HESI MED SURG EXAMS V2 LATEST 2025 REAL ACTUAL
SCREENSHOTS VERIFIED QUESTIONS AND ANSWERS GRADED A
Question 1
A nurse is caring for a client with a history of hypertension. The client's blood pressure is
consistently 160/98 mmHg despite being on two antihypertensive medications. Which action
should the nurse prioritize?
A) Document the blood pressure readings.
B) Educate the client about the importance of medication adherence.
C) Encourage the client to increase physical activity.
D) Notify the healthcare provider of the uncontrolled hypertension.
E) Recheck the blood pressure in 30 minutes.
Correct Answer: D) Notify the healthcare provider of the uncontrolled hypertension.
Rationale: Consistently high blood pressure (160/98 mmHg) despite being on two
medications indicates uncontrolled hypertension, which increases the risk for target organ
damage (e.g., stroke, myocardial infarction, kidney disease). The nurse's priority is to
notify the healthcare provider so that the medication regimen can be re-evaluated and
adjusted.
Question 2
A client with acute kidney injury (AKI) has a serum potassium level of 6.2 mEq/L. Which
medication would the nurse anticipate administering to rapidly lower the potassium level?
A) Furosemide (Lasix)
B) Sodium polystyrene sulfonate (Kayexalate)
C) Insulin and Dextrose
D) Calcium gluconate
E) Albuterol (inhaled)
Correct Answer: C) Insulin and Dextrose
Rationale: For rapidly lowering dangerously high potassium levels (hyperkalemia), a
combination of intravenous insulin and dextrose is often administered. Insulin drives
potassium into cells, and dextrose is given concurrently to prevent hypoglycemia. While
Kayexalate promotes slower excretion of potassium through the GI tract, and Calcium
gluconate stabilizes cardiac membranes, insulin and dextrose provide a rapid intracellular
shift of potassium.
Question 3
The nurse is providing discharge teaching for a client with a new diagnosis of type 1 diabetes.
Which statement indicates the client understands the relationship between insulin and exercise?
A) "I should skip my insulin dose before exercising vigorously."
B) "I will need to increase my insulin dose before exercise to prevent hypoglycemia."
C) "I should carry a carbohydrate snack when I exercise."
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D) "Exercise will increase my blood glucose, so I need extra insulin."
E) "I don't need to adjust my insulin or diet for exercise."
Correct Answer: C) "I should carry a carbohydrate snack when I exercise."
Rationale: Exercise increases glucose uptake by muscles and can significantly lower blood
glucose levels, potentially leading to hypoglycemia in clients with type 1 diabetes. Carrying
a carbohydrate snack (e.g., glucose tablets, juice) allows the client to quickly treat or
prevent exercise-induced hypoglycemia. Skipping insulin or increasing insulin dose before
exercise is generally incorrect and dangerous without specific guidance.
Question 4
A client with chronic obstructive pulmonary disease (COPD) is admitted with increased dyspnea
and productive cough. The nurse notes expiratory wheezing and prolonged expiration. Which
medication class would the nurse anticipate being prescribed to manage these acute symptoms?
A) Long-acting beta-agonists (LABAs)
B) Inhaled corticosteroids
C) Short-acting beta-agonists (SABAs)
D) Oral antibiotics
E) Mucolytics
Correct Answer: C) Short-acting beta-agonists (SABAs)
Rationale: Short-acting beta-agonists (SABAs) like albuterol are rapid-onset
bronchodilators used as "rescue" medications for acute exacerbations of COPD, providing
quick relief from bronchospasm, wheezing, and dyspnea. LABAs are for maintenance.
Inhaled corticosteroids are for inflammation, often maintenance. Antibiotics might be
needed for infection, and mucolytics help with secretions, but bronchodilation is primary
for acute airflow limitation.
Question 5
A client is post-gastrectomy and is experiencing symptoms of dumping syndrome. Which dietary
modification should the nurse recommend?
A) Consume high-carbohydrate meals.
B) Drink fluids with meals.
C) Lie down for 30 minutes after eating.
D) Eat three large meals a day.
E) Increase intake of sugary foods.
Correct Answer: C) Lie down for 30 minutes after eating.
Rationale: Dumping syndrome occurs when food (especially high-sugar content) moves too
quickly from the stomach to the small intestine. Lying down after eating slows gastric
emptying. Other recommendations include eating small, frequent meals, separating fluids
from solids (drinking between meals), and consuming a diet high in protein and fat, and
low in simple carbohydrates.
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Question 6
The nurse is caring for a client with a severe head injury. The client's Glasgow Coma Scale
(GCS) score has decreased from 10 to 7. What is the nurse's priority action?
A) Administer a prescribed antipyretic.
B) Elevate the head of the bed to 30 degrees.
C) Prepare for endotracheal intubation.
D) Document the change and re-assess in 1 hour.
E) Perform a neurological assessment.
Correct Answer: C) Prepare for endotracheal intubation.
Rationale: A significant decrease in GCS score (especially below 8) indicates a deteriorating
neurological status and impaired airway protective reflexes. The priority is to secure the
airway to prevent aspiration and ensure adequate ventilation and oxygenation. Preparing
for intubation is critical in this situation. While elevating the head of the bed and
performing a neurological assessment are important, airway management takes
precedence.
Question 7
A client with hyperparathyroidism is at risk for developing which musculoskeletal complication?
A) Osteoarthritis
B) Gout
C) Osteoporosis
D) Rheumatoid arthritis
E) Muscular dystrophy
Correct Answer: C) Osteoporosis
Rationale: Hyperparathyroidism leads to excessive secretion of parathyroid hormone
(PTH), which promotes calcium resorption from bones. This chronic demineralization of
bone can result in osteoporosis, increasing the risk of fractures.
Question 8
The nurse is providing wound care for a client with a venous stasis ulcer on the ankle. Which
intervention is most appropriate for promoting healing?
A) Keep the wound dry and uncovered.
B) Apply tight-fitting dressings to the wound.
C) Elevate the affected leg and apply compression stockings.
D) Scrub the wound vigorously during dressing changes.
E) Encourage the client to remain sedentary.
Correct Answer: C) Elevate the affected leg and apply compression stockings.
Rationale: Venous stasis ulcers are caused by impaired venous return. Elevating the affected
leg and applying compression stockings (or bandages) helps to reduce venous pooling,
decrease edema, improve circulation, and promote healing of the ulcer. Keeping the wound
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dry is generally incorrect; a moist wound environment is preferred. Vigorous scrubbing
can damage tissue. Remaining sedentary worsens venous stasis.
Question 9
A client with adrenal insufficiency (Addison's disease) is being discharged. Which instruction is
most important for the nurse to include in the teaching plan?
A) "Increase your fluid intake only if you feel thirsty."
B) "Take your glucocorticoids exactly as prescribed and do not abruptly stop them."
C) "Avoid all salt in your diet."
D) "Report any weight gain immediately."
E) "You will need to take insulin daily for the rest of your life."
Correct Answer: B) "Take your glucocorticoids exactly as prescribed and do not abruptly
stop them."
Rationale: Abruptly stopping glucocorticoid replacement therapy can precipitate an
adrenal crisis, a life-threatening emergency. Clients must understand the critical
importance of taking their medications consistently and never discontinuing them without
healthcare provider instruction. The dose may need to be increased during stress (sick
days).
Question 10
A client with a new colostomy is being taught about pouch care. Which statement by the client
indicates effective teaching?
A) "I should change my pouch every morning after showering."
B) "I will empty my pouch when it is about one-third to one-half full."
C) "It's normal for the stoma to be blueish-purple immediately after surgery."
D) "I need to clean around the stoma with harsh soap and water."
E) "If the skin around my stoma is red, that means it's healing normally."
Correct Answer: B) "I will empty my pouch when it is about one-third to one-half full."
Rationale: Emptying the ostomy pouch when it is one-third to one-half full prevents it from
becoming too heavy and pulling away from the skin, which can lead to leakage and skin
irritation. Waiting until it's too full also increases the risk of embarrassing incidents. The
other statements are incorrect or indicate a need for further teaching.
Question 11
The nurse is preparing to administer an oral medication to a client. Which action is the most
important to ensure client safety?
A) Administer all medications with a full glass of water.
B) Check the client's identification band against the medication administration record.
C) Crush all tablets to facilitate swallowing.
D) Document the medication administration immediately after preparing it.
E) Ask the client about their preference for the medication.
SCREENSHOTS VERIFIED QUESTIONS AND ANSWERS GRADED A
Question 1
A nurse is caring for a client with a history of hypertension. The client's blood pressure is
consistently 160/98 mmHg despite being on two antihypertensive medications. Which action
should the nurse prioritize?
A) Document the blood pressure readings.
B) Educate the client about the importance of medication adherence.
C) Encourage the client to increase physical activity.
D) Notify the healthcare provider of the uncontrolled hypertension.
E) Recheck the blood pressure in 30 minutes.
Correct Answer: D) Notify the healthcare provider of the uncontrolled hypertension.
Rationale: Consistently high blood pressure (160/98 mmHg) despite being on two
medications indicates uncontrolled hypertension, which increases the risk for target organ
damage (e.g., stroke, myocardial infarction, kidney disease). The nurse's priority is to
notify the healthcare provider so that the medication regimen can be re-evaluated and
adjusted.
Question 2
A client with acute kidney injury (AKI) has a serum potassium level of 6.2 mEq/L. Which
medication would the nurse anticipate administering to rapidly lower the potassium level?
A) Furosemide (Lasix)
B) Sodium polystyrene sulfonate (Kayexalate)
C) Insulin and Dextrose
D) Calcium gluconate
E) Albuterol (inhaled)
Correct Answer: C) Insulin and Dextrose
Rationale: For rapidly lowering dangerously high potassium levels (hyperkalemia), a
combination of intravenous insulin and dextrose is often administered. Insulin drives
potassium into cells, and dextrose is given concurrently to prevent hypoglycemia. While
Kayexalate promotes slower excretion of potassium through the GI tract, and Calcium
gluconate stabilizes cardiac membranes, insulin and dextrose provide a rapid intracellular
shift of potassium.
Question 3
The nurse is providing discharge teaching for a client with a new diagnosis of type 1 diabetes.
Which statement indicates the client understands the relationship between insulin and exercise?
A) "I should skip my insulin dose before exercising vigorously."
B) "I will need to increase my insulin dose before exercise to prevent hypoglycemia."
C) "I should carry a carbohydrate snack when I exercise."
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D) "Exercise will increase my blood glucose, so I need extra insulin."
E) "I don't need to adjust my insulin or diet for exercise."
Correct Answer: C) "I should carry a carbohydrate snack when I exercise."
Rationale: Exercise increases glucose uptake by muscles and can significantly lower blood
glucose levels, potentially leading to hypoglycemia in clients with type 1 diabetes. Carrying
a carbohydrate snack (e.g., glucose tablets, juice) allows the client to quickly treat or
prevent exercise-induced hypoglycemia. Skipping insulin or increasing insulin dose before
exercise is generally incorrect and dangerous without specific guidance.
Question 4
A client with chronic obstructive pulmonary disease (COPD) is admitted with increased dyspnea
and productive cough. The nurse notes expiratory wheezing and prolonged expiration. Which
medication class would the nurse anticipate being prescribed to manage these acute symptoms?
A) Long-acting beta-agonists (LABAs)
B) Inhaled corticosteroids
C) Short-acting beta-agonists (SABAs)
D) Oral antibiotics
E) Mucolytics
Correct Answer: C) Short-acting beta-agonists (SABAs)
Rationale: Short-acting beta-agonists (SABAs) like albuterol are rapid-onset
bronchodilators used as "rescue" medications for acute exacerbations of COPD, providing
quick relief from bronchospasm, wheezing, and dyspnea. LABAs are for maintenance.
Inhaled corticosteroids are for inflammation, often maintenance. Antibiotics might be
needed for infection, and mucolytics help with secretions, but bronchodilation is primary
for acute airflow limitation.
Question 5
A client is post-gastrectomy and is experiencing symptoms of dumping syndrome. Which dietary
modification should the nurse recommend?
A) Consume high-carbohydrate meals.
B) Drink fluids with meals.
C) Lie down for 30 minutes after eating.
D) Eat three large meals a day.
E) Increase intake of sugary foods.
Correct Answer: C) Lie down for 30 minutes after eating.
Rationale: Dumping syndrome occurs when food (especially high-sugar content) moves too
quickly from the stomach to the small intestine. Lying down after eating slows gastric
emptying. Other recommendations include eating small, frequent meals, separating fluids
from solids (drinking between meals), and consuming a diet high in protein and fat, and
low in simple carbohydrates.
,[Type here]
Question 6
The nurse is caring for a client with a severe head injury. The client's Glasgow Coma Scale
(GCS) score has decreased from 10 to 7. What is the nurse's priority action?
A) Administer a prescribed antipyretic.
B) Elevate the head of the bed to 30 degrees.
C) Prepare for endotracheal intubation.
D) Document the change and re-assess in 1 hour.
E) Perform a neurological assessment.
Correct Answer: C) Prepare for endotracheal intubation.
Rationale: A significant decrease in GCS score (especially below 8) indicates a deteriorating
neurological status and impaired airway protective reflexes. The priority is to secure the
airway to prevent aspiration and ensure adequate ventilation and oxygenation. Preparing
for intubation is critical in this situation. While elevating the head of the bed and
performing a neurological assessment are important, airway management takes
precedence.
Question 7
A client with hyperparathyroidism is at risk for developing which musculoskeletal complication?
A) Osteoarthritis
B) Gout
C) Osteoporosis
D) Rheumatoid arthritis
E) Muscular dystrophy
Correct Answer: C) Osteoporosis
Rationale: Hyperparathyroidism leads to excessive secretion of parathyroid hormone
(PTH), which promotes calcium resorption from bones. This chronic demineralization of
bone can result in osteoporosis, increasing the risk of fractures.
Question 8
The nurse is providing wound care for a client with a venous stasis ulcer on the ankle. Which
intervention is most appropriate for promoting healing?
A) Keep the wound dry and uncovered.
B) Apply tight-fitting dressings to the wound.
C) Elevate the affected leg and apply compression stockings.
D) Scrub the wound vigorously during dressing changes.
E) Encourage the client to remain sedentary.
Correct Answer: C) Elevate the affected leg and apply compression stockings.
Rationale: Venous stasis ulcers are caused by impaired venous return. Elevating the affected
leg and applying compression stockings (or bandages) helps to reduce venous pooling,
decrease edema, improve circulation, and promote healing of the ulcer. Keeping the wound
, [Type here]
dry is generally incorrect; a moist wound environment is preferred. Vigorous scrubbing
can damage tissue. Remaining sedentary worsens venous stasis.
Question 9
A client with adrenal insufficiency (Addison's disease) is being discharged. Which instruction is
most important for the nurse to include in the teaching plan?
A) "Increase your fluid intake only if you feel thirsty."
B) "Take your glucocorticoids exactly as prescribed and do not abruptly stop them."
C) "Avoid all salt in your diet."
D) "Report any weight gain immediately."
E) "You will need to take insulin daily for the rest of your life."
Correct Answer: B) "Take your glucocorticoids exactly as prescribed and do not abruptly
stop them."
Rationale: Abruptly stopping glucocorticoid replacement therapy can precipitate an
adrenal crisis, a life-threatening emergency. Clients must understand the critical
importance of taking their medications consistently and never discontinuing them without
healthcare provider instruction. The dose may need to be increased during stress (sick
days).
Question 10
A client with a new colostomy is being taught about pouch care. Which statement by the client
indicates effective teaching?
A) "I should change my pouch every morning after showering."
B) "I will empty my pouch when it is about one-third to one-half full."
C) "It's normal for the stoma to be blueish-purple immediately after surgery."
D) "I need to clean around the stoma with harsh soap and water."
E) "If the skin around my stoma is red, that means it's healing normally."
Correct Answer: B) "I will empty my pouch when it is about one-third to one-half full."
Rationale: Emptying the ostomy pouch when it is one-third to one-half full prevents it from
becoming too heavy and pulling away from the skin, which can lead to leakage and skin
irritation. Waiting until it's too full also increases the risk of embarrassing incidents. The
other statements are incorrect or indicate a need for further teaching.
Question 11
The nurse is preparing to administer an oral medication to a client. Which action is the most
important to ensure client safety?
A) Administer all medications with a full glass of water.
B) Check the client's identification band against the medication administration record.
C) Crush all tablets to facilitate swallowing.
D) Document the medication administration immediately after preparing it.
E) Ask the client about their preference for the medication.
