HESI Med Surg Exam (Latest
2026/2027 Update) Complete Q&A
with Verified Answers and Detailed
Rationales Comprehensive Medical
HESI Med Surg Exam (Latest 2026/2027 Update) | Comprehensive
Examination
HESI Med Surg Exam (Latest 2026/2027 Update) Complete
Q&A with Verified Answers and Detailed Rationales
Comprehensive Medical Surgical Nursing Review for RN and
INTRODUCTION
This document is an important and very helpful preparation
resource for HESI Med Surg Exam (Latest 2026/2027 Update)
Complete Q&A with Verified Answers and Detailed Rationales
Comprehensive Medical Surgical Nursing Review for RN and
PN Students A+ Graded BSN 266 Downloadable PDF. Every
item uses a focused exam stem, four response options, a keyed
response, and a clear rationale, making it easier to understand
the subject, spot distractors, and build real exam confidence.
Page 1
, Question 1
A patient with acute decompensated heart failure is receiving intravenous
furosemide. Which assessment finding most urgently indicates a need to hold
the dose and notify the provider?
A. Serum potassium of 3.1 mEq/L with new-onset U waves on ECG
B. Urine output of 150 mL over the past 2 hours
C. Blood pressure of 102/68 mm Hg with mild dizziness
D. Weight loss of 1.2 kg since admission
Correct Answer: A - Serum potassium of 3.1 mEq/L with
new-onset U waves on ECG
RATIONALE
Loop diuretics cause potassium wasting; a K+ of 3.1 with U waves
signals hypokalemia and risk for lethal dysrhythmias, requiring
immediate hold and notification. The other findings are expected
therapeutic effects or mild side effects not requiring urgent
intervention.
Question 2
A patient with a new colostomy has a stoma that is dark red, moist, and
edematous. Which nursing action is most appropriate?
A. Document the finding as normal and continue routine care.
B. Apply a warm compress to reduce edema.
C. Notify the surgeon immediately for possible ischemia.
D. Increase the frequency of stoma cleansing with alcohol-based wipes.
Correct Answer: A - Document the finding as normal and
continue routine care.
Page 2
, RATIONALE
A dark red, moist, edematous stoma is a normal finding in the
immediate postoperative period due to surgical trauma and edema.
Ischemia presents as a pale, dusky, or black stoma; warm compresses
and alcohol are contraindicated.
Question 3
Which laboratory value requires immediate intervention in a patient receiving
total parenteral nutrition (TPN)?
A. Serum glucose 280 mg/dL
B. Serum potassium 3.8 mEq/L
C. Serum sodium 138 mEq/L
D. Serum magnesium 1.8 mg/dL
Correct Answer: A - Serum glucose 280 mg/dL
RATIONALE
Hyperglycemia is a common and dangerous complication of TPN,
requiring prompt insulin adjustment to prevent hyperosmolar states.
The other values are within normal limits and do not necessitate
immediate action.
Question 4
A patient with a chest tube drainage system reports sudden sharp chest pain
and dyspnea. Assessment reveals absent breath sounds on the affected side and
tracheal deviation to the opposite side. Which action should the nurse take
first?
A. Clamp the chest tube and call the provider.
B. Prepare for emergency needle decompression.
C. Reposition the patient to the affected side.
D. Increase the suction to -40 cm H2O.
Correct Answer: B - Prepare for emergency needle
Page 3
, decompression.
RATIONALE
These findings indicate tension pneumothorax, a life-threatening
emergency requiring immediate needle decompression. Clamping the
tube, repositioning, or increasing suction would delay definitive
treatment and worsen the condition.
Question 5
A patient with chronic kidney disease has a hemoglobin of 8.2 g/dL and is
prescribed epoetin alfa. Which parameter must be monitored most closely
during therapy?
A. Serum ferritin and transferrin saturation
B. Serum creatinine and BUN
C. Serum calcium and phosphorus
D. White blood cell count
Correct Answer: A - Serum ferritin and transferrin saturation
RATIONALE
Epoetin alfa requires adequate iron stores for effective erythropoiesis;
iron deficiency is a common cause of resistance. Monitoring ferritin
and transferrin saturation ensures optimal response and prevents
ineffective therapy.
Question 6
A patient is admitted with severe acute pancreatitis. Which intervention should
the nurse question?
A. Administration of intravenous morphine for pain
B. Initiating oral feedings with a low-fat diet
C. Placement of a nasogastric tube to low intermittent suction
D. Aggressive intravenous fluid resuscitation with lactated Ringer's
Correct Answer: B - Initiating oral feedings with a low-fat diet
Page 4
2026/2027 Update) Complete Q&A
with Verified Answers and Detailed
Rationales Comprehensive Medical
HESI Med Surg Exam (Latest 2026/2027 Update) | Comprehensive
Examination
HESI Med Surg Exam (Latest 2026/2027 Update) Complete
Q&A with Verified Answers and Detailed Rationales
Comprehensive Medical Surgical Nursing Review for RN and
INTRODUCTION
This document is an important and very helpful preparation
resource for HESI Med Surg Exam (Latest 2026/2027 Update)
Complete Q&A with Verified Answers and Detailed Rationales
Comprehensive Medical Surgical Nursing Review for RN and
PN Students A+ Graded BSN 266 Downloadable PDF. Every
item uses a focused exam stem, four response options, a keyed
response, and a clear rationale, making it easier to understand
the subject, spot distractors, and build real exam confidence.
Page 1
, Question 1
A patient with acute decompensated heart failure is receiving intravenous
furosemide. Which assessment finding most urgently indicates a need to hold
the dose and notify the provider?
A. Serum potassium of 3.1 mEq/L with new-onset U waves on ECG
B. Urine output of 150 mL over the past 2 hours
C. Blood pressure of 102/68 mm Hg with mild dizziness
D. Weight loss of 1.2 kg since admission
Correct Answer: A - Serum potassium of 3.1 mEq/L with
new-onset U waves on ECG
RATIONALE
Loop diuretics cause potassium wasting; a K+ of 3.1 with U waves
signals hypokalemia and risk for lethal dysrhythmias, requiring
immediate hold and notification. The other findings are expected
therapeutic effects or mild side effects not requiring urgent
intervention.
Question 2
A patient with a new colostomy has a stoma that is dark red, moist, and
edematous. Which nursing action is most appropriate?
A. Document the finding as normal and continue routine care.
B. Apply a warm compress to reduce edema.
C. Notify the surgeon immediately for possible ischemia.
D. Increase the frequency of stoma cleansing with alcohol-based wipes.
Correct Answer: A - Document the finding as normal and
continue routine care.
Page 2
, RATIONALE
A dark red, moist, edematous stoma is a normal finding in the
immediate postoperative period due to surgical trauma and edema.
Ischemia presents as a pale, dusky, or black stoma; warm compresses
and alcohol are contraindicated.
Question 3
Which laboratory value requires immediate intervention in a patient receiving
total parenteral nutrition (TPN)?
A. Serum glucose 280 mg/dL
B. Serum potassium 3.8 mEq/L
C. Serum sodium 138 mEq/L
D. Serum magnesium 1.8 mg/dL
Correct Answer: A - Serum glucose 280 mg/dL
RATIONALE
Hyperglycemia is a common and dangerous complication of TPN,
requiring prompt insulin adjustment to prevent hyperosmolar states.
The other values are within normal limits and do not necessitate
immediate action.
Question 4
A patient with a chest tube drainage system reports sudden sharp chest pain
and dyspnea. Assessment reveals absent breath sounds on the affected side and
tracheal deviation to the opposite side. Which action should the nurse take
first?
A. Clamp the chest tube and call the provider.
B. Prepare for emergency needle decompression.
C. Reposition the patient to the affected side.
D. Increase the suction to -40 cm H2O.
Correct Answer: B - Prepare for emergency needle
Page 3
, decompression.
RATIONALE
These findings indicate tension pneumothorax, a life-threatening
emergency requiring immediate needle decompression. Clamping the
tube, repositioning, or increasing suction would delay definitive
treatment and worsen the condition.
Question 5
A patient with chronic kidney disease has a hemoglobin of 8.2 g/dL and is
prescribed epoetin alfa. Which parameter must be monitored most closely
during therapy?
A. Serum ferritin and transferrin saturation
B. Serum creatinine and BUN
C. Serum calcium and phosphorus
D. White blood cell count
Correct Answer: A - Serum ferritin and transferrin saturation
RATIONALE
Epoetin alfa requires adequate iron stores for effective erythropoiesis;
iron deficiency is a common cause of resistance. Monitoring ferritin
and transferrin saturation ensures optimal response and prevents
ineffective therapy.
Question 6
A patient is admitted with severe acute pancreatitis. Which intervention should
the nurse question?
A. Administration of intravenous morphine for pain
B. Initiating oral feedings with a low-fat diet
C. Placement of a nasogastric tube to low intermittent suction
D. Aggressive intravenous fluid resuscitation with lactated Ringer's
Correct Answer: B - Initiating oral feedings with a low-fat diet
Page 4
