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HESI MED-SURG I EXAM 2026/2027 | RN MEDICAL-
SURGICAL NURSING I – ELSEVIER EVOLVE | EXPERT
VERIFIED | 150 VERIFIED Q&A | DETAILED RATIONALES |
NGN-ALIGNED | PASS GUARANTEED – A+ GRADED
Question 1
A nurse is caring for a client who is postoperative day 1 following abdominal surgery. The client
reports pain as 7 on a scale of 0-10. Which of the following is the priority nursing action?
A. Reposition the client
B. Administer prescribed analgesic
C. Encourage deep breathing exercises
D. Ambulate the client
Correct Answer: B
Rationale: The priority action is to administer the prescribed analgesic for pain management. Pain
control is essential for promoting recovery, enabling participation in deep breathing exercises, and
facilitating ambulation. Repositioning may help but does not replace analgesia for moderate-to-
severe pain.
Question 2
A nurse is assessing a client who has a chest tube in place. Which of the following findings requires
immediate intervention?
A. Intermittent bubbling in the water seal chamber with respirations
B. Continuous bubbling in the water seal chamber
C. Drainage of 50 mL in the first hour
D. Fluctuation of fluid in the water seal chamber
Correct Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak and requires
immediate intervention. Intermittent bubbling (tidaling) and fluctuation with respirations are
normal. Drainage of 50 mL in the first hour is within normal limits.
Question 3
A nurse is caring for a client who has a new colostomy. Which of the following findings indicates a
healthy stoma?
A. Dusky, dark-colored stoma
B. Moist, pink stoma
C. Dry, pale stoma
D. Bluish stoma
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Correct Answer: B
Rationale: A healthy stoma should be moist and pink, indicating adequate blood supply. A dusky,
dark, pale, or bluish stoma indicates compromised blood flow and requires immediate intervention.
Question 4
A nurse is preparing to administer a blood transfusion. Which of the following actions should the
nurse take first?
A. Obtain baseline vital signs
B. Verify the blood product with another licensed nurse
C. Prime the IV tubing with normal saline
D. Document the procedure
Correct Answer: B
Rationale: The priority action is to verify the blood product with another licensed nurse to ensure
the right client receives the right blood product. Baseline vital signs, priming tubing, and
documentation occur after verification.
Question 5
A nurse is caring for a client who has a new diagnosis of diabetes mellitus. Which of the following
laboratory values indicates good glucose control over the past 2-3 months?
A. Fasting blood glucose of 110 mg/dL
B. Hemoglobin A1c of 7.0%
C. Postprandial glucose of 180 mg/dL
D. Random glucose of 150 mg/dL
Correct Answer: B
Rationale: Hemoglobin A1c reflects average blood glucose over the past 2-3 months. A1c of 7.0% is
at goal for most clients with diabetes. Fasting, postprandial, and random glucose reflect current
levels only.
Question 6
A nurse is caring for a client who is receiving a continuous heparin infusion. Which of the following
laboratory values should the nurse monitor?
A. INR
B. aPTT
C. Platelet count
D. Hemoglobin
Correct Answer: B
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Rationale: Heparin is monitored with aPTT (activated partial thromboplastin time). INR monitors
warfarin. Platelet count should also be monitored for heparin-induced thrombocytopenia, but aPTT
is the primary monitoring parameter.
Question 7
A nurse is assessing a client who has heart failure. Which of the following findings indicates left-
sided heart failure?
A. Peripheral edema
B. Crackles on lung auscultation
C. Jugular vein distention
D. Ascites
Correct Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion, manifesting as crackles on lung
auscultation, dyspnea, and orthopnea. Peripheral edema, JVD, and ascites are signs of right-sided
heart failure.
Question 8
A nurse is caring for a client who has a new prescription for furosemide. Which of the following
laboratory values should the nurse monitor?
A. Serum potassium
B. Serum calcium
C. Serum magnesium
D. Serum phosphorus
Correct Answer: A
Rationale: Furosemide (loop diuretic) causes potassium loss, so serum potassium should be
monitored for hypokalemia.
Question 9
A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which of the
following is a sign of hypoxemia?
A. Pink mucous membranes
B. Oxygen saturation of 88% on room air
C. Respiratory rate of 14 breaths per minute
D. Clear breath sounds
Correct Answer: B
Rationale: Oxygen saturation of 88% on room air indicates hypoxemia (normal: 95-100%). Pink
mucous membranes, normal respiratory rate, and clear breath sounds do not indicate hypoxemia.
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Question 10
A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following
is a complication of TPN?
A. Hypoglycemia
B. Hyperglycemia
C. Hypotension
D. Bradycardia
Correct Answer: B
Rationale: TPN contains high glucose concentrations, which can cause hyperglycemia. Blood glucose
should be monitored regularly.
Question 11
A nurse is assessing a client who has a wound infection. Which of the following findings indicates a
systemic infection?
A. Localized redness
B. Fever and chills
C. Purulent drainage at the site
D. Warmth at the site
Correct Answer: B
Rationale: Fever and chills indicate a systemic infection. Localized redness, purulent drainage, and
warmth are signs of a localized infection.
Question 12
A nurse is caring for a client who has a new prescription for warfarin. Which of the following should
the nurse include in client education?
A. "Take warfarin with aspirin for better effect"
B. "Avoid foods high in vitamin K"
C. "You do not need regular blood tests"
D. "Stop warfarin abruptly if you feel better"
Correct Answer: B
Rationale: Clients on warfarin should avoid foods high in vitamin K (e.g., leafy green vegetables) as
they can decrease warfarin's effectiveness. Warfarin requires regular INR monitoring and should not
be combined with aspirin or stopped abruptly.
Question 13
HESI MED-SURG I EXAM 2026/2027 | RN MEDICAL-
SURGICAL NURSING I – ELSEVIER EVOLVE | EXPERT
VERIFIED | 150 VERIFIED Q&A | DETAILED RATIONALES |
NGN-ALIGNED | PASS GUARANTEED – A+ GRADED
Question 1
A nurse is caring for a client who is postoperative day 1 following abdominal surgery. The client
reports pain as 7 on a scale of 0-10. Which of the following is the priority nursing action?
A. Reposition the client
B. Administer prescribed analgesic
C. Encourage deep breathing exercises
D. Ambulate the client
Correct Answer: B
Rationale: The priority action is to administer the prescribed analgesic for pain management. Pain
control is essential for promoting recovery, enabling participation in deep breathing exercises, and
facilitating ambulation. Repositioning may help but does not replace analgesia for moderate-to-
severe pain.
Question 2
A nurse is assessing a client who has a chest tube in place. Which of the following findings requires
immediate intervention?
A. Intermittent bubbling in the water seal chamber with respirations
B. Continuous bubbling in the water seal chamber
C. Drainage of 50 mL in the first hour
D. Fluctuation of fluid in the water seal chamber
Correct Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak and requires
immediate intervention. Intermittent bubbling (tidaling) and fluctuation with respirations are
normal. Drainage of 50 mL in the first hour is within normal limits.
Question 3
A nurse is caring for a client who has a new colostomy. Which of the following findings indicates a
healthy stoma?
A. Dusky, dark-colored stoma
B. Moist, pink stoma
C. Dry, pale stoma
D. Bluish stoma
,2
Correct Answer: B
Rationale: A healthy stoma should be moist and pink, indicating adequate blood supply. A dusky,
dark, pale, or bluish stoma indicates compromised blood flow and requires immediate intervention.
Question 4
A nurse is preparing to administer a blood transfusion. Which of the following actions should the
nurse take first?
A. Obtain baseline vital signs
B. Verify the blood product with another licensed nurse
C. Prime the IV tubing with normal saline
D. Document the procedure
Correct Answer: B
Rationale: The priority action is to verify the blood product with another licensed nurse to ensure
the right client receives the right blood product. Baseline vital signs, priming tubing, and
documentation occur after verification.
Question 5
A nurse is caring for a client who has a new diagnosis of diabetes mellitus. Which of the following
laboratory values indicates good glucose control over the past 2-3 months?
A. Fasting blood glucose of 110 mg/dL
B. Hemoglobin A1c of 7.0%
C. Postprandial glucose of 180 mg/dL
D. Random glucose of 150 mg/dL
Correct Answer: B
Rationale: Hemoglobin A1c reflects average blood glucose over the past 2-3 months. A1c of 7.0% is
at goal for most clients with diabetes. Fasting, postprandial, and random glucose reflect current
levels only.
Question 6
A nurse is caring for a client who is receiving a continuous heparin infusion. Which of the following
laboratory values should the nurse monitor?
A. INR
B. aPTT
C. Platelet count
D. Hemoglobin
Correct Answer: B
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Rationale: Heparin is monitored with aPTT (activated partial thromboplastin time). INR monitors
warfarin. Platelet count should also be monitored for heparin-induced thrombocytopenia, but aPTT
is the primary monitoring parameter.
Question 7
A nurse is assessing a client who has heart failure. Which of the following findings indicates left-
sided heart failure?
A. Peripheral edema
B. Crackles on lung auscultation
C. Jugular vein distention
D. Ascites
Correct Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion, manifesting as crackles on lung
auscultation, dyspnea, and orthopnea. Peripheral edema, JVD, and ascites are signs of right-sided
heart failure.
Question 8
A nurse is caring for a client who has a new prescription for furosemide. Which of the following
laboratory values should the nurse monitor?
A. Serum potassium
B. Serum calcium
C. Serum magnesium
D. Serum phosphorus
Correct Answer: A
Rationale: Furosemide (loop diuretic) causes potassium loss, so serum potassium should be
monitored for hypokalemia.
Question 9
A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which of the
following is a sign of hypoxemia?
A. Pink mucous membranes
B. Oxygen saturation of 88% on room air
C. Respiratory rate of 14 breaths per minute
D. Clear breath sounds
Correct Answer: B
Rationale: Oxygen saturation of 88% on room air indicates hypoxemia (normal: 95-100%). Pink
mucous membranes, normal respiratory rate, and clear breath sounds do not indicate hypoxemia.
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Question 10
A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following
is a complication of TPN?
A. Hypoglycemia
B. Hyperglycemia
C. Hypotension
D. Bradycardia
Correct Answer: B
Rationale: TPN contains high glucose concentrations, which can cause hyperglycemia. Blood glucose
should be monitored regularly.
Question 11
A nurse is assessing a client who has a wound infection. Which of the following findings indicates a
systemic infection?
A. Localized redness
B. Fever and chills
C. Purulent drainage at the site
D. Warmth at the site
Correct Answer: B
Rationale: Fever and chills indicate a systemic infection. Localized redness, purulent drainage, and
warmth are signs of a localized infection.
Question 12
A nurse is caring for a client who has a new prescription for warfarin. Which of the following should
the nurse include in client education?
A. "Take warfarin with aspirin for better effect"
B. "Avoid foods high in vitamin K"
C. "You do not need regular blood tests"
D. "Stop warfarin abruptly if you feel better"
Correct Answer: B
Rationale: Clients on warfarin should avoid foods high in vitamin K (e.g., leafy green vegetables) as
they can decrease warfarin's effectiveness. Warfarin requires regular INR monitoring and should not
be combined with aspirin or stopped abruptly.
Question 13
