HESI Medical-Surgical Nursing Test | ACTUAL
EXAM | Complete Questions & Verified Answers |
Latest Comprehensive Exam Prep
for Nursing Students
1.
A client with a history of heart failure is admitted with dyspnea and bilateral crackles.
Which nursing action should be performed first?
A. Administer IV furosemide 40 mg
B. Obtain a 12-lead ECG
C. Place the client in high Fowler’s position
D. Check oxygen saturation with pulse oximetry
Correct Answer: C
Rationale: High Fowler’s reduces venous return and lung congestion, improving
oxygenation immediately. Oxygen saturation is obtained quickly but positioning is the
first physical intervention. IV furosemide is ordered after assessment; ECG is not urgent
unless ischemia is suspected.
2.
The nurse is caring for a client with a pulmonary embolism. Which finding requires
immediate intervention?
,A. Respiratory rate 24/min
B. Blood pressure 100/60 mmHg
C. Oxygen saturation 86% on 6 L O₂ via nasal cannula
D. Heart rate 110/min
Correct Answer: C
Rationale: SpO₂ <90% on high-flow oxygen indicates large PE with significant shunt;
escalate to non-rebreather or notify provider for possible thrombolysis. Tachypnea, mild
hypotension, and sinus tachycardia are expected but not immediately life-threatening.
3.
A client with chronic kidney disease (CKD) stage 4 is started on epoetin alfa. Which
laboratory value should be monitored every 2 weeks?
A. Serum ferritin
B. Hemoglobin
C. Creatinine
D. White blood cell count
Correct Answer: B
Rationale: Epoetin stimulates erythropoiesis; Hgb is checked every 2–4 weeks to titrate
dose and avoid target >12 g/dL, which increases thrombosis risk. Ferritin guides iron
repletion but is checked monthly. Creatinine and WBC are routine.
4.
,The nurse is delegating care of a stable postoperative client to an experienced LPN.
Which task must remain with the RN?
A. Administering oral pain medication
B. Reinforcing surgical dressing
C. Teaching about wound care at discharge
D. Measuring intake and output
Correct Answer: C
Rationale: Discharge teaching is an RN responsibility under state nurse practice acts.
LPNs can administer routine PO meds, perform basic wound care, and record I&O when
the client is stable.
5.
A client with cirrhosis develops increasing abdominal girth and shortness of breath.
Which intervention is priority?
A. Restrict fluid to 500 mL/day
B. Administer furosemide 40 mg IV
C. Perform paracentesis and give albumin
D. Increase dietary protein to 1.5 g/kg
Correct Answer: C
Rationale: Tense ascites compromises ventilation; large-volume paracentesis (>5 L)
plus 6–8 g albumin/L removed prevents circulatory dysfunction. Diuretics work slowly
and fluid restriction is adjunctive. High protein risks encephalopathy.
, 6.
A client with type 1 diabetes reports blood glucose 48 mg/dL and is awake. Which
action is appropriate?
A. Give 4 oz orange juice followed by protein snack
B. Administer 1 mg glucagon IM
C. Start 50% dextrose IV push
D. Encourage rest for 15 minutes
Correct Answer: A
Rationale: Conscious hypoglycemia is treated with 15 g rapid carbohydrate (4 oz juice),
followed by protein to prevent rebound. Glucagon or D50 is reserved for inability to
swallow.
7.
The nurse notes a client’s central line dressing is damp and partially occluded. Which
action is required?
A. Reinforce edges with tape
B. Change dressing using sterile technique immediately
C. Document and monitor temperature
D. Flush line with 10 mL saline
Correct Answer: B
EXAM | Complete Questions & Verified Answers |
Latest Comprehensive Exam Prep
for Nursing Students
1.
A client with a history of heart failure is admitted with dyspnea and bilateral crackles.
Which nursing action should be performed first?
A. Administer IV furosemide 40 mg
B. Obtain a 12-lead ECG
C. Place the client in high Fowler’s position
D. Check oxygen saturation with pulse oximetry
Correct Answer: C
Rationale: High Fowler’s reduces venous return and lung congestion, improving
oxygenation immediately. Oxygen saturation is obtained quickly but positioning is the
first physical intervention. IV furosemide is ordered after assessment; ECG is not urgent
unless ischemia is suspected.
2.
The nurse is caring for a client with a pulmonary embolism. Which finding requires
immediate intervention?
,A. Respiratory rate 24/min
B. Blood pressure 100/60 mmHg
C. Oxygen saturation 86% on 6 L O₂ via nasal cannula
D. Heart rate 110/min
Correct Answer: C
Rationale: SpO₂ <90% on high-flow oxygen indicates large PE with significant shunt;
escalate to non-rebreather or notify provider for possible thrombolysis. Tachypnea, mild
hypotension, and sinus tachycardia are expected but not immediately life-threatening.
3.
A client with chronic kidney disease (CKD) stage 4 is started on epoetin alfa. Which
laboratory value should be monitored every 2 weeks?
A. Serum ferritin
B. Hemoglobin
C. Creatinine
D. White blood cell count
Correct Answer: B
Rationale: Epoetin stimulates erythropoiesis; Hgb is checked every 2–4 weeks to titrate
dose and avoid target >12 g/dL, which increases thrombosis risk. Ferritin guides iron
repletion but is checked monthly. Creatinine and WBC are routine.
4.
,The nurse is delegating care of a stable postoperative client to an experienced LPN.
Which task must remain with the RN?
A. Administering oral pain medication
B. Reinforcing surgical dressing
C. Teaching about wound care at discharge
D. Measuring intake and output
Correct Answer: C
Rationale: Discharge teaching is an RN responsibility under state nurse practice acts.
LPNs can administer routine PO meds, perform basic wound care, and record I&O when
the client is stable.
5.
A client with cirrhosis develops increasing abdominal girth and shortness of breath.
Which intervention is priority?
A. Restrict fluid to 500 mL/day
B. Administer furosemide 40 mg IV
C. Perform paracentesis and give albumin
D. Increase dietary protein to 1.5 g/kg
Correct Answer: C
Rationale: Tense ascites compromises ventilation; large-volume paracentesis (>5 L)
plus 6–8 g albumin/L removed prevents circulatory dysfunction. Diuretics work slowly
and fluid restriction is adjunctive. High protein risks encephalopathy.
, 6.
A client with type 1 diabetes reports blood glucose 48 mg/dL and is awake. Which
action is appropriate?
A. Give 4 oz orange juice followed by protein snack
B. Administer 1 mg glucagon IM
C. Start 50% dextrose IV push
D. Encourage rest for 15 minutes
Correct Answer: A
Rationale: Conscious hypoglycemia is treated with 15 g rapid carbohydrate (4 oz juice),
followed by protein to prevent rebound. Glucagon or D50 is reserved for inability to
swallow.
7.
The nurse notes a client’s central line dressing is damp and partially occluded. Which
action is required?
A. Reinforce edges with tape
B. Change dressing using sterile technique immediately
C. Document and monitor temperature
D. Flush line with 10 mL saline
Correct Answer: B
