MED SURG HESI EXAMS V1 AND V2 - 2026/2027
QUESTIONS AND VERIFIED ANSWERS WITH
RATIONALES 100% GUARANTEED PASS
GRADED A+ LATEST
MED SURG HESI EXAM V1
Question 1
A patient with chronic obstructive pulmonary disease (COPD) reports increased
shortness of breath and a productive cough with green sputum. Vital signs: T
101°F, HR 110, RR 24, BP 138/82, SpO₂ 88% on room air. Which is the nurse’s
priority intervention?
A. Administer prescribed albuterol via nebulizer
B. Encourage the patient to drink 2–3 liters of water per day
C. Obtain a sputum culture and sensitivity
D. Teach pursed-lip breathing
Answer: A. Administer prescribed albuterol via nebulizer
Rationale: The patient is exhibiting signs of an acute COPD exacerbation with
hypoxemia and increased work of breathing. Administering a bronchodilator
immediately helps relieve airway obstruction, improve oxygenation, and reduce
dyspnea. While sputum culture, hydration, and breathing techniques are important,
they are not the priority in an acute exacerbation.
,Question 2
A 65-year-old patient is admitted with heart failure. Which assessment finding is
most indicative of worsening left-sided heart failure?
A. Jugular vein distention
B. Peripheral edema in ankles
C. Crackles in the lungs
D. Hepatomegaly
Answer: C. Crackles in the lungs
Rationale: Left-sided heart failure leads to pulmonary congestion and fluid
accumulation in the lungs, causing crackles and dyspnea. Right-sided heart failure
primarily causes peripheral edema, jugular vein distention, and hepatomegaly.
Question 3
A patient with a history of peptic ulcer disease complains of sudden, severe
abdominal pain and has a rigid abdomen with absent bowel sounds. What is the
priority action?
A. Administer prescribed proton pump inhibitor
B. Prepare the patient for possible surgery
C. Encourage oral intake of clear fluids
D. Obtain a stool sample for occult blood
Answer: B. Prepare the patient for possible surgery
Rationale: Sudden severe abdominal pain with rigidity and absent bowel sounds
suggests a perforated ulcer, which is a surgical emergency. Prompt surgical
intervention is necessary to prevent peritonitis and sepsis.
,Question 4
A patient with diabetes mellitus presents with fruity breath, polyuria, and
confusion. Blood glucose is 480 mg/dL. Which condition is the nurse most
concerned about?
A. Hypoglycemia
B. Hyperosmolar hyperglycemic state (HHS)
C. Diabetic ketoacidosis (DKA)
D. Insulin resistance
Answer: C. Diabetic ketoacidosis (DKA)
Rationale: Fruity breath, hyperglycemia, polyuria, and altered mental status are
classic signs of DKA. This condition requires prompt IV fluids, insulin therapy,
and electrolyte monitoring. HHS usually occurs in older adults and presents with
extreme hyperglycemia but without significant ketoacidosis.
Question 5
A patient with chronic kidney disease (CKD) is prescribed erythropoietin. Which
lab value indicates the medication is effective?
A. Serum creatinine 4.5 mg/dL
B. Hematocrit 35%
C. Potassium 6.0 mEq/L
D. BUN 50 mg/dL
Answer: B. Hematocrit 35%
Rationale: Erythropoietin stimulates red blood cell production, improving
hematocrit and hemoglobin levels. Creatinine and BUN indicate kidney function
but are not directly affected by erythropoietin. Potassium is unrelated to
erythropoietin therapy.
, Question 6
A patient is receiving morphine for postoperative pain. The nurse notes the
patient’s respiratory rate is 8/min and oxygen saturation is 88%. What is the
priority intervention?
A. Encourage the patient to cough and deep breathe
B. Administer naloxone as prescribed
C. Place the patient in high-Fowler’s position
D. Document the findings and reassess in 30 minutes
Answer: B. Administer naloxone as prescribed
Rationale: Respiratory depression is a life-threatening adverse effect of opioids.
Naloxone is an opioid antagonist and should be administered immediately.
Positioning and breathing techniques are supportive but do not reverse opioid
toxicity.
Question 7
Which lab result is most concerning in a patient receiving heparin therapy?
A. aPTT 40 seconds (control 30–40 seconds)
B. Platelet count 45,000/mm³
C. PT 14 seconds (control 12–15 seconds)
D. INR 1.1
Answer: B. Platelet count 45,000/mm³
Rationale: A low platelet count indicates heparin-induced thrombocytopenia
(HIT), a serious complication. aPTT elevation is expected during heparin therapy;
PT and INR are not significantly affected.
QUESTIONS AND VERIFIED ANSWERS WITH
RATIONALES 100% GUARANTEED PASS
GRADED A+ LATEST
MED SURG HESI EXAM V1
Question 1
A patient with chronic obstructive pulmonary disease (COPD) reports increased
shortness of breath and a productive cough with green sputum. Vital signs: T
101°F, HR 110, RR 24, BP 138/82, SpO₂ 88% on room air. Which is the nurse’s
priority intervention?
A. Administer prescribed albuterol via nebulizer
B. Encourage the patient to drink 2–3 liters of water per day
C. Obtain a sputum culture and sensitivity
D. Teach pursed-lip breathing
Answer: A. Administer prescribed albuterol via nebulizer
Rationale: The patient is exhibiting signs of an acute COPD exacerbation with
hypoxemia and increased work of breathing. Administering a bronchodilator
immediately helps relieve airway obstruction, improve oxygenation, and reduce
dyspnea. While sputum culture, hydration, and breathing techniques are important,
they are not the priority in an acute exacerbation.
,Question 2
A 65-year-old patient is admitted with heart failure. Which assessment finding is
most indicative of worsening left-sided heart failure?
A. Jugular vein distention
B. Peripheral edema in ankles
C. Crackles in the lungs
D. Hepatomegaly
Answer: C. Crackles in the lungs
Rationale: Left-sided heart failure leads to pulmonary congestion and fluid
accumulation in the lungs, causing crackles and dyspnea. Right-sided heart failure
primarily causes peripheral edema, jugular vein distention, and hepatomegaly.
Question 3
A patient with a history of peptic ulcer disease complains of sudden, severe
abdominal pain and has a rigid abdomen with absent bowel sounds. What is the
priority action?
A. Administer prescribed proton pump inhibitor
B. Prepare the patient for possible surgery
C. Encourage oral intake of clear fluids
D. Obtain a stool sample for occult blood
Answer: B. Prepare the patient for possible surgery
Rationale: Sudden severe abdominal pain with rigidity and absent bowel sounds
suggests a perforated ulcer, which is a surgical emergency. Prompt surgical
intervention is necessary to prevent peritonitis and sepsis.
,Question 4
A patient with diabetes mellitus presents with fruity breath, polyuria, and
confusion. Blood glucose is 480 mg/dL. Which condition is the nurse most
concerned about?
A. Hypoglycemia
B. Hyperosmolar hyperglycemic state (HHS)
C. Diabetic ketoacidosis (DKA)
D. Insulin resistance
Answer: C. Diabetic ketoacidosis (DKA)
Rationale: Fruity breath, hyperglycemia, polyuria, and altered mental status are
classic signs of DKA. This condition requires prompt IV fluids, insulin therapy,
and electrolyte monitoring. HHS usually occurs in older adults and presents with
extreme hyperglycemia but without significant ketoacidosis.
Question 5
A patient with chronic kidney disease (CKD) is prescribed erythropoietin. Which
lab value indicates the medication is effective?
A. Serum creatinine 4.5 mg/dL
B. Hematocrit 35%
C. Potassium 6.0 mEq/L
D. BUN 50 mg/dL
Answer: B. Hematocrit 35%
Rationale: Erythropoietin stimulates red blood cell production, improving
hematocrit and hemoglobin levels. Creatinine and BUN indicate kidney function
but are not directly affected by erythropoietin. Potassium is unrelated to
erythropoietin therapy.
, Question 6
A patient is receiving morphine for postoperative pain. The nurse notes the
patient’s respiratory rate is 8/min and oxygen saturation is 88%. What is the
priority intervention?
A. Encourage the patient to cough and deep breathe
B. Administer naloxone as prescribed
C. Place the patient in high-Fowler’s position
D. Document the findings and reassess in 30 minutes
Answer: B. Administer naloxone as prescribed
Rationale: Respiratory depression is a life-threatening adverse effect of opioids.
Naloxone is an opioid antagonist and should be administered immediately.
Positioning and breathing techniques are supportive but do not reverse opioid
toxicity.
Question 7
Which lab result is most concerning in a patient receiving heparin therapy?
A. aPTT 40 seconds (control 30–40 seconds)
B. Platelet count 45,000/mm³
C. PT 14 seconds (control 12–15 seconds)
D. INR 1.1
Answer: B. Platelet count 45,000/mm³
Rationale: A low platelet count indicates heparin-induced thrombocytopenia
(HIT), a serious complication. aPTT elevation is expected during heparin therapy;
PT and INR are not significantly affected.
