2025 HESI Med Surg V2
Exam – Actual Patient
Scenarios & Complex Clinical
Answers | 100% Accurate
Patient Scenarios and Clinical Questions (Questions 1–75)
1. A 68-year-old patient with chronic alcohol abuse presents with abdominal pain and
distension. Which condition should the nurse suspect?
o A) Pancreatitis
o B) Liver cirrhosis
o C) Peptic ulcer disease
o D) Cholecystitis
o Answer: B. Liver cirrhosis
o Rationale: Chronic alcohol abuse often leads to liver cirrhosis, presenting with
abdominal pain and distension due to ascites.
2. A 45-year-old patient with type 2 diabetes has a blood glucose of 360 mg/dL and
dehydration. What should the nurse suspect?
o A) Hypoglycemia
o B) Hyperglycemia
o C) Ketoacidosis
o D) Hypokalemia
o Answer: B. Hyperglycemia
o Rationale: Blood glucose of 360 mg/dL with dehydration indicates
hyperglycemia, potentially progressing to diabetic ketoacidosis or hyperosmolar
hyperglycemic state.
3. A 72-year-old patient presents to the ED with chest pain and shortness of breath.
What is the priority nursing intervention?
o A) Administer a bronchodilator
o B) Assess oxygen saturation
o C) Administer diuretics
o D) Restrict fluid intake
o Answer: B. Assess oxygen saturation
o Rationale: Chest pain and shortness of breath suggest cardiac or respiratory
issues; assessing oxygen saturation guides further interventions.
4. A 60-year-old patient with heart failure presents with edema and difficulty
breathing. What is the appropriate nursing intervention?
, o A) Administer NSAIDs
o B) Monitor fluid intake and output
o C) Encourage high-sodium diet
o D) Restrict ambulation
o Answer: B. Monitor fluid intake and output
o Rationale: Monitoring fluid balance is critical in heart failure to manage edema
and prevent exacerbation.
5. A 45-year-old patient with rheumatoid arthritis reports joint pain and stiffness.
What is the appropriate nursing intervention?
o A) Administer diuretics
o B) Assess range of motion
o C) Restrict protein intake
o D) Administer oxygen
o Answer: B. Assess range of motion
o Rationale: Assessing range of motion evaluates joint involvement and guides
treatment.
6. A 70-year-old patient with COPD presents with increased dyspnea and hemoptysis.
What is the priority intervention?
o A) Administer diuretics
o B) Monitor respiratory status
o C) Restrict fluid intake
o D) Administer insulin
o Answer: B. Monitor respiratory status
o Rationale: Dyspnea and hemoptysis in COPD require close respiratory
monitoring for exacerbation or complications.
7. A 55-year-old patient with chronic kidney disease presents with decreased urine
output and leg swelling. What is the appropriate intervention?
o A) Administer bronchodilators
o B) Monitor fluid intake and output
o C) Encourage high-potassium diet
o D) Restrict ambulation
o Answer: B. Monitor fluid intake and output
o Rationale: Fluid overload is common in kidney disease; monitoring intake and
output is essential.
8. A patient with heart failure presents with shortness of breath, fatigue, and edema.
Which medication is anticipated?
o A) Furosemide
o B) Ibuprofen
o C) Insulin
o D) Albuterol
o Answer: A. Furosemide
o Rationale: Furosemide, a diuretic, reduces fluid overload in heart failure.
9. A patient with COPD is admitted with worsening dyspnea. What interventions are
expected?
o A) Administer insulin
o B) Oxygen therapy and bronchodilators
Exam – Actual Patient
Scenarios & Complex Clinical
Answers | 100% Accurate
Patient Scenarios and Clinical Questions (Questions 1–75)
1. A 68-year-old patient with chronic alcohol abuse presents with abdominal pain and
distension. Which condition should the nurse suspect?
o A) Pancreatitis
o B) Liver cirrhosis
o C) Peptic ulcer disease
o D) Cholecystitis
o Answer: B. Liver cirrhosis
o Rationale: Chronic alcohol abuse often leads to liver cirrhosis, presenting with
abdominal pain and distension due to ascites.
2. A 45-year-old patient with type 2 diabetes has a blood glucose of 360 mg/dL and
dehydration. What should the nurse suspect?
o A) Hypoglycemia
o B) Hyperglycemia
o C) Ketoacidosis
o D) Hypokalemia
o Answer: B. Hyperglycemia
o Rationale: Blood glucose of 360 mg/dL with dehydration indicates
hyperglycemia, potentially progressing to diabetic ketoacidosis or hyperosmolar
hyperglycemic state.
3. A 72-year-old patient presents to the ED with chest pain and shortness of breath.
What is the priority nursing intervention?
o A) Administer a bronchodilator
o B) Assess oxygen saturation
o C) Administer diuretics
o D) Restrict fluid intake
o Answer: B. Assess oxygen saturation
o Rationale: Chest pain and shortness of breath suggest cardiac or respiratory
issues; assessing oxygen saturation guides further interventions.
4. A 60-year-old patient with heart failure presents with edema and difficulty
breathing. What is the appropriate nursing intervention?
, o A) Administer NSAIDs
o B) Monitor fluid intake and output
o C) Encourage high-sodium diet
o D) Restrict ambulation
o Answer: B. Monitor fluid intake and output
o Rationale: Monitoring fluid balance is critical in heart failure to manage edema
and prevent exacerbation.
5. A 45-year-old patient with rheumatoid arthritis reports joint pain and stiffness.
What is the appropriate nursing intervention?
o A) Administer diuretics
o B) Assess range of motion
o C) Restrict protein intake
o D) Administer oxygen
o Answer: B. Assess range of motion
o Rationale: Assessing range of motion evaluates joint involvement and guides
treatment.
6. A 70-year-old patient with COPD presents with increased dyspnea and hemoptysis.
What is the priority intervention?
o A) Administer diuretics
o B) Monitor respiratory status
o C) Restrict fluid intake
o D) Administer insulin
o Answer: B. Monitor respiratory status
o Rationale: Dyspnea and hemoptysis in COPD require close respiratory
monitoring for exacerbation or complications.
7. A 55-year-old patient with chronic kidney disease presents with decreased urine
output and leg swelling. What is the appropriate intervention?
o A) Administer bronchodilators
o B) Monitor fluid intake and output
o C) Encourage high-potassium diet
o D) Restrict ambulation
o Answer: B. Monitor fluid intake and output
o Rationale: Fluid overload is common in kidney disease; monitoring intake and
output is essential.
8. A patient with heart failure presents with shortness of breath, fatigue, and edema.
Which medication is anticipated?
o A) Furosemide
o B) Ibuprofen
o C) Insulin
o D) Albuterol
o Answer: A. Furosemide
o Rationale: Furosemide, a diuretic, reduces fluid overload in heart failure.
9. A patient with COPD is admitted with worsening dyspnea. What interventions are
expected?
o A) Administer insulin
o B) Oxygen therapy and bronchodilators
