HESI / Elsevier | Medical-Surgical Nursing Comprehensive Examination
HESI Medical-Surgical Nursing
Comprehensive Examination 2026/2027
| Verified Questions
HESI / Elsevier | Medical-Surgical Nursing Comprehensive Examination | University-Level Nursing
Students
110 Verified Questions | 4 Core Domains | Academic Year 2026/2027
Prepared by
HESI / Elsevier | Medical-Surgical Nursing Comprehensive Examination
Comprehensive Proctored Examination (Forms V1 and V2 Combined) Actual Exam |
Academic Year 2026/2027
HESI Medical-Surgical Nursing Comprehensive Examination 2026/2027 | Verified Questions
,INTRODUCTION
This comprehensive examination contains 110 verified questions covering both forms designed to
reinforce the official HESI / Elsevier Medical-Surgical Nursing Comprehensive Examination course
objectives for the Comprehensive Proctored Examination. The questions are organized across four core
domains: Respiratory and Cardiovascular Disorders; Gastrointestinal and Renal Disorders; Neurological
and Musculoskeletal Disorders; and Endocrine, Hematologic, and Integumentary Disorders. Content is
original and aligned to the 2026/2027 academic year, emphasizing clinical nursing reasoning and
foundational medical-surgical knowledge required for actual exam readiness and clinical proficiency.
ACTUAL QUESTIONS
Domain 1: Respiratory and Cardiovascular Disorders
Question 1. A client with chronic obstructive pulmonary disease (COPD) is receiving
oxygen at 2 L/min via nasal cannula. Which finding indicates the need for immediate
intervention?
A. Respiratory rate of 18 breaths/min
B. Sudden decrease in level of consciousness and respiratory rate of 8
C. Oxygen saturation of 88% on room air before therapy
D. Use of accessory muscles during inspiration
Correct Answer: B
Rationale: A sudden drop in consciousness with bradypnea suggests CO2 narcosis or impending
respiratory failure and requires immediate intervention.
Question 2. A nurse is caring for a client with pneumonia. Which intervention is priority?
A. Administering prescribed antibiotics on schedule
B. Encouraging oral fluids
C. Providing a private room
D. Limiting visitors
Correct Answer: A
Rationale: Timely antibiotic administration is the priority treatment for bacterial pneumonia.
Question 3. Which assessment finding is expected in a client with left-sided heart failure?
A. Jugular venous distention
B. Peripheral edema primarily in the legs
C. Ascites
D. Crackles in the lung bases and dyspnea
Correct Answer: D
Rationale: Left-sided failure causes pulmonary congestion, producing crackles and shortness of breath.
Question 4. A client with atrial fibrillation is prescribed warfarin. Which laboratory value
should the nurse monitor?
A. INR
B. aPTT
C. Serum potassium
D. Troponin
Correct Answer: A
Rationale: The international normalized ratio is used to monitor the anticoagulant effect of warfarin.
HESI Medical-Surgical Nursing Comprehensive Examination 2026/2027 | Verified Questions
, Question 5. Which position is most appropriate for a client experiencing an acute asthma
exacerbation?
A. Supine
B. High Fowler’s or orthopneic position
C. Trendelenburg
D. Prone
Correct Answer: B
Rationale: Upright positioning optimizes lung expansion and reduces the work of breathing during an
asthma attack.
Question 6. A nurse is assessing a client after a myocardial infarction. Which finding
indicates a complication?
A. Heart rate of 80 beats/min
B. Blood pressure of 118/76 mm Hg
C. New onset of a holosystolic murmur and pulmonary edema
D. Clear lung sounds
Correct Answer: C
Rationale: A new murmur with pulmonary edema may indicate papillary muscle rupture or ventricular
septal defect, both serious post-MI complications.
Question 7. Which instruction should the nurse give a client using a metered-dose inhaler
with a spacer?
A. Inhale rapidly after actuating
B. Actuate the inhaler and inhale slowly and deeply through the spacer
C. Exhale into the spacer after each puff
D. Hold the breath for only 2 seconds
Correct Answer: B
Rationale: Slow deep inhalation through a spacer improves delivery of medication to the lower
airways.
Question 8. A client with heart failure has a serum potassium of 2.9 mEq/L. Which
medication should the nurse question?
A. Spironolactone
B. Carvedilol
C. Lisinopril
D. Furosemide
Correct Answer: D
Rationale: Loop diuretics can worsen hypokalemia; the nurse should question administration until
potassium is repleted.
Question 9. Which finding is most consistent with a pulmonary embolism?
A. Gradual onset of productive cough
B. Bilateral wheezing only
C. Sudden onset of dyspnea, chest pain, and hypoxemia
D. Fever and night sweats
Correct Answer: C
Rationale: Classic presentation of PE includes abrupt dyspnea, pleuritic pain, and oxygen desaturation.
Question 10. A nurse is caring for a client with a chest tube. Which observation requires
immediate action?
HESI Medical-Surgical Nursing Comprehensive Examination 2026/2027 | Verified Questions
HESI Medical-Surgical Nursing
Comprehensive Examination 2026/2027
| Verified Questions
HESI / Elsevier | Medical-Surgical Nursing Comprehensive Examination | University-Level Nursing
Students
110 Verified Questions | 4 Core Domains | Academic Year 2026/2027
Prepared by
HESI / Elsevier | Medical-Surgical Nursing Comprehensive Examination
Comprehensive Proctored Examination (Forms V1 and V2 Combined) Actual Exam |
Academic Year 2026/2027
HESI Medical-Surgical Nursing Comprehensive Examination 2026/2027 | Verified Questions
,INTRODUCTION
This comprehensive examination contains 110 verified questions covering both forms designed to
reinforce the official HESI / Elsevier Medical-Surgical Nursing Comprehensive Examination course
objectives for the Comprehensive Proctored Examination. The questions are organized across four core
domains: Respiratory and Cardiovascular Disorders; Gastrointestinal and Renal Disorders; Neurological
and Musculoskeletal Disorders; and Endocrine, Hematologic, and Integumentary Disorders. Content is
original and aligned to the 2026/2027 academic year, emphasizing clinical nursing reasoning and
foundational medical-surgical knowledge required for actual exam readiness and clinical proficiency.
ACTUAL QUESTIONS
Domain 1: Respiratory and Cardiovascular Disorders
Question 1. A client with chronic obstructive pulmonary disease (COPD) is receiving
oxygen at 2 L/min via nasal cannula. Which finding indicates the need for immediate
intervention?
A. Respiratory rate of 18 breaths/min
B. Sudden decrease in level of consciousness and respiratory rate of 8
C. Oxygen saturation of 88% on room air before therapy
D. Use of accessory muscles during inspiration
Correct Answer: B
Rationale: A sudden drop in consciousness with bradypnea suggests CO2 narcosis or impending
respiratory failure and requires immediate intervention.
Question 2. A nurse is caring for a client with pneumonia. Which intervention is priority?
A. Administering prescribed antibiotics on schedule
B. Encouraging oral fluids
C. Providing a private room
D. Limiting visitors
Correct Answer: A
Rationale: Timely antibiotic administration is the priority treatment for bacterial pneumonia.
Question 3. Which assessment finding is expected in a client with left-sided heart failure?
A. Jugular venous distention
B. Peripheral edema primarily in the legs
C. Ascites
D. Crackles in the lung bases and dyspnea
Correct Answer: D
Rationale: Left-sided failure causes pulmonary congestion, producing crackles and shortness of breath.
Question 4. A client with atrial fibrillation is prescribed warfarin. Which laboratory value
should the nurse monitor?
A. INR
B. aPTT
C. Serum potassium
D. Troponin
Correct Answer: A
Rationale: The international normalized ratio is used to monitor the anticoagulant effect of warfarin.
HESI Medical-Surgical Nursing Comprehensive Examination 2026/2027 | Verified Questions
, Question 5. Which position is most appropriate for a client experiencing an acute asthma
exacerbation?
A. Supine
B. High Fowler’s or orthopneic position
C. Trendelenburg
D. Prone
Correct Answer: B
Rationale: Upright positioning optimizes lung expansion and reduces the work of breathing during an
asthma attack.
Question 6. A nurse is assessing a client after a myocardial infarction. Which finding
indicates a complication?
A. Heart rate of 80 beats/min
B. Blood pressure of 118/76 mm Hg
C. New onset of a holosystolic murmur and pulmonary edema
D. Clear lung sounds
Correct Answer: C
Rationale: A new murmur with pulmonary edema may indicate papillary muscle rupture or ventricular
septal defect, both serious post-MI complications.
Question 7. Which instruction should the nurse give a client using a metered-dose inhaler
with a spacer?
A. Inhale rapidly after actuating
B. Actuate the inhaler and inhale slowly and deeply through the spacer
C. Exhale into the spacer after each puff
D. Hold the breath for only 2 seconds
Correct Answer: B
Rationale: Slow deep inhalation through a spacer improves delivery of medication to the lower
airways.
Question 8. A client with heart failure has a serum potassium of 2.9 mEq/L. Which
medication should the nurse question?
A. Spironolactone
B. Carvedilol
C. Lisinopril
D. Furosemide
Correct Answer: D
Rationale: Loop diuretics can worsen hypokalemia; the nurse should question administration until
potassium is repleted.
Question 9. Which finding is most consistent with a pulmonary embolism?
A. Gradual onset of productive cough
B. Bilateral wheezing only
C. Sudden onset of dyspnea, chest pain, and hypoxemia
D. Fever and night sweats
Correct Answer: C
Rationale: Classic presentation of PE includes abrupt dyspnea, pleuritic pain, and oxygen desaturation.
Question 10. A nurse is caring for a client with a chest tube. Which observation requires
immediate action?
HESI Medical-Surgical Nursing Comprehensive Examination 2026/2027 | Verified Questions
