HESI ADULT HEALTH (MEDICAL–SURGICAL NURSING) EXAM PREP 2026/2027
COMPLETE PRACTICE EXAM | NCLEX READINESS & NEXT GENERATION NCLEX
(NGN) CLINICAL JUDGMENT | 50 VERIFIED PRACTICE QUESTIONS WITH DETAILED
RATIONALES | COMPREHENSIVE STUDY GUIDE
Examiner/Administrator: Elsevier HESI Assessment Program
━━━━━━━━━━━━━━━━━━━━━━━━━━━━
HESI ADULT HEALTH (MEDICAL–SURGICAL NURSING)
2026/2027 EDITION
━━━━━━━━━━━━━━━━━━━━━━━━━━━━
COMPLETE PRACTICE EXAM
50 ADVANCED MULTIPLE-CHOICE & CLINICAL JUDGMENT QUESTIONS
PASSING SCORE: 75%
TESTING TIME: 120 MINUTES
━━━━━━━━━━━━━━━━━━━━━━━━━━━━
TABLE OF CONTENT
Adult Health Foundations
Cardiovascular Nursing
Respiratory Disorders
Endocrine & Metabolic Care
Renal & Fluid-Electrolyte Management
Neurologic Disorders
Gastrointestinal Nursing
Perioperative & Safety Priorities
Pharmacologic Management
NGN Clinical Judgment & Prioritization
ELSEVIER HESI ASSESSMENT PROGRAM || ALIGNED WITH CURRENT NCLEX CLINICAL
JUDGMENT BLUEPRINTS || MEDICAL–SURGICAL NURSING REVIEW || PROFESSIONAL
STUDY GUIDE || 100% VERIFIED | GRADED A+ || COMPREHENSIVE EXAM
PREPARATION || PREPARED FOR NURSING EDUCATION & CERTIFICATION READINESS
|| PROFESSIONAL EXAMINATION USE
,Questions 1–6 → Adult Health Foundations & Nursing Priorities
Q1. A nurse receives report on four adult medical–surgical clients. Which client
should be assessed first?
A. A client with heart failure reporting increased bilateral ankle edema
B. A client receiving IV antibiotics who reports itching and throat tightness
C. A postoperative client with pain rated 8/10
D. A client with diabetes whose glucose is 214 mg/dL
Correct Answer: 🔴 B. A client receiving IV antibiotics who reports itching and
throat tightness
Explanation: 🔹 Airway takes immediate priority. Throat tightness during antibiotic
infusion suggests possible anaphylaxis with airway compromise and potential rapid
deterioration. Option A reflects worsening but stable fluid overload. Option C
requires treatment but is not immediately life-threatening. Option D is elevated
glucose without acute instability. Priority frameworks such as ABCs and acute-
versus-chronic guide this decision.
Q2. A nurse evaluates a hospitalized client’s laboratory results: sodium 128 mEq/L,
confusion, headache, and muscle weakness. Which intervention is highest priority?
A. Encourage oral free water intake
B. Restrict fluids and monitor neurologic status
C. Administer potassium supplements
D. Place client in Trendelenburg position
Correct Answer: 🔴 B. Restrict fluids and monitor neurologic status
Explanation: 🔹 The findings indicate symptomatic hyponatremia. Neurologic
assessment and limiting free water reduce worsening cerebral edema. Option A
worsens dilutional hyponatremia. Option C addresses another electrolyte
imbalance. Option D offers no therapeutic value and may worsen symptoms.
,Q3. A nurse caring for a client with sepsis notes temperature 39.3°C, HR 126, BP
86/50, and urine output 20 mL/hr. Which provider prescription should be
implemented first?
A. Obtain blood cultures
B. Administer broad-spectrum antibiotics
C. Begin rapid isotonic IV fluid infusion
D. Insert urinary catheter
Correct Answer: 🔴 C. Begin rapid isotonic IV fluid infusion
Explanation: 🔹 This client demonstrates septic shock with hypotension and organ
hypoperfusion. Immediate fluid resuscitation supports circulation before or
alongside cultures and antibiotics. Cultures and antibiotics remain critical but
circulation restoration prevents further deterioration.
Q4. A nurse teaches infection prevention to an immunocompromised client. Which
statement indicates understanding?
A. “I will avoid all fresh fruits.”
B. “I should wash hands before touching my face.”
C. “Masks eliminate infection risk completely.”
D. “I only need precautions in public places.”
Correct Answer: 🔴 B. “I should wash hands before touching my face.”
Explanation: 🔹 Hand hygiene remains the most effective infection prevention
strategy. Option A is unnecessarily restrictive. Option C falsely implies complete
protection. Option D ignores home and healthcare exposure risks.
Q5. A hospitalized client suddenly becomes restless and confused with SpO₂ 86%.
Which nursing action is priority?
A. Reorient client
B. Apply oxygen and assess airway
, C. Call family
D. Obtain pain score
Correct Answer: 🔴 B. Apply oxygen and assess airway
Explanation: 🔹 Restlessness and confusion are early indicators of hypoxia.
Immediate airway and oxygen assessment take precedence before other
interventions. Family notification and pain evaluation occur after stabilization.
Q6. A nurse reviews medication administration practices. Which action requires
intervention?
A. Confirming two identifiers
B. Scanning barcode before administration
C. Crushing enteric-coated medication
D. Documenting after administration
Correct Answer: 🔴 C. Crushing enteric-coated medication
Explanation: 🔹 Enteric-coated medications are designed for delayed absorption
and should not be crushed. Doing so can alter effectiveness and increase adverse
effects. The remaining actions reflect safe medication practice.
Questions 7–12 → Cardiovascular Nursing
Q7. A client with acute myocardial infarction develops chest pain unrelieved by
nitroglycerin and BP 82/54 mmHg. Which action is priority?
A. Administer additional nitroglycerin
B. Obtain 12-lead ECG and notify provider
C. Encourage ambulation
D. Administer oral fluids
Correct Answer: 🔴 B. Obtain 12-lead ECG and notify provider
COMPLETE PRACTICE EXAM | NCLEX READINESS & NEXT GENERATION NCLEX
(NGN) CLINICAL JUDGMENT | 50 VERIFIED PRACTICE QUESTIONS WITH DETAILED
RATIONALES | COMPREHENSIVE STUDY GUIDE
Examiner/Administrator: Elsevier HESI Assessment Program
━━━━━━━━━━━━━━━━━━━━━━━━━━━━
HESI ADULT HEALTH (MEDICAL–SURGICAL NURSING)
2026/2027 EDITION
━━━━━━━━━━━━━━━━━━━━━━━━━━━━
COMPLETE PRACTICE EXAM
50 ADVANCED MULTIPLE-CHOICE & CLINICAL JUDGMENT QUESTIONS
PASSING SCORE: 75%
TESTING TIME: 120 MINUTES
━━━━━━━━━━━━━━━━━━━━━━━━━━━━
TABLE OF CONTENT
Adult Health Foundations
Cardiovascular Nursing
Respiratory Disorders
Endocrine & Metabolic Care
Renal & Fluid-Electrolyte Management
Neurologic Disorders
Gastrointestinal Nursing
Perioperative & Safety Priorities
Pharmacologic Management
NGN Clinical Judgment & Prioritization
ELSEVIER HESI ASSESSMENT PROGRAM || ALIGNED WITH CURRENT NCLEX CLINICAL
JUDGMENT BLUEPRINTS || MEDICAL–SURGICAL NURSING REVIEW || PROFESSIONAL
STUDY GUIDE || 100% VERIFIED | GRADED A+ || COMPREHENSIVE EXAM
PREPARATION || PREPARED FOR NURSING EDUCATION & CERTIFICATION READINESS
|| PROFESSIONAL EXAMINATION USE
,Questions 1–6 → Adult Health Foundations & Nursing Priorities
Q1. A nurse receives report on four adult medical–surgical clients. Which client
should be assessed first?
A. A client with heart failure reporting increased bilateral ankle edema
B. A client receiving IV antibiotics who reports itching and throat tightness
C. A postoperative client with pain rated 8/10
D. A client with diabetes whose glucose is 214 mg/dL
Correct Answer: 🔴 B. A client receiving IV antibiotics who reports itching and
throat tightness
Explanation: 🔹 Airway takes immediate priority. Throat tightness during antibiotic
infusion suggests possible anaphylaxis with airway compromise and potential rapid
deterioration. Option A reflects worsening but stable fluid overload. Option C
requires treatment but is not immediately life-threatening. Option D is elevated
glucose without acute instability. Priority frameworks such as ABCs and acute-
versus-chronic guide this decision.
Q2. A nurse evaluates a hospitalized client’s laboratory results: sodium 128 mEq/L,
confusion, headache, and muscle weakness. Which intervention is highest priority?
A. Encourage oral free water intake
B. Restrict fluids and monitor neurologic status
C. Administer potassium supplements
D. Place client in Trendelenburg position
Correct Answer: 🔴 B. Restrict fluids and monitor neurologic status
Explanation: 🔹 The findings indicate symptomatic hyponatremia. Neurologic
assessment and limiting free water reduce worsening cerebral edema. Option A
worsens dilutional hyponatremia. Option C addresses another electrolyte
imbalance. Option D offers no therapeutic value and may worsen symptoms.
,Q3. A nurse caring for a client with sepsis notes temperature 39.3°C, HR 126, BP
86/50, and urine output 20 mL/hr. Which provider prescription should be
implemented first?
A. Obtain blood cultures
B. Administer broad-spectrum antibiotics
C. Begin rapid isotonic IV fluid infusion
D. Insert urinary catheter
Correct Answer: 🔴 C. Begin rapid isotonic IV fluid infusion
Explanation: 🔹 This client demonstrates septic shock with hypotension and organ
hypoperfusion. Immediate fluid resuscitation supports circulation before or
alongside cultures and antibiotics. Cultures and antibiotics remain critical but
circulation restoration prevents further deterioration.
Q4. A nurse teaches infection prevention to an immunocompromised client. Which
statement indicates understanding?
A. “I will avoid all fresh fruits.”
B. “I should wash hands before touching my face.”
C. “Masks eliminate infection risk completely.”
D. “I only need precautions in public places.”
Correct Answer: 🔴 B. “I should wash hands before touching my face.”
Explanation: 🔹 Hand hygiene remains the most effective infection prevention
strategy. Option A is unnecessarily restrictive. Option C falsely implies complete
protection. Option D ignores home and healthcare exposure risks.
Q5. A hospitalized client suddenly becomes restless and confused with SpO₂ 86%.
Which nursing action is priority?
A. Reorient client
B. Apply oxygen and assess airway
, C. Call family
D. Obtain pain score
Correct Answer: 🔴 B. Apply oxygen and assess airway
Explanation: 🔹 Restlessness and confusion are early indicators of hypoxia.
Immediate airway and oxygen assessment take precedence before other
interventions. Family notification and pain evaluation occur after stabilization.
Q6. A nurse reviews medication administration practices. Which action requires
intervention?
A. Confirming two identifiers
B. Scanning barcode before administration
C. Crushing enteric-coated medication
D. Documenting after administration
Correct Answer: 🔴 C. Crushing enteric-coated medication
Explanation: 🔹 Enteric-coated medications are designed for delayed absorption
and should not be crushed. Doing so can alter effectiveness and increase adverse
effects. The remaining actions reflect safe medication practice.
Questions 7–12 → Cardiovascular Nursing
Q7. A client with acute myocardial infarction develops chest pain unrelieved by
nitroglycerin and BP 82/54 mmHg. Which action is priority?
A. Administer additional nitroglycerin
B. Obtain 12-lead ECG and notify provider
C. Encourage ambulation
D. Administer oral fluids
Correct Answer: 🔴 B. Obtain 12-lead ECG and notify provider
