HESI Med Surg EXAM 2026 Questions
and Answers
The nurse assesses a patient with shortness of breath for evidence of long-standing
hypoxemia by inspecting:
A. Chest excursion
B. Spinal curvatures
C. The respiratory pattern
D. The fingernail and its base - Correct answer-D. The fingernail and its base
Clubbing, a sign of long-standing hypoxemia, is evidenced by an increase in the
angle between the base of the nail and the fingernail to 180 degrees or more,
usually accompanied by an increase in the depth, bulk, and sponginess of the end
of the finger.
2. The nurse is caring for a patient with COPD and pneumonia who has an order
for arterial blood gases to be drawn. Which of the following is the minimum length
of time the nurse should plan to hold pressure on the puncture site?
A. 2 minutes
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,B. 5 minutes
C. 10 minutes
D. 15 minutes - Correct answer-B. 5 minutes Following obtaining an arterial blood
gas, the nurse should hold pressure on the puncture site for 5 minutes by the clock
to be sure that bleeding has stopped. An artery is an elastic vessel under higher
pressure than veins, and significant blood loss or hematoma formation could occur
if the time is insufficient.
3. The nurse notices clear nasal drainage in a patient newly admitted with facial
trauma, including a nasal fracture. The nurse should:
A. test the drainage for the presence of glucose.
B. suction the nose to maintain airway clearance.
C. document the findings and continue monitoring.
D. apply a drip pad and reassure the patient this is normal. - Correct answer-A. test
the drainage for the presence of glucose. Clear nasal drainage suggests leakage of
cerebrospinal fluid (CSF). The drainage should be tested for the presence of
glucose, which would indicate the presence of CSF.
4. When caring for a patient who is 3 hours postoperative laryngectomy, the nurse's
highest priority assessment would be:
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,A. Airway patency
B. Patient comfort
C. Incisional drainage
D. Blood pressure and heart rate - Correct answer-A. Airway patency Remember
ABCs with prioritization. Airway patency is always the highest priority and is
essential for a patient undergoing surgery surrounding the upper respiratory
system.
5. When initially teaching a patient the supraglottic swallow following a radical
neck dissection, with which of the following foods should the nurse begin?
A. Cola
B. Applesauce
C. French fries
D. White grape juice - Correct answer-A. ColaWhen learning the supraglottic
swallow, it may be helpful to start with carbonated beverages because the
effervescence provides clues about the liquid's position. Thin, watery fluids should
be avoided because they are difficult to swallow and increase the risk of aspiration.
Nonpourable pureed foods, such as applesauce, would decrease the risk of
aspiration, but carbonated beverages are the better choice to start with.
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, 6. The nurse is caring for a patient admitted to the hospital with pneumonia. Upon
assessment, the nurse notes a temperature of 101.4° F, a productive cough with
yellow sputum and a respiratory rate of 20. Which of the following nursing
diagnosis is most appropriate based upon this assessment? A. Hyperthermia related
to infectious illness
B. Ineffective thermoregulation related to chilling
C. Ineffective breathing pattern related to pneumonia
D. Ineffective airway clearance related to thick secretions - Correct answer-A.
Hyperthermia related to infectious illness Because the patient has spiked a
temperature and has a diagnosis of pneumonia, the logical nursing diagnosis is
hyperthermia related to infectious illness. There is no evidence of a chill, and her
breathing pattern is within normal limits at 20 breaths per minute. There is no
evidence of ineffective airway clearance from the information given because the
patient is expectorating sputum.
7. Which of the following physical assessment findings in a patient with
pneumonia best supports the nursing diagnosis of ineffective airway clearance? A.
Oxygen saturation of 85%
B. Respiratory rate of 28
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and Answers
The nurse assesses a patient with shortness of breath for evidence of long-standing
hypoxemia by inspecting:
A. Chest excursion
B. Spinal curvatures
C. The respiratory pattern
D. The fingernail and its base - Correct answer-D. The fingernail and its base
Clubbing, a sign of long-standing hypoxemia, is evidenced by an increase in the
angle between the base of the nail and the fingernail to 180 degrees or more,
usually accompanied by an increase in the depth, bulk, and sponginess of the end
of the finger.
2. The nurse is caring for a patient with COPD and pneumonia who has an order
for arterial blood gases to be drawn. Which of the following is the minimum length
of time the nurse should plan to hold pressure on the puncture site?
A. 2 minutes
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,B. 5 minutes
C. 10 minutes
D. 15 minutes - Correct answer-B. 5 minutes Following obtaining an arterial blood
gas, the nurse should hold pressure on the puncture site for 5 minutes by the clock
to be sure that bleeding has stopped. An artery is an elastic vessel under higher
pressure than veins, and significant blood loss or hematoma formation could occur
if the time is insufficient.
3. The nurse notices clear nasal drainage in a patient newly admitted with facial
trauma, including a nasal fracture. The nurse should:
A. test the drainage for the presence of glucose.
B. suction the nose to maintain airway clearance.
C. document the findings and continue monitoring.
D. apply a drip pad and reassure the patient this is normal. - Correct answer-A. test
the drainage for the presence of glucose. Clear nasal drainage suggests leakage of
cerebrospinal fluid (CSF). The drainage should be tested for the presence of
glucose, which would indicate the presence of CSF.
4. When caring for a patient who is 3 hours postoperative laryngectomy, the nurse's
highest priority assessment would be:
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,A. Airway patency
B. Patient comfort
C. Incisional drainage
D. Blood pressure and heart rate - Correct answer-A. Airway patency Remember
ABCs with prioritization. Airway patency is always the highest priority and is
essential for a patient undergoing surgery surrounding the upper respiratory
system.
5. When initially teaching a patient the supraglottic swallow following a radical
neck dissection, with which of the following foods should the nurse begin?
A. Cola
B. Applesauce
C. French fries
D. White grape juice - Correct answer-A. ColaWhen learning the supraglottic
swallow, it may be helpful to start with carbonated beverages because the
effervescence provides clues about the liquid's position. Thin, watery fluids should
be avoided because they are difficult to swallow and increase the risk of aspiration.
Nonpourable pureed foods, such as applesauce, would decrease the risk of
aspiration, but carbonated beverages are the better choice to start with.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, 6. The nurse is caring for a patient admitted to the hospital with pneumonia. Upon
assessment, the nurse notes a temperature of 101.4° F, a productive cough with
yellow sputum and a respiratory rate of 20. Which of the following nursing
diagnosis is most appropriate based upon this assessment? A. Hyperthermia related
to infectious illness
B. Ineffective thermoregulation related to chilling
C. Ineffective breathing pattern related to pneumonia
D. Ineffective airway clearance related to thick secretions - Correct answer-A.
Hyperthermia related to infectious illness Because the patient has spiked a
temperature and has a diagnosis of pneumonia, the logical nursing diagnosis is
hyperthermia related to infectious illness. There is no evidence of a chill, and her
breathing pattern is within normal limits at 20 breaths per minute. There is no
evidence of ineffective airway clearance from the information given because the
patient is expectorating sputum.
7. Which of the following physical assessment findings in a patient with
pneumonia best supports the nursing diagnosis of ineffective airway clearance? A.
Oxygen saturation of 85%
B. Respiratory rate of 28
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