HESI MED SURG III FINAL EXAM QUESTIONS
AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF.
Core Domains
• Cardiovascular Disorders
• Respiratory Disorders
• Neurological Disorders
• Endocrine Disorders
• Renal and Urinary Disorders
• Gastrointestinal Disorders
• Musculoskeletal Disorders
• Perioperative Care
• Emergency and Critical Care
• Oncological Nursing
Introduction
This comprehensive examination assesses the advanced medical-
surgical nursing knowledge required for the HESI Med Surg III final exam.
It evaluates skills in managing complex patient conditions across the
lifespan, including cardiovascular, respiratory, neurological, and
endocrine systems. The test features multiple-choice and scenario-
based questions emphasizing clinical judgment, prioritization, and
,evidence-based practice. Real-world application and decision-making
are central, ensuring readiness for professional nursing practice.
Section One: Questions 1–100
1. A patient with heart failure is prescribed furosemide. Which
assessment finding indicates a therapeutic effect?
A. Decreased urine output
B. Weight loss of 2 kg in 24 hours
C. Increased jugular venous distension
D. Crackles in the lung bases
Correct answer: B
RATIONALE: Furosemide is a loop diuretic used to reduce fluid
overload in heart failure. A weight loss of 2 kg in 24 hours indicates
effective diuresis and fluid removal. Decreased urine output, increased
JVD, and crackles would indicate worsening fluid retention.
2. A nurse is caring for a patient with COPD. Which oxygen delivery
method is most appropriate?
A. Nasal cannula at 6 L/min
B. Simple face mask at 10 L/min
C. Venturi mask at 2 L/min
D. Non-rebreather mask at 15 L/min
Correct answer: C
RATIONALE: Patients with COPD have a hypoxic drive to breathe.
High levels of oxygen can suppress this drive, leading to respiratory
depression. A Venturi mask provides precise, low-flow oxygen
concentrations (e.g., 24-28%) and is the safest choice.
, 3. A patient is admitted with an acute ischemic stroke. Which
medication should be administered within the first 3-4.5 hours?
A. Aspirin
B. Heparin
C. Alteplase (tPA)
D. Clopidogrel
Correct answer: C
RATIONALE: Alteplase (tPA) is a thrombolytic that can dissolve the
clot causing an ischemic stroke. It must be given within 3 to 4.5 hours of
symptom onset, after ruling out hemorrhage on CT scan.
4. A patient with diabetes mellitus is experiencing hypoglycemia.
Which symptom is most indicative?
A. Polyuria
B. Polydipsia
C. Diaphoresis and tremors
D. Kussmaul respirations
Correct answer: C
RATIONALE: Hypoglycemia causes sympathetic nervous system
activation, leading to diaphoresis, tremors, tachycardia, and anxiety.
Polyuria and polydipsia are signs of hyperglycemia. Kussmaul
respirations are seen in diabetic ketoacidosis.
5. A patient is scheduled for a kidney biopsy. Which nursing
intervention is priority post-procedure?
A. Encourage ambulation
B. Monitor for hematuria
, C. Apply a warm compress to the site
D. Restrict fluids
Correct answer: B
RATIONALE: The most common complication after a kidney biopsy is
bleeding. Monitoring for hematuria (blood in urine) and checking vital
signs for hypotension are critical. The patient should remain on bed rest,
not ambulate.
6. A patient with cirrhosis has a serum ammonia level of 150 mcg/dL.
Which medication is expected?
A. Lactulose
B. Furosemide
C. Spironolactone
D. Propranolol
Correct answer: A
RATIONALE: Elevated ammonia levels in cirrhosis lead to hepatic
encephalopathy. Lactulose is a laxative that traps ammonia in the gut and
promotes its excretion, lowering serum ammonia.
7. A nurse is assessing a patient with a suspected fracture of the
femur. Which sign is most concerning for a fat embolism?
A. Bradycardia
B. Petechiae on the chest
C. Hypertension
D. Warm, flushed extremities
Correct answer: B
RATIONALE: Fat embolism syndrome can occur after long bone
fractures. Classic signs include petechiae (especially on the chest, axilla,
AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF.
Core Domains
• Cardiovascular Disorders
• Respiratory Disorders
• Neurological Disorders
• Endocrine Disorders
• Renal and Urinary Disorders
• Gastrointestinal Disorders
• Musculoskeletal Disorders
• Perioperative Care
• Emergency and Critical Care
• Oncological Nursing
Introduction
This comprehensive examination assesses the advanced medical-
surgical nursing knowledge required for the HESI Med Surg III final exam.
It evaluates skills in managing complex patient conditions across the
lifespan, including cardiovascular, respiratory, neurological, and
endocrine systems. The test features multiple-choice and scenario-
based questions emphasizing clinical judgment, prioritization, and
,evidence-based practice. Real-world application and decision-making
are central, ensuring readiness for professional nursing practice.
Section One: Questions 1–100
1. A patient with heart failure is prescribed furosemide. Which
assessment finding indicates a therapeutic effect?
A. Decreased urine output
B. Weight loss of 2 kg in 24 hours
C. Increased jugular venous distension
D. Crackles in the lung bases
Correct answer: B
RATIONALE: Furosemide is a loop diuretic used to reduce fluid
overload in heart failure. A weight loss of 2 kg in 24 hours indicates
effective diuresis and fluid removal. Decreased urine output, increased
JVD, and crackles would indicate worsening fluid retention.
2. A nurse is caring for a patient with COPD. Which oxygen delivery
method is most appropriate?
A. Nasal cannula at 6 L/min
B. Simple face mask at 10 L/min
C. Venturi mask at 2 L/min
D. Non-rebreather mask at 15 L/min
Correct answer: C
RATIONALE: Patients with COPD have a hypoxic drive to breathe.
High levels of oxygen can suppress this drive, leading to respiratory
depression. A Venturi mask provides precise, low-flow oxygen
concentrations (e.g., 24-28%) and is the safest choice.
, 3. A patient is admitted with an acute ischemic stroke. Which
medication should be administered within the first 3-4.5 hours?
A. Aspirin
B. Heparin
C. Alteplase (tPA)
D. Clopidogrel
Correct answer: C
RATIONALE: Alteplase (tPA) is a thrombolytic that can dissolve the
clot causing an ischemic stroke. It must be given within 3 to 4.5 hours of
symptom onset, after ruling out hemorrhage on CT scan.
4. A patient with diabetes mellitus is experiencing hypoglycemia.
Which symptom is most indicative?
A. Polyuria
B. Polydipsia
C. Diaphoresis and tremors
D. Kussmaul respirations
Correct answer: C
RATIONALE: Hypoglycemia causes sympathetic nervous system
activation, leading to diaphoresis, tremors, tachycardia, and anxiety.
Polyuria and polydipsia are signs of hyperglycemia. Kussmaul
respirations are seen in diabetic ketoacidosis.
5. A patient is scheduled for a kidney biopsy. Which nursing
intervention is priority post-procedure?
A. Encourage ambulation
B. Monitor for hematuria
, C. Apply a warm compress to the site
D. Restrict fluids
Correct answer: B
RATIONALE: The most common complication after a kidney biopsy is
bleeding. Monitoring for hematuria (blood in urine) and checking vital
signs for hypotension are critical. The patient should remain on bed rest,
not ambulate.
6. A patient with cirrhosis has a serum ammonia level of 150 mcg/dL.
Which medication is expected?
A. Lactulose
B. Furosemide
C. Spironolactone
D. Propranolol
Correct answer: A
RATIONALE: Elevated ammonia levels in cirrhosis lead to hepatic
encephalopathy. Lactulose is a laxative that traps ammonia in the gut and
promotes its excretion, lowering serum ammonia.
7. A nurse is assessing a patient with a suspected fracture of the
femur. Which sign is most concerning for a fat embolism?
A. Bradycardia
B. Petechiae on the chest
C. Hypertension
D. Warm, flushed extremities
Correct answer: B
RATIONALE: Fat embolism syndrome can occur after long bone
fractures. Classic signs include petechiae (especially on the chest, axilla,
