HESI Med-Surg PN Specialty
Exam 2026 (V1 & V2)
55 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Cardiovascular
2 Respiratory
3 Renal & Fluid/Electrolyte
4 Endocrine
5 Gastrointestinal
6 Neurological
7 Musculoskeletal & Perioperative
8 Wound & Skin Care
9 PN Scope & Prioritization
Page 1
,Q1
A client with heart failure has gained 2 kg since yesterday and reports new shortness of
breath when lying flat. Which action should the PN take first?
A) Restrict the client's oral fluids
B) Administer a PRN diuretic without an order
C) *Elevate the head of the bed and report the findings to the RN CORRECT
D) Document the weight and reassess the next shift
Rationale
Positioning improves breathing immediately; new fluid overload findings must be reported to the
RN.
Q2
A client with COPD has an oxygen saturation of 90% on 2 L/min via nasal cannula and is
alert. Which action should the PN take?
A) *Continue the ordered oxygen and recheck the saturation in 30 minutes CORRECT
B) Increase the oxygen to 6 L/min
C) Discontinue the oxygen and encourage coughing
D) Place the client flat and reassess in 1 hour
Rationale
SpO2 90% is within the 88–92% target for COPD; never adjust oxygen without an order.
Q3
A client is 2 days post-operative and the PN notes the incision edges are separating with
intact tissue beneath. Which action should the PN take first?
A) Push the tissue back into place
B) Apply a tight pressure dressing
C) Irrigate the wound with hydrogen peroxide
Page 2
, D) *Cover the wound with a sterile saline-moistened dressing and notify
CORRECT
the RN
Rationale
This is dehiscence; moist sterile covering protects tissue while the RN and provider are notified.
Q4
A client with type 1 diabetes has a blood glucose of 48 mg/dL and is awake and able to
swallow. Which action should the PN take first?
A) Administer the scheduled insulin dose
B) *Give 15 grams of a fast-acting carbohydrate such as 4 oz of juice CORRECT
C) Start an IV line for dextrose
D) Wait 30 minutes and recheck the glucose
Rationale
Conscious hypoglycemia is treated orally first, followed by a recheck in 15 minutes.
Q5
A client is receiving a continuous heparin infusion. Which laboratory value should the PN
expect the RN to review before the next dose adjustment?
A) *Activated partial thromboplastin time (aPTT) CORRECT
B) Prothrombin time (PT)
C) International normalized ratio (INR)
D) Bleeding time
Rationale
aPTT monitors unfractionated heparin therapy; PT/INR monitor warfarin.
Page 3
Exam 2026 (V1 & V2)
55 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Cardiovascular
2 Respiratory
3 Renal & Fluid/Electrolyte
4 Endocrine
5 Gastrointestinal
6 Neurological
7 Musculoskeletal & Perioperative
8 Wound & Skin Care
9 PN Scope & Prioritization
Page 1
,Q1
A client with heart failure has gained 2 kg since yesterday and reports new shortness of
breath when lying flat. Which action should the PN take first?
A) Restrict the client's oral fluids
B) Administer a PRN diuretic without an order
C) *Elevate the head of the bed and report the findings to the RN CORRECT
D) Document the weight and reassess the next shift
Rationale
Positioning improves breathing immediately; new fluid overload findings must be reported to the
RN.
Q2
A client with COPD has an oxygen saturation of 90% on 2 L/min via nasal cannula and is
alert. Which action should the PN take?
A) *Continue the ordered oxygen and recheck the saturation in 30 minutes CORRECT
B) Increase the oxygen to 6 L/min
C) Discontinue the oxygen and encourage coughing
D) Place the client flat and reassess in 1 hour
Rationale
SpO2 90% is within the 88–92% target for COPD; never adjust oxygen without an order.
Q3
A client is 2 days post-operative and the PN notes the incision edges are separating with
intact tissue beneath. Which action should the PN take first?
A) Push the tissue back into place
B) Apply a tight pressure dressing
C) Irrigate the wound with hydrogen peroxide
Page 2
, D) *Cover the wound with a sterile saline-moistened dressing and notify
CORRECT
the RN
Rationale
This is dehiscence; moist sterile covering protects tissue while the RN and provider are notified.
Q4
A client with type 1 diabetes has a blood glucose of 48 mg/dL and is awake and able to
swallow. Which action should the PN take first?
A) Administer the scheduled insulin dose
B) *Give 15 grams of a fast-acting carbohydrate such as 4 oz of juice CORRECT
C) Start an IV line for dextrose
D) Wait 30 minutes and recheck the glucose
Rationale
Conscious hypoglycemia is treated orally first, followed by a recheck in 15 minutes.
Q5
A client is receiving a continuous heparin infusion. Which laboratory value should the PN
expect the RN to review before the next dose adjustment?
A) *Activated partial thromboplastin time (aPTT) CORRECT
B) Prothrombin time (PT)
C) International normalized ratio (INR)
D) Bleeding time
Rationale
aPTT monitors unfractionated heparin therapy; PT/INR monitor warfarin.
Page 3
