HESI MED-SURG V1 TEST BANK 2026/2027 | Questions &
Answers | Verified Answers Edition | Version 1 Question
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SECTION 1: FUNDAMENTALS OF MED-SURG NURSING
Q1: A patient is scheduled for an elective cholecystectomy in 4 hours. The nurse notes
the patient ate a light breakfast 2 hours ago. What is the nurse's priority action?
A. Proceed with surgery as scheduled since it was only a light meal
B. Notify the surgeon and anesthesiologist immediately [CORRECT]
C. Administer metoclopramide to promote gastric emptying
D. Reschedule the surgery for the following day without consulting the surgeon
Correct Answer: B
Rationale: The standard NPO (nothing by mouth) guideline for elective surgery is
typically 6-8 hours for solid foods to reduce aspiration risk. Eating 2 hours before
surgery significantly increases the risk of aspiration during anesthesia induction. The
nurse must immediately notify the surgeon and anesthesiologist to determine if the
procedure should be delayed or cancelled. This is a patient safety issue that requires
provider notification, not independent nursing decision (Option D) or masking the
problem (Option C). Option A ignores the serious aspiration risk.
Test-taking tip: When a patient violates preoperative instructions, always notify the
provider. Never proceed with surgery or make independent decisions to cancel without
consultation.
,Q2: A postoperative patient develops wound dehiscence with evisceration 5 days after
abdominal surgery. What is the nurse's immediate action?
A. Apply sterile saline-soaked dressings and cover with sterile towel [CORRECT]
B. Push the protruding organs back into the abdominal cavity
C. Remove the sutures to allow for better drainage
D. Place the patient in high Fowler's position
Correct Answer: A
Rationale: Wound dehiscence (separation of wound edges) with evisceration (protrusion
of organs) is a surgical emergency. The nurse must: (1) call for help and notify surgeon
immediately, (2) place patient in low Fowler's position with knees flexed to reduce
abdominal tension, (3) cover exposed organs with sterile saline-soaked dressings to
prevent desiccation, and (4) never attempt to reinsert organs (risk of infection, trauma).
Option B is contraindicated. Option C worsens the situation. Option D increases
intra-abdominal pressure.
Key point: Soaked dressings keep tissues moist; dry dressings adhere and cause
damage. Low Fowler's reduces strain on the wound.
Q3: A patient has a serum potassium level of 6.2 mEq/L. Which ECG change should the
nurse anticipate?
A. Peaked T waves, widened QRS complex, and absent P waves [CORRECT]
B. ST segment elevation and pathological Q waves
C. Prolonged QT interval and flattened T waves
D. Sinus tachycardia with normal PR interval
Correct Answer: A
Rationale: Hyperkalemia (K+ >5.0 mEq/L) produces characteristic ECG changes that
progress with severity: peaked T waves (earliest sign), PR prolongation, P wave
,flattening/absence, widened QRS (bundle branch block pattern), sine wave pattern, and
ventricular fibrillation/asystole. Option B describes MI changes. Option C describes
hypokalemia or hypocalcemia. Option D is not specific to hyperkalemia.
Progression to remember: Peaked T waves → PR prolongation → P waves disappear →
QRS widens → sine wave → cardiac arrest.
Q4: A patient is receiving IV therapy through a peripheral catheter. The nurse notes the
insertion site is cool, pale, and edematous with sluggish flow. The patient complains of
tightness and discomfort. What complication is occurring?
A. Phlebitis
B. Infiltration [CORRECT]
C. Air embolism
D. Septicemia
Correct Answer: B
Rationale: Infiltration occurs when IV fluid leaks into interstitial tissue due to catheter
dislodgement or vein perforation. Signs include: coolness, pallor, edema, sluggish or
stopped flow, tightness, and discomfort at site. Phlebitis (Option A) presents with
warmth, erythema, and tenderness along the vein. Air embolism (Option C) causes
sudden dyspnea, chest pain, and cardiovascular collapse. Septicemia (Option D) causes
fever, chills, and systemic symptoms.
Infiltration vs. Phlebitis: Cool and pale = infiltration; Warm and red = phlebitis.
Q5: A patient has the following arterial blood gas results: pH 7.32, PaCO₂ 55 mmHg,
HCO₃⁻ 28 mEq/L. What acid-base imbalance is present?
A. Respiratory acidosis with metabolic compensation [CORRECT]
, B. Metabolic acidosis with respiratory compensation
C. Respiratory alkalosis with metabolic compensation
D. Metabolic alkalosis with respiratory compensation
Correct Answer: A
Rationale: Step-by-step ABG analysis: (1) pH 7.32 is acidemic, (2) PaCO₂ 55 is elevated
(respiratory acid), (3) HCO₃⁻ 28 is elevated (metabolic alkalosis, but this is
compensation, not primary disorder). The primary disorder is respiratory acidosis
(hypoventilation), and the kidneys have compensated by retaining bicarbonate (elevated
HCO₃⁻). The pH is not normal, indicating incomplete compensation.
ABG interpretation tip: Look at pH first (acidosis or alkalosis), then identify which value
(PaCO₂ or HCO₃⁻) matches the pH direction—that's your primary disorder.
Q6: A patient is using a patient-controlled analgesia (PCA) pump with morphine
following abdominal surgery. Which statement by the patient indicates understanding of
the PCA?
A. "I should press the button whenever I feel any pain, even if I just received a dose"
[CORRECT]
B. "My family can press the button for me when I'm sleeping"
C. "I should wait until the pain is severe before using the pump"
D. "Using the pump frequently will cause me to become addicted"
Correct Answer: A
Rationale: PCA pumps have lockout intervals (typically 6-15 minutes) that prevent
overdose. Patients should be taught to press the button when they feel pain beginning,
maintaining therapeutic blood levels and preventing pain from becoming severe. Option
B is dangerous—only the patient should administer (prevents overdose when patient is
Answers | Verified Answers Edition | Version 1 Question
Bank | Pass Guaranteed - A+ Graded
SECTION 1: FUNDAMENTALS OF MED-SURG NURSING
Q1: A patient is scheduled for an elective cholecystectomy in 4 hours. The nurse notes
the patient ate a light breakfast 2 hours ago. What is the nurse's priority action?
A. Proceed with surgery as scheduled since it was only a light meal
B. Notify the surgeon and anesthesiologist immediately [CORRECT]
C. Administer metoclopramide to promote gastric emptying
D. Reschedule the surgery for the following day without consulting the surgeon
Correct Answer: B
Rationale: The standard NPO (nothing by mouth) guideline for elective surgery is
typically 6-8 hours for solid foods to reduce aspiration risk. Eating 2 hours before
surgery significantly increases the risk of aspiration during anesthesia induction. The
nurse must immediately notify the surgeon and anesthesiologist to determine if the
procedure should be delayed or cancelled. This is a patient safety issue that requires
provider notification, not independent nursing decision (Option D) or masking the
problem (Option C). Option A ignores the serious aspiration risk.
Test-taking tip: When a patient violates preoperative instructions, always notify the
provider. Never proceed with surgery or make independent decisions to cancel without
consultation.
,Q2: A postoperative patient develops wound dehiscence with evisceration 5 days after
abdominal surgery. What is the nurse's immediate action?
A. Apply sterile saline-soaked dressings and cover with sterile towel [CORRECT]
B. Push the protruding organs back into the abdominal cavity
C. Remove the sutures to allow for better drainage
D. Place the patient in high Fowler's position
Correct Answer: A
Rationale: Wound dehiscence (separation of wound edges) with evisceration (protrusion
of organs) is a surgical emergency. The nurse must: (1) call for help and notify surgeon
immediately, (2) place patient in low Fowler's position with knees flexed to reduce
abdominal tension, (3) cover exposed organs with sterile saline-soaked dressings to
prevent desiccation, and (4) never attempt to reinsert organs (risk of infection, trauma).
Option B is contraindicated. Option C worsens the situation. Option D increases
intra-abdominal pressure.
Key point: Soaked dressings keep tissues moist; dry dressings adhere and cause
damage. Low Fowler's reduces strain on the wound.
Q3: A patient has a serum potassium level of 6.2 mEq/L. Which ECG change should the
nurse anticipate?
A. Peaked T waves, widened QRS complex, and absent P waves [CORRECT]
B. ST segment elevation and pathological Q waves
C. Prolonged QT interval and flattened T waves
D. Sinus tachycardia with normal PR interval
Correct Answer: A
Rationale: Hyperkalemia (K+ >5.0 mEq/L) produces characteristic ECG changes that
progress with severity: peaked T waves (earliest sign), PR prolongation, P wave
,flattening/absence, widened QRS (bundle branch block pattern), sine wave pattern, and
ventricular fibrillation/asystole. Option B describes MI changes. Option C describes
hypokalemia or hypocalcemia. Option D is not specific to hyperkalemia.
Progression to remember: Peaked T waves → PR prolongation → P waves disappear →
QRS widens → sine wave → cardiac arrest.
Q4: A patient is receiving IV therapy through a peripheral catheter. The nurse notes the
insertion site is cool, pale, and edematous with sluggish flow. The patient complains of
tightness and discomfort. What complication is occurring?
A. Phlebitis
B. Infiltration [CORRECT]
C. Air embolism
D. Septicemia
Correct Answer: B
Rationale: Infiltration occurs when IV fluid leaks into interstitial tissue due to catheter
dislodgement or vein perforation. Signs include: coolness, pallor, edema, sluggish or
stopped flow, tightness, and discomfort at site. Phlebitis (Option A) presents with
warmth, erythema, and tenderness along the vein. Air embolism (Option C) causes
sudden dyspnea, chest pain, and cardiovascular collapse. Septicemia (Option D) causes
fever, chills, and systemic symptoms.
Infiltration vs. Phlebitis: Cool and pale = infiltration; Warm and red = phlebitis.
Q5: A patient has the following arterial blood gas results: pH 7.32, PaCO₂ 55 mmHg,
HCO₃⁻ 28 mEq/L. What acid-base imbalance is present?
A. Respiratory acidosis with metabolic compensation [CORRECT]
, B. Metabolic acidosis with respiratory compensation
C. Respiratory alkalosis with metabolic compensation
D. Metabolic alkalosis with respiratory compensation
Correct Answer: A
Rationale: Step-by-step ABG analysis: (1) pH 7.32 is acidemic, (2) PaCO₂ 55 is elevated
(respiratory acid), (3) HCO₃⁻ 28 is elevated (metabolic alkalosis, but this is
compensation, not primary disorder). The primary disorder is respiratory acidosis
(hypoventilation), and the kidneys have compensated by retaining bicarbonate (elevated
HCO₃⁻). The pH is not normal, indicating incomplete compensation.
ABG interpretation tip: Look at pH first (acidosis or alkalosis), then identify which value
(PaCO₂ or HCO₃⁻) matches the pH direction—that's your primary disorder.
Q6: A patient is using a patient-controlled analgesia (PCA) pump with morphine
following abdominal surgery. Which statement by the patient indicates understanding of
the PCA?
A. "I should press the button whenever I feel any pain, even if I just received a dose"
[CORRECT]
B. "My family can press the button for me when I'm sleeping"
C. "I should wait until the pain is severe before using the pump"
D. "Using the pump frequently will cause me to become addicted"
Correct Answer: A
Rationale: PCA pumps have lockout intervals (typically 6-15 minutes) that prevent
overdose. Patients should be taught to press the button when they feel pain beginning,
maintaining therapeutic blood levels and preventing pain from becoming severe. Option
B is dangerous—only the patient should administer (prevents overdose when patient is
