MED-SURG HESI RN EXAM – 2025/2026
EDITION – 100 COMPLETE QUESTIONS
WITH CORRECT ANSWERS & DETAILED
RATIONALES | NGN-STYLE PRACTICE
FOR GUARANTEED SUCCESS
Cardiovascular Disorders
1. A client with heart failure reports increased shortness of breath and notices a
3-pound weight gain over 2 days. Which nursing intervention is the PRIORITY?
A. Restrict fluid intake to 1500 mL/day
B. Assess the client for jugular venous distension
C. Assess current weight and compare with baseline
D. Administer the prescribed diuretic
Correct Answer: D. Rationale: The 3-pound weight gain in 2 days indicates fluid
retention requiring immediate intervention. Administering the prescribed diuretic
addresses the fluid overload directly. While all options are appropriate nursing actions,
administering the diuretic takes priority because it treats the underlying problem of
fluid retention causing the increased shortness of breath and weight gain. Daily
weights should be performed to monitor trends rather than as a first response to an
acute change.
2. A nurse is caring for a client with atrial fibrillation. Which finding requires
IMMEDIATE intervention by the nurse?
A. Heart rate of 98 bpm with an irregularly irregular rhythm
B. Blood pressure of 110/70 mmHg
C. Sudden onset of left-sided weakness and slurred speech
D. Client reports feeling fatigued during ambulation
Correct Answer: C. Rationale: Sudden onset of left-sided weakness and slurred speech
suggests an embolic stroke, a life-threatening complication of atrial fibrillation. Atrial
fibrillation increases thromboembolism risk due to stasis of blood in the atria, and this
finding requires immediate notification of the healthcare provider and emergency
intervention. The irregularly irregular rhythm is expected with atrial fibrillation. Fatigue
and stable vital signs do not represent an immediate life-threatening situation.
,3. A client is being discharged following a myocardial infarction. Which
statement by the client indicates the need for FURTHER teaching?
A. "I will take my aspirin exactly as prescribed."
B. "I can resume my usual activities immediately."
C. "I will report any chest pain that is not relieved by rest."
D. "I will keep my follow-up appointment with the cardiologist."
Correct Answer: B. Rationale: The client should be taught to gradually increase activity
and to avoid strenuous exertion initially. Resuming usual activities immediately can
strain the heart and is unsafe. The other statements reflect correct understanding of
discharge instructions regarding medication adherence, symptom reporting, and
follow-up care.
Respiratory Disorders
4. During a health fair, a male client with emphysema tells the nurse that he
fatigues easily. Assessment reveals marked clubbing of the fingernails and an
increased anteroposterior chest diameter. Which instruction is best to provide
the client?
A. "Pace your activities and schedule rest periods."
B. "Increase the amount of oxygen you use at night."
C. "Obtain medical evaluation for antibiotic therapy."
D. "Reduce your intake of fluids containing caffeine."
Correct Answer: A. Rationale: Manifestations of emphysema include an increase in AP
diameter (referred to as a barrel chest), nail bed clubbing, and fatigue. The nurse can
provide instructions to promote energy management, such as pacing activities and
scheduling rest periods. Increasing oxygen use at night may result in a decreased drive
to breathe. The client is not exhibiting any symptoms of infection, so antibiotic therapy
is not necessary. Reducing caffeine is less beneficial than energy management.
5. A client who has partial-thickness burns on the chest, abdomen, and right
side arrives in the emergency department. Which action will the nurse take
first?
A. Remove the client's clothing.
B. Evaluate whether the client has inhaled smoke.
C. Administer intravenous pain medication.
D. Calculate the extent of the burn injury.
Correct Answer: B. Rationale: The priority in burn management is to assess for airway
compromise. Evaluating whether the client has inhaled smoke takes precedence over
, removing clothing, administering pain medication, or calculating burn extent, as
inhalation injury can rapidly become life-threatening.
Neurological Disorders
6. A client is admitted with a diagnosis of increased intracranial pressure (ICP).
Which finding should the nurse report to the healthcare provider
IMMEDIATELY?
A. A decrease in level of consciousness
B. A blood pressure of 130/80 mmHg
C. A heart rate of 88 beats per minute
D. A respiratory rate of 16 breaths per minute
Correct Answer: A. Rationale: A decrease in level of consciousness is an early and
critical sign of worsening increased intracranial pressure. The other vital signs listed are
within normal limits and do not require immediate reporting. Early recognition of
neurological deterioration is essential to prevent irreversible brain damage.
7. The nurse is caring for a client who had a stroke (CVA). Which nursing
intervention is the PRIORITY during the acute phase?
A. Maintain a patent airway and adequate oxygenation.
B. Begin passive range-of-motion exercises.
C. Encourage the client to verbalize feelings.
D. Assist the client with feeding.
Correct Answer: A. Rationale: During the acute phase of a stroke, airway and breathing
are the highest priorities. Maintaining a patent airway and adequate oxygenation are
essential to prevent further neurological damage. Range-of-motion exercises,
emotional support, and feeding assistance are important but are secondary to airway
management.
Renal and Genitourinary Disorders
8. A client with chronic kidney disease (CKD) has a hemoglobin of 9 g/dL and a
ferritin level of 100 ng/mL. Which order should the nurse anticipate?
A. Administer IV iron sucrose
B. Transfuse packed red blood cells
EDITION – 100 COMPLETE QUESTIONS
WITH CORRECT ANSWERS & DETAILED
RATIONALES | NGN-STYLE PRACTICE
FOR GUARANTEED SUCCESS
Cardiovascular Disorders
1. A client with heart failure reports increased shortness of breath and notices a
3-pound weight gain over 2 days. Which nursing intervention is the PRIORITY?
A. Restrict fluid intake to 1500 mL/day
B. Assess the client for jugular venous distension
C. Assess current weight and compare with baseline
D. Administer the prescribed diuretic
Correct Answer: D. Rationale: The 3-pound weight gain in 2 days indicates fluid
retention requiring immediate intervention. Administering the prescribed diuretic
addresses the fluid overload directly. While all options are appropriate nursing actions,
administering the diuretic takes priority because it treats the underlying problem of
fluid retention causing the increased shortness of breath and weight gain. Daily
weights should be performed to monitor trends rather than as a first response to an
acute change.
2. A nurse is caring for a client with atrial fibrillation. Which finding requires
IMMEDIATE intervention by the nurse?
A. Heart rate of 98 bpm with an irregularly irregular rhythm
B. Blood pressure of 110/70 mmHg
C. Sudden onset of left-sided weakness and slurred speech
D. Client reports feeling fatigued during ambulation
Correct Answer: C. Rationale: Sudden onset of left-sided weakness and slurred speech
suggests an embolic stroke, a life-threatening complication of atrial fibrillation. Atrial
fibrillation increases thromboembolism risk due to stasis of blood in the atria, and this
finding requires immediate notification of the healthcare provider and emergency
intervention. The irregularly irregular rhythm is expected with atrial fibrillation. Fatigue
and stable vital signs do not represent an immediate life-threatening situation.
,3. A client is being discharged following a myocardial infarction. Which
statement by the client indicates the need for FURTHER teaching?
A. "I will take my aspirin exactly as prescribed."
B. "I can resume my usual activities immediately."
C. "I will report any chest pain that is not relieved by rest."
D. "I will keep my follow-up appointment with the cardiologist."
Correct Answer: B. Rationale: The client should be taught to gradually increase activity
and to avoid strenuous exertion initially. Resuming usual activities immediately can
strain the heart and is unsafe. The other statements reflect correct understanding of
discharge instructions regarding medication adherence, symptom reporting, and
follow-up care.
Respiratory Disorders
4. During a health fair, a male client with emphysema tells the nurse that he
fatigues easily. Assessment reveals marked clubbing of the fingernails and an
increased anteroposterior chest diameter. Which instruction is best to provide
the client?
A. "Pace your activities and schedule rest periods."
B. "Increase the amount of oxygen you use at night."
C. "Obtain medical evaluation for antibiotic therapy."
D. "Reduce your intake of fluids containing caffeine."
Correct Answer: A. Rationale: Manifestations of emphysema include an increase in AP
diameter (referred to as a barrel chest), nail bed clubbing, and fatigue. The nurse can
provide instructions to promote energy management, such as pacing activities and
scheduling rest periods. Increasing oxygen use at night may result in a decreased drive
to breathe. The client is not exhibiting any symptoms of infection, so antibiotic therapy
is not necessary. Reducing caffeine is less beneficial than energy management.
5. A client who has partial-thickness burns on the chest, abdomen, and right
side arrives in the emergency department. Which action will the nurse take
first?
A. Remove the client's clothing.
B. Evaluate whether the client has inhaled smoke.
C. Administer intravenous pain medication.
D. Calculate the extent of the burn injury.
Correct Answer: B. Rationale: The priority in burn management is to assess for airway
compromise. Evaluating whether the client has inhaled smoke takes precedence over
, removing clothing, administering pain medication, or calculating burn extent, as
inhalation injury can rapidly become life-threatening.
Neurological Disorders
6. A client is admitted with a diagnosis of increased intracranial pressure (ICP).
Which finding should the nurse report to the healthcare provider
IMMEDIATELY?
A. A decrease in level of consciousness
B. A blood pressure of 130/80 mmHg
C. A heart rate of 88 beats per minute
D. A respiratory rate of 16 breaths per minute
Correct Answer: A. Rationale: A decrease in level of consciousness is an early and
critical sign of worsening increased intracranial pressure. The other vital signs listed are
within normal limits and do not require immediate reporting. Early recognition of
neurological deterioration is essential to prevent irreversible brain damage.
7. The nurse is caring for a client who had a stroke (CVA). Which nursing
intervention is the PRIORITY during the acute phase?
A. Maintain a patent airway and adequate oxygenation.
B. Begin passive range-of-motion exercises.
C. Encourage the client to verbalize feelings.
D. Assist the client with feeding.
Correct Answer: A. Rationale: During the acute phase of a stroke, airway and breathing
are the highest priorities. Maintaining a patent airway and adequate oxygenation are
essential to prevent further neurological damage. Range-of-motion exercises,
emotional support, and feeding assistance are important but are secondary to airway
management.
Renal and Genitourinary Disorders
8. A client with chronic kidney disease (CKD) has a hemoglobin of 9 g/dL and a
ferritin level of 100 ng/mL. Which order should the nurse anticipate?
A. Administer IV iron sucrose
B. Transfuse packed red blood cells
