HESI EXAM: NUR201 / NUR 201 (LATEST
UPDATE) MEDICAL-SURGICAL NURSING I | QUESTIONS
AND VERIFIED ANSWERS 100% CORRECT | GRADE A -
FORTIS
Fortis College | HESI Medical-Surgical Nursing I | Verified 100% Correct | Grade A Preparation
Fortis College | NUR 201 Medical-Surgical Nursing I | HESI Practice Examination
Latest Update | 150 Questions | Verified Answers | Grade A Preparation
Section Topic Questions
1 Health Assessment & Nursing Process 15
2 Perioperative Nursing 15
3 Fluid, Electrolyte, & Acid-Base Imbalances 15
4 Cardiovascular Disorders 20
5 Respiratory Disorders 18
6 Gastrointestinal Disorders 15
7 Renal & Genitourinary Disorders 15
8 Endocrine Disorders 12
9 Musculoskeletal & Integumentary Disorders 10
10 Pharmacology & Medication Management 15
Total Questions 150
Examination Overview: This comprehensive 150-question HESI practice examination is designed to assess readiness for
the NUR 201 Medical-Surgical Nursing I course examination at Fortis College. The exam aligns with the HESI
Medical-Surgical Nursing Exam Blueprint, NCLEX-RN Test Plan, and Medical-Surgical Nursing I Competencies
(2026/2027 Edition). Cognitive level distribution: 20% recall, 50% application, and 30% analysis. Question style: 75%
scenario-based clinical reasoning items and 25% direct knowledge items. Special inclusions: 20 priority-setting questions,
15 pharmacology-focused items, and 10 laboratory value interpretation items. Each question includes a verified correct
answer and a 2-4 sentence rationale citing the NUR 201 curriculum, HESI blueprint, and NCLEX-RN standards.
Instructions: Read each question carefully. Select the ONE best response from options A through D. The verified correct
answer is marked *[CORRECT]* and listed below each question, followed by the rationale. Use this examination for
self-assessment, content review, and NCLEX-style test-taking practice.
Section 1: Health Assessment & Nursing Process (15 Questions)
Page 1 | NUR 201 HESI Practice Examination | Grade A Preparation
,HESI Exam: NUR 201 Medical-Surgical Nursing I | Fortis College | 2026/2027 Edition
Q1: The nurse is completing a comprehensive health history for a 68-year-old Vietnamese American patient
admitted with new-onset atrial fibrillation. Which approach best demonstrates culturally competent care
during the interview?
A. Speak loudly and slowly to ensure the patient understands the questions, then proceed with the full
assessment.
B. Use a professional medical interpreter, address the patient directly, and observe nonverbal cues such
as nodding or smiling before documenting responses. *[CORRECT]*
C. Ask the patient's eldest family member to translate sensitive cardiac symptoms to preserve cultural respect.
D. Document "non-compliant with interview" if the patient avoids direct eye contact and proceed with the
physical examination.
Correct Answer: B
Rationale: Cultural competence requires use of a qualified medical interpreter (not family, who may filter or distort content),
direct addressing of the patient, and attention to nonverbal communication; in many Vietnamese and other Asian cultures,
avoiding eye contact is a sign of respect rather than non-compliance. The NUR 201 curriculum emphasizes patient-centered,
culturally safe assessment per the ANA Code of Ethics and the NCLEX-RN Test Plan (Psychosocial Integrity). Options A, C, and
D reflect stereotypes, scope violations, or mislabeling of culturally normative behavior.
Q2: A nurse is preparing to perform a focused abdominal assessment on a 54-year-old patient admitted with
right lower quadrant pain. Place the four physical examination techniques in the correct sequence for this
assessment.
A. Auscultation, inspection, percussion, palpation
B. Inspection, auscultation, percussion, palpation *[CORRECT]*
C. Inspection, palpation, percussion, auscultation
D. Percussion, inspection, palpation, auscultation
Correct Answer: B
Rationale: The correct sequence for abdominal assessment is inspection, auscultation, percussion, and palpation, because
palpation and percussion can alter bowel sounds; therefore auscultation must precede them. This is an NCLEX-RN standard
assessment skill (Health Assessment & Nursing Process). Option A starts with auscultation before inspection; C and D use
palpation or percussion before auscultation, which can stimulate or distort peristalsis and produce inaccurate findings.
Q3: A nurse is assessing the vital signs of four patients on a medical-surgical unit. Which finding requires the
nurse to act first using the ABC priority-setting framework?
A. A 72-year-old patient with pneumonia and a respiratory rate of 24 breaths/min
B. A 58-year-old patient with heart failure and a blood pressure of 88/52 mm Hg
C. A 65-year-old patient with COPD and an SpO2 of 88% on room air *[CORRECT]*
D. A 49-year-old patient with diabetes and a heart rate of 112 beats/min
Correct Answer: C
Rationale: Using the ABC (Airway, Breathing, Circulation) framework, the patient with COPD and SpO2 of 88% on room air
has the most immediate threat to oxygenation; chronic COPD patients require careful oxygen titration but 88% requires
intervention to prevent hypoxic injury. Option A (RR 24) is borderline; B (BP 88/52) reflects circulation but is less acute than
hypoxemia; D (HR 112) suggests tachycardia but is not immediately life-threatening. The HESI blueprint and NCLEX-RN Test
Plan emphasize ABC and Maslow priority-setting for first-action questions.
Page 2 | NUR 201 HESI Practice Examination | Grade A Preparation
,HESI Exam: NUR 201 Medical-Surgical Nursing I | Fortis College | 2026/2027 Edition
Q4: A nurse uses SBAR to communicate a change in patient status to the on-call provider. Which statement
by the nurse best reflects the "R" (Recommendation) component?
A. "The patient's blood pressure has dropped from 132/84 to 92/56 over the past two hours."
B. "The patient is a 78-year-old female admitted with pneumonia who started IV antibiotics this morning."
C. "I think the patient may be developing sepsis; I recommend you come evaluate her and consider
ordering a lactate level and a stat fluid bolus." *[CORRECT]*
D. "The patient's heart rate is 118, temperature is 38.8°C, and she reports new-onset confusion."
Correct Answer: C
Rationale: The "R" in SBAR is the Recommendation — what the nurse thinks should happen next, including the suggested
action and proposed orders. Option A is Assessment; B is Situation; D is also Assessment data. The NUR 201 curriculum and
The Joint Commission require structured handoff communication, and HESI tests SBAR application in clinical scenarios.
Q5: A nurse is delegating care for a four-patient assignment to a licensed practical nurse (LPN). Which task is
most appropriate to delegate to the LPN?
A. Initial postoperative teaching for a patient receiving a colostomy for the first time
B. Performing a sterile dressing change on a patient with a stage 4 sacral pressure injury
C. Administering scheduled oral acetaminophen 650 mg to a patient with chronic osteoarthritis pain
*[CORRECT]*
D. Reassessing a patient who is short of breath after a scheduled albuterol treatment
Correct Answer: C
Rationale: Administration of an oral scheduled medication to a stable patient is within the LPN scope of practice. Initial
teaching (A) and reassessment of an unstable respiratory patient (D) require RN-level judgment. A sterile dressing change for a
stage 4 pressure injury (B) is within LPN skill but typically requires RN oversight for wound assessment; most state practice
acts limit LPNs to dressing changes on stable, established wounds. The NUR 201 curriculum and NCLEX-RN Test Plan
(Management of Care) test delegation using the Five Rights: right task, right circumstance, right person, right direction, right
supervision.
Q6: A nurse is documenting a focused pain assessment using the PQRSTU mnemonic for a patient with
chronic low back pain. Which statement by the nurse represents the "S" component?
A. "The pain started three days ago after lifting a heavy box at work."
B. "The pain is described as a sharp, burning sensation that radiates down the left leg." *[CORRECT]*
C. "The pain worsens when the patient sits for more than 30 minutes and improves with walking."
D. "The patient rates the pain as a 7 on a 0-10 numeric rating scale today."
Correct Answer: B
Rationale: In the PQRSTU pain mnemonic, "S" stands for Signs/Symptoms (also called quality or characteristics) — the
descriptive quality of pain (sharp, burning, throbbing). Option A is T (Timing); C is R (Region/Radiation) and provoking
factors; D is severity rating. The NUR 201 curriculum uses PQRSTU for comprehensive pain assessment, consistent with the
NCLEX-RN Test Plan (Basic Care and Comfort).
Page 3 | NUR 201 HESI Practice Examination | Grade A Preparation
, HESI Exam: NUR 201 Medical-Surgical Nursing I | Fortis College | 2026/2027 Edition
Q7: A 45-year-old patient is admitted with acute cholecystitis. Which nursing assessment finding is most
important to report to the provider immediately?
A. Rebound tenderness in the right upper quadrant with a positive Murphy's sign *[CORRECT]*
B. Temperature 37.8°C, heart rate 96, blood pressure 124/78
C. Yellow-tinged sclera noted on inspection of the eyes
D. Pain rated 8/10 in the right upper quadrant after eating a fatty meal
Correct Answer: A
Rationale: Rebound tenderness and a positive Murphy's sign suggest peritoneal inflammation or possible rupture requiring
urgent surgical evaluation; this is the highest-priority finding. Option B is consistent with mild infection but stable. C (scleral
icterus) suggests biliary obstruction but is a chronic finding. D (severe postprandial pain) is expected in cholecystitis but not
emergent alone. The NUR 201 curriculum teaches clinical reasoning using the ABC and acute- versus-chronic frameworks;
peritoneal signs always warrant urgent escalation.
Q8: During a focused respiratory assessment, the nurse auscultates high-pitched, musical, squeaking sounds
primarily during expiration in a patient with a history of asthma. How should the nurse document this
finding?
A. Crackles (rales) in the lower lung fields bilaterally
B. Wheezes bilaterally throughout the expiratory phase *[CORRECT]*
C. Pleural friction rub on the right lateral chest wall
D. Rhonchi (sonorous wheezes) clearing with cough
Correct Answer: B
Rationale: High-pitched, musical, expiratory sounds are wheezes, caused by narrowed airways (bronchoconstriction) typical in
asthma. Option A describes crackles, which are discontinuous sounds from fluid in alveoli; C is a grating rub from inflamed
pleura; D describes rhonchi, low-pitched sounds from larger airway secretions. The NUR 201 Health Assessment module tests
breath sound identification consistent with the NCLEX-RN Test Plan (Reduction of Risk Potential).
Q9: A nurse is preparing to insert a nasogastric (NG) tube for gastric decompression. Which landmark should
the nurse use to measure the insertion length from the nose to the stomach?
A. Measure from the tip of the nose to the earlobe and then to the xiphoid process *[CORRECT]*
B. Measure from the bridge of the nose to the tragus of the ear and then to the umbilicus
C. Measure from the tip of the nose to the angle of the mandible and then to the sternal notch
D. Measure from the bridge of the nose to the earlobe and then to the seventh intercostal space
Correct Answer: A
Rationale: The correct NG tube measurement is from the tip of the nose to the earlobe (tip of the mastoid process) and then
down to the xiphoid process, approximating the distance to the stomach. The NUR 201 perioperative and GI modules emphasize
this measurement as a NCLEX-RN skill (Pharmacological and Parenteral Therapies). The other landmarks do not correspond
to the anatomic distance to the stomach and risk malposition.
Page 4 | NUR 201 HESI Practice Examination | Grade A Preparation
UPDATE) MEDICAL-SURGICAL NURSING I | QUESTIONS
AND VERIFIED ANSWERS 100% CORRECT | GRADE A -
FORTIS
Fortis College | HESI Medical-Surgical Nursing I | Verified 100% Correct | Grade A Preparation
Fortis College | NUR 201 Medical-Surgical Nursing I | HESI Practice Examination
Latest Update | 150 Questions | Verified Answers | Grade A Preparation
Section Topic Questions
1 Health Assessment & Nursing Process 15
2 Perioperative Nursing 15
3 Fluid, Electrolyte, & Acid-Base Imbalances 15
4 Cardiovascular Disorders 20
5 Respiratory Disorders 18
6 Gastrointestinal Disorders 15
7 Renal & Genitourinary Disorders 15
8 Endocrine Disorders 12
9 Musculoskeletal & Integumentary Disorders 10
10 Pharmacology & Medication Management 15
Total Questions 150
Examination Overview: This comprehensive 150-question HESI practice examination is designed to assess readiness for
the NUR 201 Medical-Surgical Nursing I course examination at Fortis College. The exam aligns with the HESI
Medical-Surgical Nursing Exam Blueprint, NCLEX-RN Test Plan, and Medical-Surgical Nursing I Competencies
(2026/2027 Edition). Cognitive level distribution: 20% recall, 50% application, and 30% analysis. Question style: 75%
scenario-based clinical reasoning items and 25% direct knowledge items. Special inclusions: 20 priority-setting questions,
15 pharmacology-focused items, and 10 laboratory value interpretation items. Each question includes a verified correct
answer and a 2-4 sentence rationale citing the NUR 201 curriculum, HESI blueprint, and NCLEX-RN standards.
Instructions: Read each question carefully. Select the ONE best response from options A through D. The verified correct
answer is marked *[CORRECT]* and listed below each question, followed by the rationale. Use this examination for
self-assessment, content review, and NCLEX-style test-taking practice.
Section 1: Health Assessment & Nursing Process (15 Questions)
Page 1 | NUR 201 HESI Practice Examination | Grade A Preparation
,HESI Exam: NUR 201 Medical-Surgical Nursing I | Fortis College | 2026/2027 Edition
Q1: The nurse is completing a comprehensive health history for a 68-year-old Vietnamese American patient
admitted with new-onset atrial fibrillation. Which approach best demonstrates culturally competent care
during the interview?
A. Speak loudly and slowly to ensure the patient understands the questions, then proceed with the full
assessment.
B. Use a professional medical interpreter, address the patient directly, and observe nonverbal cues such
as nodding or smiling before documenting responses. *[CORRECT]*
C. Ask the patient's eldest family member to translate sensitive cardiac symptoms to preserve cultural respect.
D. Document "non-compliant with interview" if the patient avoids direct eye contact and proceed with the
physical examination.
Correct Answer: B
Rationale: Cultural competence requires use of a qualified medical interpreter (not family, who may filter or distort content),
direct addressing of the patient, and attention to nonverbal communication; in many Vietnamese and other Asian cultures,
avoiding eye contact is a sign of respect rather than non-compliance. The NUR 201 curriculum emphasizes patient-centered,
culturally safe assessment per the ANA Code of Ethics and the NCLEX-RN Test Plan (Psychosocial Integrity). Options A, C, and
D reflect stereotypes, scope violations, or mislabeling of culturally normative behavior.
Q2: A nurse is preparing to perform a focused abdominal assessment on a 54-year-old patient admitted with
right lower quadrant pain. Place the four physical examination techniques in the correct sequence for this
assessment.
A. Auscultation, inspection, percussion, palpation
B. Inspection, auscultation, percussion, palpation *[CORRECT]*
C. Inspection, palpation, percussion, auscultation
D. Percussion, inspection, palpation, auscultation
Correct Answer: B
Rationale: The correct sequence for abdominal assessment is inspection, auscultation, percussion, and palpation, because
palpation and percussion can alter bowel sounds; therefore auscultation must precede them. This is an NCLEX-RN standard
assessment skill (Health Assessment & Nursing Process). Option A starts with auscultation before inspection; C and D use
palpation or percussion before auscultation, which can stimulate or distort peristalsis and produce inaccurate findings.
Q3: A nurse is assessing the vital signs of four patients on a medical-surgical unit. Which finding requires the
nurse to act first using the ABC priority-setting framework?
A. A 72-year-old patient with pneumonia and a respiratory rate of 24 breaths/min
B. A 58-year-old patient with heart failure and a blood pressure of 88/52 mm Hg
C. A 65-year-old patient with COPD and an SpO2 of 88% on room air *[CORRECT]*
D. A 49-year-old patient with diabetes and a heart rate of 112 beats/min
Correct Answer: C
Rationale: Using the ABC (Airway, Breathing, Circulation) framework, the patient with COPD and SpO2 of 88% on room air
has the most immediate threat to oxygenation; chronic COPD patients require careful oxygen titration but 88% requires
intervention to prevent hypoxic injury. Option A (RR 24) is borderline; B (BP 88/52) reflects circulation but is less acute than
hypoxemia; D (HR 112) suggests tachycardia but is not immediately life-threatening. The HESI blueprint and NCLEX-RN Test
Plan emphasize ABC and Maslow priority-setting for first-action questions.
Page 2 | NUR 201 HESI Practice Examination | Grade A Preparation
,HESI Exam: NUR 201 Medical-Surgical Nursing I | Fortis College | 2026/2027 Edition
Q4: A nurse uses SBAR to communicate a change in patient status to the on-call provider. Which statement
by the nurse best reflects the "R" (Recommendation) component?
A. "The patient's blood pressure has dropped from 132/84 to 92/56 over the past two hours."
B. "The patient is a 78-year-old female admitted with pneumonia who started IV antibiotics this morning."
C. "I think the patient may be developing sepsis; I recommend you come evaluate her and consider
ordering a lactate level and a stat fluid bolus." *[CORRECT]*
D. "The patient's heart rate is 118, temperature is 38.8°C, and she reports new-onset confusion."
Correct Answer: C
Rationale: The "R" in SBAR is the Recommendation — what the nurse thinks should happen next, including the suggested
action and proposed orders. Option A is Assessment; B is Situation; D is also Assessment data. The NUR 201 curriculum and
The Joint Commission require structured handoff communication, and HESI tests SBAR application in clinical scenarios.
Q5: A nurse is delegating care for a four-patient assignment to a licensed practical nurse (LPN). Which task is
most appropriate to delegate to the LPN?
A. Initial postoperative teaching for a patient receiving a colostomy for the first time
B. Performing a sterile dressing change on a patient with a stage 4 sacral pressure injury
C. Administering scheduled oral acetaminophen 650 mg to a patient with chronic osteoarthritis pain
*[CORRECT]*
D. Reassessing a patient who is short of breath after a scheduled albuterol treatment
Correct Answer: C
Rationale: Administration of an oral scheduled medication to a stable patient is within the LPN scope of practice. Initial
teaching (A) and reassessment of an unstable respiratory patient (D) require RN-level judgment. A sterile dressing change for a
stage 4 pressure injury (B) is within LPN skill but typically requires RN oversight for wound assessment; most state practice
acts limit LPNs to dressing changes on stable, established wounds. The NUR 201 curriculum and NCLEX-RN Test Plan
(Management of Care) test delegation using the Five Rights: right task, right circumstance, right person, right direction, right
supervision.
Q6: A nurse is documenting a focused pain assessment using the PQRSTU mnemonic for a patient with
chronic low back pain. Which statement by the nurse represents the "S" component?
A. "The pain started three days ago after lifting a heavy box at work."
B. "The pain is described as a sharp, burning sensation that radiates down the left leg." *[CORRECT]*
C. "The pain worsens when the patient sits for more than 30 minutes and improves with walking."
D. "The patient rates the pain as a 7 on a 0-10 numeric rating scale today."
Correct Answer: B
Rationale: In the PQRSTU pain mnemonic, "S" stands for Signs/Symptoms (also called quality or characteristics) — the
descriptive quality of pain (sharp, burning, throbbing). Option A is T (Timing); C is R (Region/Radiation) and provoking
factors; D is severity rating. The NUR 201 curriculum uses PQRSTU for comprehensive pain assessment, consistent with the
NCLEX-RN Test Plan (Basic Care and Comfort).
Page 3 | NUR 201 HESI Practice Examination | Grade A Preparation
, HESI Exam: NUR 201 Medical-Surgical Nursing I | Fortis College | 2026/2027 Edition
Q7: A 45-year-old patient is admitted with acute cholecystitis. Which nursing assessment finding is most
important to report to the provider immediately?
A. Rebound tenderness in the right upper quadrant with a positive Murphy's sign *[CORRECT]*
B. Temperature 37.8°C, heart rate 96, blood pressure 124/78
C. Yellow-tinged sclera noted on inspection of the eyes
D. Pain rated 8/10 in the right upper quadrant after eating a fatty meal
Correct Answer: A
Rationale: Rebound tenderness and a positive Murphy's sign suggest peritoneal inflammation or possible rupture requiring
urgent surgical evaluation; this is the highest-priority finding. Option B is consistent with mild infection but stable. C (scleral
icterus) suggests biliary obstruction but is a chronic finding. D (severe postprandial pain) is expected in cholecystitis but not
emergent alone. The NUR 201 curriculum teaches clinical reasoning using the ABC and acute- versus-chronic frameworks;
peritoneal signs always warrant urgent escalation.
Q8: During a focused respiratory assessment, the nurse auscultates high-pitched, musical, squeaking sounds
primarily during expiration in a patient with a history of asthma. How should the nurse document this
finding?
A. Crackles (rales) in the lower lung fields bilaterally
B. Wheezes bilaterally throughout the expiratory phase *[CORRECT]*
C. Pleural friction rub on the right lateral chest wall
D. Rhonchi (sonorous wheezes) clearing with cough
Correct Answer: B
Rationale: High-pitched, musical, expiratory sounds are wheezes, caused by narrowed airways (bronchoconstriction) typical in
asthma. Option A describes crackles, which are discontinuous sounds from fluid in alveoli; C is a grating rub from inflamed
pleura; D describes rhonchi, low-pitched sounds from larger airway secretions. The NUR 201 Health Assessment module tests
breath sound identification consistent with the NCLEX-RN Test Plan (Reduction of Risk Potential).
Q9: A nurse is preparing to insert a nasogastric (NG) tube for gastric decompression. Which landmark should
the nurse use to measure the insertion length from the nose to the stomach?
A. Measure from the tip of the nose to the earlobe and then to the xiphoid process *[CORRECT]*
B. Measure from the bridge of the nose to the tragus of the ear and then to the umbilicus
C. Measure from the tip of the nose to the angle of the mandible and then to the sternal notch
D. Measure from the bridge of the nose to the earlobe and then to the seventh intercostal space
Correct Answer: A
Rationale: The correct NG tube measurement is from the tip of the nose to the earlobe (tip of the mastoid process) and then
down to the xiphoid process, approximating the distance to the stomach. The NUR 201 perioperative and GI modules emphasize
this measurement as a NCLEX-RN skill (Pharmacological and Parenteral Therapies). The other landmarks do not correspond
to the anatomic distance to the stomach and risk malposition.
Page 4 | NUR 201 HESI Practice Examination | Grade A Preparation
