HESI RN Medical-Surgical Nursing
Exam | Comprehensive Review |
2025/2026 Edition
Section 1: Introduction
This document provides verified questions and answers from the HESI RN Med-Surg Exam,
aligned with 2025/2026 clinical standards. Topics include major body systems—cardiac,
respiratory, renal, GI, neuro—and common acute and chronic disease management strategies.
Ideal for students seeking A+ level preparation for adult patient care scenarios in hospital
settings.
Section 2: Exam Questions
1. A client with heart failure has dyspnea and crackles. What is the nurse’s priority
action?
A. Administer oxygen
B. Provide a low-sodium diet
C. Check daily weight
D. Encourage fluid intake
Correct Answer: A
Rationale: Oxygen addresses acute respiratory distress in heart failure.
2. A client post-myocardial infarction has chest pain. What should the nurse do
first?
A. Administer nitroglycerin
B. Prepare for PCI
C. Check vital signs
D. Provide oxygen
Correct Answer: A
Rationale: Nitroglycerin relieves chest pain in myocardial infarction.
3. A client with pneumonia has a respiratory rate of 32/min. What is the priority?
A. Administer antibiotics
B. Assess oxygen saturation
C. Encourage coughing
D. Prepare for intubation
Correct Answer: B
Rationale: Assessing oxygen saturation guides oxygen therapy.
4. A client with COPD has cyanosis. What should the nurse do first?
A. Administer bronchodilators
B. Increase oxygen to 2 L/min
C. Encourage deep breathing
D. Prepare for mechanical ventilation
Correct Answer: B
Rationale: Low oxygen flow improves saturation without suppressing drive.
,5. A client with acute renal failure has oliguria. What is the priority?
A. Administer diuretics
B. Assess fluid status
C. Check potassium levels
D. Prepare for dialysis
Correct Answer: B
Rationale: Assessing fluid status prevents overload.
6. A client with chronic kidney disease has edema. What should the nurse do?
A. Restrict fluid intake
B. Administer IV fluids
C. Encourage ambulation
D. Increase protein intake
Correct Answer: A
Rationale: Fluid restriction manages edema.
7. A client with a GI bleed has melena. What is the nurse’s priority action?
A. Administer antacids
B. Assess for hypovolemic shock
C. Encourage oral fluids
D. Check stool for blood
Correct Answer: B
Rationale: Assessing for shock addresses bleeding severity.
8. A client with ulcerative colitis has diarrhea. What should the nurse do first?
A. Administer antidiarrheals
B. Assess hydration status
C. Encourage a high-fiber diet
D. Prepare for surgery
Correct Answer: B
Rationale: Hydration assessment prevents complications.
9. A client with a stroke has facial droop. What is the priority?
A. Administer tPA
B. Perform a neurological assessment
C. Encourage speech practice
D. Elevate the head
Correct Answer: B
Rationale: Neurological assessment confirms stroke severity.
10. A client with a traumatic brain injury has a GCS of 6. What should the nurse
do?
A. Administer mannitol
B. Maintain airway patency
C. Check pupil response
D. Prepare for CT scan
Correct Answer: B
Rationale: Airway maintenance is critical with a low GCS.
11. A client with hypertension has a blood pressure of 180/110 mmHg. What is the
priority?
A. Administer an antihypertensive
B. Provide education on diet
C. Recheck in 1 hour
D. Initiate IV fluids
, Correct Answer: A
Rationale: Antihypertensives address acute elevation.
12. A client post-appendectomy has a fever of 38.9°C. What should the nurse do
first?
A. Administer antibiotics
B. Assess the incision
C. Apply a cooling blanket
D. Notify the surgeon
Correct Answer: B
Rationale: Assessing the incision identifies infection.
13. A client with a pulmonary embolism has sudden dyspnea. What is the priority?
A. Administer heparin
B. Assess oxygen saturation
C. Prepare for thrombolytics
D. Encourage rest
Correct Answer: B
Rationale: Assessing saturation guides oxygen therapy.
14. A client with asthma has wheezing. What should the nurse do first?
A. Administer a bronchodilator
B. Encourage rest
C. Increase oxygen flow
D. Prepare for intubation
Correct Answer: A
Rationale: A bronchodilator relieves acute symptoms.
15. A client with acute kidney injury has a potassium of 6.0 mEq/L. What is the
priority?
A. Administer insulin and glucose
B. Assess ECG changes
C. Start dialysis
D. Encourage fluids
Correct Answer: B
Rationale: ECG assessment detects hyperkalemia effects.
16. A client with end-stage renal disease misses dialysis. What should the nurse do?
A. Administer IV fluids
B. Assess for fluid overload
C. Encourage oral intake
D. Prepare for transplant
Correct Answer: B
Rationale: Assessing for overload prevents complications.
17. A client with a gastric ulcer has epigastric pain. What is the priority?
A. Administer proton pump inhibitors
B. Assess for perforation
C. Encourage a bland diet
D. Check stool for blood
Correct Answer: B
Rationale: Assessing for perforation addresses a life-threatening risk.
18. A client with cirrhosis has ascites. What should the nurse do?
A. Administer diuretics
B. Assess for spontaneous bacterial peritonitis
C. Encourage ambulation
Exam | Comprehensive Review |
2025/2026 Edition
Section 1: Introduction
This document provides verified questions and answers from the HESI RN Med-Surg Exam,
aligned with 2025/2026 clinical standards. Topics include major body systems—cardiac,
respiratory, renal, GI, neuro—and common acute and chronic disease management strategies.
Ideal for students seeking A+ level preparation for adult patient care scenarios in hospital
settings.
Section 2: Exam Questions
1. A client with heart failure has dyspnea and crackles. What is the nurse’s priority
action?
A. Administer oxygen
B. Provide a low-sodium diet
C. Check daily weight
D. Encourage fluid intake
Correct Answer: A
Rationale: Oxygen addresses acute respiratory distress in heart failure.
2. A client post-myocardial infarction has chest pain. What should the nurse do
first?
A. Administer nitroglycerin
B. Prepare for PCI
C. Check vital signs
D. Provide oxygen
Correct Answer: A
Rationale: Nitroglycerin relieves chest pain in myocardial infarction.
3. A client with pneumonia has a respiratory rate of 32/min. What is the priority?
A. Administer antibiotics
B. Assess oxygen saturation
C. Encourage coughing
D. Prepare for intubation
Correct Answer: B
Rationale: Assessing oxygen saturation guides oxygen therapy.
4. A client with COPD has cyanosis. What should the nurse do first?
A. Administer bronchodilators
B. Increase oxygen to 2 L/min
C. Encourage deep breathing
D. Prepare for mechanical ventilation
Correct Answer: B
Rationale: Low oxygen flow improves saturation without suppressing drive.
,5. A client with acute renal failure has oliguria. What is the priority?
A. Administer diuretics
B. Assess fluid status
C. Check potassium levels
D. Prepare for dialysis
Correct Answer: B
Rationale: Assessing fluid status prevents overload.
6. A client with chronic kidney disease has edema. What should the nurse do?
A. Restrict fluid intake
B. Administer IV fluids
C. Encourage ambulation
D. Increase protein intake
Correct Answer: A
Rationale: Fluid restriction manages edema.
7. A client with a GI bleed has melena. What is the nurse’s priority action?
A. Administer antacids
B. Assess for hypovolemic shock
C. Encourage oral fluids
D. Check stool for blood
Correct Answer: B
Rationale: Assessing for shock addresses bleeding severity.
8. A client with ulcerative colitis has diarrhea. What should the nurse do first?
A. Administer antidiarrheals
B. Assess hydration status
C. Encourage a high-fiber diet
D. Prepare for surgery
Correct Answer: B
Rationale: Hydration assessment prevents complications.
9. A client with a stroke has facial droop. What is the priority?
A. Administer tPA
B. Perform a neurological assessment
C. Encourage speech practice
D. Elevate the head
Correct Answer: B
Rationale: Neurological assessment confirms stroke severity.
10. A client with a traumatic brain injury has a GCS of 6. What should the nurse
do?
A. Administer mannitol
B. Maintain airway patency
C. Check pupil response
D. Prepare for CT scan
Correct Answer: B
Rationale: Airway maintenance is critical with a low GCS.
11. A client with hypertension has a blood pressure of 180/110 mmHg. What is the
priority?
A. Administer an antihypertensive
B. Provide education on diet
C. Recheck in 1 hour
D. Initiate IV fluids
, Correct Answer: A
Rationale: Antihypertensives address acute elevation.
12. A client post-appendectomy has a fever of 38.9°C. What should the nurse do
first?
A. Administer antibiotics
B. Assess the incision
C. Apply a cooling blanket
D. Notify the surgeon
Correct Answer: B
Rationale: Assessing the incision identifies infection.
13. A client with a pulmonary embolism has sudden dyspnea. What is the priority?
A. Administer heparin
B. Assess oxygen saturation
C. Prepare for thrombolytics
D. Encourage rest
Correct Answer: B
Rationale: Assessing saturation guides oxygen therapy.
14. A client with asthma has wheezing. What should the nurse do first?
A. Administer a bronchodilator
B. Encourage rest
C. Increase oxygen flow
D. Prepare for intubation
Correct Answer: A
Rationale: A bronchodilator relieves acute symptoms.
15. A client with acute kidney injury has a potassium of 6.0 mEq/L. What is the
priority?
A. Administer insulin and glucose
B. Assess ECG changes
C. Start dialysis
D. Encourage fluids
Correct Answer: B
Rationale: ECG assessment detects hyperkalemia effects.
16. A client with end-stage renal disease misses dialysis. What should the nurse do?
A. Administer IV fluids
B. Assess for fluid overload
C. Encourage oral intake
D. Prepare for transplant
Correct Answer: B
Rationale: Assessing for overload prevents complications.
17. A client with a gastric ulcer has epigastric pain. What is the priority?
A. Administer proton pump inhibitors
B. Assess for perforation
C. Encourage a bland diet
D. Check stool for blood
Correct Answer: B
Rationale: Assessing for perforation addresses a life-threatening risk.
18. A client with cirrhosis has ascites. What should the nurse do?
A. Administer diuretics
B. Assess for spontaneous bacterial peritonitis
C. Encourage ambulation
