MSN DE MEDICAL-SURGICAL HESI EXAM 1
HERZING UNIVERSITY/ ACTUAL EXAM
QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES
GRADED A+ 100% GUARANTEED PASS!!
Question 1
A patient with chronic kidney disease presents with muscle weakness and peaked
T waves on telemetry. Which laboratory value is most concerning?
A. Sodium 130 mEq/L
B. Potassium 6.2 mEq/L
C. Calcium 8.1 mg/dL
D. Magnesium 1.9 mg/dL
Correct Answer: B
Rationale: Hyperkalemia directly affects cardiac conduction and can cause life-
threatening dysrhythmias. Peaked T waves are classic for elevated potassium and
require immediate intervention.
Question 2
A patient with left-sided heart failure reports worsening dyspnea at night and must
sleep on three pillows. Which assessment finding best supports this diagnosis?
A. Peripheral edema
B. Jugular venous distension
C. Crackles in the lung bases
D. Hepatomegaly
Correct Answer: C
Rationale: Left-sided heart failure leads to pulmonary congestion. Crackles and
orthopnea indicate fluid accumulation in the lungs.
,Question 3
A postoperative patient suddenly becomes restless, hypotensive, and tachycardic.
The surgical dressing is saturated with blood. What is the nurse’s priority action?
A. Recheck vital signs
B. Increase IV fluids
C. Notify the provider immediately
D. Reinforce the dressing
Correct Answer: C
Rationale: These findings suggest acute hemorrhage. Rapid provider notification
is critical to prevent shock and organ failure.
Question 4
A patient with COPD is admitted for an acute exacerbation. Which intervention
should the nurse implement first?
A. Administer IV corticosteroids
B. Initiate chest physiotherapy
C. Administer a short-acting bronchodilator
D. Obtain sputum cultures
Correct Answer: C
Rationale: In acute respiratory distress, bronchodilation to improve airflow takes
priority over long-term or diagnostic interventions.
Question 5
A patient with diabetic ketoacidosis arrives in the emergency department. Which
provider order should the nurse anticipate implementing first?
A. IV insulin infusion
B. Potassium replacement
C. Isotonic IV fluids
D. Sodium bicarbonate
,Correct Answer: C
Rationale: Severe dehydration is present in DKA. Restoring circulating volume
with isotonic fluids is the first priority before insulin administration.
Question 6
A nurse is assessing a patient after thyroidectomy. Which finding requires
immediate intervention?
A. Hoarseness
B. Neck swelling and stridor
C. Mild pain at the incision
D. Decreased appetite
Correct Answer: B
Rationale: Stridor and neck swelling indicate airway compromise from
hemorrhage or edema and require emergent action.
Question 7
A patient with hypocalcemia exhibits carpal spasm when a blood pressure cuff is
inflated. This finding indicates:
A. Trousseau’s sign
B. Chvostek’s sign
C. Tetany
D. Hypercalcemia
Correct Answer: A
Rationale: Trousseau’s sign is a classic indicator of hypocalcemia and reflects
neuromuscular irritability.
, Question 8
Which patient should the nurse assess first?
A. Stable angina with chest pain relieved by rest
B. COPD patient with oxygen saturation of 90%
C. Post-op patient with new-onset confusion and hypotension
D. Diabetic patient with glucose of 220 mg/dL
Correct Answer: C
Rationale: New-onset confusion and hypotension suggest acute instability,
possibly hemorrhage or sepsis, requiring immediate assessment.
Question 9
A patient with Addison’s disease is admitted with vomiting and hypotension.
Which medication is most critical to administer?
A. Furosemide
B. Insulin
C. Hydrocortisone
D. Levothyroxine
Correct Answer: C
Rationale: Addisonian crisis requires immediate corticosteroid replacement to
prevent circulatory collapse.
Question 10
A nurse notes ST-segment elevation on the ECG of a patient with chest pain. What
is the priority nursing action?
A. Obtain cardiac enzymes
B. Administer oxygen
C. Prepare for thrombolytic therapy
D. Insert a urinary catheter
HERZING UNIVERSITY/ ACTUAL EXAM
QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES
GRADED A+ 100% GUARANTEED PASS!!
Question 1
A patient with chronic kidney disease presents with muscle weakness and peaked
T waves on telemetry. Which laboratory value is most concerning?
A. Sodium 130 mEq/L
B. Potassium 6.2 mEq/L
C. Calcium 8.1 mg/dL
D. Magnesium 1.9 mg/dL
Correct Answer: B
Rationale: Hyperkalemia directly affects cardiac conduction and can cause life-
threatening dysrhythmias. Peaked T waves are classic for elevated potassium and
require immediate intervention.
Question 2
A patient with left-sided heart failure reports worsening dyspnea at night and must
sleep on three pillows. Which assessment finding best supports this diagnosis?
A. Peripheral edema
B. Jugular venous distension
C. Crackles in the lung bases
D. Hepatomegaly
Correct Answer: C
Rationale: Left-sided heart failure leads to pulmonary congestion. Crackles and
orthopnea indicate fluid accumulation in the lungs.
,Question 3
A postoperative patient suddenly becomes restless, hypotensive, and tachycardic.
The surgical dressing is saturated with blood. What is the nurse’s priority action?
A. Recheck vital signs
B. Increase IV fluids
C. Notify the provider immediately
D. Reinforce the dressing
Correct Answer: C
Rationale: These findings suggest acute hemorrhage. Rapid provider notification
is critical to prevent shock and organ failure.
Question 4
A patient with COPD is admitted for an acute exacerbation. Which intervention
should the nurse implement first?
A. Administer IV corticosteroids
B. Initiate chest physiotherapy
C. Administer a short-acting bronchodilator
D. Obtain sputum cultures
Correct Answer: C
Rationale: In acute respiratory distress, bronchodilation to improve airflow takes
priority over long-term or diagnostic interventions.
Question 5
A patient with diabetic ketoacidosis arrives in the emergency department. Which
provider order should the nurse anticipate implementing first?
A. IV insulin infusion
B. Potassium replacement
C. Isotonic IV fluids
D. Sodium bicarbonate
,Correct Answer: C
Rationale: Severe dehydration is present in DKA. Restoring circulating volume
with isotonic fluids is the first priority before insulin administration.
Question 6
A nurse is assessing a patient after thyroidectomy. Which finding requires
immediate intervention?
A. Hoarseness
B. Neck swelling and stridor
C. Mild pain at the incision
D. Decreased appetite
Correct Answer: B
Rationale: Stridor and neck swelling indicate airway compromise from
hemorrhage or edema and require emergent action.
Question 7
A patient with hypocalcemia exhibits carpal spasm when a blood pressure cuff is
inflated. This finding indicates:
A. Trousseau’s sign
B. Chvostek’s sign
C. Tetany
D. Hypercalcemia
Correct Answer: A
Rationale: Trousseau’s sign is a classic indicator of hypocalcemia and reflects
neuromuscular irritability.
, Question 8
Which patient should the nurse assess first?
A. Stable angina with chest pain relieved by rest
B. COPD patient with oxygen saturation of 90%
C. Post-op patient with new-onset confusion and hypotension
D. Diabetic patient with glucose of 220 mg/dL
Correct Answer: C
Rationale: New-onset confusion and hypotension suggest acute instability,
possibly hemorrhage or sepsis, requiring immediate assessment.
Question 9
A patient with Addison’s disease is admitted with vomiting and hypotension.
Which medication is most critical to administer?
A. Furosemide
B. Insulin
C. Hydrocortisone
D. Levothyroxine
Correct Answer: C
Rationale: Addisonian crisis requires immediate corticosteroid replacement to
prevent circulatory collapse.
Question 10
A nurse notes ST-segment elevation on the ECG of a patient with chest pain. What
is the priority nursing action?
A. Obtain cardiac enzymes
B. Administer oxygen
C. Prepare for thrombolytic therapy
D. Insert a urinary catheter
