HESI MEDICAL SURGERY EXAM – QUESTIONS AND ANSWERS | VERIFIED AND WELL
DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
*Core Domains*
*Perioperative Nursing Care*
*Fluid and Electrolyte Balance*
*Cardiovascular System Disorders*
*Respiratory System Management*
*Endocrine and Metabolic Disorders*
*Gastrointestinal and Nutritional Support*
*Integumentary and Wound Care*
*Musculoskeletal Trauma and Repair*
*Introduction*
*This comprehensive assessment is designed to evaluate clinical proficiency in medical-
surgical nursing. It measures essential skills, theoretical knowledge, and the ability to apply
evidence-based practice to complex patient scenarios. The exam utilizes a multiple-choice
format to assess diagnostic reasoning, prioritization, and safety protocols in acute care
settings. Candidates are challenged to demonstrate critical thinking through real-world
clinical applications, reflecting the decision-making processes required in professional
practice. This evaluation serves to confirm readiness for clinical responsibilities by
emphasizing patient-centered outcomes, adherence to legal standards, and the mastery of
specialized interventions required in diverse medical-surgical nursing environments.*
SECTION ONE: QUESTIONS 1–100
1. A patient is recovering from a thyroidectomy. Which assessment finding requires
immediate intervention by the nurse? A. Incisional pain rated 4/10 B. Hoarseness
when speaking C. Stridor upon inspiration D. Hypocalcemia symptoms C. Stridor
upon inspiration Explanation: Stridor indicates laryngeal edema or airway
obstruction, which is a life-threatening emergency following neck surgery.
2. A patient with heart failure is prescribed furosemide. Which electrolyte should the
nurse monitor most closely? A. Potassium B. Calcium C. Phosphorus D. Magnesium
, A. Potassium Explanation: Furosemide is a loop diuretic that promotes the
excretion of potassium, placing the patient at risk for hypokalemia.
3. Which finding in a patient with a chest tube indicates a potential air leak? A. Tidaling
in the water seal chamber B. Continuous bubbling in the water seal chamber C.
Absence of bubbles in the suction control chamber D. Subcutaneous emphysema at
the insertion site B. Continuous bubbling in the water seal chamber
Explanation: Continuous bubbling in the water seal chamber suggests air is escaping
from the system or the patient's pleural space, indicating a leak.
4. A patient is admitted with suspected appendicitis. Which intervention is
contraindicated? A. Monitoring vital signs B. Administering IV fluids C. Applying a
heating pad to the abdomen D. Keeping the patient NPO C. Applying a heating
pad to the abdomen Explanation: Heat application increases blood flow and
metabolic rate, which can lead to appendix rupture and subsequent peritonitis.
5. Which nursing action is priority for a patient experiencing a tonic-clonic seizure? A.
Inserting an oral airway B. Restraining the patient's extremities C. Turning the patient
to the side D. Administering IV diazepam C. Turning the patient to the side
Explanation: Protecting the airway is the priority; side-lying prevents aspiration of
secretions.
6. A patient has a nursing diagnosis of Risk for Impaired Skin Integrity. Which
intervention is most effective? A. Massaging bony prominences B. Repositioning
every 2 hours C. Using a donut-style cushion D. Maintaining a high-protein diet B.
Repositioning every 2 hours Explanation: Repositioning relieves pressure on
tissues, which is the primary cause of pressure ulcers.
7. Which laboratory value should the nurse review before administering heparin? A.
PT/INR B. Platelet count C. Serum creatinine D. Albumin B. Platelet count
Explanation: Heparin can cause Heparin-Induced Thrombocytopenia (HIT), making
monitoring of platelet counts essential.
8. A patient is scheduled for a colonoscopy. Which instruction is correct regarding pre-
procedure preparation? A. Follow a clear liquid diet for 24 hours B. Increase fiber
intake for two days C. Take oral anticoagulants as scheduled D. Maintain NPO status
for 12 hours A. Follow a clear liquid diet for 24 hours Explanation: A clear
liquid diet ensures the bowel is sufficiently clear for optimal visualization during the
procedure.
9. When assessing a patient with chronic obstructive pulmonary disease (COPD), what
respiratory pattern is most expected? A. Kussmaul respirations B. Cheyne-Stokes
respirations C. Dyspnea on exertion D. Apneustic breathing C. Dyspnea on
, exertion Explanation: COPD causes structural changes in the lungs, leading to
reduced exercise tolerance and shortness of breath during activity.
10. A patient presents with acute chest pain. Which diagnostic test is the priority for
identifying myocardial infarction? A. Chest X-ray B. Electrocardiogram (ECG) C.
Echocardiogram D. Stress test B. Electrocardiogram (ECG) Explanation: An
ECG provides immediate data on cardiac electrical activity to confirm ST-elevation or
other signs of myocardial injury.
11. Which instruction should be provided to a patient taking alendronate for
osteoporosis? A. Take with a full glass of milk B. Lie down for 30 minutes after taking
C. Remain upright for 30 minutes after taking D. Take before the evening meal C.
Remain upright for 30 minutes after taking Explanation: Alendronate is highly
irritating to the esophagus; remaining upright prevents esophageal reflux and
ulceration.
12. A patient with diabetes mellitus has a glucose level of 45 mg/dL. Which action is the
priority? A. Administer regular insulin subcutaneously B. Provide 15g of rapid-acting
carbohydrates C. Notify the healthcare provider D. Assess the patient for respiratory
distress B. Provide 15g of rapid-acting carbohydrates Explanation:
Hypoglycemia must be treated immediately with quick-acting glucose to prevent
neurological damage.
13. What is the priority nursing intervention for a patient experiencing an acute asthma
attack? A. Assessing lung sounds B. Administering oxygen via nasal cannula C.
Administering a short-acting beta-agonist D. Placing the patient in high-Fowler’s
position C. Administering a short-acting beta-agonist Explanation:
Bronchodilation via a beta-agonist is the immediate priority to reverse airway
constriction.
14. Which symptom is most indicative of a pulmonary embolism? A. Productive cough B.
Sudden onset of dyspnea C. Symmetrical leg swelling D. Dull chest pain B. Sudden
onset of dyspnea Explanation: Sudden dyspnea, often accompanied by
tachycardia and chest pain, is a classic presentation of pulmonary embolism.
15. A patient has a Foley catheter. What nursing action prevents catheter-associated
urinary tract infection (CAUTI)? A. Disconnecting the catheter to obtain a sample B.
Keeping the drainage bag below the level of the bladder C. Irrigating the catheter
daily D. Applying antibiotic ointment to the meatus B. Keeping the drainage bag
below the level of the bladder Explanation: Keeping the bag below the bladder
prevents backflow of urine, which is a primary cause of infection.
DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
*Core Domains*
*Perioperative Nursing Care*
*Fluid and Electrolyte Balance*
*Cardiovascular System Disorders*
*Respiratory System Management*
*Endocrine and Metabolic Disorders*
*Gastrointestinal and Nutritional Support*
*Integumentary and Wound Care*
*Musculoskeletal Trauma and Repair*
*Introduction*
*This comprehensive assessment is designed to evaluate clinical proficiency in medical-
surgical nursing. It measures essential skills, theoretical knowledge, and the ability to apply
evidence-based practice to complex patient scenarios. The exam utilizes a multiple-choice
format to assess diagnostic reasoning, prioritization, and safety protocols in acute care
settings. Candidates are challenged to demonstrate critical thinking through real-world
clinical applications, reflecting the decision-making processes required in professional
practice. This evaluation serves to confirm readiness for clinical responsibilities by
emphasizing patient-centered outcomes, adherence to legal standards, and the mastery of
specialized interventions required in diverse medical-surgical nursing environments.*
SECTION ONE: QUESTIONS 1–100
1. A patient is recovering from a thyroidectomy. Which assessment finding requires
immediate intervention by the nurse? A. Incisional pain rated 4/10 B. Hoarseness
when speaking C. Stridor upon inspiration D. Hypocalcemia symptoms C. Stridor
upon inspiration Explanation: Stridor indicates laryngeal edema or airway
obstruction, which is a life-threatening emergency following neck surgery.
2. A patient with heart failure is prescribed furosemide. Which electrolyte should the
nurse monitor most closely? A. Potassium B. Calcium C. Phosphorus D. Magnesium
, A. Potassium Explanation: Furosemide is a loop diuretic that promotes the
excretion of potassium, placing the patient at risk for hypokalemia.
3. Which finding in a patient with a chest tube indicates a potential air leak? A. Tidaling
in the water seal chamber B. Continuous bubbling in the water seal chamber C.
Absence of bubbles in the suction control chamber D. Subcutaneous emphysema at
the insertion site B. Continuous bubbling in the water seal chamber
Explanation: Continuous bubbling in the water seal chamber suggests air is escaping
from the system or the patient's pleural space, indicating a leak.
4. A patient is admitted with suspected appendicitis. Which intervention is
contraindicated? A. Monitoring vital signs B. Administering IV fluids C. Applying a
heating pad to the abdomen D. Keeping the patient NPO C. Applying a heating
pad to the abdomen Explanation: Heat application increases blood flow and
metabolic rate, which can lead to appendix rupture and subsequent peritonitis.
5. Which nursing action is priority for a patient experiencing a tonic-clonic seizure? A.
Inserting an oral airway B. Restraining the patient's extremities C. Turning the patient
to the side D. Administering IV diazepam C. Turning the patient to the side
Explanation: Protecting the airway is the priority; side-lying prevents aspiration of
secretions.
6. A patient has a nursing diagnosis of Risk for Impaired Skin Integrity. Which
intervention is most effective? A. Massaging bony prominences B. Repositioning
every 2 hours C. Using a donut-style cushion D. Maintaining a high-protein diet B.
Repositioning every 2 hours Explanation: Repositioning relieves pressure on
tissues, which is the primary cause of pressure ulcers.
7. Which laboratory value should the nurse review before administering heparin? A.
PT/INR B. Platelet count C. Serum creatinine D. Albumin B. Platelet count
Explanation: Heparin can cause Heparin-Induced Thrombocytopenia (HIT), making
monitoring of platelet counts essential.
8. A patient is scheduled for a colonoscopy. Which instruction is correct regarding pre-
procedure preparation? A. Follow a clear liquid diet for 24 hours B. Increase fiber
intake for two days C. Take oral anticoagulants as scheduled D. Maintain NPO status
for 12 hours A. Follow a clear liquid diet for 24 hours Explanation: A clear
liquid diet ensures the bowel is sufficiently clear for optimal visualization during the
procedure.
9. When assessing a patient with chronic obstructive pulmonary disease (COPD), what
respiratory pattern is most expected? A. Kussmaul respirations B. Cheyne-Stokes
respirations C. Dyspnea on exertion D. Apneustic breathing C. Dyspnea on
, exertion Explanation: COPD causes structural changes in the lungs, leading to
reduced exercise tolerance and shortness of breath during activity.
10. A patient presents with acute chest pain. Which diagnostic test is the priority for
identifying myocardial infarction? A. Chest X-ray B. Electrocardiogram (ECG) C.
Echocardiogram D. Stress test B. Electrocardiogram (ECG) Explanation: An
ECG provides immediate data on cardiac electrical activity to confirm ST-elevation or
other signs of myocardial injury.
11. Which instruction should be provided to a patient taking alendronate for
osteoporosis? A. Take with a full glass of milk B. Lie down for 30 minutes after taking
C. Remain upright for 30 minutes after taking D. Take before the evening meal C.
Remain upright for 30 minutes after taking Explanation: Alendronate is highly
irritating to the esophagus; remaining upright prevents esophageal reflux and
ulceration.
12. A patient with diabetes mellitus has a glucose level of 45 mg/dL. Which action is the
priority? A. Administer regular insulin subcutaneously B. Provide 15g of rapid-acting
carbohydrates C. Notify the healthcare provider D. Assess the patient for respiratory
distress B. Provide 15g of rapid-acting carbohydrates Explanation:
Hypoglycemia must be treated immediately with quick-acting glucose to prevent
neurological damage.
13. What is the priority nursing intervention for a patient experiencing an acute asthma
attack? A. Assessing lung sounds B. Administering oxygen via nasal cannula C.
Administering a short-acting beta-agonist D. Placing the patient in high-Fowler’s
position C. Administering a short-acting beta-agonist Explanation:
Bronchodilation via a beta-agonist is the immediate priority to reverse airway
constriction.
14. Which symptom is most indicative of a pulmonary embolism? A. Productive cough B.
Sudden onset of dyspnea C. Symmetrical leg swelling D. Dull chest pain B. Sudden
onset of dyspnea Explanation: Sudden dyspnea, often accompanied by
tachycardia and chest pain, is a classic presentation of pulmonary embolism.
15. A patient has a Foley catheter. What nursing action prevents catheter-associated
urinary tract infection (CAUTI)? A. Disconnecting the catheter to obtain a sample B.
Keeping the drainage bag below the level of the bladder C. Irrigating the catheter
daily D. Applying antibiotic ointment to the meatus B. Keeping the drainage bag
below the level of the bladder Explanation: Keeping the bag below the bladder
prevents backflow of urine, which is a primary cause of infection.
