HESI MEDICAL-SURGICAL NURSING PRACTICE EXAM
2025-2026 QUESTIONS COMPLETE 100 QUESTIONS &
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||BRAND NEW VERSION!!
1. A patient with chronic kidney disease has a serum potassium of 6.2 mEq/L.
Which action should the nurse take first?
A. Administer potassium-binding resin
B. Place the patient on a cardiac monitor
C. Encourage increased potassium intake
D. Obtain a blood glucose level
B – Hyperkalemia can cause life-threatening cardiac arrhythmias; continuous
cardiac monitoring is the priority.
2. A client with heart failure is prescribed furosemide. Which electrolyte
should the nurse monitor closely?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
B – Furosemide is a loop diuretic that can cause hypokalemia, which can lead to
arrhythmias.
3. A patient develops sudden shortness of breath and pleuritic chest pain
post-surgery. Which is the priority nursing action?
A. Administer oxygen
B. Notify the healthcare provider
C. Encourage coughing and deep breathing
D. Prepare for chest tube insertion
A – Oxygen is priority to relieve hypoxemia; further interventions follow
assessment.
, 4. A patient receiving morphine reports itching and rash. What is the nurse’s
best action?
A. Administer diphenhydramine
B. Hold the next morphine dose
C. Notify the provider immediately
D. Reassure the patient this is normal
A – Mild allergic reactions to morphine can be managed with antihistamines;
severe reactions require escalation.
5. Which laboratory value indicates effective anticoagulation in a patient
receiving warfarin?
A. INR 1.0
B. INR 2.5
C. aPTT 30 sec
D. Platelets 200,000
B – Therapeutic INR for most indications is 2–3; it monitors warfarin effectiveness.
6. A patient has a nasogastric tube attached to suction. The nurse notices
sudden abdominal distension. What is the priority?
A. Check tube placement
B. Irrigate the tube
C. Notify the provider
D. Document the finding
A – Abdominal distension may indicate obstruction or displacement; tube
placement must be verified immediately.
7. Which finding is most concerning in a patient with myocardial infarction?
A. Heart rate 110 bpm
B. BP 140/88 mmHg
C. ST-segment elevation on ECG
D. Mild chest discomfort
C – ST-segment elevation indicates ongoing myocardial injury and requires
immediate intervention.
, 8. A patient with COPD has an oxygen saturation of 88% on 2 L/min nasal
cannula. What is the best nursing action?
A. Increase O2 to 4 L/min
B. Encourage pursed-lip breathing
C. Call rapid response team
D. Reposition patient on the left side
B – Pursed-lip breathing helps improve gas exchange; COPD patients may require
careful O2 titration to avoid suppressing hypoxic drive.
9. Which patient is at highest risk for developing a pressure ulcer?
A. A 25-year-old post-appendectomy
B. A 65-year-old with diabetes and immobility
C. A 40-year-old with asthma
D. A 50-year-old recovering from pneumonia
B – Immobility and chronic disease increase pressure ulcer risk due to impaired
circulation and tissue perfusion.
10.A patient with liver cirrhosis is admitted with ascites. Which lab finding is
expected?
A. Increased albumin
B. Decreased bilirubin
C. Elevated ammonia
D. Decreased INR
C – Liver dysfunction leads to accumulation of ammonia, causing hepatic
encephalopathy risk.
11.A patient reports severe flank pain and hematuria. What is the nurse’s
priority?
A. Administer acetaminophen
B. Increase oral fluids
C. Assess vital signs and pain
D. Prepare for MRI
2025-2026 QUESTIONS COMPLETE 100 QUESTIONS &
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||BRAND NEW VERSION!!
1. A patient with chronic kidney disease has a serum potassium of 6.2 mEq/L.
Which action should the nurse take first?
A. Administer potassium-binding resin
B. Place the patient on a cardiac monitor
C. Encourage increased potassium intake
D. Obtain a blood glucose level
B – Hyperkalemia can cause life-threatening cardiac arrhythmias; continuous
cardiac monitoring is the priority.
2. A client with heart failure is prescribed furosemide. Which electrolyte
should the nurse monitor closely?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
B – Furosemide is a loop diuretic that can cause hypokalemia, which can lead to
arrhythmias.
3. A patient develops sudden shortness of breath and pleuritic chest pain
post-surgery. Which is the priority nursing action?
A. Administer oxygen
B. Notify the healthcare provider
C. Encourage coughing and deep breathing
D. Prepare for chest tube insertion
A – Oxygen is priority to relieve hypoxemia; further interventions follow
assessment.
, 4. A patient receiving morphine reports itching and rash. What is the nurse’s
best action?
A. Administer diphenhydramine
B. Hold the next morphine dose
C. Notify the provider immediately
D. Reassure the patient this is normal
A – Mild allergic reactions to morphine can be managed with antihistamines;
severe reactions require escalation.
5. Which laboratory value indicates effective anticoagulation in a patient
receiving warfarin?
A. INR 1.0
B. INR 2.5
C. aPTT 30 sec
D. Platelets 200,000
B – Therapeutic INR for most indications is 2–3; it monitors warfarin effectiveness.
6. A patient has a nasogastric tube attached to suction. The nurse notices
sudden abdominal distension. What is the priority?
A. Check tube placement
B. Irrigate the tube
C. Notify the provider
D. Document the finding
A – Abdominal distension may indicate obstruction or displacement; tube
placement must be verified immediately.
7. Which finding is most concerning in a patient with myocardial infarction?
A. Heart rate 110 bpm
B. BP 140/88 mmHg
C. ST-segment elevation on ECG
D. Mild chest discomfort
C – ST-segment elevation indicates ongoing myocardial injury and requires
immediate intervention.
, 8. A patient with COPD has an oxygen saturation of 88% on 2 L/min nasal
cannula. What is the best nursing action?
A. Increase O2 to 4 L/min
B. Encourage pursed-lip breathing
C. Call rapid response team
D. Reposition patient on the left side
B – Pursed-lip breathing helps improve gas exchange; COPD patients may require
careful O2 titration to avoid suppressing hypoxic drive.
9. Which patient is at highest risk for developing a pressure ulcer?
A. A 25-year-old post-appendectomy
B. A 65-year-old with diabetes and immobility
C. A 40-year-old with asthma
D. A 50-year-old recovering from pneumonia
B – Immobility and chronic disease increase pressure ulcer risk due to impaired
circulation and tissue perfusion.
10.A patient with liver cirrhosis is admitted with ascites. Which lab finding is
expected?
A. Increased albumin
B. Decreased bilirubin
C. Elevated ammonia
D. Decreased INR
C – Liver dysfunction leads to accumulation of ammonia, causing hepatic
encephalopathy risk.
11.A patient reports severe flank pain and hematuria. What is the nurse’s
priority?
A. Administer acetaminophen
B. Increase oral fluids
C. Assess vital signs and pain
D. Prepare for MRI
