HESI MED SURG FINAL EXAM 2026/2027
QUESTIONS AND ANSWERS LATEST
UPDATE
1. A client with chronic heart failure is prescribed digoxin and furosemide. Which laboratory
result should the nurse prioritize for immediate follow-up?
A. Sodium level of 138 mEq/L
B. Potassium level of 3.2 mEq/L
C. Calcium level of 9.0 mg/dL
D. Digoxin level of 1.2 ng/mL
Answer: B
Conceptual Explanation: Furosemide is a loop diuretic that can cause hypokalemia. Low
potassium levels significantly increase the risk of digoxin toxicity, making the potassium
level the priority assessment.
2. The nurse is caring for a patient who had a total thyroidectomy 6 hours ago. The patient
reports tingling in the fingers and around the mouth. Which action should the nurse take
first?
A. Encourage the patient to use an incentive spirometer
B. Administer a PRN sedative
,C. Check the surgical dressing for bleeding
D. Assess for Chvostek’s sign
Answer: D
Conceptual Explanation: Tingling in the fingers and perioral area are early signs of
hypocalcemia, which can occur if the parathyroid glands are accidentally removed or
damaged during a thyroidectomy. Assessing for Chvostek’s sign confirms neuromuscular
irritability.
3. An arterial blood gas (ABG) report shows pH 7.30, PaCO2 55 mmHg, and HCO3 26 mEq/L.
How should the nurse interpret these findings?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis. The PaCO2 is elevated above
45 mmHg, indicating a respiratory cause, while the HCO3 is within the normal range,
confirming respiratory acidosis.
, 4. A patient with Type 1 Diabetes Mellitus presents to the ED with a blood glucose of 600
mg/dL and fruity breath. Which intravenous fluid order should the nurse expect first?
A. 5% Dextrose in 0.45% Saline
B. 3% Hypertonic Saline
C. 0.9% Normal Saline
D. Lactated Ringer’s
Answer: C
Conceptual Explanation: In Diabetic Ketoacidosis (DKA), the initial priority is fluid
resuscitation with isotonic saline (0.9% NS) to restore circulating volume and stabilize
blood pressure before insulin therapy begins to drop glucose levels.
5. A client develops sudden chest pain and dyspnea 2 days after a total hip replacement.
Which complication does the nurse suspect first?
A. Pneumonia
B. Atelectasis
C. Myocardial Infarction
D. Pulmonary Embolism
Answer: D
QUESTIONS AND ANSWERS LATEST
UPDATE
1. A client with chronic heart failure is prescribed digoxin and furosemide. Which laboratory
result should the nurse prioritize for immediate follow-up?
A. Sodium level of 138 mEq/L
B. Potassium level of 3.2 mEq/L
C. Calcium level of 9.0 mg/dL
D. Digoxin level of 1.2 ng/mL
Answer: B
Conceptual Explanation: Furosemide is a loop diuretic that can cause hypokalemia. Low
potassium levels significantly increase the risk of digoxin toxicity, making the potassium
level the priority assessment.
2. The nurse is caring for a patient who had a total thyroidectomy 6 hours ago. The patient
reports tingling in the fingers and around the mouth. Which action should the nurse take
first?
A. Encourage the patient to use an incentive spirometer
B. Administer a PRN sedative
,C. Check the surgical dressing for bleeding
D. Assess for Chvostek’s sign
Answer: D
Conceptual Explanation: Tingling in the fingers and perioral area are early signs of
hypocalcemia, which can occur if the parathyroid glands are accidentally removed or
damaged during a thyroidectomy. Assessing for Chvostek’s sign confirms neuromuscular
irritability.
3. An arterial blood gas (ABG) report shows pH 7.30, PaCO2 55 mmHg, and HCO3 26 mEq/L.
How should the nurse interpret these findings?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis. The PaCO2 is elevated above
45 mmHg, indicating a respiratory cause, while the HCO3 is within the normal range,
confirming respiratory acidosis.
, 4. A patient with Type 1 Diabetes Mellitus presents to the ED with a blood glucose of 600
mg/dL and fruity breath. Which intravenous fluid order should the nurse expect first?
A. 5% Dextrose in 0.45% Saline
B. 3% Hypertonic Saline
C. 0.9% Normal Saline
D. Lactated Ringer’s
Answer: C
Conceptual Explanation: In Diabetic Ketoacidosis (DKA), the initial priority is fluid
resuscitation with isotonic saline (0.9% NS) to restore circulating volume and stabilize
blood pressure before insulin therapy begins to drop glucose levels.
5. A client develops sudden chest pain and dyspnea 2 days after a total hip replacement.
Which complication does the nurse suspect first?
A. Pneumonia
B. Atelectasis
C. Myocardial Infarction
D. Pulmonary Embolism
Answer: D
