Herzing University NSG 233 / NSG233: Medical-
Surgical Nursing II HESI Exit Exam (2026/2027) –
300 Practice Questions with Verified Answers and
Detailed Rationales
Domain 1: Safe and Effective Care Environment (Management of Care, Safety,
Infection Control) – Questions 1-40
1. A nurse is caring for a client who has a new diagnosis of methicillin-resistant
Staphylococcus aureus (MRSA) in a surgical wound. Which of the following
precautions should the nurse implement?
A. Standard precautions only
B. Contact precautions
C. Droplet precautions
D. Airborne precautions
Correct Answer: B
Rationale: MRSA requires contact precautions to prevent transmission via direct
contact. This includes a private room, gloves, and gown for all interactions that
involve contact with the patient or environment.
2. A nurse is preparing to transfer a client from the bed to a stretcher. Which of
the following actions demonstrates safe body mechanics?
A. Keeping feet together while lifting
B. Bending at the waist to reach the client
C. Positioning the stretcher slightly lower than the bed
1|Page
,D. Using the large muscles of the legs and keeping the back straight
Correct Answer: D
Rationale: Proper body mechanics involve using leg muscles (not back), keeping
feet shoulder-width apart, and maintaining a straight back. The stretcher should
be at the same height as the bed.
3. A client with a history of falls is at risk for injury. Which of the following is the
most appropriate nursing intervention?
A. Apply soft wrist restraints at all times
B. Keep all four side rails up while the client is in bed
C. Place a fall risk alert sign on the door and ensure the call light is within reach
D. Encourage the client to remain in bed without assistance
Correct Answer: C
Rationale: Fall prevention includes identifying at-risk patients, using alert signs,
keeping call light accessible, and non-skid footwear. Restraints are a last resort.
Side rails may increase risk if patient tries to climb over.
4. A nurse is caring for a client receiving a blood transfusion. Fifteen minutes after
starting the transfusion, the client reports chills and low back pain. What is the
nurse’s priority action?
A. Slow the transfusion rate
B. Stop the transfusion and infuse normal saline
C. Administer acetaminophen as prescribed
D. Notify the provider after assessing vital signs
Correct Answer: B
2|Page
,Rationale: Chills and back pain indicate a possible hemolytic transfusion reaction.
The transfusion must be stopped immediately to prevent further complications.
Maintain IV access with saline, then notify the provider.
5. A nurse is preparing to administer a scheduled dose of intravenous
vancomycin. Which of the following requires the nurse to hold the medication
and contact the provider?
A. The client’s serum creatinine is 1.8 mg/dL (baseline 0.9)
B. The client’s heart rate is 88 bpm
C. The client reports mild nausea
D. The client’s temperature is 37.2°C (99.0°F)
Correct Answer: A
Rationale: Vancomycin is nephrotoxic. An elevated creatinine indicates possible
renal impairment; the dose may need adjustment. The nurse should notify the
provider before administration.
6. A nurse is teaching a client about home safety after a stroke. Which statement
by the client indicates a need for further teaching?
A. “I will remove throw rugs from the floor.”
B. “I will install grab bars in the shower.”
C. “I will keep the pathway to the bathroom clear.”
D. “I will wear socks without skid pads to make walking easier.”
Correct Answer: D
Rationale: Non-skid footwear or socks with grips reduce fall risk. Smooth socks
increase slipping hazard.
3|Page
, 7. A client is placed on contact precautions for Clostridioides difficile. Which of
the following actions by the nursing assistant requires intervention?
A. Wearing a gown and gloves before entering the room
B. Using alcohol-based hand sanitizer after removing gloves
C. Disposing of soiled linens in a leak-proof bag
D. Using dedicated equipment for the client
Correct Answer: B
Rationale: Alcohol-based hand sanitizer is ineffective against C. difficile spores.
The assistant must wash hands with soap and water after glove removal.
8. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which of
the following tasks is appropriate to delegate?
A. Measuring a client’s post-void residual with a bladder scanner
B. Assessing a client’s surgical incision for redness
C. Administering a tube feeding via gastrostomy tube
D. Evaluating the effectiveness of a pain medication
Correct Answer: A
Rationale: Bladder scanning is a technical skill within the scope of UAP after
training. Assessment, evaluation, and medication administration are RN
responsibilities.
9. A nurse is preparing a client for surgery. Which of the following findings should
be reported to the provider immediately?
A. The client reports a history of smoking
B. The client’s blood pressure is 150/90 mm Hg
C. The client reports taking warfarin at home
4|Page
Surgical Nursing II HESI Exit Exam (2026/2027) –
300 Practice Questions with Verified Answers and
Detailed Rationales
Domain 1: Safe and Effective Care Environment (Management of Care, Safety,
Infection Control) – Questions 1-40
1. A nurse is caring for a client who has a new diagnosis of methicillin-resistant
Staphylococcus aureus (MRSA) in a surgical wound. Which of the following
precautions should the nurse implement?
A. Standard precautions only
B. Contact precautions
C. Droplet precautions
D. Airborne precautions
Correct Answer: B
Rationale: MRSA requires contact precautions to prevent transmission via direct
contact. This includes a private room, gloves, and gown for all interactions that
involve contact with the patient or environment.
2. A nurse is preparing to transfer a client from the bed to a stretcher. Which of
the following actions demonstrates safe body mechanics?
A. Keeping feet together while lifting
B. Bending at the waist to reach the client
C. Positioning the stretcher slightly lower than the bed
1|Page
,D. Using the large muscles of the legs and keeping the back straight
Correct Answer: D
Rationale: Proper body mechanics involve using leg muscles (not back), keeping
feet shoulder-width apart, and maintaining a straight back. The stretcher should
be at the same height as the bed.
3. A client with a history of falls is at risk for injury. Which of the following is the
most appropriate nursing intervention?
A. Apply soft wrist restraints at all times
B. Keep all four side rails up while the client is in bed
C. Place a fall risk alert sign on the door and ensure the call light is within reach
D. Encourage the client to remain in bed without assistance
Correct Answer: C
Rationale: Fall prevention includes identifying at-risk patients, using alert signs,
keeping call light accessible, and non-skid footwear. Restraints are a last resort.
Side rails may increase risk if patient tries to climb over.
4. A nurse is caring for a client receiving a blood transfusion. Fifteen minutes after
starting the transfusion, the client reports chills and low back pain. What is the
nurse’s priority action?
A. Slow the transfusion rate
B. Stop the transfusion and infuse normal saline
C. Administer acetaminophen as prescribed
D. Notify the provider after assessing vital signs
Correct Answer: B
2|Page
,Rationale: Chills and back pain indicate a possible hemolytic transfusion reaction.
The transfusion must be stopped immediately to prevent further complications.
Maintain IV access with saline, then notify the provider.
5. A nurse is preparing to administer a scheduled dose of intravenous
vancomycin. Which of the following requires the nurse to hold the medication
and contact the provider?
A. The client’s serum creatinine is 1.8 mg/dL (baseline 0.9)
B. The client’s heart rate is 88 bpm
C. The client reports mild nausea
D. The client’s temperature is 37.2°C (99.0°F)
Correct Answer: A
Rationale: Vancomycin is nephrotoxic. An elevated creatinine indicates possible
renal impairment; the dose may need adjustment. The nurse should notify the
provider before administration.
6. A nurse is teaching a client about home safety after a stroke. Which statement
by the client indicates a need for further teaching?
A. “I will remove throw rugs from the floor.”
B. “I will install grab bars in the shower.”
C. “I will keep the pathway to the bathroom clear.”
D. “I will wear socks without skid pads to make walking easier.”
Correct Answer: D
Rationale: Non-skid footwear or socks with grips reduce fall risk. Smooth socks
increase slipping hazard.
3|Page
, 7. A client is placed on contact precautions for Clostridioides difficile. Which of
the following actions by the nursing assistant requires intervention?
A. Wearing a gown and gloves before entering the room
B. Using alcohol-based hand sanitizer after removing gloves
C. Disposing of soiled linens in a leak-proof bag
D. Using dedicated equipment for the client
Correct Answer: B
Rationale: Alcohol-based hand sanitizer is ineffective against C. difficile spores.
The assistant must wash hands with soap and water after glove removal.
8. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which of
the following tasks is appropriate to delegate?
A. Measuring a client’s post-void residual with a bladder scanner
B. Assessing a client’s surgical incision for redness
C. Administering a tube feeding via gastrostomy tube
D. Evaluating the effectiveness of a pain medication
Correct Answer: A
Rationale: Bladder scanning is a technical skill within the scope of UAP after
training. Assessment, evaluation, and medication administration are RN
responsibilities.
9. A nurse is preparing a client for surgery. Which of the following findings should
be reported to the provider immediately?
A. The client reports a history of smoking
B. The client’s blood pressure is 150/90 mm Hg
C. The client reports taking warfarin at home
4|Page
