Med-Surg 1 HESI 2026/2027 Latest PREP
EXAM with 180 Questions and Correct
Answers WITH DETAILED
EXPLANATIONS/ Med-Surg HESI Exam
COVERING RECENT AND MOST TESTED
QUESTIONS A+ GRADE ASSURED
Question 1
A 68-year-old male is admitted with acute decompensated heart failure. He
presents with severe dyspnea, orthopnea, and pink frothy sputum. His blood
pressure is 160/95 mmHg, heart rate 110 bpm, and oxygen saturation 88% on
room air. Which intervention should the nurse implement FIRST?
A) Administer IV furosemide
B) Place the patient in high Fowler's position
C) Administer sublingual nitroglycerin
D) Prepare for intubation
,,,answer,,,,: B) Place the patient in high Fowler's position
Rationale: The priority intervention for a patient with acute pulmonary edema is to
position the patient in high Fowler's position to reduce venous return (preload) and
facilitate breathing by allowing maximal lung expansion. While furosemide and
nitroglycerin are important interventions, positioning is the immediate nursing
,action that can be implemented while preparing medications. Intubation is
indicated only if the patient fails to respond to initial therapy.
Question 2
A patient with atrial fibrillation is prescribed warfarin. Which laboratory value is
most important for the nurse to monitor to evaluate the effectiveness of this
medication?
A) Platelet count
B) Activated partial thromboplastin time (aPTT)
C) International Normalized Ratio (INR)
D) Prothrombin time (PT)
,,,answer,,,,: C) International Normalized Ratio (INR)
Rationale: The INR is the standardized laboratory value used to monitor warfarin
therapy. The therapeutic INR range for atrial fibrillation is typically 2.0-3.0. PT is the
raw value but INR accounts for variability between laboratories. aPTT monitors
heparin therapy, not warfarin. Platelet count monitors for thrombocytopenia but
does not evaluate warfarin effectiveness.
Question 3
A postoperative client's skin is cool, pale, and moist. The client is restless and has
scant urine output. These findings are most consistent with which condition?
A) Neurogenic shock
B) Hypovolemic shock
,C) Septic shock
D) Anaphylactic shock
,,,answer,,,,: B) Hypovolemic shock
Rationale: Cool, pale, moist skin (due to peripheral vasoconstriction), restlessness
(due to decreased cerebral perfusion), and oliguria (due to decreased renal
perfusion) are classic signs of hypovolemic shock. In neurogenic shock, skin would
be warm and dry due to loss of vasomotor tone. Septic shock typically presents
with warm, flushed skin in the early phase. Anaphylactic shock presents with
urticaria and respiratory distress.
Question 4
A client who had a myocardial infarction asks the nurse, "What's the chance of my
having another heart attack if I carefully watch my diet and stress levels?" Which
response by the nurse is most appropriate?
A) "If you follow your diet and reduce stress, you won't have another heart attack."
B) "Making lifestyle changes can significantly reduce your risk of another heart
attack."
C) "You shouldn't worry about that right now; focus on getting better."
D) "Most people who have one heart attack will have another within five years."
,,,answer,,,,: B) "Making lifestyle changes can significantly reduce your risk of
another heart attack."
Rationale: This response is honest, supportive, and evidence-based. It
acknowledges the patient's concern while providing realistic hope. Option A
provides false reassurance. Option C dismisses the patient's valid concerns.
Option D is not entirely accurate and may cause unnecessary anxiety.
, Question 5
A client with heart failure is prescribed digoxin. Which assessment finding indicates
digoxin toxicity?
A) Heart rate 62 bpm
B) Yellow-green halos around lights
C) Blood pressure 140/88 mmHg
D) Weight gain of 2 pounds in 24 hours
,,,answer,,,,: B) Yellow-green halos around lights
Rationale: Visual disturbances, including yellow-green halos (xanthopsia), are
classic signs of digoxin toxicity. Other signs include nausea, vomiting, anorexia, and
cardiac arrhythmias. A heart rate of 62 bpm is within normal limits and may be a
therapeutic effect. Weight gain indicates fluid retention, which may indicate
worsening heart failure, not digoxin toxicity.
Question 6
A client with peripheral arterial disease (PAD) reports leg pain that occurs when
walking and is relieved by rest. The nurse correctly documents this finding as:
A) Rest pain
B) Intermittent claudication
C) Venous insufficiency
D) Neuropathic pain
,,,answer,,,,: B) Intermittent claudication
EXAM with 180 Questions and Correct
Answers WITH DETAILED
EXPLANATIONS/ Med-Surg HESI Exam
COVERING RECENT AND MOST TESTED
QUESTIONS A+ GRADE ASSURED
Question 1
A 68-year-old male is admitted with acute decompensated heart failure. He
presents with severe dyspnea, orthopnea, and pink frothy sputum. His blood
pressure is 160/95 mmHg, heart rate 110 bpm, and oxygen saturation 88% on
room air. Which intervention should the nurse implement FIRST?
A) Administer IV furosemide
B) Place the patient in high Fowler's position
C) Administer sublingual nitroglycerin
D) Prepare for intubation
,,,answer,,,,: B) Place the patient in high Fowler's position
Rationale: The priority intervention for a patient with acute pulmonary edema is to
position the patient in high Fowler's position to reduce venous return (preload) and
facilitate breathing by allowing maximal lung expansion. While furosemide and
nitroglycerin are important interventions, positioning is the immediate nursing
,action that can be implemented while preparing medications. Intubation is
indicated only if the patient fails to respond to initial therapy.
Question 2
A patient with atrial fibrillation is prescribed warfarin. Which laboratory value is
most important for the nurse to monitor to evaluate the effectiveness of this
medication?
A) Platelet count
B) Activated partial thromboplastin time (aPTT)
C) International Normalized Ratio (INR)
D) Prothrombin time (PT)
,,,answer,,,,: C) International Normalized Ratio (INR)
Rationale: The INR is the standardized laboratory value used to monitor warfarin
therapy. The therapeutic INR range for atrial fibrillation is typically 2.0-3.0. PT is the
raw value but INR accounts for variability between laboratories. aPTT monitors
heparin therapy, not warfarin. Platelet count monitors for thrombocytopenia but
does not evaluate warfarin effectiveness.
Question 3
A postoperative client's skin is cool, pale, and moist. The client is restless and has
scant urine output. These findings are most consistent with which condition?
A) Neurogenic shock
B) Hypovolemic shock
,C) Septic shock
D) Anaphylactic shock
,,,answer,,,,: B) Hypovolemic shock
Rationale: Cool, pale, moist skin (due to peripheral vasoconstriction), restlessness
(due to decreased cerebral perfusion), and oliguria (due to decreased renal
perfusion) are classic signs of hypovolemic shock. In neurogenic shock, skin would
be warm and dry due to loss of vasomotor tone. Septic shock typically presents
with warm, flushed skin in the early phase. Anaphylactic shock presents with
urticaria and respiratory distress.
Question 4
A client who had a myocardial infarction asks the nurse, "What's the chance of my
having another heart attack if I carefully watch my diet and stress levels?" Which
response by the nurse is most appropriate?
A) "If you follow your diet and reduce stress, you won't have another heart attack."
B) "Making lifestyle changes can significantly reduce your risk of another heart
attack."
C) "You shouldn't worry about that right now; focus on getting better."
D) "Most people who have one heart attack will have another within five years."
,,,answer,,,,: B) "Making lifestyle changes can significantly reduce your risk of
another heart attack."
Rationale: This response is honest, supportive, and evidence-based. It
acknowledges the patient's concern while providing realistic hope. Option A
provides false reassurance. Option C dismisses the patient's valid concerns.
Option D is not entirely accurate and may cause unnecessary anxiety.
, Question 5
A client with heart failure is prescribed digoxin. Which assessment finding indicates
digoxin toxicity?
A) Heart rate 62 bpm
B) Yellow-green halos around lights
C) Blood pressure 140/88 mmHg
D) Weight gain of 2 pounds in 24 hours
,,,answer,,,,: B) Yellow-green halos around lights
Rationale: Visual disturbances, including yellow-green halos (xanthopsia), are
classic signs of digoxin toxicity. Other signs include nausea, vomiting, anorexia, and
cardiac arrhythmias. A heart rate of 62 bpm is within normal limits and may be a
therapeutic effect. Weight gain indicates fluid retention, which may indicate
worsening heart failure, not digoxin toxicity.
Question 6
A client with peripheral arterial disease (PAD) reports leg pain that occurs when
walking and is relieved by rest. The nurse correctly documents this finding as:
A) Rest pain
B) Intermittent claudication
C) Venous insufficiency
D) Neuropathic pain
,,,answer,,,,: B) Intermittent claudication
