Med Surg Hesi Exam (NEW UPDATED VERSION) LATEST ACTUAL
EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED QUESTIONS
AND ANSWERS) | GUARANTEED PASS A+ [2025]
Page | 1
Med-Surg HESI
1. A patient with chronic heart failure has a BNP of 450 pg/mL. Which action should the nurse take first?
A) Encourage daily exercise
B) Administer diuretics as prescribed
C) Monitor blood glucose
D) Increase fluid intake
Rationale: BNP (B-type natriuretic peptide) is elevated in heart failure. Administering prescribed
diuretics helps reduce fluid overload and symptoms.
2. A patient with COPD reports increasing dyspnea and a productive cough. Which assessment is most
important?
A) Lung sounds
B) Bowel sounds
C) Heart rate
D) Temperature
Rationale: Assessing lung sounds can identify areas of congestion, wheezing, or crackles indicating
worsening COPD exacerbation.
3. A patient with type 1 diabetes has glucose 320 mg/dL and ketones in urine. Which complication is most
likely?
A) Hypoglycemia
B) Diabetic ketoacidosis
C) Hyperosmolar hyperglycemic state
D) Lactic acidosis
Rationale: Hyperglycemia with ketones suggests DKA, a life-threatening complication in type 1
diabetes.
EXAMPREPMASTER
, 4. Which electrolyte imbalance is most concerning in a patient receiving furosemide?
A) Hypernatremia
B) Hypokalemia
Page | 2 C) Hypercalcemia
D) Hypermagnesemia
Rationale: Loop diuretics like furosemide increase potassium excretion, risking hypokalemia, which
can cause arrhythmias.
5. A patient with a NG tube complains of nausea and abdominal distention. The nurse notes minimal
output from the tube. What is the priority action?
A) Irrigate the tube
B) Provide antiemetic
C) Call the physician
D) Reposition the patient
Rationale: Minimal output may indicate NG tube obstruction; irrigation is the first action to restore
patency.
6. A patient with a new colostomy is anxious about self-care. Which nursing action is most therapeutic?
A) Demonstrate stoma care step by step
B) Leave written instructions only
C) Encourage family to do all care
D) Tell patient it will get easier
Rationale: Demonstrating care and involving the patient encourages learning, independence, and
reduces anxiety.
7. A patient with myocardial infarction is prescribed nitroglycerin. Which instruction should the nurse
include?
A) Take one tablet every 5 minutes up to three doses for chest pain
B) Crush tablets if chest pain persists
C) Avoid sitting while taking the medication
D) Only use at bedtime
Rationale: Sublingual nitroglycerin is given every 5 minutes up to three doses for acute angina,
monitoring blood pressure.
EXAMPREPMASTER
, 8. Which assessment finding indicates worsening left-sided heart failure?
A) Jugular vein distention
B) Pulmonary crackles
C) Peripheral edema
Page | 3 D) Hepatomegaly
Rationale: Left-sided heart failure causes pulmonary congestion, leading to crackles, dyspnea, and
orthopnea.
9. A patient with pneumonia is receiving oxygen at 2 L/min via nasal cannula. The patient becomes
confused and drowsy. What should the nurse do first?
A) Increase oxygen flow
B) Assess respiratory rate and oxygen saturation
C) Call the physician immediately
D) Place patient in Trendelenburg position
Rationale: Sudden confusion may indicate hypoxia; first assess oxygenation and respiratory status
before interventions.
10. Which lab indicates renal impairment in a patient taking aminoglycosides?
A) Hemoglobin 12 g/dL
B) BUN 40 mg/dL
C) WBC 8,000/mm³
D) Sodium 140 mEq/L
Rationale: Aminoglycosides are nephrotoxic; an elevated BUN suggests impaired renal function.
11. Which action is priority for a patient with a suspected pulmonary embolism?
A) Administer oxygen
B) Apply compression stockings
C) Encourage ambulation
D) Give a stool softener
Rationale: Oxygenation is the highest priority in pulmonary embolism due to impaired gas
exchange.
EXAMPREPMASTER
, 12. A patient receiving IV potassium complains of burning at the insertion site. What should the nurse do
first?
A) Stop infusion and assess IV site
B) Administer antihistamine
Page | 4 C) Slow the infusion rate
D) Notify family
Rationale: IV potassium can irritate veins; stopping and assessing prevents infiltration and phlebitis.
13. A patient with cirrhosis has ascites. Which intervention is priority?
A) Restrict sodium intake
B) Increase fluid intake
C) Encourage bedrest
D) Provide high-protein diet
Rationale: Sodium restriction reduces fluid accumulation in ascites.
14. A patient reports sudden right-sided weakness and slurred speech. What is the first nursing action?
A) Call stroke code
B) Obtain vital signs
C) Place patient in Trendelenburg position
D) Start IV fluids
Rationale: Sudden neurological deficits suggest stroke; rapid response (stroke code) is critical for
timely intervention.
15. Which sign is most concerning in a patient receiving heparin?
A) Bruising at IV site
B) Hematuria
C) Mild headache
D) Fatigue
Rationale: Hematuria indicates bleeding, a serious complication of heparin therapy.
16. A patient with hypocalcemia is at risk for which complication?
A) Hyperglycemia
B) Tetany
EXAMPREPMASTER
EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED QUESTIONS
AND ANSWERS) | GUARANTEED PASS A+ [2025]
Page | 1
Med-Surg HESI
1. A patient with chronic heart failure has a BNP of 450 pg/mL. Which action should the nurse take first?
A) Encourage daily exercise
B) Administer diuretics as prescribed
C) Monitor blood glucose
D) Increase fluid intake
Rationale: BNP (B-type natriuretic peptide) is elevated in heart failure. Administering prescribed
diuretics helps reduce fluid overload and symptoms.
2. A patient with COPD reports increasing dyspnea and a productive cough. Which assessment is most
important?
A) Lung sounds
B) Bowel sounds
C) Heart rate
D) Temperature
Rationale: Assessing lung sounds can identify areas of congestion, wheezing, or crackles indicating
worsening COPD exacerbation.
3. A patient with type 1 diabetes has glucose 320 mg/dL and ketones in urine. Which complication is most
likely?
A) Hypoglycemia
B) Diabetic ketoacidosis
C) Hyperosmolar hyperglycemic state
D) Lactic acidosis
Rationale: Hyperglycemia with ketones suggests DKA, a life-threatening complication in type 1
diabetes.
EXAMPREPMASTER
, 4. Which electrolyte imbalance is most concerning in a patient receiving furosemide?
A) Hypernatremia
B) Hypokalemia
Page | 2 C) Hypercalcemia
D) Hypermagnesemia
Rationale: Loop diuretics like furosemide increase potassium excretion, risking hypokalemia, which
can cause arrhythmias.
5. A patient with a NG tube complains of nausea and abdominal distention. The nurse notes minimal
output from the tube. What is the priority action?
A) Irrigate the tube
B) Provide antiemetic
C) Call the physician
D) Reposition the patient
Rationale: Minimal output may indicate NG tube obstruction; irrigation is the first action to restore
patency.
6. A patient with a new colostomy is anxious about self-care. Which nursing action is most therapeutic?
A) Demonstrate stoma care step by step
B) Leave written instructions only
C) Encourage family to do all care
D) Tell patient it will get easier
Rationale: Demonstrating care and involving the patient encourages learning, independence, and
reduces anxiety.
7. A patient with myocardial infarction is prescribed nitroglycerin. Which instruction should the nurse
include?
A) Take one tablet every 5 minutes up to three doses for chest pain
B) Crush tablets if chest pain persists
C) Avoid sitting while taking the medication
D) Only use at bedtime
Rationale: Sublingual nitroglycerin is given every 5 minutes up to three doses for acute angina,
monitoring blood pressure.
EXAMPREPMASTER
, 8. Which assessment finding indicates worsening left-sided heart failure?
A) Jugular vein distention
B) Pulmonary crackles
C) Peripheral edema
Page | 3 D) Hepatomegaly
Rationale: Left-sided heart failure causes pulmonary congestion, leading to crackles, dyspnea, and
orthopnea.
9. A patient with pneumonia is receiving oxygen at 2 L/min via nasal cannula. The patient becomes
confused and drowsy. What should the nurse do first?
A) Increase oxygen flow
B) Assess respiratory rate and oxygen saturation
C) Call the physician immediately
D) Place patient in Trendelenburg position
Rationale: Sudden confusion may indicate hypoxia; first assess oxygenation and respiratory status
before interventions.
10. Which lab indicates renal impairment in a patient taking aminoglycosides?
A) Hemoglobin 12 g/dL
B) BUN 40 mg/dL
C) WBC 8,000/mm³
D) Sodium 140 mEq/L
Rationale: Aminoglycosides are nephrotoxic; an elevated BUN suggests impaired renal function.
11. Which action is priority for a patient with a suspected pulmonary embolism?
A) Administer oxygen
B) Apply compression stockings
C) Encourage ambulation
D) Give a stool softener
Rationale: Oxygenation is the highest priority in pulmonary embolism due to impaired gas
exchange.
EXAMPREPMASTER
, 12. A patient receiving IV potassium complains of burning at the insertion site. What should the nurse do
first?
A) Stop infusion and assess IV site
B) Administer antihistamine
Page | 4 C) Slow the infusion rate
D) Notify family
Rationale: IV potassium can irritate veins; stopping and assessing prevents infiltration and phlebitis.
13. A patient with cirrhosis has ascites. Which intervention is priority?
A) Restrict sodium intake
B) Increase fluid intake
C) Encourage bedrest
D) Provide high-protein diet
Rationale: Sodium restriction reduces fluid accumulation in ascites.
14. A patient reports sudden right-sided weakness and slurred speech. What is the first nursing action?
A) Call stroke code
B) Obtain vital signs
C) Place patient in Trendelenburg position
D) Start IV fluids
Rationale: Sudden neurological deficits suggest stroke; rapid response (stroke code) is critical for
timely intervention.
15. Which sign is most concerning in a patient receiving heparin?
A) Bruising at IV site
B) Hematuria
C) Mild headache
D) Fatigue
Rationale: Hematuria indicates bleeding, a serious complication of heparin therapy.
16. A patient with hypocalcemia is at risk for which complication?
A) Hyperglycemia
B) Tetany
EXAMPREPMASTER
