Med-Surg HESI Exam 2025 – Two Versions Included:
Complete Medical-Surgical Nursing Review, High-Yield
Practice Questions, Rationales, Study Guide & HESI
Readiness Tips
Med-Surg HESI
HESI Med-Surg exam
Med-Surg HESI 2 versions
Medical-surgical HESI practice test
Get fully prepared for the Med-Surg HESI Exam with two complete versions of high-yield
practice questions and detailed rationales. This 2025 medical-surgical nursing study guide
covers pathophysiology, priority setting, pharmacology, lab values, nursing interventions, and
HESI-style critical thinking items. Ideal for nursing students preparing for the HESI RN or HESI
Med-Surg specialty exam who need comprehensive review material to boost their scores and
clinical readiness
The nurse notes that the only ECG for a 55-year-old male client scheduled for surgery in two
hours is dated two years ago. The client reports that he has a history of "heart trouble," but has
no problems at present. Hospital protocol requires that those over 50 years of age have a recent
ECG prior to surgery. What nursing action is best for the nurse to implement?
Ask the client what he means by "heart trouble."
Call for an ECG to be performed immediately.
Notify surgery that the ECG is over two years old.
Notify the client's surgeon immediately. - ANSWER-Call for an ECG to be performed
immediately.
,According to the hospital policy, clients over the age of 50 and/or with a history of
cardiovascular disease, should receive ECG evaluation prior to surgery, generally 24 hours to
two weeks before. The nurse needs to first arrange for an ECG to be performed immediately
prior to surgery.
A client with multiple sclerosis has experienced an exacerbation of symptoms, including
paresthesias, diplopia, and nystagmus. Which instruction should the nurse provide?
Stay out of direct sunlight.
Restrict intake of high protein foods.
Schedule extra rest periods.
Go to the emergency room immediately. - ANSWER-Schedule extra rest periods.
Exacerbations of the symptoms of MS occur most commonly as the result of fatigue and stress.
The client should be encouraged to schedule extra rest periods to help reduce the symptoms.
A client experiencing uncontrolled atrial fibrillation is admitted to the telemetry unit. What
initial medication should the nurse anticipate administering to the client?
Xylocaine (Lidocaine).
Procainamide (Pronestyl).
Phenytoin (Dilantin).
Digoxin (Lanoxin). - ANSWER-Digoxin (Lanoxin).
Digoxin (Lanoxin) is administered for uncontrolled, symptomatic atrial fibrillation resulting in a
decreased cardiac output. Digoxin slows the rate of conduction by prolonging the refractory
period of the AV node, thus slowing the ventricular response, decreasing the heart rate, and
effecting cardiac output.
,The nurse knows that lab values sometimes vary for the older client. Which data would the
nurse expect to find when reviewing laboratory values of an 80-year-old male?
Increased WBC, decreased RBC.
Increased serum bilirubin, slightly increased liver enzymes.
Increased protein in the urine, slightly increased serum glucose levels.
Decreased serum sodium, an increased urine specific gravity. - ANSWER-Increased protein in the
urine, slightly increased serum glucose levels.
As older adults aged, the protein found in urine slightly rises as a result of kidney changes and
the serum glucose increases slightly, also due to changes in the kidney. The specific gravity
declines by age 80 from 1.032 to 1.024.
The nurse is assessing a client with bacterial meningitis. Which assessment finding indicates the
client may have developed septic emboli?
The nurse is assessing a client with bacterial meningitis. Which assessment finding indicates the
client may have developed septic emboli?
Cyanosis of the fingertips.
Bradycardia and bradypnea.
Presence of S3 and S4 heart sounds.
3+ pitting edema of the lower extremities. - ANSWER-Cyanosis of the fingertips.
Septic emboli secondary to meningitis commonly lodge in the small arterioles of the
extremities, causing a decrease in circulation to the hands which may lead to gangrene.
How should the nurse position the electrodes for modified chest lead one (MCL I) telemetry
monitoring?
Positive polarity right shoulder, negative polarity left shoulder, ground left chest nipple line.
Positive polarity left shoulder, negative polarity right chest nipple line, ground left chest nipple
line.
, Positive polarity right chest nipple line, negative polarity left chest nipple line, ground left
shoulder.
Negative polarity left shoulder, positive polarity right chest nipple line, ground left chest nipple
line. - ANSWER-Negative polarity left shoulder, positive polarity right chest nipple line, ground
left chest nipple line.
In MCL I monitoring, the positive electrode is placed on the client's mid-chest to the right of the
sternum, and the negative electrode is placed on the upper left part of the chest. The ground
may be placed anywhere, but is usually placed on the lower left portion of the chest.
During a health fair, a 72-year-old male client tells the nurse that he is experiencing shortness of
breath. Auscultation reveals crackles and wheezing in both lungs. Suspecting that the client
might have chronic bronchitis, which classic symptom would the nurse expect this client to
have?
Racing pulse with exertion.
Clubbing of the fingers.
An increased chest diameter.
Productive cough with grayish-white sputum. - ANSWER-Productive cough with grayish-white
sputum.
Smoking is the most common cause of chronic bronchitis, one of the diseases comprising the
diagnosis of COPD, it is characterized by a productive cough with grayish-white sputum.
Smokers generally experience this cough when they first awaken and rise in the morning.
The nurse would be correct in withholding a dose of digoxin in a client with congestive heart
failure without specific instruction from the healthcare provider if the client's
serum digoxin level is 1.5.
blood pressure is 104/68.
serum potassium level is 3.
Complete Medical-Surgical Nursing Review, High-Yield
Practice Questions, Rationales, Study Guide & HESI
Readiness Tips
Med-Surg HESI
HESI Med-Surg exam
Med-Surg HESI 2 versions
Medical-surgical HESI practice test
Get fully prepared for the Med-Surg HESI Exam with two complete versions of high-yield
practice questions and detailed rationales. This 2025 medical-surgical nursing study guide
covers pathophysiology, priority setting, pharmacology, lab values, nursing interventions, and
HESI-style critical thinking items. Ideal for nursing students preparing for the HESI RN or HESI
Med-Surg specialty exam who need comprehensive review material to boost their scores and
clinical readiness
The nurse notes that the only ECG for a 55-year-old male client scheduled for surgery in two
hours is dated two years ago. The client reports that he has a history of "heart trouble," but has
no problems at present. Hospital protocol requires that those over 50 years of age have a recent
ECG prior to surgery. What nursing action is best for the nurse to implement?
Ask the client what he means by "heart trouble."
Call for an ECG to be performed immediately.
Notify surgery that the ECG is over two years old.
Notify the client's surgeon immediately. - ANSWER-Call for an ECG to be performed
immediately.
,According to the hospital policy, clients over the age of 50 and/or with a history of
cardiovascular disease, should receive ECG evaluation prior to surgery, generally 24 hours to
two weeks before. The nurse needs to first arrange for an ECG to be performed immediately
prior to surgery.
A client with multiple sclerosis has experienced an exacerbation of symptoms, including
paresthesias, diplopia, and nystagmus. Which instruction should the nurse provide?
Stay out of direct sunlight.
Restrict intake of high protein foods.
Schedule extra rest periods.
Go to the emergency room immediately. - ANSWER-Schedule extra rest periods.
Exacerbations of the symptoms of MS occur most commonly as the result of fatigue and stress.
The client should be encouraged to schedule extra rest periods to help reduce the symptoms.
A client experiencing uncontrolled atrial fibrillation is admitted to the telemetry unit. What
initial medication should the nurse anticipate administering to the client?
Xylocaine (Lidocaine).
Procainamide (Pronestyl).
Phenytoin (Dilantin).
Digoxin (Lanoxin). - ANSWER-Digoxin (Lanoxin).
Digoxin (Lanoxin) is administered for uncontrolled, symptomatic atrial fibrillation resulting in a
decreased cardiac output. Digoxin slows the rate of conduction by prolonging the refractory
period of the AV node, thus slowing the ventricular response, decreasing the heart rate, and
effecting cardiac output.
,The nurse knows that lab values sometimes vary for the older client. Which data would the
nurse expect to find when reviewing laboratory values of an 80-year-old male?
Increased WBC, decreased RBC.
Increased serum bilirubin, slightly increased liver enzymes.
Increased protein in the urine, slightly increased serum glucose levels.
Decreased serum sodium, an increased urine specific gravity. - ANSWER-Increased protein in the
urine, slightly increased serum glucose levels.
As older adults aged, the protein found in urine slightly rises as a result of kidney changes and
the serum glucose increases slightly, also due to changes in the kidney. The specific gravity
declines by age 80 from 1.032 to 1.024.
The nurse is assessing a client with bacterial meningitis. Which assessment finding indicates the
client may have developed septic emboli?
The nurse is assessing a client with bacterial meningitis. Which assessment finding indicates the
client may have developed septic emboli?
Cyanosis of the fingertips.
Bradycardia and bradypnea.
Presence of S3 and S4 heart sounds.
3+ pitting edema of the lower extremities. - ANSWER-Cyanosis of the fingertips.
Septic emboli secondary to meningitis commonly lodge in the small arterioles of the
extremities, causing a decrease in circulation to the hands which may lead to gangrene.
How should the nurse position the electrodes for modified chest lead one (MCL I) telemetry
monitoring?
Positive polarity right shoulder, negative polarity left shoulder, ground left chest nipple line.
Positive polarity left shoulder, negative polarity right chest nipple line, ground left chest nipple
line.
, Positive polarity right chest nipple line, negative polarity left chest nipple line, ground left
shoulder.
Negative polarity left shoulder, positive polarity right chest nipple line, ground left chest nipple
line. - ANSWER-Negative polarity left shoulder, positive polarity right chest nipple line, ground
left chest nipple line.
In MCL I monitoring, the positive electrode is placed on the client's mid-chest to the right of the
sternum, and the negative electrode is placed on the upper left part of the chest. The ground
may be placed anywhere, but is usually placed on the lower left portion of the chest.
During a health fair, a 72-year-old male client tells the nurse that he is experiencing shortness of
breath. Auscultation reveals crackles and wheezing in both lungs. Suspecting that the client
might have chronic bronchitis, which classic symptom would the nurse expect this client to
have?
Racing pulse with exertion.
Clubbing of the fingers.
An increased chest diameter.
Productive cough with grayish-white sputum. - ANSWER-Productive cough with grayish-white
sputum.
Smoking is the most common cause of chronic bronchitis, one of the diseases comprising the
diagnosis of COPD, it is characterized by a productive cough with grayish-white sputum.
Smokers generally experience this cough when they first awaken and rise in the morning.
The nurse would be correct in withholding a dose of digoxin in a client with congestive heart
failure without specific instruction from the healthcare provider if the client's
serum digoxin level is 1.5.
blood pressure is 104/68.
serum potassium level is 3.
