HESI PN Med-Surg Test Bank (NGN-Style
Questions & Case Scenarios)
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
200 questions
Questions
Format Multiple-choice, NGN-style case scenarios, prioritization
Content Medical-Surgical Nursing, Pharmacology, Fluid/Electrolytes, Respiratory, Cardiac, GI,
Areas Renal, Endocrine, Neurological, Musculoskeletal, Oncology, Perioperative Care
Rationales Expert-verified explanations for every answer
,Section 1: Core Medical-Surgical Concepts (Questions
1-30)
Question 1
Which acid-base imbalance is most commonly associated with severe,
prolonged vomiting?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
*Correct Answer: B. Metabolic alkalosis. *
Rationale: Gastric fluid is rich in hydrochloric acid. Loss of gastric acid
through prolonged vomiting leads to an increase in serum bicarbonate,
causing metabolic alkalosis.
Question 2
A client with emphysema is receiving oxygen at 2 L/min via nasal cannula.
Which assessment finding indicates an adverse effect of oxygen therapy?
A. Oxygen saturation of 92%
B. Respiratory rate of 10 breaths/min
C. Client reports feeling more rested
D. Productive cough
*Correct Answer: B. Respiratory rate of 10 breaths/min. *
Rationale: Clients with COPD may rely on a hypoxic drive to breathe.
Excessive oxygen can suppress this drive, leading to respiratory depression,
hypercapnia, and acidosis. A respiratory rate of 10 is significantly below
normal.
,Question 3
The nurse is caring for a client who had a total knee replacement 8 hours
ago. Which intervention is most important to prevent venous
thromboembolism (VTE)?
A. Apply sequential compression devices (SCDs)
B. Administer oral warfarin as prescribed
C. Encourage isometric quadriceps exercises
D. Elevate the affected leg on pillows
*Correct Answer: A. Apply sequential compression devices (SCDs). *
Rationale: SCDs provide mechanical prophylaxis by enhancing venous return
and reducing stasis. While all options may be part of VTE prevention,
mechanical devices are often initiated immediately post-operatively.
Question 4
A client with heart failure reports a weight gain of 5 pounds in 3 days. What
is the nurse's priority action?
A. Encourage the client to restrict oral fluids
B. Assess for peripheral edema and crackles
C. Notify the healthcare provider immediately
D. Increase the dose of furosemide
*Correct Answer: C. Notify the healthcare provider immediately. *
Rationale: A rapid weight gain of 2–3 pounds in 24 hours or 5 pounds in 1
week is a sign of worsening fluid overload. The provider should be notified for
potential adjustment of diuretic therapy.
, Question 5
The nurse is teaching a client with diabetes about proper foot care. Which
statement indicates the need for further instruction?
A. "I will wear cotton socks and well-fitting shoes."
B. "I will soak my feet daily to keep them soft."
C. "I will inspect my feet daily for cuts or blisters."
D. "I will dry between my toes after washing."
*Correct Answer: B. "I will soak my feet daily to keep them soft." *
Rationale: Soaking feet daily can lead to maceration and skin breakdown,
increasing infection risk. Clients with diabetes should wash feet daily with
mild soap, dry thoroughly, and inspect for any abnormalities.
Question 6
Which finding would the nurse expect in a client with hypokalemia?
A. Hypertension
B. Muscle weakness and cardiac arrhythmias
C. Hyperactive reflexes
D. Weight gain
*Correct Answer: B. Muscle weakness and cardiac arrhythmias. *
Rationale: Hypokalemia (potassium <3.5 mEq/L) causes muscle weakness,
fatigue, and cardiac arrhythmias. Hyperactive reflexes are seen in
hypocalcemia or hypomagnesemia.
Question 7
What is the most common cause of acute pancreatitis?
Questions & Case Scenarios)
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
200 questions
Questions
Format Multiple-choice, NGN-style case scenarios, prioritization
Content Medical-Surgical Nursing, Pharmacology, Fluid/Electrolytes, Respiratory, Cardiac, GI,
Areas Renal, Endocrine, Neurological, Musculoskeletal, Oncology, Perioperative Care
Rationales Expert-verified explanations for every answer
,Section 1: Core Medical-Surgical Concepts (Questions
1-30)
Question 1
Which acid-base imbalance is most commonly associated with severe,
prolonged vomiting?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
*Correct Answer: B. Metabolic alkalosis. *
Rationale: Gastric fluid is rich in hydrochloric acid. Loss of gastric acid
through prolonged vomiting leads to an increase in serum bicarbonate,
causing metabolic alkalosis.
Question 2
A client with emphysema is receiving oxygen at 2 L/min via nasal cannula.
Which assessment finding indicates an adverse effect of oxygen therapy?
A. Oxygen saturation of 92%
B. Respiratory rate of 10 breaths/min
C. Client reports feeling more rested
D. Productive cough
*Correct Answer: B. Respiratory rate of 10 breaths/min. *
Rationale: Clients with COPD may rely on a hypoxic drive to breathe.
Excessive oxygen can suppress this drive, leading to respiratory depression,
hypercapnia, and acidosis. A respiratory rate of 10 is significantly below
normal.
,Question 3
The nurse is caring for a client who had a total knee replacement 8 hours
ago. Which intervention is most important to prevent venous
thromboembolism (VTE)?
A. Apply sequential compression devices (SCDs)
B. Administer oral warfarin as prescribed
C. Encourage isometric quadriceps exercises
D. Elevate the affected leg on pillows
*Correct Answer: A. Apply sequential compression devices (SCDs). *
Rationale: SCDs provide mechanical prophylaxis by enhancing venous return
and reducing stasis. While all options may be part of VTE prevention,
mechanical devices are often initiated immediately post-operatively.
Question 4
A client with heart failure reports a weight gain of 5 pounds in 3 days. What
is the nurse's priority action?
A. Encourage the client to restrict oral fluids
B. Assess for peripheral edema and crackles
C. Notify the healthcare provider immediately
D. Increase the dose of furosemide
*Correct Answer: C. Notify the healthcare provider immediately. *
Rationale: A rapid weight gain of 2–3 pounds in 24 hours or 5 pounds in 1
week is a sign of worsening fluid overload. The provider should be notified for
potential adjustment of diuretic therapy.
, Question 5
The nurse is teaching a client with diabetes about proper foot care. Which
statement indicates the need for further instruction?
A. "I will wear cotton socks and well-fitting shoes."
B. "I will soak my feet daily to keep them soft."
C. "I will inspect my feet daily for cuts or blisters."
D. "I will dry between my toes after washing."
*Correct Answer: B. "I will soak my feet daily to keep them soft." *
Rationale: Soaking feet daily can lead to maceration and skin breakdown,
increasing infection risk. Clients with diabetes should wash feet daily with
mild soap, dry thoroughly, and inspect for any abnormalities.
Question 6
Which finding would the nurse expect in a client with hypokalemia?
A. Hypertension
B. Muscle weakness and cardiac arrhythmias
C. Hyperactive reflexes
D. Weight gain
*Correct Answer: B. Muscle weakness and cardiac arrhythmias. *
Rationale: Hypokalemia (potassium <3.5 mEq/L) causes muscle weakness,
fatigue, and cardiac arrhythmias. Hyperactive reflexes are seen in
hypocalcemia or hypomagnesemia.
Question 7
What is the most common cause of acute pancreatitis?
