2026 UPDATED QUESTIONS DOWNLOAD
2026 Med-Surg Hesi PN Final Medical-Surgical nursing EXAM
LATEST VERSION QUESTIONS AND VERIFIED CORRECT
ANSWERS JUST RELEASED
HESI PN Med-Surg Final Practice Questions
1. A nurse is caring for a client who is 4 hours postoperative following a subtotal
thyroidectomy. Which of the following is the priority assessment?
A. Assessing the client’s pain level.
B. Checking for laryngeal stridor.
C. Monitoring the surgical dressing for bleeding.
D. Checking the client's temperature for fever.
Rationale: Laryngeal stridor indicates airway obstruction due to edema or nerve
damage, which is a life-threatening emergency. ABCs (Airway, Breathing,
Circulation) always take priority.
2. A nurse is teaching a client with Type 1 Diabetes Mellitus about Exercise. Which of
the following instructions should the nurse include?
A. "Inject your insulin into the muscle you will be exercising."
B. "Exercise when your insulin is at its peak action."
C. "Eat a carbohydrate snack before exercising."
D. "Avoid exercise if your blood glucose is 150 mg/dL."
Rationale: Exercise increases glucose uptake by muscles. A snack prevents
hypoglycemia. Injecting into an active muscle increases absorption too rapidly,
risking a "crash."
3. A nurse is assessing a client with Right-Sided Heart Failure. Which of the following
findings is expected?
A. Crackles in the lungs.
B. Dependent edema and jugular venous distention (JVD).
C. Orthopnea.
D. Frothy, pink-tinged sputum.
Rationale: Right-sided failure causes systemic congestion (edema, JVD, enlarged
liver). Crackles and frothy sputum are signs of Left-sided (Pulmonary) failure.
,2026 UPDATED QUESTIONS DOWNLOAD
4. A nurse is caring for a client with a deep vein thrombosis (DVT) receiving a
continuous Heparin infusion. Which lab value should the nurse monitor?
A. PT/INR
B. aPTT
C. Platelet count
D. Hemoglobin
Rationale: aPTT (Activated Partial Thromboplastin Time) is the standard for
monitoring Heparin. PT/INR is used for Warfarin (Coumadin).
5. A client with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen.
What is the priority nursing action?
A. Maintain oxygen flow at 2 L/min or less.
B. Encourage the client to drink 3 liters of fluid daily.
C. Position the client in a side-lying position.
D. Perform chest physiotherapy every 2 hours.
Rationale: High concentrations of oxygen can abolish the hypoxic drive to breathe
in chronic COPD patients, leading to respiratory arrest.
6. Which of the following is an early sign of Compartment Syndrome in a client with a
leg cast?
A. Pulselessness
B. Paralysis
C. Pain that is unrelieved by opioids.
D. Pallor
Rationale: Pain "out of proportion" to the injury or unrelieved by medication is the
earliest sign. The "P's" like pulselessness and paralysis are late signs indicating
permanent damage.
7. A nurse is caring for a client with a suspected Myocardial Infarction (MI). Which
cardiac enzyme is the most specific for heart muscle damage?
A. CK-MB
B. Troponin I
C. Myoglobin
D. LDH
Rationale: Troponin I is the "gold standard" because it is only found in cardiac
muscle and stays elevated longer than other enzymes.
,2026 UPDATED QUESTIONS DOWNLOAD
8. A nurse is teaching a client with GERD. Which of the following should the nurse
recommend the client avoid?
A. Low-fat milk
B. Peppermint and chocolate
C. Baked chicken
D. High-protein shakes
Rationale: Peppermint, chocolate, caffeine, and fatty foods relax the lower
esophageal sphincter (LES), worsening reflux.
9. A client is 2 days postoperative following an abdominal surgery. The nurse notes the
wound has eviscerated. What is the nurse's first action?
A. Re-insert the protruding organs.
B. Cover the area with sterile gauze soaked in normal saline.
C. Call the surgeon immediately.
D. Take the client's vital signs.
Rationale: You must protect the organs from drying out and infection first.
Assessment and calling the surgeon follow immediately after.
10. A nurse is assessing a client with Cushing’s Syndrome. Which of the following
findings is expected?
A. Weight loss and hypotension.
B. Moon face and truncal obesity.
C. Hyperpigmentation of the skin.
D. Hyperkalemia.
Rationale: Cushing's (excess cortisol) causes fat redistribution (moon face/buffalo
hump) and sodium/water retention.
11. A nurse is caring for a client with a chest tube. The nurse notes continuous bubbling
in the water seal chamber. What does this indicate?
A. The system is functioning normally.
B. The lung has fully re-expanded.
C. There is an air leak in the system.
D. The suction is too high.
Rationale: Intermittent bubbling is normal (with breathing); continuous bubbling
indicates a leak in the tubing or at the insertion site.
12. A nurse is preparing to administer Digoxin. For which of the following should the
nurse hold the medication?
, 2026 UPDATED QUESTIONS DOWNLOAD
A. Blood pressure 100/60 mmHg.
B. Apical pulse of 52 bpm.
C. Potassium level of 4.5 mEq/L.
D. Respiratory rate of 12/min.
Rationale: Digoxin is a negative chronotrope (slows heart rate). It must be held if
the apical pulse is <60 bpm in adults.
13. A nurse is assessing a client for Chvostek’s sign. A positive result (facial twitching)
indicates which electrolyte imbalance?
A. Hypercalcemia
B. Hypocalcemia
C. Hypokalemia
D. Hypermagnesemia
Rationale: Hypocalcemia causes neuromuscular irritability. Chvostek’s (face) and
Trousseau’s (hand) are the key tests.
14. A client has a new prescription for Alendronate (Fosamax) for osteoporosis. Which
instruction is vital?
A. Take with a full glass of milk.
B. Sit upright for 30 minutes after taking it.
C. Take it right before bedtime.
D. Take it with a light snack.
Rationale: Alendronate can cause severe esophageal erosion. Sitting upright and
taking it with water on an empty stomach prevents this.
15. A nurse is caring for a client with Addison’s Disease. What is a priority nursing
diagnosis?
A. Risk for deficient fluid volume.
B. Risk for infection.
C. Activity intolerance.
D. Disturbed body image.
Rationale: Addison’s (low cortisol/aldosterone) causes "salt wasting," leadings to
profound dehydration and potential "Addisonian Crisis" (shock).
16. A nurse is assessing a client with a hip fracture. Which of the following is a classic
sign?
A. Internal rotation of the affected leg.
B. Shortening and external rotation of the affected leg.
2026 Med-Surg Hesi PN Final Medical-Surgical nursing EXAM
LATEST VERSION QUESTIONS AND VERIFIED CORRECT
ANSWERS JUST RELEASED
HESI PN Med-Surg Final Practice Questions
1. A nurse is caring for a client who is 4 hours postoperative following a subtotal
thyroidectomy. Which of the following is the priority assessment?
A. Assessing the client’s pain level.
B. Checking for laryngeal stridor.
C. Monitoring the surgical dressing for bleeding.
D. Checking the client's temperature for fever.
Rationale: Laryngeal stridor indicates airway obstruction due to edema or nerve
damage, which is a life-threatening emergency. ABCs (Airway, Breathing,
Circulation) always take priority.
2. A nurse is teaching a client with Type 1 Diabetes Mellitus about Exercise. Which of
the following instructions should the nurse include?
A. "Inject your insulin into the muscle you will be exercising."
B. "Exercise when your insulin is at its peak action."
C. "Eat a carbohydrate snack before exercising."
D. "Avoid exercise if your blood glucose is 150 mg/dL."
Rationale: Exercise increases glucose uptake by muscles. A snack prevents
hypoglycemia. Injecting into an active muscle increases absorption too rapidly,
risking a "crash."
3. A nurse is assessing a client with Right-Sided Heart Failure. Which of the following
findings is expected?
A. Crackles in the lungs.
B. Dependent edema and jugular venous distention (JVD).
C. Orthopnea.
D. Frothy, pink-tinged sputum.
Rationale: Right-sided failure causes systemic congestion (edema, JVD, enlarged
liver). Crackles and frothy sputum are signs of Left-sided (Pulmonary) failure.
,2026 UPDATED QUESTIONS DOWNLOAD
4. A nurse is caring for a client with a deep vein thrombosis (DVT) receiving a
continuous Heparin infusion. Which lab value should the nurse monitor?
A. PT/INR
B. aPTT
C. Platelet count
D. Hemoglobin
Rationale: aPTT (Activated Partial Thromboplastin Time) is the standard for
monitoring Heparin. PT/INR is used for Warfarin (Coumadin).
5. A client with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen.
What is the priority nursing action?
A. Maintain oxygen flow at 2 L/min or less.
B. Encourage the client to drink 3 liters of fluid daily.
C. Position the client in a side-lying position.
D. Perform chest physiotherapy every 2 hours.
Rationale: High concentrations of oxygen can abolish the hypoxic drive to breathe
in chronic COPD patients, leading to respiratory arrest.
6. Which of the following is an early sign of Compartment Syndrome in a client with a
leg cast?
A. Pulselessness
B. Paralysis
C. Pain that is unrelieved by opioids.
D. Pallor
Rationale: Pain "out of proportion" to the injury or unrelieved by medication is the
earliest sign. The "P's" like pulselessness and paralysis are late signs indicating
permanent damage.
7. A nurse is caring for a client with a suspected Myocardial Infarction (MI). Which
cardiac enzyme is the most specific for heart muscle damage?
A. CK-MB
B. Troponin I
C. Myoglobin
D. LDH
Rationale: Troponin I is the "gold standard" because it is only found in cardiac
muscle and stays elevated longer than other enzymes.
,2026 UPDATED QUESTIONS DOWNLOAD
8. A nurse is teaching a client with GERD. Which of the following should the nurse
recommend the client avoid?
A. Low-fat milk
B. Peppermint and chocolate
C. Baked chicken
D. High-protein shakes
Rationale: Peppermint, chocolate, caffeine, and fatty foods relax the lower
esophageal sphincter (LES), worsening reflux.
9. A client is 2 days postoperative following an abdominal surgery. The nurse notes the
wound has eviscerated. What is the nurse's first action?
A. Re-insert the protruding organs.
B. Cover the area with sterile gauze soaked in normal saline.
C. Call the surgeon immediately.
D. Take the client's vital signs.
Rationale: You must protect the organs from drying out and infection first.
Assessment and calling the surgeon follow immediately after.
10. A nurse is assessing a client with Cushing’s Syndrome. Which of the following
findings is expected?
A. Weight loss and hypotension.
B. Moon face and truncal obesity.
C. Hyperpigmentation of the skin.
D. Hyperkalemia.
Rationale: Cushing's (excess cortisol) causes fat redistribution (moon face/buffalo
hump) and sodium/water retention.
11. A nurse is caring for a client with a chest tube. The nurse notes continuous bubbling
in the water seal chamber. What does this indicate?
A. The system is functioning normally.
B. The lung has fully re-expanded.
C. There is an air leak in the system.
D. The suction is too high.
Rationale: Intermittent bubbling is normal (with breathing); continuous bubbling
indicates a leak in the tubing or at the insertion site.
12. A nurse is preparing to administer Digoxin. For which of the following should the
nurse hold the medication?
, 2026 UPDATED QUESTIONS DOWNLOAD
A. Blood pressure 100/60 mmHg.
B. Apical pulse of 52 bpm.
C. Potassium level of 4.5 mEq/L.
D. Respiratory rate of 12/min.
Rationale: Digoxin is a negative chronotrope (slows heart rate). It must be held if
the apical pulse is <60 bpm in adults.
13. A nurse is assessing a client for Chvostek’s sign. A positive result (facial twitching)
indicates which electrolyte imbalance?
A. Hypercalcemia
B. Hypocalcemia
C. Hypokalemia
D. Hypermagnesemia
Rationale: Hypocalcemia causes neuromuscular irritability. Chvostek’s (face) and
Trousseau’s (hand) are the key tests.
14. A client has a new prescription for Alendronate (Fosamax) for osteoporosis. Which
instruction is vital?
A. Take with a full glass of milk.
B. Sit upright for 30 minutes after taking it.
C. Take it right before bedtime.
D. Take it with a light snack.
Rationale: Alendronate can cause severe esophageal erosion. Sitting upright and
taking it with water on an empty stomach prevents this.
15. A nurse is caring for a client with Addison’s Disease. What is a priority nursing
diagnosis?
A. Risk for deficient fluid volume.
B. Risk for infection.
C. Activity intolerance.
D. Disturbed body image.
Rationale: Addison’s (low cortisol/aldosterone) causes "salt wasting," leadings to
profound dehydration and potential "Addisonian Crisis" (shock).
16. A nurse is assessing a client with a hip fracture. Which of the following is a classic
sign?
A. Internal rotation of the affected leg.
B. Shortening and external rotation of the affected leg.
