HESI Medical-Surgical Nursing
HESI / Elsevier
Academic Year 2026/2027
Medical-Surgical Nursing Comprehensive Practice Examination
Instructions: Select the single best answer. The correct answer is italicized.
1.
A nurse is assessing a patient who reports crushing substernal chest pain radiating to the
left arm. Which condition should the nurse suspect first?
A. Gastroesophageal reflux
B. Acute coronary syndrome
C. Pneumonia
D. Costochondritis
2.
Which laboratory value is most specific for myocardial injury?
,A. BNP
B. CK-MB only
C. Cardiac troponin
D. D-dimer
3.
A patient with heart failure has worsening dyspnea and bilateral crackles. Which
complication is most likely?
A. Hypoglycemia
B. Pulmonary congestion
C. Renal calculi
D. Intestinal obstruction
4.
Which finding is commonly associated with left-sided heart failure?
A. Ascites only
B. Peripheral neuropathy
C. Pulmonary crackles and dyspnea
D. Increased bowel sounds
5.
Which finding is more characteristic of right-sided heart failure?
A. Pulmonary edema only
B. Peripheral edema and jugular venous distention
,C. Hemoptysis only
D. Wheezing after exercise
6.
Which patient is at greatest risk for coronary artery disease?
A. Patient with normal blood pressure
B. Patient who exercises regularly
C. Patient with tobacco use, hypertension, and elevated LDL cholesterol
D. Patient with high HDL cholesterol
7.
A patient taking digoxin reports nausea, weakness, and visual disturbances. What should
the nurse suspect?
A. Therapeutic response
B. Digoxin toxicity
C. Hypocalcemia
D. Dehydration only
8.
Which electrolyte imbalance increases the risk of digoxin toxicity?
A. Hypernatremia
B. Hyperchloremia
C. Hypokalemia
D. Hyperphosphatemia
, 9.
A patient receiving an ACE inhibitor develops facial swelling and difficulty breathing. What is
the priority action?
A. Give the next dose
B. Encourage oral fluids
C. Treat as a possible angioedema emergency and discontinue the medication as
directed
D. Place the patient flat and reassess later
10.
Which adverse effect is commonly associated with ACE inhibitors?
A. Severe hypoglycemia
B. Persistent dry cough
C. Hearing loss
D. Urinary retention
11.
A patient with atrial fibrillation is prescribed anticoagulation. The primary purpose is to
reduce the risk of:
A. Pneumonia
B. Thromboembolic stroke
HESI / Elsevier
Academic Year 2026/2027
Medical-Surgical Nursing Comprehensive Practice Examination
Instructions: Select the single best answer. The correct answer is italicized.
1.
A nurse is assessing a patient who reports crushing substernal chest pain radiating to the
left arm. Which condition should the nurse suspect first?
A. Gastroesophageal reflux
B. Acute coronary syndrome
C. Pneumonia
D. Costochondritis
2.
Which laboratory value is most specific for myocardial injury?
,A. BNP
B. CK-MB only
C. Cardiac troponin
D. D-dimer
3.
A patient with heart failure has worsening dyspnea and bilateral crackles. Which
complication is most likely?
A. Hypoglycemia
B. Pulmonary congestion
C. Renal calculi
D. Intestinal obstruction
4.
Which finding is commonly associated with left-sided heart failure?
A. Ascites only
B. Peripheral neuropathy
C. Pulmonary crackles and dyspnea
D. Increased bowel sounds
5.
Which finding is more characteristic of right-sided heart failure?
A. Pulmonary edema only
B. Peripheral edema and jugular venous distention
,C. Hemoptysis only
D. Wheezing after exercise
6.
Which patient is at greatest risk for coronary artery disease?
A. Patient with normal blood pressure
B. Patient who exercises regularly
C. Patient with tobacco use, hypertension, and elevated LDL cholesterol
D. Patient with high HDL cholesterol
7.
A patient taking digoxin reports nausea, weakness, and visual disturbances. What should
the nurse suspect?
A. Therapeutic response
B. Digoxin toxicity
C. Hypocalcemia
D. Dehydration only
8.
Which electrolyte imbalance increases the risk of digoxin toxicity?
A. Hypernatremia
B. Hyperchloremia
C. Hypokalemia
D. Hyperphosphatemia
, 9.
A patient receiving an ACE inhibitor develops facial swelling and difficulty breathing. What is
the priority action?
A. Give the next dose
B. Encourage oral fluids
C. Treat as a possible angioedema emergency and discontinue the medication as
directed
D. Place the patient flat and reassess later
10.
Which adverse effect is commonly associated with ACE inhibitors?
A. Severe hypoglycemia
B. Persistent dry cough
C. Hearing loss
D. Urinary retention
11.
A patient with atrial fibrillation is prescribed anticoagulation. The primary purpose is to
reduce the risk of:
A. Pneumonia
B. Thromboembolic stroke
