HESI PN Med-Surg Test Bank (NGN-Style
Questions & Case Scenarios)2026
Welcome to this comprehensive HESI PN Medical-Surgical Test
Bank featuring NGN-style questions and case scenarios with
detailed rationales. The HESI PN Med-Surg exam evaluates your
ability to apply medical-surgical nursing knowledge to practical,
real-world patient care scenarios. These questions are designed to
mirror the format and difficulty of the actual HESI PN exam,
including Next Generation NCLEX (NGN)-style questions that test
clinical judgment across the nursing process.
📚 Exam Quick Facts
Feature Details
Total
250 questions
Questions
Format Multiple-choice, NGN-style case scenarios, prioritization
Medical-Surgical Nursing, Pharmacology, Fluid/Electrolytes, Respiratory
Content
Cardiac, GI, Renal, Endocrine, Neurological, Musculoskeletal, Oncology,
Areas
Perioperative Care
,Feature Details
Rationales Expert-verified explanations for every answer
Question 1
A client with a diagnosis of herpes zoster (shingles) asks the nurse about
the cause of the rash. Which response is most accurate?
A. "Shingles is caused by a bacterial infection."
B. "Shingles is caused by the reactivation of the varicella-zoster virus."
C. "Shingles is a fungal infection of the skin."
D. "Shingles is caused by an allergic reaction."
*Correct Answer: B. *
Rationale: Herpes zoster (shingles) is caused by the reactivation of the
varicella-zoster virus, the same virus that causes chickenpox. The virus lies
dormant in the dorsal root ganglia and can reactivate later in life, especially
when the immune system is compromised.
Question 2
The nurse is caring for a client with a pressure ulcer on the sacrum. The
wound bed is covered with yellow, stringy tissue. Which term best describes
this tissue?
A. Eschar
B. Slough
C. Granulation tissue
D. Epithelial tissue
,*Correct Answer: B. *
Rationale: Slough is yellow, stringy, or mucinous tissue that covers a wound.
It is devitalized tissue that should be removed to promote healing. Eschar is
black and dry, granulation is red/beefy, and epithelial tissue is pink tissue
that forms over healing wounds.
Question 3
A client with open-angle glaucoma is prescribed timolol eye drops. Which
instruction should the nurse include in the teaching?
A. "Apply the drops directly to the cornea."
B. "Apply pressure to the inner canthus after instilling the drops."
C. "Shake the bottle vigorously before each use."
D. "Use the drops only when you have eye pain."
*Correct Answer: B. *
Rationale: Applying pressure to the inner canthus (nasolacrimal occlusion)
after instilling eye drops helps reduce systemic absorption and side effects.
Timolol is a beta-blocker that can cause systemic effects including
bradycardia and bronchospasm if absorbed.
Question 4
A client with a history of deep vein thrombosis (DVT) is prescribed warfarin.
Which over-the-counter medication should the client be advised to avoid?
A. Acetaminophen
B. Ibuprofen
C. Calcium supplements
D. Vitamin C
, *Correct Answer: B. *
Rationale: NSAIDs such as ibuprofen can increase the risk of bleeding in
clients taking warfarin. Acetaminophen is generally safe but should be used
in moderation. NSAIDs also interfere with platelet function and can increase
GI bleeding risk.
Question 5
The nurse is assessing a client with diabetic retinopathy. Which finding
would the nurse expect?
A. Blurred vision in one eye only
B. Microaneurysms and dot-blot hemorrhages on fundoscopic
examination
C. Sudden loss of vision in both eyes
D. Eye pain and redness
*Correct Answer: B. *
Rationale: Diabetic retinopathy is characterized by microaneurysms, dot-blot
hemorrhages, and exudates on fundoscopic examination. It is a complication
of diabetes caused by damage to the retinal blood vessels. Sudden vision loss
is less common in early stages.
Question 6
A client with a history of seizures is prescribed phenytoin. Which side effect
should the nurse monitor for?
A. Weight gain
B. Gingival hyperplasia
Questions & Case Scenarios)2026
Welcome to this comprehensive HESI PN Medical-Surgical Test
Bank featuring NGN-style questions and case scenarios with
detailed rationales. The HESI PN Med-Surg exam evaluates your
ability to apply medical-surgical nursing knowledge to practical,
real-world patient care scenarios. These questions are designed to
mirror the format and difficulty of the actual HESI PN exam,
including Next Generation NCLEX (NGN)-style questions that test
clinical judgment across the nursing process.
📚 Exam Quick Facts
Feature Details
Total
250 questions
Questions
Format Multiple-choice, NGN-style case scenarios, prioritization
Medical-Surgical Nursing, Pharmacology, Fluid/Electrolytes, Respiratory
Content
Cardiac, GI, Renal, Endocrine, Neurological, Musculoskeletal, Oncology,
Areas
Perioperative Care
,Feature Details
Rationales Expert-verified explanations for every answer
Question 1
A client with a diagnosis of herpes zoster (shingles) asks the nurse about
the cause of the rash. Which response is most accurate?
A. "Shingles is caused by a bacterial infection."
B. "Shingles is caused by the reactivation of the varicella-zoster virus."
C. "Shingles is a fungal infection of the skin."
D. "Shingles is caused by an allergic reaction."
*Correct Answer: B. *
Rationale: Herpes zoster (shingles) is caused by the reactivation of the
varicella-zoster virus, the same virus that causes chickenpox. The virus lies
dormant in the dorsal root ganglia and can reactivate later in life, especially
when the immune system is compromised.
Question 2
The nurse is caring for a client with a pressure ulcer on the sacrum. The
wound bed is covered with yellow, stringy tissue. Which term best describes
this tissue?
A. Eschar
B. Slough
C. Granulation tissue
D. Epithelial tissue
,*Correct Answer: B. *
Rationale: Slough is yellow, stringy, or mucinous tissue that covers a wound.
It is devitalized tissue that should be removed to promote healing. Eschar is
black and dry, granulation is red/beefy, and epithelial tissue is pink tissue
that forms over healing wounds.
Question 3
A client with open-angle glaucoma is prescribed timolol eye drops. Which
instruction should the nurse include in the teaching?
A. "Apply the drops directly to the cornea."
B. "Apply pressure to the inner canthus after instilling the drops."
C. "Shake the bottle vigorously before each use."
D. "Use the drops only when you have eye pain."
*Correct Answer: B. *
Rationale: Applying pressure to the inner canthus (nasolacrimal occlusion)
after instilling eye drops helps reduce systemic absorption and side effects.
Timolol is a beta-blocker that can cause systemic effects including
bradycardia and bronchospasm if absorbed.
Question 4
A client with a history of deep vein thrombosis (DVT) is prescribed warfarin.
Which over-the-counter medication should the client be advised to avoid?
A. Acetaminophen
B. Ibuprofen
C. Calcium supplements
D. Vitamin C
, *Correct Answer: B. *
Rationale: NSAIDs such as ibuprofen can increase the risk of bleeding in
clients taking warfarin. Acetaminophen is generally safe but should be used
in moderation. NSAIDs also interfere with platelet function and can increase
GI bleeding risk.
Question 5
The nurse is assessing a client with diabetic retinopathy. Which finding
would the nurse expect?
A. Blurred vision in one eye only
B. Microaneurysms and dot-blot hemorrhages on fundoscopic
examination
C. Sudden loss of vision in both eyes
D. Eye pain and redness
*Correct Answer: B. *
Rationale: Diabetic retinopathy is characterized by microaneurysms, dot-blot
hemorrhages, and exudates on fundoscopic examination. It is a complication
of diabetes caused by damage to the retinal blood vessels. Sudden vision loss
is less common in early stages.
Question 6
A client with a history of seizures is prescribed phenytoin. Which side effect
should the nurse monitor for?
A. Weight gain
B. Gingival hyperplasia
