MEDICAL-SURGICAL NURSING · OBJECTIVE ASSESSMENT
A+ VERIFIED
HESI RN Medical-Surgical 2026/2027 |
Verified Questions & Answers — Complete
Official Exam
A+ Verified Questions Full Rationales Verified Answers
A+ 5 100%
QUESTIONS SECTIONS RATIONALES
Complete coverage Core exam domains Every answer explained
WHAT THIS COVERS
01 Cardiovascular & Respiratory Disorders
02 Fluid, Electrolyte, Renal & Endocrine
03 Gastrointestinal, Hepatic & Musculoskeletal
04 Neurological, Immune & Hematologic
05 Perioperative Care, Pain & Complex Management
ABOUT THIS ASSESSMENT
Build mastery in medical-surgical nursing — from perioperative care, fluid and electrolyte
balance, and wound management to cardiovascular, respiratory, renal, endocrine, and
neurological disorders across the adult lifespan. This assessment targets application and
analysis skills required for the HESI RN Medical-Surgical specialty exam, with full
rationales for every answer. Content aligns to pre-licensure nursing competencies.
PASSING SCORE LEVEL FORMAT
75% Advanced (Pre-Licensure Specialty) Application / Analysis
STUVIA ACTUAL EXAM Page 1
, SECTION 1: Cardiovascular & Respiratory Disorders
Q1. A 68-year-old client with heart failure is receiving intravenous furosemide. Two hours after the dose the nurse notes the
client’s blood pressure has dropped from 142/86 mm Hg to 98/58 mm Hg and the client reports feeling light-headed when
sitting up. Which immediate nursing action is the priority?
A. Document the vital signs and reassess in one hour
B. Place the client in a supine position with legs elevated and notify the provider
C. Increase the rate of the maintenance intravenous fluids
D. Administer the next scheduled dose of digoxin early
Correct Answer: B
Rationale: Acute hypotension after loop diuretic administration indicates volume depletion; elevating the legs and notifying the provider addresses
perfusion while awaiting further orders. Continuing the diuretic or increasing fluids without assessment would be unsafe.
Q2. A client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min via nasal cannula. Arterial blood gas
results show pH 7.29, PaCO2 62 mm Hg, PaO2 58 mm Hg, and HCO3 28 mEq/L. Which interpretation of these values is
most accurate?
A. Partially compensated respiratory acidosis with hypoxemia
B. Fully compensated metabolic acidosis
C. Uncompensated respiratory alkalosis
D. Normal acid-base balance with mild hypoxemia
Correct Answer: A
Rationale: Elevated PaCO2 with low pH indicates respiratory acidosis; the elevated HCO3 shows partial renal compensation, and the low PaO2
confirms concurrent hypoxemia typical of COPD exacerbation.
Q3. A client who underwent coronary artery bypass grafting 18 hours earlier suddenly develops restlessness, a drop in blood
pressure to 88/50 mm Hg, and muffled heart sounds. The nurse also notes jugular venous distention. Which complication is
the nurse most concerned about?
A. Cardiac tamponade
B. Postoperative atrial fibrillation
C. Pulmonary embolism
D. Acute graft occlusion
Correct Answer: A
Rationale: The triad of hypotension, muffled heart sounds, and jugular venous distention is classic for cardiac tamponade, a surgical emergency
after open-heart procedures. Immediate provider notification and preparation for pericardiocentesis or return to surgery are required.
Q4. A client with community-acquired pneumonia is receiving intravenous antibiotics and oxygen. The nurse auscultates
diminished breath sounds over the right lower lobe and notes the client’s temperature remains 38.9 °C (102 °F). Which
additional assessment finding would most strongly suggest the development of a pleural effusion?
A. Increased tactile fremitus over the affected area
B. Hyperresonance and increased breath sounds
C. Bilateral wheezing that clears with coughing
D. Dullness to percussion and decreased fremitus over the right base
Correct Answer: D
Rationale: Fluid in the pleural space produces dullness to percussion and dampens transmission of fremitus. Increased fremitus would be expected
with consolidation, not effusion.
Q5. A client admitted with acute decompensated heart failure has crackles bilaterally to the mid-lung fields, an S3 gallop, and
3+ pitting edema of both lower extremities. The provider orders intravenous nitroglycerin. Which physiological effect of this
medication is the primary reason for its use in this setting?
A. Positive inotropic support of contractility
B. Direct stimulation of beta-1 receptors
C. Reduction of preload through venous dilation
D. Increase in afterload to improve coronary perfusion
Correct Answer: C
Rationale: Nitroglycerin dilates venous capacitance vessels,
STUVIA decreasing
ACTUAL EXAMvenous
· Pagereturn
2 and thereby reducing preload and pulmonary congestion in
acute heart failure. It does not provide primary inotropic support.
A+ VERIFIED
HESI RN Medical-Surgical 2026/2027 |
Verified Questions & Answers — Complete
Official Exam
A+ Verified Questions Full Rationales Verified Answers
A+ 5 100%
QUESTIONS SECTIONS RATIONALES
Complete coverage Core exam domains Every answer explained
WHAT THIS COVERS
01 Cardiovascular & Respiratory Disorders
02 Fluid, Electrolyte, Renal & Endocrine
03 Gastrointestinal, Hepatic & Musculoskeletal
04 Neurological, Immune & Hematologic
05 Perioperative Care, Pain & Complex Management
ABOUT THIS ASSESSMENT
Build mastery in medical-surgical nursing — from perioperative care, fluid and electrolyte
balance, and wound management to cardiovascular, respiratory, renal, endocrine, and
neurological disorders across the adult lifespan. This assessment targets application and
analysis skills required for the HESI RN Medical-Surgical specialty exam, with full
rationales for every answer. Content aligns to pre-licensure nursing competencies.
PASSING SCORE LEVEL FORMAT
75% Advanced (Pre-Licensure Specialty) Application / Analysis
STUVIA ACTUAL EXAM Page 1
, SECTION 1: Cardiovascular & Respiratory Disorders
Q1. A 68-year-old client with heart failure is receiving intravenous furosemide. Two hours after the dose the nurse notes the
client’s blood pressure has dropped from 142/86 mm Hg to 98/58 mm Hg and the client reports feeling light-headed when
sitting up. Which immediate nursing action is the priority?
A. Document the vital signs and reassess in one hour
B. Place the client in a supine position with legs elevated and notify the provider
C. Increase the rate of the maintenance intravenous fluids
D. Administer the next scheduled dose of digoxin early
Correct Answer: B
Rationale: Acute hypotension after loop diuretic administration indicates volume depletion; elevating the legs and notifying the provider addresses
perfusion while awaiting further orders. Continuing the diuretic or increasing fluids without assessment would be unsafe.
Q2. A client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min via nasal cannula. Arterial blood gas
results show pH 7.29, PaCO2 62 mm Hg, PaO2 58 mm Hg, and HCO3 28 mEq/L. Which interpretation of these values is
most accurate?
A. Partially compensated respiratory acidosis with hypoxemia
B. Fully compensated metabolic acidosis
C. Uncompensated respiratory alkalosis
D. Normal acid-base balance with mild hypoxemia
Correct Answer: A
Rationale: Elevated PaCO2 with low pH indicates respiratory acidosis; the elevated HCO3 shows partial renal compensation, and the low PaO2
confirms concurrent hypoxemia typical of COPD exacerbation.
Q3. A client who underwent coronary artery bypass grafting 18 hours earlier suddenly develops restlessness, a drop in blood
pressure to 88/50 mm Hg, and muffled heart sounds. The nurse also notes jugular venous distention. Which complication is
the nurse most concerned about?
A. Cardiac tamponade
B. Postoperative atrial fibrillation
C. Pulmonary embolism
D. Acute graft occlusion
Correct Answer: A
Rationale: The triad of hypotension, muffled heart sounds, and jugular venous distention is classic for cardiac tamponade, a surgical emergency
after open-heart procedures. Immediate provider notification and preparation for pericardiocentesis or return to surgery are required.
Q4. A client with community-acquired pneumonia is receiving intravenous antibiotics and oxygen. The nurse auscultates
diminished breath sounds over the right lower lobe and notes the client’s temperature remains 38.9 °C (102 °F). Which
additional assessment finding would most strongly suggest the development of a pleural effusion?
A. Increased tactile fremitus over the affected area
B. Hyperresonance and increased breath sounds
C. Bilateral wheezing that clears with coughing
D. Dullness to percussion and decreased fremitus over the right base
Correct Answer: D
Rationale: Fluid in the pleural space produces dullness to percussion and dampens transmission of fremitus. Increased fremitus would be expected
with consolidation, not effusion.
Q5. A client admitted with acute decompensated heart failure has crackles bilaterally to the mid-lung fields, an S3 gallop, and
3+ pitting edema of both lower extremities. The provider orders intravenous nitroglycerin. Which physiological effect of this
medication is the primary reason for its use in this setting?
A. Positive inotropic support of contractility
B. Direct stimulation of beta-1 receptors
C. Reduction of preload through venous dilation
D. Increase in afterload to improve coronary perfusion
Correct Answer: C
Rationale: Nitroglycerin dilates venous capacitance vessels,
STUVIA decreasing
ACTUAL EXAMvenous
· Pagereturn
2 and thereby reducing preload and pulmonary congestion in
acute heart failure. It does not provide primary inotropic support.
