HESI MED SURG 2026/2027 EXIT EXAM
REVIEW QUESTIONS AND ANSWERS
LATEST UPDATE
1. A client with Chronic Kidney Disease (CKD) presents with a serum potassium level of 7.2
mEq/L. Which prescription should the nurse implement first?
A. Administer sodium polystyrene sulfonate orally
B. Administer intravenous calcium gluconate
C. Initiate a potassium-restricted diet
D. Obtain a repeat serum potassium level
Answer: B
Conceptual Explanation: Severe hyperkalemia (above 6.5 mEq/L) is a medical
emergency. Calcium gluconate is the priority to stabilize the myocardium and prevent
lethal arrhythmias.
2. A patient is admitted with suspected Acute Respiratory Distress Syndrome (ARDS). Which
assessment finding is most characteristic of this condition?
A. Hypoxemia that does not respond to oxygen therapy
B. Increased lung compliance
C. Respiratory alkalosis in the late stages
,D. Left-sided heart failure symptoms
Answer: A
Conceptual Explanation: Refractory hypoxemia, or hypoxemia that persists despite high
concentrations of oxygen, is a hallmark sign of ARDS.
3. A nurse is caring for a client with a suspected Myocardial Infarction (MI). Which cardiac
biomarker is most specific for myocardial injury?
A. Creatine Kinase (CK)
B. Myoglobin
C. Lactate Dehydrogenase (LDH)
D. Troponin I
Answer: D
Conceptual Explanation: Troponin I and Troponin T are highly specific markers for
cardiac muscle injury and stay elevated longer than other enzymes.
4. The nurse is monitoring a client with an intracranial pressure (ICP) of 22 mmHg. Which
positioning is appropriate?
A. Head of bed elevated 30 to 45 degrees
B. Flat in bed
C. Trendelenburg position
D. Side-lying with knees flexed
, Answer: A
Conceptual Explanation: Elevating the head of the bed promotes venous drainage from
the brain and helps lower intracranial pressure.
5. A client is diagnosed with Diabetic Ketoacidosis (DKA). Which acid-base imbalance does the
nurse expect to see on the Arterial Blood Gas (ABG)?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Conceptual Explanation: DKA results in the accumulation of ketones, which are acidic,
leading to a decrease in serum pH and bicarbonate.
6. Which clinical manifestation should the nurse anticipate in a client with Right-sided Heart
Failure?
A. Crackles in lung bases
B. Orthopnea
C. Dyspnea on exertion
D. Peripheral edema
Answer: D
REVIEW QUESTIONS AND ANSWERS
LATEST UPDATE
1. A client with Chronic Kidney Disease (CKD) presents with a serum potassium level of 7.2
mEq/L. Which prescription should the nurse implement first?
A. Administer sodium polystyrene sulfonate orally
B. Administer intravenous calcium gluconate
C. Initiate a potassium-restricted diet
D. Obtain a repeat serum potassium level
Answer: B
Conceptual Explanation: Severe hyperkalemia (above 6.5 mEq/L) is a medical
emergency. Calcium gluconate is the priority to stabilize the myocardium and prevent
lethal arrhythmias.
2. A patient is admitted with suspected Acute Respiratory Distress Syndrome (ARDS). Which
assessment finding is most characteristic of this condition?
A. Hypoxemia that does not respond to oxygen therapy
B. Increased lung compliance
C. Respiratory alkalosis in the late stages
,D. Left-sided heart failure symptoms
Answer: A
Conceptual Explanation: Refractory hypoxemia, or hypoxemia that persists despite high
concentrations of oxygen, is a hallmark sign of ARDS.
3. A nurse is caring for a client with a suspected Myocardial Infarction (MI). Which cardiac
biomarker is most specific for myocardial injury?
A. Creatine Kinase (CK)
B. Myoglobin
C. Lactate Dehydrogenase (LDH)
D. Troponin I
Answer: D
Conceptual Explanation: Troponin I and Troponin T are highly specific markers for
cardiac muscle injury and stay elevated longer than other enzymes.
4. The nurse is monitoring a client with an intracranial pressure (ICP) of 22 mmHg. Which
positioning is appropriate?
A. Head of bed elevated 30 to 45 degrees
B. Flat in bed
C. Trendelenburg position
D. Side-lying with knees flexed
, Answer: A
Conceptual Explanation: Elevating the head of the bed promotes venous drainage from
the brain and helps lower intracranial pressure.
5. A client is diagnosed with Diabetic Ketoacidosis (DKA). Which acid-base imbalance does the
nurse expect to see on the Arterial Blood Gas (ABG)?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Conceptual Explanation: DKA results in the accumulation of ketones, which are acidic,
leading to a decrease in serum pH and bicarbonate.
6. Which clinical manifestation should the nurse anticipate in a client with Right-sided Heart
Failure?
A. Crackles in lung bases
B. Orthopnea
C. Dyspnea on exertion
D. Peripheral edema
Answer: D
