HESI MEDICAL-SURGICAL EXAM
2026-2027 – PRACTICE TEST
QUESTIONS AND ANSWERS
WITH RATIONALES/GRADED
A+/2026 UPDATE/100% CORRECT
/INSTANT DOWNLOAD
1. A client with heart failure presents with dyspnea, crackles in
lung bases, and jugular venous distension. Which medication
does the nurse prepare to administer first?
a) Digoxin
b) Metoprolol
c) Furosemide
d) Spironolactone
Rationale: Furosemide is a loop diuretic that rapidly reduces preload and pulmonary
congestion in acute decompensated heart failure. Digoxin and beta-blockers are not
first-line for acute symptoms.
2. A client with chronic kidney disease (stage 4) has a potassium
level of 6.2 mEq/L. Which intervention is priority?
a) Restrict fluids
b) Administer calcium gluconate
c) Prepare for hemodialysis
d) Give sodium polystyrene sulfonate
, Rationale: Severe hyperkalemia (>6.0 with ECG changes) requires emergent dialysis.
Sodium polystyrene works slower; calcium gluconate stabilizes the heart but does
not remove potassium.
3. A nurse is caring for a client post–left pneumonectomy. In
which position should the client be placed?
a) Left side-lying
b) Semi-Fowler’s on surgical side
c) Supine with head flat
d) Right side-lying
Rationale: Position on the surgical side (left) allows the remaining lung to expand
better and prevents mediastinal shift.
4. Select all that apply: Which findings indicate worsening
right-sided heart failure?
a) Peripheral edema
b) Hepatomegaly
c) Jugular vein distension
d) Crackles in lung bases
e) Ascites
Rationale: Right-sided failure → systemic congestion: edema, JVD, ascites,
hepatomegaly. Crackles indicate left-sided failure.
5. A client with diabetes mellitus type 2 is prescribed
metformin. Which lab result should the nurse report before
administration?
a) HbA1c 7.2%
b) Creatinine 1.9 mg/dL
2026-2027 – PRACTICE TEST
QUESTIONS AND ANSWERS
WITH RATIONALES/GRADED
A+/2026 UPDATE/100% CORRECT
/INSTANT DOWNLOAD
1. A client with heart failure presents with dyspnea, crackles in
lung bases, and jugular venous distension. Which medication
does the nurse prepare to administer first?
a) Digoxin
b) Metoprolol
c) Furosemide
d) Spironolactone
Rationale: Furosemide is a loop diuretic that rapidly reduces preload and pulmonary
congestion in acute decompensated heart failure. Digoxin and beta-blockers are not
first-line for acute symptoms.
2. A client with chronic kidney disease (stage 4) has a potassium
level of 6.2 mEq/L. Which intervention is priority?
a) Restrict fluids
b) Administer calcium gluconate
c) Prepare for hemodialysis
d) Give sodium polystyrene sulfonate
, Rationale: Severe hyperkalemia (>6.0 with ECG changes) requires emergent dialysis.
Sodium polystyrene works slower; calcium gluconate stabilizes the heart but does
not remove potassium.
3. A nurse is caring for a client post–left pneumonectomy. In
which position should the client be placed?
a) Left side-lying
b) Semi-Fowler’s on surgical side
c) Supine with head flat
d) Right side-lying
Rationale: Position on the surgical side (left) allows the remaining lung to expand
better and prevents mediastinal shift.
4. Select all that apply: Which findings indicate worsening
right-sided heart failure?
a) Peripheral edema
b) Hepatomegaly
c) Jugular vein distension
d) Crackles in lung bases
e) Ascites
Rationale: Right-sided failure → systemic congestion: edema, JVD, ascites,
hepatomegaly. Crackles indicate left-sided failure.
5. A client with diabetes mellitus type 2 is prescribed
metformin. Which lab result should the nurse report before
administration?
a) HbA1c 7.2%
b) Creatinine 1.9 mg/dL
