HESI MED SURG 2026/2027 MASTERY
EXAM QUESTIONS AND ANSWERS
LATEST UPDATE
1. A client with chronic heart failure is prescribed digoxin 0.25 mg daily and furosemide 40 mg
daily. Which laboratory result should the nurse report to the healthcare provider
immediately?
A. Serum sodium 138 mEq/L
B. Serum digoxin 1.1 ng/mL
C. Serum potassium 3.2 mEq/L
D. Serum creatinine 1.0 mg/dL
Answer: C
Conceptual Explanation: Furosemide is a loop diuretic that causes potassium loss.
Hypokalemia (potassium < 3.5 mEq/L) sensitizes the myocardium to digoxin, significantly
increasing the risk of digoxin toxicity.
2. The nurse is caring for a client with Diabetic Ketoacidosis (DKA). Which clinical finding
requires the most immediate intervention?
A. Blood glucose level of 450 mg/dL
B. Serum potassium of 6.2 mEq/L
,C. Kussmaul respirations and fruity breath
D. Presence of ketones in the urine
Answer: B
Conceptual Explanation: Hyperkalemia is a life-threatening complication of DKA due to
the shift of potassium out of cells in an acidic state. Cardiac dysrhythmias are the primary
risk; this takes priority over the metabolic acidosis and hyperglycemia.
3. A nurse is caring for a client who is 24 hours post-thyroidectomy. The client reports tingling
in the fingers and around the mouth. Which action should the nurse take first?
A. Check the client’s blood pressure for hypertension
B. Prepare the client for a stat CT scan of the neck
C. Administer a PRN dose of intravenous potassium
D. Assess for Chvostek’s or Trousseau’s sign
Answer: D
Conceptual Explanation: Tingling (paresthesia) is an early sign of hypocalcemia, often
caused by accidental damage to the parathyroid glands during a thyroidectomy. Assessing
for Chvostek’s or Trousseau’s sign confirms neuromuscular irritability before notifying the
provider for calcium replacement.
, 4. An arterial blood gas (ABG) report for a client with COPD shows: pH 7.30, PaCO2 55 mm Hg,
PaO2 70 mm Hg, and HCO3 30 mEq/L. How should the nurse interpret these findings?
A. Uncompensated respiratory acidosis
B. Fully compensated metabolic alkalosis
C. Partially compensated respiratory acidosis
D. Uncompensated metabolic acidosis
Answer: C
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated (indicating the kidneys are attempting to compensate). Because
the pH is not yet within normal range, it is partially compensated.
5. A client with a head injury has an intracranial pressure (ICP) of 22 mmHg and a blood
pressure of 160/90 mmHg. Which nursing intervention is most appropriate?
A. Place the client in Trendelenburg position
B. Administer a bolus of 5% Dextrose in Water (D5W)
C. Encourage the client to perform isometric exercises
D. Maintain the head of the bed at 30 to 45 degrees
Answer: D
Conceptual Explanation: Normal ICP is 5-15 mmHg. Elevating the head of the bed to 30-
45 degrees promotes venous drainage from the head, which helps decrease ICP.
EXAM QUESTIONS AND ANSWERS
LATEST UPDATE
1. A client with chronic heart failure is prescribed digoxin 0.25 mg daily and furosemide 40 mg
daily. Which laboratory result should the nurse report to the healthcare provider
immediately?
A. Serum sodium 138 mEq/L
B. Serum digoxin 1.1 ng/mL
C. Serum potassium 3.2 mEq/L
D. Serum creatinine 1.0 mg/dL
Answer: C
Conceptual Explanation: Furosemide is a loop diuretic that causes potassium loss.
Hypokalemia (potassium < 3.5 mEq/L) sensitizes the myocardium to digoxin, significantly
increasing the risk of digoxin toxicity.
2. The nurse is caring for a client with Diabetic Ketoacidosis (DKA). Which clinical finding
requires the most immediate intervention?
A. Blood glucose level of 450 mg/dL
B. Serum potassium of 6.2 mEq/L
,C. Kussmaul respirations and fruity breath
D. Presence of ketones in the urine
Answer: B
Conceptual Explanation: Hyperkalemia is a life-threatening complication of DKA due to
the shift of potassium out of cells in an acidic state. Cardiac dysrhythmias are the primary
risk; this takes priority over the metabolic acidosis and hyperglycemia.
3. A nurse is caring for a client who is 24 hours post-thyroidectomy. The client reports tingling
in the fingers and around the mouth. Which action should the nurse take first?
A. Check the client’s blood pressure for hypertension
B. Prepare the client for a stat CT scan of the neck
C. Administer a PRN dose of intravenous potassium
D. Assess for Chvostek’s or Trousseau’s sign
Answer: D
Conceptual Explanation: Tingling (paresthesia) is an early sign of hypocalcemia, often
caused by accidental damage to the parathyroid glands during a thyroidectomy. Assessing
for Chvostek’s or Trousseau’s sign confirms neuromuscular irritability before notifying the
provider for calcium replacement.
, 4. An arterial blood gas (ABG) report for a client with COPD shows: pH 7.30, PaCO2 55 mm Hg,
PaO2 70 mm Hg, and HCO3 30 mEq/L. How should the nurse interpret these findings?
A. Uncompensated respiratory acidosis
B. Fully compensated metabolic alkalosis
C. Partially compensated respiratory acidosis
D. Uncompensated metabolic acidosis
Answer: C
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated (indicating the kidneys are attempting to compensate). Because
the pH is not yet within normal range, it is partially compensated.
5. A client with a head injury has an intracranial pressure (ICP) of 22 mmHg and a blood
pressure of 160/90 mmHg. Which nursing intervention is most appropriate?
A. Place the client in Trendelenburg position
B. Administer a bolus of 5% Dextrose in Water (D5W)
C. Encourage the client to perform isometric exercises
D. Maintain the head of the bed at 30 to 45 degrees
Answer: D
Conceptual Explanation: Normal ICP is 5-15 mmHg. Elevating the head of the bed to 30-
45 degrees promotes venous drainage from the head, which helps decrease ICP.
