HESI MED SURG EXIT EXAM PREP
2026/2027 QUESTIONS AND ANSWERS
LATEST UPDATE
1. A client with chronic heart failure is prescribed digoxin and furosemide. The nurse notes
the client reports seeing yellow halos around lights. Which action should the nurse take first?
A. Administer the next dose of furosemide as scheduled.
B. Encourage the client to increase intake of potassium-rich foods.
C. Assess the client’s apical pulse for one full minute.
D. Document the finding as a common side effect of diuretic therapy.
Answer: C
Conceptual Explanation: Yellow-green halos (xanthopsia) are a classic sign of digoxin
toxicity. The nurse must first assess the heart rate/rhythm via apical pulse and then notify
the provider to likely hold the medication and check serum digoxin and potassium levels.
2. A client is admitted with a suspected diagnosis of Addisonian Crisis. Which laboratory
result should the nurse anticipate?
A. Serum sodium 150 mEq/L
B. Serum potassium 3.2 mEq/L
C. Blood glucose 55 mg/dL
,D. Serum calcium 7.5 mg/dL
Answer: C
Conceptual Explanation: Addisonian crisis is characterized by glucocorticoid and
mineralocorticoid deficiency, leading to hypoglycemia, hyponatremia, and hyperkalemia. A
glucose of 55 mg/dL is consistent with this deficiency.
3. The nurse is caring for a client who is 24 hours post-thyroidectomy. The client reports
tingling in the fingertips and around the mouth. Which PRN medication should the nurse
prepare to administer?
A. Calcium gluconate
B. Potassium chloride
C. Magnesium sulfate
D. Sodium bicarbonate
Answer: A
Conceptual Explanation: Tingling (paresthesia) and numbness are early signs of
hypocalcemia, which can occur if the parathyroid glands are accidentally damaged or
removed during a thyroidectomy. Calcium gluconate is the treatment of choice.
4. Which assessment finding in a client with a chest tube requires immediate intervention by
the nurse?
A. 100 mL of serosanguinous drainage in the collection chamber over 4 hours.
, B. Intermittent bubbling in the water seal chamber during expiration.
C. Oscillation of the water level in the water seal chamber with respiration.
D. Continuous bubbling in the water seal chamber.
Answer: D
Conceptual Explanation: Continuous bubbling in the water seal chamber indicates an air
leak in the system. Intermittent bubbling or tidaling (oscillation) are normal findings
depending on the client’s status.
5. A client with a history of atrial fibrillation is receiving a continuous heparin infusion. The
current aPTT is 110 seconds (control 35 seconds). Which action should the nurse take?
A. Increase the infusion rate by 100 units/hour.
B. Maintain the current rate and recheck aPTT in 4 hours.
C. Stop the infusion for 30 to 60 minutes and decrease the rate per protocol.
D. Stop the infusion and prepare protamine sulfate.
Answer: C
Conceptual Explanation: A normal therapeutic aPTT is typically 1.5 to 2.5 times the
control (approx 52-87 seconds). A value of 110 is dangerously high. Most protocols require
stopping the infusion temporarily and then restarting at a lower rate. Protamine is only
used for severe, life-threatening hemorrhage.
2026/2027 QUESTIONS AND ANSWERS
LATEST UPDATE
1. A client with chronic heart failure is prescribed digoxin and furosemide. The nurse notes
the client reports seeing yellow halos around lights. Which action should the nurse take first?
A. Administer the next dose of furosemide as scheduled.
B. Encourage the client to increase intake of potassium-rich foods.
C. Assess the client’s apical pulse for one full minute.
D. Document the finding as a common side effect of diuretic therapy.
Answer: C
Conceptual Explanation: Yellow-green halos (xanthopsia) are a classic sign of digoxin
toxicity. The nurse must first assess the heart rate/rhythm via apical pulse and then notify
the provider to likely hold the medication and check serum digoxin and potassium levels.
2. A client is admitted with a suspected diagnosis of Addisonian Crisis. Which laboratory
result should the nurse anticipate?
A. Serum sodium 150 mEq/L
B. Serum potassium 3.2 mEq/L
C. Blood glucose 55 mg/dL
,D. Serum calcium 7.5 mg/dL
Answer: C
Conceptual Explanation: Addisonian crisis is characterized by glucocorticoid and
mineralocorticoid deficiency, leading to hypoglycemia, hyponatremia, and hyperkalemia. A
glucose of 55 mg/dL is consistent with this deficiency.
3. The nurse is caring for a client who is 24 hours post-thyroidectomy. The client reports
tingling in the fingertips and around the mouth. Which PRN medication should the nurse
prepare to administer?
A. Calcium gluconate
B. Potassium chloride
C. Magnesium sulfate
D. Sodium bicarbonate
Answer: A
Conceptual Explanation: Tingling (paresthesia) and numbness are early signs of
hypocalcemia, which can occur if the parathyroid glands are accidentally damaged or
removed during a thyroidectomy. Calcium gluconate is the treatment of choice.
4. Which assessment finding in a client with a chest tube requires immediate intervention by
the nurse?
A. 100 mL of serosanguinous drainage in the collection chamber over 4 hours.
, B. Intermittent bubbling in the water seal chamber during expiration.
C. Oscillation of the water level in the water seal chamber with respiration.
D. Continuous bubbling in the water seal chamber.
Answer: D
Conceptual Explanation: Continuous bubbling in the water seal chamber indicates an air
leak in the system. Intermittent bubbling or tidaling (oscillation) are normal findings
depending on the client’s status.
5. A client with a history of atrial fibrillation is receiving a continuous heparin infusion. The
current aPTT is 110 seconds (control 35 seconds). Which action should the nurse take?
A. Increase the infusion rate by 100 units/hour.
B. Maintain the current rate and recheck aPTT in 4 hours.
C. Stop the infusion for 30 to 60 minutes and decrease the rate per protocol.
D. Stop the infusion and prepare protamine sulfate.
Answer: C
Conceptual Explanation: A normal therapeutic aPTT is typically 1.5 to 2.5 times the
control (approx 52-87 seconds). A value of 110 is dangerously high. Most protocols require
stopping the infusion temporarily and then restarting at a lower rate. Protamine is only
used for severe, life-threatening hemorrhage.
