This comprehensive test bank is designed for nursing students preparing for the HESI
Medical-Surgical (Med Surg) exam. It features 500 practice questions covering key topics
including cardiovascular, respiratory, endocrine, renal, neurological, gastrointestinal, and
musculoskeletal disorders. Each question includes multiple-choice options, the correct
answer, and a detailed rationale to reinforce clinical reasoning. The questions reflect the
latest 2026-2027 exam standards and focus on high-yield content such as diabetes
management, wound care, pharmacology, fluid/electrolyte balance, and postoperative care.
Ideal for self-assessment, remediation, and exam readiness. Perfect for NCLEX and HESI
success.
1. A client is receiving IV heparin therapy for a pulmonary embolism. The nurse monitors the
client for which adverse effect?
1) Thrombocytopenia.
2) Hypertension.
3) Bradycardia.
4) Hyperglycemia.
Correct Answer: 1
Rationale: Heparin-induced thrombocytopenia (HIT) is a serious adverse effect of heparin
therapy (Option 1), causing a significant drop in platelet count. Hypertension (Option 2) is not a
typical adverse effect of heparin. Bradycardia (Option 3) is not associated with heparin use.
Hyperglycemia (Option 4) is not related to heparin therapy.
Page | 1
,2. The nurse is assessing a client with heart failure who has crackles in the lung bases, jugular
venous distention, and peripheral edema. These findings are consistent with which type of
heart failure?
1) Left-sided heart failure.
2) Right-sided heart failure.
3) High-output heart failure.
4) Systolic heart failure.
Correct Answer: 2
Rationale: Right-sided heart failure manifests with systemic congestion including jugular venous
distention, peripheral edema, and hepatomegaly (Option 2). Left-sided heart failure (Option 1)
presents with pulmonary congestion (crackles, dyspnea, orthopnea). High-output heart failure
(Option 3) is caused by increased metabolic demands. Systolic heart failure (Option 4) is
characterized by decreased ejection fraction but can be left- or right-sided.
3. A client with cirrhosis of the liver is prescribed spironolactone. Which assessment finding
indicates the medication is having the desired effect?
1) Decreased abdominal girth.
2) Increased urine specific gravity.
3) Decreased serum albumin.
4) Increased blood pressure.
Correct Answer: 1
Rationale: Spironolactone is a potassium-sparing diuretic used in cirrhosis to reduce ascites. A
decrease in abdominal girth (Option 1) indicates successful reduction of fluid volume. Increased
urine specific gravity (Option 2) suggests dehydration, not diuresis. Decreased serum albumin
(Option 3) would worsen ascites. Increased blood pressure (Option 4) is not the primary goal;
blood pressure should be maintained within normal limits.
4. The nurse is providing dietary instructions to a 68-year-old client who is at high risk for
development of coronary heart disease (CHD). Which information should the nurse include?
1) Limit dietary selection of cholesterol to 300 mg per day.
Page | 2
,2) Increase intake of soluble fiber to 10 to 25 grams per day.
3) Decrease plant stanols and sterols to less than 2 grams/day.
4) Ensure saturated fat is less than 30% of total caloric intake.
Correct Answer: 2
Rationale: To reduce the risk of coronary heart disease, the American Heart Association
recommends increasing soluble fiber intake to 10–25 grams per day (Option 2) from sources
such as oats, beans, and psyllium. Cholesterol intake (Option 1) should be limited to less than
180 mg/day, not 300 mg. Plant stanols and sterols (Option 3) should be increased to 2
grams/day, not decreased. Saturated fat intake (Option 4) should be limited to less than 7% of
total daily calories, not 30%.
5. A splint is prescribed for nighttime use by a client with rheumatoid arthritis. Which statement
by the nurse provides the most accurate explanation for use of the splints?
1) Prevention of deformities.
2) Avoidance of joint trauma.
3) Relief of joint inflammation.
4) Improvement in joint strength.
Correct Answer: 1
Rationale: Night splints are used in rheumatoid arthritis primarily to prevent deformities
(Option 1) by maintaining proper joint alignment and reducing muscle spasms and
contractures. Splints are not used to avoid joint trauma (Option 2); that would be achieved
through activity modification. Joint inflammation (Option 3) is managed with medications such
as NSAIDs and DMARDs. Joint strength improvement (Option 4) is achieved through prescribed
exercise programs, not splint use.
6. A 32-year-old female client complains of severe abdominal pain each month before her
menstrual period, painful intercourse, and painful defecation. Which additional history should
the nurse obtain that is consistent with the client's complaints?
1) Frequent urinary tract infections.
2) Inability to get pregnant.
Page | 3
, 3) Premenstrual syndrome.
4) Chronic use of laxatives.
Correct Answer: 2
Rationale: The client's symptoms (dysmenorrhea, dyspareunia, and painful defecation) are
classic manifestations of endometriosis. Infertility (Option 2) is a common associated finding
because endometrial implants can cause adhesions and block fallopian tubes. Frequent UTIs
(Option 1) are not specifically associated with endometriosis. Premenstrual syndrome (Option
3) may cause discomfort but does not typically cause dyspareunia or painful defecation. Chronic
laxative use (Option 4) would be associated with constipation issues, not these symptoms.
7. A client with a 16-year history of diabetes mellitus is having renal function tests because of
recent fatigue, weakness, elevated blood urea nitrogen, and serum creatinine levels. Which
finding should the nurse conclude as an early symptom of renal insufficiency?
1) Dyspnea.
2) Nocturia.
3) Oliguria.
4) Edema.
Correct Answer: 2
Rationale: Nocturia (Option 2) is often an early symptom of renal insufficiency in diabetic
nephropathy. As the kidneys lose their ability to concentrate urine, the client experiences
increased nighttime urination. Dyspnea (Option 1) and edema (Option 4) are later signs
associated with fluid overload and heart failure. Oliguria (Option 3) is a late sign indicating
significant loss of renal function.
8. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min via
nasal cannula. The client's respiratory rate has decreased from 24 to 10 breaths per minute.
What action should the nurse take first?
1) Increase the oxygen flow rate to 4 L/min.
2) Assess the client's level of consciousness.
3) Notify the healthcare provider immediately.
Page | 4
Medical-Surgical (Med Surg) exam. It features 500 practice questions covering key topics
including cardiovascular, respiratory, endocrine, renal, neurological, gastrointestinal, and
musculoskeletal disorders. Each question includes multiple-choice options, the correct
answer, and a detailed rationale to reinforce clinical reasoning. The questions reflect the
latest 2026-2027 exam standards and focus on high-yield content such as diabetes
management, wound care, pharmacology, fluid/electrolyte balance, and postoperative care.
Ideal for self-assessment, remediation, and exam readiness. Perfect for NCLEX and HESI
success.
1. A client is receiving IV heparin therapy for a pulmonary embolism. The nurse monitors the
client for which adverse effect?
1) Thrombocytopenia.
2) Hypertension.
3) Bradycardia.
4) Hyperglycemia.
Correct Answer: 1
Rationale: Heparin-induced thrombocytopenia (HIT) is a serious adverse effect of heparin
therapy (Option 1), causing a significant drop in platelet count. Hypertension (Option 2) is not a
typical adverse effect of heparin. Bradycardia (Option 3) is not associated with heparin use.
Hyperglycemia (Option 4) is not related to heparin therapy.
Page | 1
,2. The nurse is assessing a client with heart failure who has crackles in the lung bases, jugular
venous distention, and peripheral edema. These findings are consistent with which type of
heart failure?
1) Left-sided heart failure.
2) Right-sided heart failure.
3) High-output heart failure.
4) Systolic heart failure.
Correct Answer: 2
Rationale: Right-sided heart failure manifests with systemic congestion including jugular venous
distention, peripheral edema, and hepatomegaly (Option 2). Left-sided heart failure (Option 1)
presents with pulmonary congestion (crackles, dyspnea, orthopnea). High-output heart failure
(Option 3) is caused by increased metabolic demands. Systolic heart failure (Option 4) is
characterized by decreased ejection fraction but can be left- or right-sided.
3. A client with cirrhosis of the liver is prescribed spironolactone. Which assessment finding
indicates the medication is having the desired effect?
1) Decreased abdominal girth.
2) Increased urine specific gravity.
3) Decreased serum albumin.
4) Increased blood pressure.
Correct Answer: 1
Rationale: Spironolactone is a potassium-sparing diuretic used in cirrhosis to reduce ascites. A
decrease in abdominal girth (Option 1) indicates successful reduction of fluid volume. Increased
urine specific gravity (Option 2) suggests dehydration, not diuresis. Decreased serum albumin
(Option 3) would worsen ascites. Increased blood pressure (Option 4) is not the primary goal;
blood pressure should be maintained within normal limits.
4. The nurse is providing dietary instructions to a 68-year-old client who is at high risk for
development of coronary heart disease (CHD). Which information should the nurse include?
1) Limit dietary selection of cholesterol to 300 mg per day.
Page | 2
,2) Increase intake of soluble fiber to 10 to 25 grams per day.
3) Decrease plant stanols and sterols to less than 2 grams/day.
4) Ensure saturated fat is less than 30% of total caloric intake.
Correct Answer: 2
Rationale: To reduce the risk of coronary heart disease, the American Heart Association
recommends increasing soluble fiber intake to 10–25 grams per day (Option 2) from sources
such as oats, beans, and psyllium. Cholesterol intake (Option 1) should be limited to less than
180 mg/day, not 300 mg. Plant stanols and sterols (Option 3) should be increased to 2
grams/day, not decreased. Saturated fat intake (Option 4) should be limited to less than 7% of
total daily calories, not 30%.
5. A splint is prescribed for nighttime use by a client with rheumatoid arthritis. Which statement
by the nurse provides the most accurate explanation for use of the splints?
1) Prevention of deformities.
2) Avoidance of joint trauma.
3) Relief of joint inflammation.
4) Improvement in joint strength.
Correct Answer: 1
Rationale: Night splints are used in rheumatoid arthritis primarily to prevent deformities
(Option 1) by maintaining proper joint alignment and reducing muscle spasms and
contractures. Splints are not used to avoid joint trauma (Option 2); that would be achieved
through activity modification. Joint inflammation (Option 3) is managed with medications such
as NSAIDs and DMARDs. Joint strength improvement (Option 4) is achieved through prescribed
exercise programs, not splint use.
6. A 32-year-old female client complains of severe abdominal pain each month before her
menstrual period, painful intercourse, and painful defecation. Which additional history should
the nurse obtain that is consistent with the client's complaints?
1) Frequent urinary tract infections.
2) Inability to get pregnant.
Page | 3
, 3) Premenstrual syndrome.
4) Chronic use of laxatives.
Correct Answer: 2
Rationale: The client's symptoms (dysmenorrhea, dyspareunia, and painful defecation) are
classic manifestations of endometriosis. Infertility (Option 2) is a common associated finding
because endometrial implants can cause adhesions and block fallopian tubes. Frequent UTIs
(Option 1) are not specifically associated with endometriosis. Premenstrual syndrome (Option
3) may cause discomfort but does not typically cause dyspareunia or painful defecation. Chronic
laxative use (Option 4) would be associated with constipation issues, not these symptoms.
7. A client with a 16-year history of diabetes mellitus is having renal function tests because of
recent fatigue, weakness, elevated blood urea nitrogen, and serum creatinine levels. Which
finding should the nurse conclude as an early symptom of renal insufficiency?
1) Dyspnea.
2) Nocturia.
3) Oliguria.
4) Edema.
Correct Answer: 2
Rationale: Nocturia (Option 2) is often an early symptom of renal insufficiency in diabetic
nephropathy. As the kidneys lose their ability to concentrate urine, the client experiences
increased nighttime urination. Dyspnea (Option 1) and edema (Option 4) are later signs
associated with fluid overload and heart failure. Oliguria (Option 3) is a late sign indicating
significant loss of renal function.
8. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min via
nasal cannula. The client's respiratory rate has decreased from 24 to 10 breaths per minute.
What action should the nurse take first?
1) Increase the oxygen flow rate to 4 L/min.
2) Assess the client's level of consciousness.
3) Notify the healthcare provider immediately.
Page | 4
