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EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM (NEW UPDATED
VERSION) LATEST ACTUAL EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
QUESTIONS AND ANSWERS) | GUARANTEED PASS A+ UPDATED THIS YEAR
HESI Med-Surg Practice Exam
1. A 68-year-old male patient is admitted with complaints of severe chest pain radiating to his
left arm and jaw. He appears anxious and diaphoretic. His blood pressure is 160/98 mmHg, heart
rate is 110 bpm, and ECG shows ST-segment elevation. The patient has a history of hypertension
and hyperlipidemia. What is the priority nursing action at this time?
Answer: Administer prescribed nitroglycerin, monitor vital signs, and prepare for potential
emergency interventions (e.g., cardiac catheterization).
2. A 72-year-old female with chronic heart failure presents with increasing shortness of breath,
3+ bilateral ankle edema, and crackles in the lower lobes of the lungs. Lab results show elevated
BNP and serum creatinine within normal limits. Which nursing intervention should be prioritized
to manage fluid overload?
Answer: Administer prescribed diuretics, monitor fluid intake and output, assess daily weights,
and elevate the head of the bed to ease breathing.
3. A patient with newly diagnosed atrial fibrillation reports palpitations and dizziness. The
patient is currently on no medications. The provider orders anticoagulation therapy. Which
complication is the patient most at risk for if anticoagulation is not initiated promptly, and why?
Answer: Stroke due to thrombus formation in the atria caused by irregular blood flow.
4. A 55-year-old male patient with poorly controlled hypertension asks the nurse which lifestyle
modifications can reduce his blood pressure. Which recommendation should the nurse prioritize?
Answer: Reduce dietary sodium intake, follow a heart-healthy diet, increase physical activity,
avoid tobacco and excessive alcohol.
2026 2027 GRADED A+
,2|Page
5. A patient is scheduled for an echocardiogram due to suspected valvular heart disease. The
patient asks the nurse how the procedure works. How should the nurse respond?
Answer: Explain that an echocardiogram uses ultrasound waves to create images of the heart,
allowing visualization of structure, function, and blood flow without radiation.
Respiratory System
6. A 65-year-old patient with a history of COPD presents to the clinic with increasing confusion,
lethargy, and shortness of breath. Oxygen saturation is 88% on room air. The nurse notes barrel
chest and use of accessory muscles. What is the most likely cause of the patient’s altered mental
status, and what immediate action should the nurse take?
Answer: Hypercapnia (elevated CO2) due to impaired gas exchange; place the patient on
supplemental oxygen carefully, monitor respiratory status, and notify the provider.
7. A patient with COPD reports difficulty breathing while lying flat at night. The patient asks
why this occurs. What is the best position for the nurse to place the patient to maximize lung
expansion and ease breathing?
Answer: High Fowler’s position to facilitate diaphragmatic movement and improve
oxygenation.
8. A patient presents with a persistent cough, night sweats, and weight loss. A TB skin test is
positive. The patient asks what the positive result means. How should the nurse explain the
findings?
Answer: A positive skin test indicates exposure to Mycobacterium tuberculosis and the need for
further evaluation (e.g., chest X-ray, sputum testing) to confirm active infection.
9. A patient diagnosed with community-acquired pneumonia has dullness to percussion in the
right lower lobe and decreased breath sounds. Which nursing action is appropriate to monitor for
worsening infection?
Answer: Monitor vital signs, oxygen saturation, respiratory rate, and auscultate lung sounds
regularly while administering prescribed antibiotics.
10. A patient with a history of asthma uses a peak flow meter at home. The readings have
dropped 30% from their personal best. What should the patient do, and why?
Answer: Follow the asthma action plan, usually involving administration of a rescue inhaler,
2026 2027 GRADED A+
, 3|Page
monitoring symptoms closely, and seeking medical attention if improvement does not occur. A
drop indicates bronchoconstriction.
Endocrine System
11. A 24-year-old patient with type 1 diabetes presents with confusion, tremors, diaphoresis, and
tachycardia. Blood glucose is 48 mg/dL. What is the immediate nursing intervention, and why?
Answer: Administer fast-acting glucose orally if the patient is conscious or IV dextrose if
unconscious; monitor blood glucose and prevent hypoglycemia-related complications.
12. A patient is prescribed long-acting insulin (glargine) at bedtime. The patient asks why it does
not have a peak effect like regular insulin. How should the nurse respond?
Answer: Long-acting insulin provides a steady level of insulin throughout 24 hours with no
pronounced peak to maintain basal glucose control.
13. A patient with hyperthyroidism complains of palpitations, heat intolerance, and unintentional
weight loss. Which nursing assessment should be prioritized?
Answer: Assess heart rate, rhythm, and signs of thyroid storm while educating the patient on the
importance of medication adherence.
14. A patient with Cushing’s syndrome reports rapid weight gain and purple striae on the
abdomen. What laboratory findings would support this diagnosis?
Answer: Hyperglycemia, elevated cortisol levels, and possible electrolyte imbalances (e.g.,
hypokalemia).
15. A patient with Addison’s disease presents with hypotension, fatigue, and hyperpigmentation.
What is the priority nursing intervention?
Answer: Administer prescribed corticosteroids and monitor for signs of adrenal crisis (e.g.,
hypotension, hyponatremia).
Gastrointestinal System
16. A patient with a history of peptic ulcer disease reports burning epigastric pain 2 hours after
meals. What is the most appropriate nursing intervention to relieve discomfort?
2026 2027 GRADED A+
EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM (NEW UPDATED
VERSION) LATEST ACTUAL EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
QUESTIONS AND ANSWERS) | GUARANTEED PASS A+ UPDATED THIS YEAR
HESI Med-Surg Practice Exam
1. A 68-year-old male patient is admitted with complaints of severe chest pain radiating to his
left arm and jaw. He appears anxious and diaphoretic. His blood pressure is 160/98 mmHg, heart
rate is 110 bpm, and ECG shows ST-segment elevation. The patient has a history of hypertension
and hyperlipidemia. What is the priority nursing action at this time?
Answer: Administer prescribed nitroglycerin, monitor vital signs, and prepare for potential
emergency interventions (e.g., cardiac catheterization).
2. A 72-year-old female with chronic heart failure presents with increasing shortness of breath,
3+ bilateral ankle edema, and crackles in the lower lobes of the lungs. Lab results show elevated
BNP and serum creatinine within normal limits. Which nursing intervention should be prioritized
to manage fluid overload?
Answer: Administer prescribed diuretics, monitor fluid intake and output, assess daily weights,
and elevate the head of the bed to ease breathing.
3. A patient with newly diagnosed atrial fibrillation reports palpitations and dizziness. The
patient is currently on no medications. The provider orders anticoagulation therapy. Which
complication is the patient most at risk for if anticoagulation is not initiated promptly, and why?
Answer: Stroke due to thrombus formation in the atria caused by irregular blood flow.
4. A 55-year-old male patient with poorly controlled hypertension asks the nurse which lifestyle
modifications can reduce his blood pressure. Which recommendation should the nurse prioritize?
Answer: Reduce dietary sodium intake, follow a heart-healthy diet, increase physical activity,
avoid tobacco and excessive alcohol.
2026 2027 GRADED A+
,2|Page
5. A patient is scheduled for an echocardiogram due to suspected valvular heart disease. The
patient asks the nurse how the procedure works. How should the nurse respond?
Answer: Explain that an echocardiogram uses ultrasound waves to create images of the heart,
allowing visualization of structure, function, and blood flow without radiation.
Respiratory System
6. A 65-year-old patient with a history of COPD presents to the clinic with increasing confusion,
lethargy, and shortness of breath. Oxygen saturation is 88% on room air. The nurse notes barrel
chest and use of accessory muscles. What is the most likely cause of the patient’s altered mental
status, and what immediate action should the nurse take?
Answer: Hypercapnia (elevated CO2) due to impaired gas exchange; place the patient on
supplemental oxygen carefully, monitor respiratory status, and notify the provider.
7. A patient with COPD reports difficulty breathing while lying flat at night. The patient asks
why this occurs. What is the best position for the nurse to place the patient to maximize lung
expansion and ease breathing?
Answer: High Fowler’s position to facilitate diaphragmatic movement and improve
oxygenation.
8. A patient presents with a persistent cough, night sweats, and weight loss. A TB skin test is
positive. The patient asks what the positive result means. How should the nurse explain the
findings?
Answer: A positive skin test indicates exposure to Mycobacterium tuberculosis and the need for
further evaluation (e.g., chest X-ray, sputum testing) to confirm active infection.
9. A patient diagnosed with community-acquired pneumonia has dullness to percussion in the
right lower lobe and decreased breath sounds. Which nursing action is appropriate to monitor for
worsening infection?
Answer: Monitor vital signs, oxygen saturation, respiratory rate, and auscultate lung sounds
regularly while administering prescribed antibiotics.
10. A patient with a history of asthma uses a peak flow meter at home. The readings have
dropped 30% from their personal best. What should the patient do, and why?
Answer: Follow the asthma action plan, usually involving administration of a rescue inhaler,
2026 2027 GRADED A+
, 3|Page
monitoring symptoms closely, and seeking medical attention if improvement does not occur. A
drop indicates bronchoconstriction.
Endocrine System
11. A 24-year-old patient with type 1 diabetes presents with confusion, tremors, diaphoresis, and
tachycardia. Blood glucose is 48 mg/dL. What is the immediate nursing intervention, and why?
Answer: Administer fast-acting glucose orally if the patient is conscious or IV dextrose if
unconscious; monitor blood glucose and prevent hypoglycemia-related complications.
12. A patient is prescribed long-acting insulin (glargine) at bedtime. The patient asks why it does
not have a peak effect like regular insulin. How should the nurse respond?
Answer: Long-acting insulin provides a steady level of insulin throughout 24 hours with no
pronounced peak to maintain basal glucose control.
13. A patient with hyperthyroidism complains of palpitations, heat intolerance, and unintentional
weight loss. Which nursing assessment should be prioritized?
Answer: Assess heart rate, rhythm, and signs of thyroid storm while educating the patient on the
importance of medication adherence.
14. A patient with Cushing’s syndrome reports rapid weight gain and purple striae on the
abdomen. What laboratory findings would support this diagnosis?
Answer: Hyperglycemia, elevated cortisol levels, and possible electrolyte imbalances (e.g.,
hypokalemia).
15. A patient with Addison’s disease presents with hypotension, fatigue, and hyperpigmentation.
What is the priority nursing intervention?
Answer: Administer prescribed corticosteroids and monitor for signs of adrenal crisis (e.g.,
hypotension, hyponatremia).
Gastrointestinal System
16. A patient with a history of peptic ulcer disease reports burning epigastric pain 2 hours after
meals. What is the most appropriate nursing intervention to relieve discomfort?
2026 2027 GRADED A+
