HESI MED-SURG 3 EXAM
77 High-Accuracy Questions | 2025/2026 Real Exam Format | Professionally Verified |
A+ Quality
EXAM OVERVIEW
The HESI MED-SURG 3 EXAM delivers a realistic and fully verified 2025/2026 exam
experience designed to strengthen mastery and test readiness. Featuring 77 carefully
structured questions and professional-level accuracy, this resource enhances critical
reasoning and supports confident performance, making it an essential tool for students
seeking reliable, high-quality exam preparation that accurately mirrors the authenticity of
the actual exam.
EXAM FEATURES
• 77 exam-accurate questions aligned with standards to ensure you're prepared for the HESI
MED-SURG 3 EXAM.
• Comprehensive coverage of 5 domains for complete preparation and mastery of key
concepts.
• Verified accuracy and high-yield content for efficient study and effective learning.
• Realistic practice questions that mimic the actual exam experience to build your confidence
and skills.
• Detailed explanations and feedback to help you identify areas for improvement and achieve
exam success.
CORE TESTING AREAS
→ Body Systems & Pathophysiology (21 Questions)
→ Nursing Process & Clinical Management (10 Questions)
→ Patient Safety & Infection Control (13 Questions)
→ Pharmacology (22 Questions)
→ Specialty & High-risk Conditions (11 Questions)
Page 1
,Body Systems & Pathophysiology (21 Questions)
Question 1
A client with chronic heart failure exhibits a left ventricular end‑diastolic volume increase from
120 mL to 180 mL, while stroke volume rises from 55 mL to 70 mL. Which physiologic principle
best explains this change?
A. Starling's law of the heart
B. Bernoulli's principle
C. Frank‑Frankel hypothesis
D. Guyton's renal compensation model
Correct Answer
Starling's law of the heart
Rationale:
Starling's law states that increased ventricular filling (preload) leads to a proportionate increase in stroke volume
due to optimal sarcomere length, which is reflected in the observed data.
Question 2
A 68‑year‑old male with severe COPD has a pH of 7.30, PaCO₂ of 58 mmHg, and HCO₃⁻ of 30
mEq/L. Which compensatory mechanism is the respiratory system employing?
A. Renal retention of bicarbonate
B. Increased alveolar ventilation
C. Enhanced peripheral chemoreceptor sensitivity
D. Shift of the oxyhemoglobin dissociation curve to the left
Correct Answer
Renal retention of bicarbonate
Rationale:
In chronic respiratory acidosis, the kidneys compensate by retaining bicarbonate, raising HCO₃⁻ to buffer the
elevated CO₂, as demonstrated by the lab values.
Page 2
,Question 3
During renal autoregulation, an abrupt rise in systemic arterial pressure is detected. Which
intrinsic mechanism most immediately counters this change to maintain constant glomerular
filtration rate (GFR)?
A. Myogenic response of afferent arterioles
B. Tubuloglomerular feedback via macula densa
C. Renin‑angiotensin‑aldosterone system activation
D. Atrial natriuretic peptide release
Correct Answer
Myogenic response of afferent arterioles
Rationale:
The myogenic response causes afferent arteriolar smooth muscle to contract when pressure rises, rapidly
normalizing GFR independent of hormonal pathways.
Question 4
A patient with Cushing disease shows elevated cortisol despite high circulating ACTH levels.
Which feedback loop component is most likely defective?
A. Negative feedback at the hypothalamic level
B. Positive feedback from the adrenal cortex
C. Autocrine inhibition within the pituitary gland
D. Peripheral conversion of cortisol to cortisone
Correct Answer
Negative feedback at the hypothalamic level
Rationale:
Cushing disease (pituitary adenoma) produces excess ACTH; the hypothalamic CRH‑cortisol negative feedback is
impaired, allowing continued ACTH and cortisol secretion.
Page 3
, Question 5
A newborn fails to pass meconium within 48 hours and presents with abdominal distention.
Which pathophysiologic alteration underlies this presentation?
A. Absence of enteric ganglion cells in the distal colon
B. Hyperactive cholinergic innervation of the ileum
C. Increased secretion of pancreatic enzymes
D. Excessive nitric oxide synthesis in the intestinal smooth muscle
Correct Answer
Absence of enteric ganglion cells in the distal colon
Rationale:
Hirschsprung disease is characterized by aganglionosis of the distal bowel, leading to functional obstruction and
delayed meconium passage.
Question 6
An MRI of a patient with relapsing‑remitting multiple sclerosis shows demyelinated plaques in
the periventricular white matter. How does demyelination most directly affect neuronal
conduction?
A. Decreases the amplitude of action potentials without altering speed
B. Increases the refractory period of axons
C. Slows the velocity of impulse propagation along affected fibers
D. Enhances synaptic vesicle release at the neuromuscular junction
Correct Answer
Slows the velocity of impulse propagation along affected fibers
Rationale:
Myelin acts as an insulator; its loss reduces saltatory conduction, resulting in slower impulse transmission along the
affected axons.
Page 4
77 High-Accuracy Questions | 2025/2026 Real Exam Format | Professionally Verified |
A+ Quality
EXAM OVERVIEW
The HESI MED-SURG 3 EXAM delivers a realistic and fully verified 2025/2026 exam
experience designed to strengthen mastery and test readiness. Featuring 77 carefully
structured questions and professional-level accuracy, this resource enhances critical
reasoning and supports confident performance, making it an essential tool for students
seeking reliable, high-quality exam preparation that accurately mirrors the authenticity of
the actual exam.
EXAM FEATURES
• 77 exam-accurate questions aligned with standards to ensure you're prepared for the HESI
MED-SURG 3 EXAM.
• Comprehensive coverage of 5 domains for complete preparation and mastery of key
concepts.
• Verified accuracy and high-yield content for efficient study and effective learning.
• Realistic practice questions that mimic the actual exam experience to build your confidence
and skills.
• Detailed explanations and feedback to help you identify areas for improvement and achieve
exam success.
CORE TESTING AREAS
→ Body Systems & Pathophysiology (21 Questions)
→ Nursing Process & Clinical Management (10 Questions)
→ Patient Safety & Infection Control (13 Questions)
→ Pharmacology (22 Questions)
→ Specialty & High-risk Conditions (11 Questions)
Page 1
,Body Systems & Pathophysiology (21 Questions)
Question 1
A client with chronic heart failure exhibits a left ventricular end‑diastolic volume increase from
120 mL to 180 mL, while stroke volume rises from 55 mL to 70 mL. Which physiologic principle
best explains this change?
A. Starling's law of the heart
B. Bernoulli's principle
C. Frank‑Frankel hypothesis
D. Guyton's renal compensation model
Correct Answer
Starling's law of the heart
Rationale:
Starling's law states that increased ventricular filling (preload) leads to a proportionate increase in stroke volume
due to optimal sarcomere length, which is reflected in the observed data.
Question 2
A 68‑year‑old male with severe COPD has a pH of 7.30, PaCO₂ of 58 mmHg, and HCO₃⁻ of 30
mEq/L. Which compensatory mechanism is the respiratory system employing?
A. Renal retention of bicarbonate
B. Increased alveolar ventilation
C. Enhanced peripheral chemoreceptor sensitivity
D. Shift of the oxyhemoglobin dissociation curve to the left
Correct Answer
Renal retention of bicarbonate
Rationale:
In chronic respiratory acidosis, the kidneys compensate by retaining bicarbonate, raising HCO₃⁻ to buffer the
elevated CO₂, as demonstrated by the lab values.
Page 2
,Question 3
During renal autoregulation, an abrupt rise in systemic arterial pressure is detected. Which
intrinsic mechanism most immediately counters this change to maintain constant glomerular
filtration rate (GFR)?
A. Myogenic response of afferent arterioles
B. Tubuloglomerular feedback via macula densa
C. Renin‑angiotensin‑aldosterone system activation
D. Atrial natriuretic peptide release
Correct Answer
Myogenic response of afferent arterioles
Rationale:
The myogenic response causes afferent arteriolar smooth muscle to contract when pressure rises, rapidly
normalizing GFR independent of hormonal pathways.
Question 4
A patient with Cushing disease shows elevated cortisol despite high circulating ACTH levels.
Which feedback loop component is most likely defective?
A. Negative feedback at the hypothalamic level
B. Positive feedback from the adrenal cortex
C. Autocrine inhibition within the pituitary gland
D. Peripheral conversion of cortisol to cortisone
Correct Answer
Negative feedback at the hypothalamic level
Rationale:
Cushing disease (pituitary adenoma) produces excess ACTH; the hypothalamic CRH‑cortisol negative feedback is
impaired, allowing continued ACTH and cortisol secretion.
Page 3
, Question 5
A newborn fails to pass meconium within 48 hours and presents with abdominal distention.
Which pathophysiologic alteration underlies this presentation?
A. Absence of enteric ganglion cells in the distal colon
B. Hyperactive cholinergic innervation of the ileum
C. Increased secretion of pancreatic enzymes
D. Excessive nitric oxide synthesis in the intestinal smooth muscle
Correct Answer
Absence of enteric ganglion cells in the distal colon
Rationale:
Hirschsprung disease is characterized by aganglionosis of the distal bowel, leading to functional obstruction and
delayed meconium passage.
Question 6
An MRI of a patient with relapsing‑remitting multiple sclerosis shows demyelinated plaques in
the periventricular white matter. How does demyelination most directly affect neuronal
conduction?
A. Decreases the amplitude of action potentials without altering speed
B. Increases the refractory period of axons
C. Slows the velocity of impulse propagation along affected fibers
D. Enhances synaptic vesicle release at the neuromuscular junction
Correct Answer
Slows the velocity of impulse propagation along affected fibers
Rationale:
Myelin acts as an insulator; its loss reduces saltatory conduction, resulting in slower impulse transmission along the
affected axons.
Page 4
