HESI Medical-Surgical Exam 200 Questions and Correct
Answers (Verified Answers) Plus Rationales 2026 Q&A |
Instant Download PDF Already Graded A+
Question 1
A client with chronic obstructive pulmonary disease (COPD) presents
with worsening dyspnea and a productive cough. Which arterial blood
gas (ABG) finding is most consistent with this condition?
A) pH 7.38, PaCO2 48 mmHg, HCO3 26 mEq/L
B) pH 7.32, PaCO2 55 mmHg, HCO3 30 mEq/L
C) pH 7.42, PaCO2 38 mmHg, HCO3 22 mEq/L
D) pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L
Correct Answer: B
Explanation: Clients with COPD often develop chronic respiratory
acidosis with metabolic compensation. Option B shows respiratory
acidosis (low pH, elevated PaCO2) with metabolic compensation
(elevated HCO3), which is characteristic of COPD. Option A shows
compensated respiratory acidosis, but the values are less severe. Option
C represents normal values. Option D shows respiratory acidosis without
adequate compensation.
Question 2
A client is admitted with acute pancreatitis. Which laboratory finding is
most specific for this diagnosis?
A) Elevated blood urea nitrogen
,B) Elevated serum amylase
C) Elevated serum lipase
D) Elevated white blood cell count
Correct Answer: C
Explanation: Serum lipase is more specific for acute pancreatitis than
serum amylase because lipase remains elevated longer and is produced
only in the pancreas. Amylase can be elevated in other conditions such
as salivary gland disorders and intestinal obstruction. BUN elevation
indicates dehydration or renal impairment, and WBC elevation indicates
inflammation but is nonspecific.
Question 3
A client with heart failure is prescribed furosemide. Which assessment
finding indicates the medication is effective?
A) Decreased peripheral edema
B) Increased blood pressure
C) Increased heart rate
D) Decreased urine output
Correct Answer: A
Explanation: Furosemide is a loop diuretic that reduces fluid volume by
increasing urine output. Effectiveness is demonstrated by decreased
peripheral edema, decreased pulmonary congestion, and weight loss.
Blood pressure should decrease, not increase. Heart rate may decrease
as fluid volume decreases. Urine output should increase with diuretic
therapy.
,Question 4
A client is 24 hours post-gastrectomy and has a nasogastric (NG) tube
connected to low intermittent suction. Which finding requires
immediate intervention?
A) 200 mL of green drainage in the past 8 hours
B) Complaints of nausea
C) Absent bowel sounds
D) Bright red drainage from the NG tube
Correct Answer: D
Explanation: Bright red drainage from the NG tube indicates active
bleeding and requires immediate intervention. The nurse should notify
the healthcare provider and assess vital signs. Green drainage is
expected from gastric contents. Nausea is common postoperatively.
Absent bowel sounds are expected in the immediate postoperative
period.
Question 5
A client with diabetes mellitus type 2 has a blood glucose level of 320
mg/dL and urine ketones are positive. Which nursing intervention is
priority?
A) Administer regular insulin as prescribed
B) Encourage oral fluid intake
C) Check vital signs
D) Notify the healthcare provider
Correct Answer: C
Explanation: Before administering insulin or other interventions, the
nurse must assess vital signs to evaluate for signs of diabetic
, ketoacidosis (DKA) such as hypotension and tachycardia. This
assessment guides subsequent interventions and ensures client safety.
While all options are appropriate, checking vital signs is the priority
action to determine the client's stability.
Question 6
A client with cirrhosis develops ascites. Which dietary modification is
most important for this client?
A) High-protein diet
B) Low-sodium diet
C) Low-carbohydrate diet
D) High-fat diet
Correct Answer: B
Explanation: Ascites results from portal hypertension and decreased
albumin synthesis, leading to fluid accumulation in the abdominal
cavity. A low-sodium diet is essential to reduce fluid retention. While
protein restriction may be needed if hepatic encephalopathy develops,
high-quality protein is generally encouraged unless contraindicated.
Carbohydrates and fats are not directly implicated in ascites
management.
Question 7
A client is receiving heparin therapy for deep vein thrombosis. Which
laboratory value should the nurse monitor to evaluate therapeutic
effectiveness?
A) Prothrombin time (PT)
B) Activated partial thromboplastin time (aPTT)
Answers (Verified Answers) Plus Rationales 2026 Q&A |
Instant Download PDF Already Graded A+
Question 1
A client with chronic obstructive pulmonary disease (COPD) presents
with worsening dyspnea and a productive cough. Which arterial blood
gas (ABG) finding is most consistent with this condition?
A) pH 7.38, PaCO2 48 mmHg, HCO3 26 mEq/L
B) pH 7.32, PaCO2 55 mmHg, HCO3 30 mEq/L
C) pH 7.42, PaCO2 38 mmHg, HCO3 22 mEq/L
D) pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L
Correct Answer: B
Explanation: Clients with COPD often develop chronic respiratory
acidosis with metabolic compensation. Option B shows respiratory
acidosis (low pH, elevated PaCO2) with metabolic compensation
(elevated HCO3), which is characteristic of COPD. Option A shows
compensated respiratory acidosis, but the values are less severe. Option
C represents normal values. Option D shows respiratory acidosis without
adequate compensation.
Question 2
A client is admitted with acute pancreatitis. Which laboratory finding is
most specific for this diagnosis?
A) Elevated blood urea nitrogen
,B) Elevated serum amylase
C) Elevated serum lipase
D) Elevated white blood cell count
Correct Answer: C
Explanation: Serum lipase is more specific for acute pancreatitis than
serum amylase because lipase remains elevated longer and is produced
only in the pancreas. Amylase can be elevated in other conditions such
as salivary gland disorders and intestinal obstruction. BUN elevation
indicates dehydration or renal impairment, and WBC elevation indicates
inflammation but is nonspecific.
Question 3
A client with heart failure is prescribed furosemide. Which assessment
finding indicates the medication is effective?
A) Decreased peripheral edema
B) Increased blood pressure
C) Increased heart rate
D) Decreased urine output
Correct Answer: A
Explanation: Furosemide is a loop diuretic that reduces fluid volume by
increasing urine output. Effectiveness is demonstrated by decreased
peripheral edema, decreased pulmonary congestion, and weight loss.
Blood pressure should decrease, not increase. Heart rate may decrease
as fluid volume decreases. Urine output should increase with diuretic
therapy.
,Question 4
A client is 24 hours post-gastrectomy and has a nasogastric (NG) tube
connected to low intermittent suction. Which finding requires
immediate intervention?
A) 200 mL of green drainage in the past 8 hours
B) Complaints of nausea
C) Absent bowel sounds
D) Bright red drainage from the NG tube
Correct Answer: D
Explanation: Bright red drainage from the NG tube indicates active
bleeding and requires immediate intervention. The nurse should notify
the healthcare provider and assess vital signs. Green drainage is
expected from gastric contents. Nausea is common postoperatively.
Absent bowel sounds are expected in the immediate postoperative
period.
Question 5
A client with diabetes mellitus type 2 has a blood glucose level of 320
mg/dL and urine ketones are positive. Which nursing intervention is
priority?
A) Administer regular insulin as prescribed
B) Encourage oral fluid intake
C) Check vital signs
D) Notify the healthcare provider
Correct Answer: C
Explanation: Before administering insulin or other interventions, the
nurse must assess vital signs to evaluate for signs of diabetic
, ketoacidosis (DKA) such as hypotension and tachycardia. This
assessment guides subsequent interventions and ensures client safety.
While all options are appropriate, checking vital signs is the priority
action to determine the client's stability.
Question 6
A client with cirrhosis develops ascites. Which dietary modification is
most important for this client?
A) High-protein diet
B) Low-sodium diet
C) Low-carbohydrate diet
D) High-fat diet
Correct Answer: B
Explanation: Ascites results from portal hypertension and decreased
albumin synthesis, leading to fluid accumulation in the abdominal
cavity. A low-sodium diet is essential to reduce fluid retention. While
protein restriction may be needed if hepatic encephalopathy develops,
high-quality protein is generally encouraged unless contraindicated.
Carbohydrates and fats are not directly implicated in ascites
management.
Question 7
A client is receiving heparin therapy for deep vein thrombosis. Which
laboratory value should the nurse monitor to evaluate therapeutic
effectiveness?
A) Prothrombin time (PT)
B) Activated partial thromboplastin time (aPTT)
