HESI MED SURG V1 2026/2027 EXIT
EXAM QUESTIONS AND ANSWERS
LATEST UPDATE
1. A patient with a history of Chronic Obstructive Pulmonary Disease (COPD) presents with a
pH of 7.30, PaCO2 of 52 mmHg, and HCO3 of 28 mEq/L. Which acid-base imbalance is
occurring?
A. Metabolic Acidosis
B. Respiratory Alkalosis, fully compensated
C. Respiratory Acidosis, partially compensated
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is high (attempting to compensate), indicating a partially compensated
respiratory acidosis.
2. A client is diagnosed with Cushing’s Syndrome. Which assessment finding should the nurse
anticipate?
A. Hyperglycemia and truncal obesity
B. Hypotension and tachycardia
,C. Hyperkalemia and weight loss
D. Hyponatremia and hyperpigmentation
Answer: A
Conceptual Explanation: Cushing’s syndrome is characterized by excess cortisol, leading
to hyperglycemia, central or truncal obesity, moon face, and a buffalo hump.
3. A patient in the ICU has a sudden onset of shortness of breath and chest pain. The nurse
notes a deviated trachea to the right and absent breath sounds on the left. What is the
priority intervention?
A. Obtain a stat chest X-ray
B. Administer high-flow oxygen via nasal cannula
C. Prepare for immediate needle thoracostomy
D. Start a large-bore IV for fluid resuscitation
Answer: C
Conceptual Explanation: These are classic signs of a tension pneumothorax (tracheal
deviation, absent breath sounds). Immediate decompression is required to prevent
cardiovascular collapse.
4. Which laboratory value is most indicative of a patient transitioning from HIV to AIDS?
A. A positive ELISA test result
B. A CD4+ T-cell count of less than 200 cells/mm3
, C. A viral load of 1,000 copies/mL
D. An elevated White Blood Cell (WBC) count
Answer: B
Conceptual Explanation: The diagnostic criteria for AIDS include a CD4+ T-cell count
below 200 cells/mm3 or the presence of an AIDS-defining opportunistic infection.
5. A patient is receiving a blood transfusion and begins to complain of back pain, chills, and
hematuria. Which action should the nurse take first?
A. Notify the healthcare provider
B. Stop the transfusion immediately
C. Slow the infusion rate to keep the vein open
D. Administer diphenhydramine as ordered
Answer: B
Conceptual Explanation: These symptoms suggest a hemolytic reaction. The first priority
is to stop the transfusion to prevent further exposure to the incompatible blood.
6. A nurse is caring for a patient post-thyroidectomy. The patient reports tingling in the
fingers and toes. The nurse should immediately assess for which sign?
A. Chvostek’s sign
B. Babinski sign
C. Kernig’s sign
EXAM QUESTIONS AND ANSWERS
LATEST UPDATE
1. A patient with a history of Chronic Obstructive Pulmonary Disease (COPD) presents with a
pH of 7.30, PaCO2 of 52 mmHg, and HCO3 of 28 mEq/L. Which acid-base imbalance is
occurring?
A. Metabolic Acidosis
B. Respiratory Alkalosis, fully compensated
C. Respiratory Acidosis, partially compensated
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is high (attempting to compensate), indicating a partially compensated
respiratory acidosis.
2. A client is diagnosed with Cushing’s Syndrome. Which assessment finding should the nurse
anticipate?
A. Hyperglycemia and truncal obesity
B. Hypotension and tachycardia
,C. Hyperkalemia and weight loss
D. Hyponatremia and hyperpigmentation
Answer: A
Conceptual Explanation: Cushing’s syndrome is characterized by excess cortisol, leading
to hyperglycemia, central or truncal obesity, moon face, and a buffalo hump.
3. A patient in the ICU has a sudden onset of shortness of breath and chest pain. The nurse
notes a deviated trachea to the right and absent breath sounds on the left. What is the
priority intervention?
A. Obtain a stat chest X-ray
B. Administer high-flow oxygen via nasal cannula
C. Prepare for immediate needle thoracostomy
D. Start a large-bore IV for fluid resuscitation
Answer: C
Conceptual Explanation: These are classic signs of a tension pneumothorax (tracheal
deviation, absent breath sounds). Immediate decompression is required to prevent
cardiovascular collapse.
4. Which laboratory value is most indicative of a patient transitioning from HIV to AIDS?
A. A positive ELISA test result
B. A CD4+ T-cell count of less than 200 cells/mm3
, C. A viral load of 1,000 copies/mL
D. An elevated White Blood Cell (WBC) count
Answer: B
Conceptual Explanation: The diagnostic criteria for AIDS include a CD4+ T-cell count
below 200 cells/mm3 or the presence of an AIDS-defining opportunistic infection.
5. A patient is receiving a blood transfusion and begins to complain of back pain, chills, and
hematuria. Which action should the nurse take first?
A. Notify the healthcare provider
B. Stop the transfusion immediately
C. Slow the infusion rate to keep the vein open
D. Administer diphenhydramine as ordered
Answer: B
Conceptual Explanation: These symptoms suggest a hemolytic reaction. The first priority
is to stop the transfusion to prevent further exposure to the incompatible blood.
6. A nurse is caring for a patient post-thyroidectomy. The patient reports tingling in the
fingers and toes. The nurse should immediately assess for which sign?
A. Chvostek’s sign
B. Babinski sign
C. Kernig’s sign
