c) Urine output of 50 mL/hr
d) Temperature of 98.6°F
b) Absent bowel sounds
Rationale: Absent bowel sounds may indicate paralytic ileus, a common postoperative
complication.
9. A client with a peptic ulcer is prescribed omeprazole. What is the purpose
of this medication?
a) Increase gastric acid production
b) Reduce gastric acid production
c) Coat the stomach lining
d) Kill H. pylori bacteria
b) Reduce gastric acid production
Rationale: Omeprazole, a proton pump inhibitor, reduces gastric acid production to promote
ulcer healing.
10. A client with cirrhosis is experiencing ascites. Which medication should
the nurse expect to administer?
a) Furosemide
b) Spironolactone
c) Mannitol
d) Acetaminophen
b) Spironolactone
Rationale: Spironolactone, a potassium-sparing diuretic, is first-line for ascites in cirrhosis to
reduce fluid retention.
11. A client with atrial fibrillation is prescribed warfarin. Which dietary
recommendation should the nurse provide?
a) Increase intake of leafy green vegetables
b) Maintain consistent intake of vitamin K-rich foods
c) Avoid all dairy products
d) Eliminate carbohydrates
b) Maintain consistent intake of vitamin K-rich foods
Rationale: Warfarin’s anticoagulant effect is influenced by vitamin K. Consistent intake of
vitamin K-rich foods ensures stable INR levels.
, 12. A client with a suspected pulmonary embolism is admitted. Which
diagnostic test should the nurse expect to be ordered?
a) Chest X-ray
b) CT pulmonary angiography
c) ECG
d) ABG analysis
b) CT pulmonary angiography
Rationale: CT pulmonary angiography is the gold standard for diagnosing pulmonary
embolism.
13. A client with type 2 diabetes is prescribed metformin. Which side effect
should the nurse monitor for?
a) Hypoglycemia
b) Lactic acidosis
c) Hyperkalemia
d) Weight gain
b) Lactic acidosis
Rationale: Metformin can rarely cause lactic acidosis, a serious side effect, especially in renal
impairment.
14. A client with a history of stroke presents with dysphagia. Which nursing
intervention is the priority?
a) Administer oral medications
b) Perform a swallow evaluation
c) Encourage fluid intake
d) Place in a high Fowler’s position
b) Perform a swallow evaluation
Rationale: A swallow evaluation is critical to prevent aspiration in clients with dysphagia.
15. A client is receiving chemotherapy and reports nausea. Which
medication should the nurse anticipate?
a) Ondansetron
b) Diphenhydramine
c) Lorazepam
d) Morphine
a) Ondansetron
Rationale: Ondansetron, a 5-HT3 receptor antagonist, is first-line for chemotherapy-induced
nausea.
16. A client with a fractured femur is in traction. Which assessment finding
requires immediate intervention?
a) Pain at the fracture site
b) Numbness in the toes
c) Localized swelling
d) Mild muscle spasms
