HESI MEDSURG1 QUESTIONS AND ANSWERS
2026 COMPREHENSIVE EXAM SCRIPT FULL
QUESTIONS AND CORRECT ANSWERS
◉ The nurse is preparing a teaching plan for a client who is newly
diagnosed with Type 1 diabetes mellitus. Which signs and symptoms
should the nurse describe when teaching the client about
hypoglycemia?
A) Sweating, trembling, tachycardia.
B) Polyuria, polydipsia, polyphagia.
C) Nausea, vomiting, anorexia.
D) Fruity breath, tachypnea, chest pain. Answer: A) Sweating,
trembling, tachycardia.
Rationale: Sweating, dizziness, and trembling are signs of
hypoglycemic reactions related to the release of epinephrine as a
compensatory response to the low blood sugar (A). (B, C, and D) do
not describe common symptoms of hypoglycemia.
◉ Which reaction should the nurse identify in a client who is
responding to stimulation of the sympathetic nervous system?
,A) Pupil constriction.
B) Increased heart rate.
C) Bronchial constriction.
D) Decreased blood pressure. Answer: B) Increased heart rate.
Rationale: Any stressor that is perceived as threatening to
homeostasis acts to stimulate the sympathetic nervous system and
manifests as a flight-or-fight response, which includes an increase in
heart rate (B). (A, C, and D) are responses of the parasympathetic
nervous system.
◉ Which client should the nurse recognize as most likely to
experience sleep apnea?
A) Middle-aged female who takes a diuretic nightly.
B) Obese older male client with a short, thick neck.
C) Adolescent female with a history of tonsillectomy.
D) School-aged male with a history of hyperactivity disorder.
Answer: B) Obese older male client with a short, thick neck.
Rationale: Sleep apnea is characterized by lack of respirations for 10
seconds or more during sleep and is due to the loss of pharyngeal
tone which allows the pharynx to collapse during inspiration and
obstructs air flow through the nose and mouth. With obstructive
,sleep apnea, the client is often obese or has a short, thick neck as in
(B). (A, C, and D) are not typically prone to sleep apnea.
◉ To decrease the risk of acid-base imbalance, what goal must the
client with diabetes mellitus strive for?
A) Checking blood glucose levels once daily
B) Drinking 3 L of fluid per day
C) Eating regularly, every 4 to 8 hours
D) Maintaining blood glucose level within normal limits Answer: D)
Maintaining blood glucose level within normal limits
Rationale: Maintaining blood glucose levels within normal limits is
the best way to decrease the risk of acid-base imbalance. A) Blood
glucose levels must be checked several times a day. B) Drinking 3 L
of fluid per day is not necessary to maintain acid-base balance. C)
Eating regularly is a way to achieve acid-base balance but is not the
goal itself.
◉ After the fourth dose of gentamicin sulfate (Garamycin) IV, the
nurse plans to draw blood samples to determine peak and trough
levels. When are the best times to draw these samples?
A) 15 minutes before and 15 minutes after the next dose.
, B) One hour before and one hour after the next dose.
C) 5 minutes before and 30 minutes after the next dose.
D) 30 minutes before and 30 minutes after the next dose. Answer: C)
5 minutes before and 30 minutes after the next dose.
Rationale: Peak drug serum levels are achieved 30 minutes after IV
administration of aminoglycosides. The best time to draw a trough is
the closest time to the next administration (C). (A, B, and D) are not
as good a time to draw the trough as (C). (B and D) are not the best
times to draw the peak of an aminoglycoside that has been
administered IV.
◉ The nurse is caring for a client with an oxygen saturation of 88%
and accessory muscle use. The nurse provides oxygen and
anticipates which of these physician orders?
A) Administration of IV sodium bicarbonate
B) Computed tomography (CT) of the chest, stat
C) Intubation and mechanical ventilation
D) Administration of concentrated potassium chloride solution
Answer: C) Intubation and mechanical ventilation
Rationale: Support with mechanical ventilation may be needed for
clients who cannot keep their oxygen saturation at 90% or who have
respiratory muscle fatigue. A) Sodium bicarbonate is used to treat
2026 COMPREHENSIVE EXAM SCRIPT FULL
QUESTIONS AND CORRECT ANSWERS
◉ The nurse is preparing a teaching plan for a client who is newly
diagnosed with Type 1 diabetes mellitus. Which signs and symptoms
should the nurse describe when teaching the client about
hypoglycemia?
A) Sweating, trembling, tachycardia.
B) Polyuria, polydipsia, polyphagia.
C) Nausea, vomiting, anorexia.
D) Fruity breath, tachypnea, chest pain. Answer: A) Sweating,
trembling, tachycardia.
Rationale: Sweating, dizziness, and trembling are signs of
hypoglycemic reactions related to the release of epinephrine as a
compensatory response to the low blood sugar (A). (B, C, and D) do
not describe common symptoms of hypoglycemia.
◉ Which reaction should the nurse identify in a client who is
responding to stimulation of the sympathetic nervous system?
,A) Pupil constriction.
B) Increased heart rate.
C) Bronchial constriction.
D) Decreased blood pressure. Answer: B) Increased heart rate.
Rationale: Any stressor that is perceived as threatening to
homeostasis acts to stimulate the sympathetic nervous system and
manifests as a flight-or-fight response, which includes an increase in
heart rate (B). (A, C, and D) are responses of the parasympathetic
nervous system.
◉ Which client should the nurse recognize as most likely to
experience sleep apnea?
A) Middle-aged female who takes a diuretic nightly.
B) Obese older male client with a short, thick neck.
C) Adolescent female with a history of tonsillectomy.
D) School-aged male with a history of hyperactivity disorder.
Answer: B) Obese older male client with a short, thick neck.
Rationale: Sleep apnea is characterized by lack of respirations for 10
seconds or more during sleep and is due to the loss of pharyngeal
tone which allows the pharynx to collapse during inspiration and
obstructs air flow through the nose and mouth. With obstructive
,sleep apnea, the client is often obese or has a short, thick neck as in
(B). (A, C, and D) are not typically prone to sleep apnea.
◉ To decrease the risk of acid-base imbalance, what goal must the
client with diabetes mellitus strive for?
A) Checking blood glucose levels once daily
B) Drinking 3 L of fluid per day
C) Eating regularly, every 4 to 8 hours
D) Maintaining blood glucose level within normal limits Answer: D)
Maintaining blood glucose level within normal limits
Rationale: Maintaining blood glucose levels within normal limits is
the best way to decrease the risk of acid-base imbalance. A) Blood
glucose levels must be checked several times a day. B) Drinking 3 L
of fluid per day is not necessary to maintain acid-base balance. C)
Eating regularly is a way to achieve acid-base balance but is not the
goal itself.
◉ After the fourth dose of gentamicin sulfate (Garamycin) IV, the
nurse plans to draw blood samples to determine peak and trough
levels. When are the best times to draw these samples?
A) 15 minutes before and 15 minutes after the next dose.
, B) One hour before and one hour after the next dose.
C) 5 minutes before and 30 minutes after the next dose.
D) 30 minutes before and 30 minutes after the next dose. Answer: C)
5 minutes before and 30 minutes after the next dose.
Rationale: Peak drug serum levels are achieved 30 minutes after IV
administration of aminoglycosides. The best time to draw a trough is
the closest time to the next administration (C). (A, B, and D) are not
as good a time to draw the trough as (C). (B and D) are not the best
times to draw the peak of an aminoglycoside that has been
administered IV.
◉ The nurse is caring for a client with an oxygen saturation of 88%
and accessory muscle use. The nurse provides oxygen and
anticipates which of these physician orders?
A) Administration of IV sodium bicarbonate
B) Computed tomography (CT) of the chest, stat
C) Intubation and mechanical ventilation
D) Administration of concentrated potassium chloride solution
Answer: C) Intubation and mechanical ventilation
Rationale: Support with mechanical ventilation may be needed for
clients who cannot keep their oxygen saturation at 90% or who have
respiratory muscle fatigue. A) Sodium bicarbonate is used to treat
