MED-SURG HESI TEST LATEST UPDATE 2026 WITH
QUESTIONS AND VERIFIED ANSWERS
1) A female client with a nasogastric tube attached to low suction states that
she is nauseated. The nurse assesses that there has been no drainage through the
nasogastric tube in the last 2 hours. Which action should the nurse take first? -
answer- Reposition the client on her side. The priority is to determined if the
tube is functioning correctly, which would relieve the client's nausea. The least
invasive intervention is to reposition the client (B), should be attempted first,
followed by (A & C) if these are unsuccessful then (D).
2) When assigning clients on a medical-surgical floor to a RN and a LPN, it is
best for the charge nurse to assign which client to the LPN?
A. A child with bacterial meningitis with recent seizures.
B. An older adult client with pneumonia and viral meningitis.
C. A female client in isolation with meningococcal meningitis.
D. A male client 1 day post-op after drainage of a brain abscess. - answer-B.
Is the most stable. A, C, D have an increased risk for elevated ICP.
3) Which description of symptoms is characteristic of a client diagnosed with
trigeminal neuralgia (tic douloureux)?
A. Tinnitus, vertigo, and hearing difficulties.
B. Sudden, stabbing, severe pain over the lip and chin.
C. Unilateral facial weakness and paralysis.
4) Difficulty in talking, chewing, and swallowing. - answer-B. Trigeminal
neuralgia is characterized by paroxysms of pain, similar to an electric shock, in
the area innervated by one or more branches of the trigeminal nerve.
A. Characteristic of Meniere's
C. Characteristic of Bell palsey
D. Characteristic of disorders of the hypoglossal (12th cranial nerve)
5) Which abnormal lab finding indicates that a client with diabetes needs
further evaluation for diabetic nephropathy?
A. Hypokalemia
B. Microalbuminauria
C. Elevated serum lipids
D. Ketonuria - answer-B. Microalbuminuria is the earliest sign of nephropathy
and indicates the need for follow-up evaluation. Hyperkalemia (A) is associated
with end stage renal disease caused by diabetic nephropathy. (C) may be elevated
in end stage renal disease. (D) may signal the onset of DKA.
, MED-SURG HESI TEST LATEST UPDATE 2026 WITH
QUESTIONS AND VERIFIED ANSWERS
6) An older male client comes to the geriatric screening clinic complaining of
pain in his left calf. The nurse notices a reddened area on the calf of his right
leg that is warm to touch and the nurse suspects that the client may have
thrombophlebitis. Which addition assessment is most important for the nurse to
perform?
A. Measure calf circumference.
B. Auscultate the client's breath sounds.
C. Observe for ecchymosis and petechiae.
Obtain the client's blood pressure. - answer-B. Since the client mayhave a
pulmonary embolus secondary to the thrombophlebitis.
A. Would support the nurses assessment.
C. Least helpful since bruising is not associated with thrombophlebitis.
D. Less important then auscultation.
7) The nurse know that a client taking diuretics must be assessed for the
development of hypokalemia, and that hypokalemia will create changes in the
client's normal ECG tracing. Which ECG change would be an expected finding in the
client with hypokalemia?
A. Tall, spiked T waves
B. A prolonged QT interval
C. A widening QRS complex
D. Presence of a U wave - answer-D. A U wave is a positive deflection
following the T wave and is often present with hypokalemia. A, B, C indicate
hyperkalemia.
8) An older client is admitted with a diagnosis of bacterial pneumonia.
The nurse's assessment of the client will most likely reveal which S/SX?
A. Leukocytosis and febrile.
B. Polycythemia and crackles.
C. Pharyngitis and sputum production.
D. Confusion and tachycardia. - answer-D. The onset of pneumonia is the older
may be signaled by general deterioration, confusion, increased heart rate or
increased respiratory rate.
(A, B, C) are often absent in the older with bacterial pneumonia.
9) The nurse observes ventricular fibrillation on telemetry and upon entering
the clients bathroom finds the client unconscious on the floor. What intervention
should the nurse implement first?
A. Administer an antidysrhythmic medication.
B. Start cardiopulmonary resuscitation.
, MED-SURG HESI TEST LATEST UPDATE 2026 WITH
QUESTIONS AND VERIFIED ANSWERS
C. Defibrillate the client at 200 joules.
D. Assess the client's pulse oximetry. - answer-B. Ventricular fibrillation is
a life-threatening dysrhythmia and CPR should be started immediately. A & C are
appropriate but B is the priority. D does not address the seriousness of the
situation.
10) An older female client with dementia is transferred from a long term care
unit to an acute care unit. The client's children express concern that their
mother's confusion is worsening. How should the nurse respond?
A. "It is to be expected that older people will experience progressive
confusion."
B. "Confusion in an older person often follows relocation to new
surroundings."
C. "The dementia is progressing rapidly, but we will do everything we can to
keep your mother safe."
D. "The acute care staff is not as experienced as the long-term care staff at
dealing with dementia." - answer-B. Relocation often results in confusion among
older clients and is stressful to clients of all ages. (A) is an inaccurate
stereotype. (C) is most likely false there are many factors that cause increased
temporary confusion. (D) may be true but does not offer the family a sense of
security about the care.
11) The nurse plans to help an 18-year-old developmentally disabled female
client ambulate on the first postoperative day. When the nurse tells her it is
time to get out of bed, the client becomes angry and yells at the nurse. "Get out
of here! I'll get up when I'm ready." Which response should the nurse provide?
A. "Your healthcare provider has prescribed ambulation on the first
postoperative day."
B. "You must ambulate to avoid serious complications that are much more
painful."
C. "I know how you feel; you're angry about having to do this, but it
isrequired."
D. "I'll be back in 30 minutes to help you get out of bed and walk around the
room." - answer-D. Returning in 30 minutes provides a cooling off period, is firm,
direct, nonthreatening, and avoids argument with the client. B is threatening. C.
assumes what the client is feeling. A. avoids the nurse's responsibility to
ambulate the client.
12) The nurse is performing hourly neurological check for a client with a head
injury. Which new assessment finding warrants the most immediate intervention by
the nurse?
A. A unilateral pupil that is dilated and nonreactive to light.
B. Client cries out when awakened by a verbal stimulus.
C. Client demonstrates a loss of memory to the events leading up to the
injury.
, MED-SURG HESI TEST LATEST UPDATE 2026 WITH
QUESTIONS AND VERIFIED ANSWERS
D. Onset of nausea, headache, and vertigo. - answer-A. Any changes in pupil
size and reactivity is an indication of increasing ICP and should be reported
immediately. (B) is normal for being awakened. (C & D) are common manifestations
of head injury and less of an immediacy than (A).
A male client with arterial peripheral vascular disease (PVD) complains of pain in
his feet. Which instruction should the nurse give to the UPA to quickly relieve
the client's pain?
A. Help the client to dangle his legs.
B. Apply compression stockings.
C. Assist with passive leg exercises.
D. Ambulate three times daily. - answer-A. A client who has arterial PVD may
benefit from a dependent position which can be achieved by dangling by improving
blood flow and relieving pain.
(B) is indicated for venous insufficiency and (C) is indicated for bed rest. (D)
is indicated to facilitate collateral circulation and may improve long term
complaints of pain.
A 58-year-old client, who has no health problems, asks the nurse about taking the
pneumococcal vaccine (Pneumovax). Which statement give by the nurse would offer
the client accurate information about this vaccine?
A. "The vaccine is given annually before the flue season to those over50 years
of age."
B. "The immunization is administered once to older adults or personswith a
history of chronic illness."
C. "The vaccine is for all ages and is given primarily to those person
traveling overseas to infected areas."
D. "The vaccine will prevent the occurrence of pneumococcal pneumonia for up
to 5 years." - answer-B. It is usually recommended that persons over 65 years of
age and those with a history of chronic illness should receive the vaccine once in
a lifetime. (A) the influenza vaccine is given annually. (C) travel is not the
main rationale for the vaccine. (D) The vaccine is usually given once in a
lifetime.
A client with hypertension has been receiving ramipril (Altace) 5 mg PO daily for
2 weeks and is scheduled to receive a dose at 0900. At 0830 the client's blood
pressure is 120/70. Which action should the nurse take?
A. Administer the dose as prescribed.
B. Hold the dose and contact the healthcare provider.
C. Hold the dose and recheck the blood pressure in 1 hour.
QUESTIONS AND VERIFIED ANSWERS
1) A female client with a nasogastric tube attached to low suction states that
she is nauseated. The nurse assesses that there has been no drainage through the
nasogastric tube in the last 2 hours. Which action should the nurse take first? -
answer- Reposition the client on her side. The priority is to determined if the
tube is functioning correctly, which would relieve the client's nausea. The least
invasive intervention is to reposition the client (B), should be attempted first,
followed by (A & C) if these are unsuccessful then (D).
2) When assigning clients on a medical-surgical floor to a RN and a LPN, it is
best for the charge nurse to assign which client to the LPN?
A. A child with bacterial meningitis with recent seizures.
B. An older adult client with pneumonia and viral meningitis.
C. A female client in isolation with meningococcal meningitis.
D. A male client 1 day post-op after drainage of a brain abscess. - answer-B.
Is the most stable. A, C, D have an increased risk for elevated ICP.
3) Which description of symptoms is characteristic of a client diagnosed with
trigeminal neuralgia (tic douloureux)?
A. Tinnitus, vertigo, and hearing difficulties.
B. Sudden, stabbing, severe pain over the lip and chin.
C. Unilateral facial weakness and paralysis.
4) Difficulty in talking, chewing, and swallowing. - answer-B. Trigeminal
neuralgia is characterized by paroxysms of pain, similar to an electric shock, in
the area innervated by one or more branches of the trigeminal nerve.
A. Characteristic of Meniere's
C. Characteristic of Bell palsey
D. Characteristic of disorders of the hypoglossal (12th cranial nerve)
5) Which abnormal lab finding indicates that a client with diabetes needs
further evaluation for diabetic nephropathy?
A. Hypokalemia
B. Microalbuminauria
C. Elevated serum lipids
D. Ketonuria - answer-B. Microalbuminuria is the earliest sign of nephropathy
and indicates the need for follow-up evaluation. Hyperkalemia (A) is associated
with end stage renal disease caused by diabetic nephropathy. (C) may be elevated
in end stage renal disease. (D) may signal the onset of DKA.
, MED-SURG HESI TEST LATEST UPDATE 2026 WITH
QUESTIONS AND VERIFIED ANSWERS
6) An older male client comes to the geriatric screening clinic complaining of
pain in his left calf. The nurse notices a reddened area on the calf of his right
leg that is warm to touch and the nurse suspects that the client may have
thrombophlebitis. Which addition assessment is most important for the nurse to
perform?
A. Measure calf circumference.
B. Auscultate the client's breath sounds.
C. Observe for ecchymosis and petechiae.
Obtain the client's blood pressure. - answer-B. Since the client mayhave a
pulmonary embolus secondary to the thrombophlebitis.
A. Would support the nurses assessment.
C. Least helpful since bruising is not associated with thrombophlebitis.
D. Less important then auscultation.
7) The nurse know that a client taking diuretics must be assessed for the
development of hypokalemia, and that hypokalemia will create changes in the
client's normal ECG tracing. Which ECG change would be an expected finding in the
client with hypokalemia?
A. Tall, spiked T waves
B. A prolonged QT interval
C. A widening QRS complex
D. Presence of a U wave - answer-D. A U wave is a positive deflection
following the T wave and is often present with hypokalemia. A, B, C indicate
hyperkalemia.
8) An older client is admitted with a diagnosis of bacterial pneumonia.
The nurse's assessment of the client will most likely reveal which S/SX?
A. Leukocytosis and febrile.
B. Polycythemia and crackles.
C. Pharyngitis and sputum production.
D. Confusion and tachycardia. - answer-D. The onset of pneumonia is the older
may be signaled by general deterioration, confusion, increased heart rate or
increased respiratory rate.
(A, B, C) are often absent in the older with bacterial pneumonia.
9) The nurse observes ventricular fibrillation on telemetry and upon entering
the clients bathroom finds the client unconscious on the floor. What intervention
should the nurse implement first?
A. Administer an antidysrhythmic medication.
B. Start cardiopulmonary resuscitation.
, MED-SURG HESI TEST LATEST UPDATE 2026 WITH
QUESTIONS AND VERIFIED ANSWERS
C. Defibrillate the client at 200 joules.
D. Assess the client's pulse oximetry. - answer-B. Ventricular fibrillation is
a life-threatening dysrhythmia and CPR should be started immediately. A & C are
appropriate but B is the priority. D does not address the seriousness of the
situation.
10) An older female client with dementia is transferred from a long term care
unit to an acute care unit. The client's children express concern that their
mother's confusion is worsening. How should the nurse respond?
A. "It is to be expected that older people will experience progressive
confusion."
B. "Confusion in an older person often follows relocation to new
surroundings."
C. "The dementia is progressing rapidly, but we will do everything we can to
keep your mother safe."
D. "The acute care staff is not as experienced as the long-term care staff at
dealing with dementia." - answer-B. Relocation often results in confusion among
older clients and is stressful to clients of all ages. (A) is an inaccurate
stereotype. (C) is most likely false there are many factors that cause increased
temporary confusion. (D) may be true but does not offer the family a sense of
security about the care.
11) The nurse plans to help an 18-year-old developmentally disabled female
client ambulate on the first postoperative day. When the nurse tells her it is
time to get out of bed, the client becomes angry and yells at the nurse. "Get out
of here! I'll get up when I'm ready." Which response should the nurse provide?
A. "Your healthcare provider has prescribed ambulation on the first
postoperative day."
B. "You must ambulate to avoid serious complications that are much more
painful."
C. "I know how you feel; you're angry about having to do this, but it
isrequired."
D. "I'll be back in 30 minutes to help you get out of bed and walk around the
room." - answer-D. Returning in 30 minutes provides a cooling off period, is firm,
direct, nonthreatening, and avoids argument with the client. B is threatening. C.
assumes what the client is feeling. A. avoids the nurse's responsibility to
ambulate the client.
12) The nurse is performing hourly neurological check for a client with a head
injury. Which new assessment finding warrants the most immediate intervention by
the nurse?
A. A unilateral pupil that is dilated and nonreactive to light.
B. Client cries out when awakened by a verbal stimulus.
C. Client demonstrates a loss of memory to the events leading up to the
injury.
, MED-SURG HESI TEST LATEST UPDATE 2026 WITH
QUESTIONS AND VERIFIED ANSWERS
D. Onset of nausea, headache, and vertigo. - answer-A. Any changes in pupil
size and reactivity is an indication of increasing ICP and should be reported
immediately. (B) is normal for being awakened. (C & D) are common manifestations
of head injury and less of an immediacy than (A).
A male client with arterial peripheral vascular disease (PVD) complains of pain in
his feet. Which instruction should the nurse give to the UPA to quickly relieve
the client's pain?
A. Help the client to dangle his legs.
B. Apply compression stockings.
C. Assist with passive leg exercises.
D. Ambulate three times daily. - answer-A. A client who has arterial PVD may
benefit from a dependent position which can be achieved by dangling by improving
blood flow and relieving pain.
(B) is indicated for venous insufficiency and (C) is indicated for bed rest. (D)
is indicated to facilitate collateral circulation and may improve long term
complaints of pain.
A 58-year-old client, who has no health problems, asks the nurse about taking the
pneumococcal vaccine (Pneumovax). Which statement give by the nurse would offer
the client accurate information about this vaccine?
A. "The vaccine is given annually before the flue season to those over50 years
of age."
B. "The immunization is administered once to older adults or personswith a
history of chronic illness."
C. "The vaccine is for all ages and is given primarily to those person
traveling overseas to infected areas."
D. "The vaccine will prevent the occurrence of pneumococcal pneumonia for up
to 5 years." - answer-B. It is usually recommended that persons over 65 years of
age and those with a history of chronic illness should receive the vaccine once in
a lifetime. (A) the influenza vaccine is given annually. (C) travel is not the
main rationale for the vaccine. (D) The vaccine is usually given once in a
lifetime.
A client with hypertension has been receiving ramipril (Altace) 5 mg PO daily for
2 weeks and is scheduled to receive a dose at 0900. At 0830 the client's blood
pressure is 120/70. Which action should the nurse take?
A. Administer the dose as prescribed.
B. Hold the dose and contact the healthcare provider.
C. Hold the dose and recheck the blood pressure in 1 hour.
