HESI MED SURG V2 2026/2027 EXIT
EXAM PRACTICE QUESTIONS AND
ANSWERS LATEST UPDATE
1. A patient with a history of heart failure presents with a potassium level of 6.2 mEq/L.
Which medication order should the nurse prioritize?
A. Oral Potassium Gluconate
B. Furosemide 40mg IV push
C. Sodium Polystyrene Sulfonate (Kayexalate)
D. Regular Insulin 10 units with 50% Dextrose
Answer: D
Conceptual Explanation: For severe hyperkalemia (above 6.0), the quickest way to lower
serum levels and protect the heart is to shift potassium into the cells using insulin and
dextrose. Kayexalate takes longer to work via the GI tract.
2. A client is 24 hours post-thyroidectomy. The nurse notes the client has a positive
Chvostek’s sign. Which action is most appropriate?
A. Administer Calcium Gluconate IV
B. Notify the provider of potential hemorrhage
C. Assess the client’s airway and breath sounds
,D. Document this as a normal post-operative finding
Answer: A
Conceptual Explanation: A positive Chvostek’s sign indicates hypocalcemia, often due to
accidental parathyroid removal during thyroid surgery. IV Calcium Gluconate is the
emergency treatment to prevent tetany and laryngospasm.
3. A patient with a T6 spinal cord injury reports a sudden, throbbing headache and nasal
congestion. Their BP is 190/110 mmHg. What is the nurse’s first action?
A. Administer PRN antihypertensive medication
B. Place the client in a high-Fowler’s position
C. Check for bladder distension or fecal impaction
D. Assess the client’s skin for pressure ulcers
Answer: B
Conceptual Explanation: The symptoms indicate Autonomic Dysreflexia. The priority is to
sit the patient up (high-Fowler’s) to help lower blood pressure via orthostatic effect before
searching for the cause.
4. Which arterial blood gas (ABG) result would the nurse expect for a patient in the early
stages of a pulmonary embolism?
A. pH 7.30, PaCO2 50, HCO3 24
B. pH 7.25, PaCO2 35, HCO3 18
, C. pH 7.35, PaCO2 40, HCO3 24
D. pH 7.48, PaCO2 30, HCO3 22
Answer: D
Conceptual Explanation: Early PE usually causes hyperventilation due to pain and
anxiety, leading to Respiratory Alkalosis (high pH, low PaCO2).
5. A client with Addison’s disease is admitted with weakness and hypotension. Which
laboratory finding is most consistent with this diagnosis?
A. Serum Sodium 150 mEq/L
B. Serum Potassium 3.2 mEq/L
C. Blood Glucose 55 mg/dL
D. Serum Calcium 11 mg/dL
Answer: C
Conceptual Explanation: Addison’s disease (adrenal insufficiency) results in low cortisol
and aldosterone, leading to hyponatremia, hyperkalemia, and hypoglycemia.
6. A nurse is caring for a patient with a chest tube. The nurse notes continuous bubbling in
the water-seal chamber. What does this indicate?
A. The lung has fully re-expanded
B. Normal functioning of the suction system
C. The patient is breathing too deeply
EXAM PRACTICE QUESTIONS AND
ANSWERS LATEST UPDATE
1. A patient with a history of heart failure presents with a potassium level of 6.2 mEq/L.
Which medication order should the nurse prioritize?
A. Oral Potassium Gluconate
B. Furosemide 40mg IV push
C. Sodium Polystyrene Sulfonate (Kayexalate)
D. Regular Insulin 10 units with 50% Dextrose
Answer: D
Conceptual Explanation: For severe hyperkalemia (above 6.0), the quickest way to lower
serum levels and protect the heart is to shift potassium into the cells using insulin and
dextrose. Kayexalate takes longer to work via the GI tract.
2. A client is 24 hours post-thyroidectomy. The nurse notes the client has a positive
Chvostek’s sign. Which action is most appropriate?
A. Administer Calcium Gluconate IV
B. Notify the provider of potential hemorrhage
C. Assess the client’s airway and breath sounds
,D. Document this as a normal post-operative finding
Answer: A
Conceptual Explanation: A positive Chvostek’s sign indicates hypocalcemia, often due to
accidental parathyroid removal during thyroid surgery. IV Calcium Gluconate is the
emergency treatment to prevent tetany and laryngospasm.
3. A patient with a T6 spinal cord injury reports a sudden, throbbing headache and nasal
congestion. Their BP is 190/110 mmHg. What is the nurse’s first action?
A. Administer PRN antihypertensive medication
B. Place the client in a high-Fowler’s position
C. Check for bladder distension or fecal impaction
D. Assess the client’s skin for pressure ulcers
Answer: B
Conceptual Explanation: The symptoms indicate Autonomic Dysreflexia. The priority is to
sit the patient up (high-Fowler’s) to help lower blood pressure via orthostatic effect before
searching for the cause.
4. Which arterial blood gas (ABG) result would the nurse expect for a patient in the early
stages of a pulmonary embolism?
A. pH 7.30, PaCO2 50, HCO3 24
B. pH 7.25, PaCO2 35, HCO3 18
, C. pH 7.35, PaCO2 40, HCO3 24
D. pH 7.48, PaCO2 30, HCO3 22
Answer: D
Conceptual Explanation: Early PE usually causes hyperventilation due to pain and
anxiety, leading to Respiratory Alkalosis (high pH, low PaCO2).
5. A client with Addison’s disease is admitted with weakness and hypotension. Which
laboratory finding is most consistent with this diagnosis?
A. Serum Sodium 150 mEq/L
B. Serum Potassium 3.2 mEq/L
C. Blood Glucose 55 mg/dL
D. Serum Calcium 11 mg/dL
Answer: C
Conceptual Explanation: Addison’s disease (adrenal insufficiency) results in low cortisol
and aldosterone, leading to hyponatremia, hyperkalemia, and hypoglycemia.
6. A nurse is caring for a patient with a chest tube. The nurse notes continuous bubbling in
the water-seal chamber. What does this indicate?
A. The lung has fully re-expanded
B. Normal functioning of the suction system
C. The patient is breathing too deeply
