MED SURG HESI V2 EXAM TEST BANK |
LATEST 2026 QUESTIONS & VERIFIED
ANSWERS (100% ACCURATE SOLUTIONS |
INSTANT PDF DOWNLOAD)
MED-SURG HESI V2 EXAM TEST BANK | LATEST 2026
DOCUMENT OVERVIEW:
• This comprehensive question exam bank mirrors the latest HESI Medical-Surgical
Nursing assessment format with verified answers and in-depth EXPERT
RATIONALE to ensure 100% exam readiness and mastery of core med-surg nursing
concepts.
• Study this material by reviewing each question carefully, understanding the
EXPERT RATIONALE behind correct answers, and identifying weak areas to focus
on during your final preparation phase.
1. A 65-year-old client with a history of hypertension and diabetes is admitted
with acute myocardial infarction. Which assessment finding would be MOST
indicative of cardiogenic shock?
A) Blood pressure of 160/95 mmHg
B) Heart rate of 88 beats per minute
C) Urine output of 15 mL/hour
D) Respiratory rate of 18 breaths per minute
E) Capillary refill of 3 seconds
CORRECT ANSWER: C) ✓ Urine output of 15 mL/hour
EXPERT RATIONALE: Cardiogenic shock occurs when the heart cannot pump
effectively, leading to inadequate perfusion of vital organs. A urine output of 15
mL/hour indicates severe hypoperfusion of the kidneys and is a critical sign of
cardiogenic shock. Normal urine output is 30-50 mL/hour or 0.5-1 mL/kg/hour. The
,other options are either compensatory responses (elevated BP and heart rate
would be expected in shock) or normal findings that would not indicate shock
severity.
2. A 52-year-old male client is recovering from a coronary artery bypass graft
(CABG). On postoperative day 2, the nurse notes decreased chest tube
drainage, no fever, and stable vital signs. Which action should the nurse take?
A) Immediately notify the physician of decreased drainage
B) Continue monitoring and assess for other complications
C) Increase the client's activity level to promote drainage
D) Administer antibiotics prophylactically
E) Remove the chest tube immediately
CORRECT ANSWER: B) ✓ Continue monitoring and assess for other
complications
EXPERT RATIONALE: Decreased chest tube drainage on postoperative day 2 is an
expected finding as bleeding naturally decreases after surgery. With no fever and
stable vital signs, this is a normal progression of recovery. The nurse should
continue monitoring for signs of complications such as infection, cardiac
tamponade, or arrhythmias, but there is no immediate intervention required. Notify
physician only if concerning signs develop (fever, hypotension, increased JVD, or
rapid deterioration).
3. A 58-year-old female client with congestive heart failure is prescribed
digoxin (Lanoxin). Which laboratory value would MOST concern the nurse and
increase the risk of digoxin toxicity?
A) Serum potassium level of 3.2 mEq/L
B) Serum calcium level of 9.5 mg/dL
C) Serum magnesium level of 2.2 mg/dL
,D) Serum sodium level of 138 mEq/L
E) Serum chloride level of 102 mEq/L
CORRECT ANSWER: A) ✓ Serum potassium level of 3.2 mEq/L
EXPERT RATIONALE: Hypokalemia (low potassium) significantly increases the risk
of digoxin toxicity. Potassium and digoxin compete for the same binding sites on
cardiac tissue; when potassium is low, digoxin binds more readily, increasing
toxicity risk. Hypokalemia also predisposes to cardiac arrhythmias. Normal
potassium is 3.5-5.0 mEq/L. The nurse should ensure potassium levels are
adequate before administering digoxin and should monitor serum potassium
regularly in clients on digoxin therapy.
4. A 70-year-old client admitted with acute stroke is receiving thrombolytic
therapy. The nurse recognizes that the thrombolytic window for ischemic
stroke intervention is approximately:
A) 1 hour
B) 3 hours
C) 6 hours
D) 12 hours
E) 24 hours
CORRECT ANSWER: B) ✓ 3 hours
EXPERT RATIONALE: The therapeutic window for administering thrombolytic
agents (alteplase/tPA) in acute ischemic stroke is 3 hours from symptom onset. This
window may be extended to 4.5 hours in select patients under certain conditions.
Time is critical in stroke intervention—"time is brain." Every minute counts, as
neurons are dying at a rate of approximately 1.9 million per minute during ischemic
stroke. After this window, the risk of hemorrhagic transformation and
complications outweighs the benefits of thrombolytic therapy.
, 5. A 45-year-old client with COPD is experiencing an acute exacerbation.
Which breath sound would indicate MOST significant airway obstruction?
A) Crackles at the lung bases
B) Silent chest on auscultation
C) Wheezing throughout respiratory cycle
D) Diminished breath sounds with prolonged expiration
E) High-pitched stridor
CORRECT ANSWER: B) ✓ Silent chest on auscultation
EXPERT RATIONALE: A silent chest is an ominous finding in COPD exacerbation,
indicating severe airway obstruction with minimal air movement through the
airways. This suggests the client is in severe respiratory distress and requires
immediate intervention. While wheezing and diminished breath sounds are present
in COPD, a silent chest indicates critically reduced airflow and is a medical
emergency requiring possible intubation and mechanical ventilation.
6. A 63-year-old male with pneumonia is being treated with IV antibiotics. His
oxygen saturation has dropped from 94% to 88% over the past 2 hours. Which
action should the nurse take FIRST?
A) Increase the oxygen flow rate
B) Notify the physician immediately
C) Place the client in Trendelenburg position
D) Assess breath sounds and respiratory status
E) Administer a sedative to reduce anxiety
CORRECT ANSWER: D) ✓ Assess breath sounds and respiratory status
EXPERT RATIONALE: The nurse should first perform a comprehensive respiratory
assessment to determine the cause of the oxygen saturation drop. This assessment
should include auscultation of breath sounds, respiratory rate, depth, work of
LATEST 2026 QUESTIONS & VERIFIED
ANSWERS (100% ACCURATE SOLUTIONS |
INSTANT PDF DOWNLOAD)
MED-SURG HESI V2 EXAM TEST BANK | LATEST 2026
DOCUMENT OVERVIEW:
• This comprehensive question exam bank mirrors the latest HESI Medical-Surgical
Nursing assessment format with verified answers and in-depth EXPERT
RATIONALE to ensure 100% exam readiness and mastery of core med-surg nursing
concepts.
• Study this material by reviewing each question carefully, understanding the
EXPERT RATIONALE behind correct answers, and identifying weak areas to focus
on during your final preparation phase.
1. A 65-year-old client with a history of hypertension and diabetes is admitted
with acute myocardial infarction. Which assessment finding would be MOST
indicative of cardiogenic shock?
A) Blood pressure of 160/95 mmHg
B) Heart rate of 88 beats per minute
C) Urine output of 15 mL/hour
D) Respiratory rate of 18 breaths per minute
E) Capillary refill of 3 seconds
CORRECT ANSWER: C) ✓ Urine output of 15 mL/hour
EXPERT RATIONALE: Cardiogenic shock occurs when the heart cannot pump
effectively, leading to inadequate perfusion of vital organs. A urine output of 15
mL/hour indicates severe hypoperfusion of the kidneys and is a critical sign of
cardiogenic shock. Normal urine output is 30-50 mL/hour or 0.5-1 mL/kg/hour. The
,other options are either compensatory responses (elevated BP and heart rate
would be expected in shock) or normal findings that would not indicate shock
severity.
2. A 52-year-old male client is recovering from a coronary artery bypass graft
(CABG). On postoperative day 2, the nurse notes decreased chest tube
drainage, no fever, and stable vital signs. Which action should the nurse take?
A) Immediately notify the physician of decreased drainage
B) Continue monitoring and assess for other complications
C) Increase the client's activity level to promote drainage
D) Administer antibiotics prophylactically
E) Remove the chest tube immediately
CORRECT ANSWER: B) ✓ Continue monitoring and assess for other
complications
EXPERT RATIONALE: Decreased chest tube drainage on postoperative day 2 is an
expected finding as bleeding naturally decreases after surgery. With no fever and
stable vital signs, this is a normal progression of recovery. The nurse should
continue monitoring for signs of complications such as infection, cardiac
tamponade, or arrhythmias, but there is no immediate intervention required. Notify
physician only if concerning signs develop (fever, hypotension, increased JVD, or
rapid deterioration).
3. A 58-year-old female client with congestive heart failure is prescribed
digoxin (Lanoxin). Which laboratory value would MOST concern the nurse and
increase the risk of digoxin toxicity?
A) Serum potassium level of 3.2 mEq/L
B) Serum calcium level of 9.5 mg/dL
C) Serum magnesium level of 2.2 mg/dL
,D) Serum sodium level of 138 mEq/L
E) Serum chloride level of 102 mEq/L
CORRECT ANSWER: A) ✓ Serum potassium level of 3.2 mEq/L
EXPERT RATIONALE: Hypokalemia (low potassium) significantly increases the risk
of digoxin toxicity. Potassium and digoxin compete for the same binding sites on
cardiac tissue; when potassium is low, digoxin binds more readily, increasing
toxicity risk. Hypokalemia also predisposes to cardiac arrhythmias. Normal
potassium is 3.5-5.0 mEq/L. The nurse should ensure potassium levels are
adequate before administering digoxin and should monitor serum potassium
regularly in clients on digoxin therapy.
4. A 70-year-old client admitted with acute stroke is receiving thrombolytic
therapy. The nurse recognizes that the thrombolytic window for ischemic
stroke intervention is approximately:
A) 1 hour
B) 3 hours
C) 6 hours
D) 12 hours
E) 24 hours
CORRECT ANSWER: B) ✓ 3 hours
EXPERT RATIONALE: The therapeutic window for administering thrombolytic
agents (alteplase/tPA) in acute ischemic stroke is 3 hours from symptom onset. This
window may be extended to 4.5 hours in select patients under certain conditions.
Time is critical in stroke intervention—"time is brain." Every minute counts, as
neurons are dying at a rate of approximately 1.9 million per minute during ischemic
stroke. After this window, the risk of hemorrhagic transformation and
complications outweighs the benefits of thrombolytic therapy.
, 5. A 45-year-old client with COPD is experiencing an acute exacerbation.
Which breath sound would indicate MOST significant airway obstruction?
A) Crackles at the lung bases
B) Silent chest on auscultation
C) Wheezing throughout respiratory cycle
D) Diminished breath sounds with prolonged expiration
E) High-pitched stridor
CORRECT ANSWER: B) ✓ Silent chest on auscultation
EXPERT RATIONALE: A silent chest is an ominous finding in COPD exacerbation,
indicating severe airway obstruction with minimal air movement through the
airways. This suggests the client is in severe respiratory distress and requires
immediate intervention. While wheezing and diminished breath sounds are present
in COPD, a silent chest indicates critically reduced airflow and is a medical
emergency requiring possible intubation and mechanical ventilation.
6. A 63-year-old male with pneumonia is being treated with IV antibiotics. His
oxygen saturation has dropped from 94% to 88% over the past 2 hours. Which
action should the nurse take FIRST?
A) Increase the oxygen flow rate
B) Notify the physician immediately
C) Place the client in Trendelenburg position
D) Assess breath sounds and respiratory status
E) Administer a sedative to reduce anxiety
CORRECT ANSWER: D) ✓ Assess breath sounds and respiratory status
EXPERT RATIONALE: The nurse should first perform a comprehensive respiratory
assessment to determine the cause of the oxygen saturation drop. This assessment
should include auscultation of breath sounds, respiratory rate, depth, work of
