HESI PN Med Surg Exit Exam 2025 –
Verified Questions with Correct
Answers and Rationales | NGN Ready
Medical-Surgical Nursing Questions (1–80)
1. A client with heart failure reports increased dyspnea and leg swelling. Which
assessment finding should the practical nurse prioritize?
a. Blood pressure 140/90 mmHg
b. Crackles in bilateral lung bases
c. Heart rate 88 bpm
d. Peripheral pulses 2+
Correct Answer: b. Crackles in bilateral lung bases
Rationale: Crackles in the lung bases indicate pulmonary edema, a life-threatening
complication of heart failure due to fluid overload. This requires immediate reporting to
the RN or provider. Blood pressure, heart rate, and pulses are less urgent unless
abnormal.
2. A client with type 2 diabetes mellitus is prescribed metformin. Which statement by
the client indicates a need for further teaching?
a. “I’ll take this medication with meals.”
b. “I should report muscle pain immediately.”
c. “This medication will cure my diabetes.”
d. “I’ll monitor my blood glucose regularly.”
Correct Answer: c. This medication will cure my diabetes.
Rationale: Metformin manages blood glucose but does not cure diabetes. Taking it with
meals, reporting muscle pain (a sign of lactic acidosis), and monitoring glucose are
correct actions.
3. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at
2 L/min via nasal cannula. Which finding indicates the oxygen therapy is effective?
a. Respiratory rate 28 breaths/min
b. Oxygen saturation 94%
c. Cyanosis of lips
d. Use of accessory muscles
Correct Answer: b. Oxygen saturation 94%
Rationale: An oxygen saturation of 94% (within 88–92% for COPD) indicates effective
oxygenation. Increased respiratory rate, cyanosis, and accessory muscle use suggest
respiratory distress.
4. A client post-appendectomy reports severe abdominal pain and a rigid abdomen.
What should the practical nurse do first?
a. Administer prescribed pain medication
, b. Assess vital signs
c. Apply a warm compress
d. Encourage ambulation
Correct Answer: b. Assess vital signs
Rationale: Severe pain and a rigid abdomen suggest peritonitis, a surgical emergency.
Assessing vital signs (e.g., fever, tachycardia) provides data to report to the RN/provider.
Pain medication, compresses, or ambulation may delay intervention.
5. A client with hypertension is prescribed lisinopril. Which side effect should the
nurse monitor for?
a. Hyperkalemia
b. Hypoglycemia
c. Weight gain
d. Constipation
Correct Answer: a. Hyperkalemia
Rationale: Lisinopril, an ACE inhibitor, can cause hyperkalemia due to reduced
aldosterone secretion. Hypoglycemia, weight gain, and constipation are not typical side
effects.
6. A client with a history of myocardial infarction is on aspirin therapy. Which
laboratory value should the nurse monitor?
a. Platelet count
b. Blood glucose
c. Serum potassium
d. Creatinine
Correct Answer: a. Platelet count
Rationale: Aspirin inhibits platelet aggregation, increasing bleeding risk. Monitoring
platelet count helps assess for thrombocytopenia. Other labs are less relevant to aspirin
therapy.
7. A client with pneumonia reports chest pain with breathing. Which position should
the nurse recommend?
a. Supine with head elevated
b. Prone position
c. Side-lying on the affected side
d. Sitting upright leaning forward
Correct Answer: d. Sitting upright leaning forward
Rationale: Sitting upright leaning forward reduces pressure on the chest, easing pleuritic
pain in pneumonia. Supine, prone, or side-lying positions may worsen discomfort.
8. A client with a new colostomy is being taught stoma care. Which statement indicates
understanding?
a. “I’ll change the pouch every day.”
b. “The stoma should be pale and dry.”
c. “I’ll clean the stoma with alcohol wipes.”
d. “I should empty the pouch when it’s one-third full.”
Correct Answer: d. I should empty the pouch when it’s one-third full.
Rationale: Emptying the pouch when one-third full prevents leaks and skin irritation.
Daily pouch changes are unnecessary, the stoma should be pink and moist, and alcohol
wipes are too harsh.
, 9. A client with a fractured femur is in traction. Which assessment finding requires
immediate action?
a. Pain at the fracture site
b. Cool toes on the affected leg
c. Swelling at the site
d. Limited range of motion
Correct Answer: b. Cool toes on the affected leg
Rationale: Cool toes suggest impaired circulation, a potential neurovascular compromise
requiring urgent reporting. Pain, swelling, and limited motion are expected but less
urgent.
10. A client with peptic ulcer disease is prescribed omeprazole. What is the primary
purpose of this medication?
a. Neutralize stomach acid
b. Reduce gastric acid production
c. Protect the stomach lining
d. Kill H. pylori bacteria
Correct Answer: b. Reduce gastric acid production
Rationale: Omeprazole, a proton pump inhibitor, reduces acid production to promote
ulcer healing. Antacids neutralize acid, sucralfate protects the lining, and antibiotics
target H. pylori.
11. A client with a history of stroke reports difficulty swallowing. What should the
nurse do first?
a. Offer thickened liquids
b. Notify the speech therapist
c. Place the client on NPO status
d. Encourage small bites
Correct Answer: c. Place the client on NPO status
Rationale: Difficulty swallowing (dysphagia) poses an aspiration risk, so NPO status is
the priority until a swallow evaluation is completed. Other actions follow assessment.
12. A client with rheumatoid arthritis reports morning stiffness. Which intervention
should the nurse recommend?
a. Apply cold packs to joints
b. Perform gentle range-of-motion exercises
c. Restrict all physical activity
d. Take ibuprofen at bedtime
Correct Answer: b. Perform gentle range-of-motion exercises
Rationale: Gentle exercises reduce stiffness and maintain mobility in rheumatoid
arthritis. Cold packs are for acute inflammation, activity restriction worsens stiffness, and
ibuprofen timing varies.
13. A client with type 1 diabetes reports shakiness and sweating. What is the nurse’s
priority action?
a. Administer insulin
b. Check blood glucose
c. Provide a high-protein snack
d. Encourage rest
Correct Answer: b. Check blood glucose
Verified Questions with Correct
Answers and Rationales | NGN Ready
Medical-Surgical Nursing Questions (1–80)
1. A client with heart failure reports increased dyspnea and leg swelling. Which
assessment finding should the practical nurse prioritize?
a. Blood pressure 140/90 mmHg
b. Crackles in bilateral lung bases
c. Heart rate 88 bpm
d. Peripheral pulses 2+
Correct Answer: b. Crackles in bilateral lung bases
Rationale: Crackles in the lung bases indicate pulmonary edema, a life-threatening
complication of heart failure due to fluid overload. This requires immediate reporting to
the RN or provider. Blood pressure, heart rate, and pulses are less urgent unless
abnormal.
2. A client with type 2 diabetes mellitus is prescribed metformin. Which statement by
the client indicates a need for further teaching?
a. “I’ll take this medication with meals.”
b. “I should report muscle pain immediately.”
c. “This medication will cure my diabetes.”
d. “I’ll monitor my blood glucose regularly.”
Correct Answer: c. This medication will cure my diabetes.
Rationale: Metformin manages blood glucose but does not cure diabetes. Taking it with
meals, reporting muscle pain (a sign of lactic acidosis), and monitoring glucose are
correct actions.
3. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at
2 L/min via nasal cannula. Which finding indicates the oxygen therapy is effective?
a. Respiratory rate 28 breaths/min
b. Oxygen saturation 94%
c. Cyanosis of lips
d. Use of accessory muscles
Correct Answer: b. Oxygen saturation 94%
Rationale: An oxygen saturation of 94% (within 88–92% for COPD) indicates effective
oxygenation. Increased respiratory rate, cyanosis, and accessory muscle use suggest
respiratory distress.
4. A client post-appendectomy reports severe abdominal pain and a rigid abdomen.
What should the practical nurse do first?
a. Administer prescribed pain medication
, b. Assess vital signs
c. Apply a warm compress
d. Encourage ambulation
Correct Answer: b. Assess vital signs
Rationale: Severe pain and a rigid abdomen suggest peritonitis, a surgical emergency.
Assessing vital signs (e.g., fever, tachycardia) provides data to report to the RN/provider.
Pain medication, compresses, or ambulation may delay intervention.
5. A client with hypertension is prescribed lisinopril. Which side effect should the
nurse monitor for?
a. Hyperkalemia
b. Hypoglycemia
c. Weight gain
d. Constipation
Correct Answer: a. Hyperkalemia
Rationale: Lisinopril, an ACE inhibitor, can cause hyperkalemia due to reduced
aldosterone secretion. Hypoglycemia, weight gain, and constipation are not typical side
effects.
6. A client with a history of myocardial infarction is on aspirin therapy. Which
laboratory value should the nurse monitor?
a. Platelet count
b. Blood glucose
c. Serum potassium
d. Creatinine
Correct Answer: a. Platelet count
Rationale: Aspirin inhibits platelet aggregation, increasing bleeding risk. Monitoring
platelet count helps assess for thrombocytopenia. Other labs are less relevant to aspirin
therapy.
7. A client with pneumonia reports chest pain with breathing. Which position should
the nurse recommend?
a. Supine with head elevated
b. Prone position
c. Side-lying on the affected side
d. Sitting upright leaning forward
Correct Answer: d. Sitting upright leaning forward
Rationale: Sitting upright leaning forward reduces pressure on the chest, easing pleuritic
pain in pneumonia. Supine, prone, or side-lying positions may worsen discomfort.
8. A client with a new colostomy is being taught stoma care. Which statement indicates
understanding?
a. “I’ll change the pouch every day.”
b. “The stoma should be pale and dry.”
c. “I’ll clean the stoma with alcohol wipes.”
d. “I should empty the pouch when it’s one-third full.”
Correct Answer: d. I should empty the pouch when it’s one-third full.
Rationale: Emptying the pouch when one-third full prevents leaks and skin irritation.
Daily pouch changes are unnecessary, the stoma should be pink and moist, and alcohol
wipes are too harsh.
, 9. A client with a fractured femur is in traction. Which assessment finding requires
immediate action?
a. Pain at the fracture site
b. Cool toes on the affected leg
c. Swelling at the site
d. Limited range of motion
Correct Answer: b. Cool toes on the affected leg
Rationale: Cool toes suggest impaired circulation, a potential neurovascular compromise
requiring urgent reporting. Pain, swelling, and limited motion are expected but less
urgent.
10. A client with peptic ulcer disease is prescribed omeprazole. What is the primary
purpose of this medication?
a. Neutralize stomach acid
b. Reduce gastric acid production
c. Protect the stomach lining
d. Kill H. pylori bacteria
Correct Answer: b. Reduce gastric acid production
Rationale: Omeprazole, a proton pump inhibitor, reduces acid production to promote
ulcer healing. Antacids neutralize acid, sucralfate protects the lining, and antibiotics
target H. pylori.
11. A client with a history of stroke reports difficulty swallowing. What should the
nurse do first?
a. Offer thickened liquids
b. Notify the speech therapist
c. Place the client on NPO status
d. Encourage small bites
Correct Answer: c. Place the client on NPO status
Rationale: Difficulty swallowing (dysphagia) poses an aspiration risk, so NPO status is
the priority until a swallow evaluation is completed. Other actions follow assessment.
12. A client with rheumatoid arthritis reports morning stiffness. Which intervention
should the nurse recommend?
a. Apply cold packs to joints
b. Perform gentle range-of-motion exercises
c. Restrict all physical activity
d. Take ibuprofen at bedtime
Correct Answer: b. Perform gentle range-of-motion exercises
Rationale: Gentle exercises reduce stiffness and maintain mobility in rheumatoid
arthritis. Cold packs are for acute inflammation, activity restriction worsens stiffness, and
ibuprofen timing varies.
13. A client with type 1 diabetes reports shakiness and sweating. What is the nurse’s
priority action?
a. Administer insulin
b. Check blood glucose
c. Provide a high-protein snack
d. Encourage rest
Correct Answer: b. Check blood glucose
