PN MEDICAL SURGICAL HESI EXIT EXAM PREP
2025/2026 | PRACTICAL NURSING HESI MED SURG TEST
BANK | 250+ VERIFIED QUESTIONS WITH CORRECT
ANSWERS & RATIONALES
1. A nurse is caring for a patient with heart failure. Which symptom would indicate
worsening heart failure?
(A) Improved exercise tolerance
(B) Increased fatigue
(C) Stable weight
(D) Normal heart rate
Rationale: Increased fatigue may indicate fluid overload or worsening heart function
due to decreased cardiac output. This symptom suggests that the heart cannot
effectively pump blood, leading to inadequate perfusion and energy levels.
2. A patient with diabetes is being educated about dietary management. Which
statement indicates a need for further teaching?
(A) "I need to monitor my carbohydrate intake."
(B) "I can eat as much sugar as I want if I take my insulin."
(C) "I should follow a meal plan."
(D) "I can skip meals if I feel fine."
Rationale: This statement reflects a misunderstanding of how insulin works.
Consuming excessive sugar can lead to hyperglycemia, regardless of insulin
administration. Patients must balance their carbohydrate intake with their medication
regimen.
3. A nurse is assessing a patient with chronic obstructive pulmonary disease
(COPD). Which finding is most concerning?
(A) Sudden change in mental status
(B) Increased sputum production
(C) Mild wheezing
(D) Productive cough
Rationale: A sudden change in mental status may indicate severe hypoxia or carbon
dioxide retention, both of which require immediate intervention. This finding suggests a
critical decline in respiratory function.
4. A patient with pneumonia is receiving antibiotics. Which finding indicates a
positive response to treatment?
,(A) Increased respiratory rate
(B) Decreased fever
(C) Increased sputum production
(D) Persistent cough
Rationale: A decreased fever is a key indicator that the body is responding to antibiotics
and that the infection is resolving. This reflects a reduction in the inflammatory
response associated with infection.
5. A patient with a history of seizures is being discharged. What is the priority
teaching point?
(A) Avoid driving until cleared by your doctor.
(B) "You can stop taking your medication if you feel fine."
(C) "You should avoid all physical activity."
(D) "You don’t need to follow up with your doctor."
Rationale: Safety is paramount for patients with a history of seizures. Driving can pose
a risk to the patient and others until the doctor confirms that seizures are well-
controlled. Patients should not discontinue medication without consulting their
healthcare provider.
6. A nurse is caring for a patient after a laparoscopic cholecystectomy. What is a
common expected outcome in the immediate postoperative period?
(A) Increased abdominal pain
(B) Minimal discomfort
(C) Severe nausea
(D) Jaundice
Rationale: Laparoscopic surgeries generally result in less postoperative pain and
discomfort due to smaller incisions. Patients often have a quicker recovery compared to
open surgeries.
7. A nurse is monitoring a patient receiving heparin. Which lab test should the
nurse monitor?
(A) Prothrombin time (PT)
(B) Activated partial thromboplastin time (aPTT)
(C) International normalized ratio (INR)
(D) Platelet count
Rationale: aPTT is used to monitor the anticoagulant effect of heparin therapy. It
assesses the intrinsic pathway of coagulation and helps prevent thrombotic
complications.
,8. A patient with chronic heart failure is experiencing dyspnea. What is the best
position for the nurse to place the patient in?
(A) Supine
(B) High Fowler’s
(C) Lateral
(D) Prone
Rationale: High Fowler's position helps alleviate dyspnea by allowing for better lung
expansion and reducing pressure on the diaphragm. This position facilitates improved
oxygenation and respiratory effort.
9. A nurse is teaching a patient about the side effects of corticosteroids. Which
statement indicates a need for further teaching?
(A) "I may experience weight gain."
(B) "I can stop taking my medication when I feel better."
(C) "I need to monitor my blood sugar levels."
(D) "I should take this medication with food."
Rationale: Corticosteroids should not be discontinued abruptly, as this can lead to
withdrawal symptoms. Patients must taper off the medication under medical
supervision to avoid adrenal crisis.
10. A patient with chronic kidney disease is prescribed erythropoietin. What is the
priority nursing assessment?
(A) Blood pressure
(B) Hemoglobin levels
(C) Serum electrolytes
(D) Urine output
Rationale: Monitoring hemoglobin levels is essential to assess the effectiveness of
erythropoietin therapy, which is used to treat anemia associated with chronic kidney
disease.
11. A nurse is providing discharge instructions for a patient with heart failure.
Which statement indicates a need for further teaching?
(A) "I will monitor my weight daily."
(B) "I can eat as much salt as I want."
(C) "I need to take my medications as prescribed."
(D) "I should report any sudden increase in swelling."
Rationale: Patients with heart failure should limit salt intake to manage fluid retention
and reduce the risk of exacerbations.
, 12. A nurse is assessing a patient with a respiratory infection. Which finding would
indicate a potential complication?
(A) Productive cough
(B) Chest pain with breathing
(C) Mild fever
(D) Normal oxygen saturation
Rationale: Chest pain with breathing may indicate pleuritic pain or potential pleural
effusion, which could signify a complication requiring further evaluation.
13. A patient is diagnosed with a urinary tract infection. Which symptom would the
nurse expect to find?
(A) Dysuria
(B) Decreased urination
(C) Increased appetite
(D) Weight gain
Rationale: Dysuria, or painful urination, is a common symptom of a urinary tract
infection due to inflammation of the bladder lining.
14. A nurse is caring for a patient with chronic kidney disease. Which lab value is a
priority to monitor?
(A) Sodium
(B) Potassium
(C) Calcium
(D) Phosphorus
Rationale: Elevated potassium levels can lead to dangerous cardiac complications
such as arrhythmias. Monitoring potassium is crucial for patient safety.
15. A nurse is teaching a patient about managing chronic obstructive pulmonary
disease (COPD). Which statement indicates effective teaching?
(A) "I should avoid respiratory irritants."
(B) "I need to participate in pulmonary rehabilitation."
(C) "I can stop using my medications when I feel better."
(D) "I should monitor my symptoms regularly."
Rationale: Ongoing management and rehabilitation are essential components of
effective COPD management, improving quality of life and functional status.
2025/2026 | PRACTICAL NURSING HESI MED SURG TEST
BANK | 250+ VERIFIED QUESTIONS WITH CORRECT
ANSWERS & RATIONALES
1. A nurse is caring for a patient with heart failure. Which symptom would indicate
worsening heart failure?
(A) Improved exercise tolerance
(B) Increased fatigue
(C) Stable weight
(D) Normal heart rate
Rationale: Increased fatigue may indicate fluid overload or worsening heart function
due to decreased cardiac output. This symptom suggests that the heart cannot
effectively pump blood, leading to inadequate perfusion and energy levels.
2. A patient with diabetes is being educated about dietary management. Which
statement indicates a need for further teaching?
(A) "I need to monitor my carbohydrate intake."
(B) "I can eat as much sugar as I want if I take my insulin."
(C) "I should follow a meal plan."
(D) "I can skip meals if I feel fine."
Rationale: This statement reflects a misunderstanding of how insulin works.
Consuming excessive sugar can lead to hyperglycemia, regardless of insulin
administration. Patients must balance their carbohydrate intake with their medication
regimen.
3. A nurse is assessing a patient with chronic obstructive pulmonary disease
(COPD). Which finding is most concerning?
(A) Sudden change in mental status
(B) Increased sputum production
(C) Mild wheezing
(D) Productive cough
Rationale: A sudden change in mental status may indicate severe hypoxia or carbon
dioxide retention, both of which require immediate intervention. This finding suggests a
critical decline in respiratory function.
4. A patient with pneumonia is receiving antibiotics. Which finding indicates a
positive response to treatment?
,(A) Increased respiratory rate
(B) Decreased fever
(C) Increased sputum production
(D) Persistent cough
Rationale: A decreased fever is a key indicator that the body is responding to antibiotics
and that the infection is resolving. This reflects a reduction in the inflammatory
response associated with infection.
5. A patient with a history of seizures is being discharged. What is the priority
teaching point?
(A) Avoid driving until cleared by your doctor.
(B) "You can stop taking your medication if you feel fine."
(C) "You should avoid all physical activity."
(D) "You don’t need to follow up with your doctor."
Rationale: Safety is paramount for patients with a history of seizures. Driving can pose
a risk to the patient and others until the doctor confirms that seizures are well-
controlled. Patients should not discontinue medication without consulting their
healthcare provider.
6. A nurse is caring for a patient after a laparoscopic cholecystectomy. What is a
common expected outcome in the immediate postoperative period?
(A) Increased abdominal pain
(B) Minimal discomfort
(C) Severe nausea
(D) Jaundice
Rationale: Laparoscopic surgeries generally result in less postoperative pain and
discomfort due to smaller incisions. Patients often have a quicker recovery compared to
open surgeries.
7. A nurse is monitoring a patient receiving heparin. Which lab test should the
nurse monitor?
(A) Prothrombin time (PT)
(B) Activated partial thromboplastin time (aPTT)
(C) International normalized ratio (INR)
(D) Platelet count
Rationale: aPTT is used to monitor the anticoagulant effect of heparin therapy. It
assesses the intrinsic pathway of coagulation and helps prevent thrombotic
complications.
,8. A patient with chronic heart failure is experiencing dyspnea. What is the best
position for the nurse to place the patient in?
(A) Supine
(B) High Fowler’s
(C) Lateral
(D) Prone
Rationale: High Fowler's position helps alleviate dyspnea by allowing for better lung
expansion and reducing pressure on the diaphragm. This position facilitates improved
oxygenation and respiratory effort.
9. A nurse is teaching a patient about the side effects of corticosteroids. Which
statement indicates a need for further teaching?
(A) "I may experience weight gain."
(B) "I can stop taking my medication when I feel better."
(C) "I need to monitor my blood sugar levels."
(D) "I should take this medication with food."
Rationale: Corticosteroids should not be discontinued abruptly, as this can lead to
withdrawal symptoms. Patients must taper off the medication under medical
supervision to avoid adrenal crisis.
10. A patient with chronic kidney disease is prescribed erythropoietin. What is the
priority nursing assessment?
(A) Blood pressure
(B) Hemoglobin levels
(C) Serum electrolytes
(D) Urine output
Rationale: Monitoring hemoglobin levels is essential to assess the effectiveness of
erythropoietin therapy, which is used to treat anemia associated with chronic kidney
disease.
11. A nurse is providing discharge instructions for a patient with heart failure.
Which statement indicates a need for further teaching?
(A) "I will monitor my weight daily."
(B) "I can eat as much salt as I want."
(C) "I need to take my medications as prescribed."
(D) "I should report any sudden increase in swelling."
Rationale: Patients with heart failure should limit salt intake to manage fluid retention
and reduce the risk of exacerbations.
, 12. A nurse is assessing a patient with a respiratory infection. Which finding would
indicate a potential complication?
(A) Productive cough
(B) Chest pain with breathing
(C) Mild fever
(D) Normal oxygen saturation
Rationale: Chest pain with breathing may indicate pleuritic pain or potential pleural
effusion, which could signify a complication requiring further evaluation.
13. A patient is diagnosed with a urinary tract infection. Which symptom would the
nurse expect to find?
(A) Dysuria
(B) Decreased urination
(C) Increased appetite
(D) Weight gain
Rationale: Dysuria, or painful urination, is a common symptom of a urinary tract
infection due to inflammation of the bladder lining.
14. A nurse is caring for a patient with chronic kidney disease. Which lab value is a
priority to monitor?
(A) Sodium
(B) Potassium
(C) Calcium
(D) Phosphorus
Rationale: Elevated potassium levels can lead to dangerous cardiac complications
such as arrhythmias. Monitoring potassium is crucial for patient safety.
15. A nurse is teaching a patient about managing chronic obstructive pulmonary
disease (COPD). Which statement indicates effective teaching?
(A) "I should avoid respiratory irritants."
(B) "I need to participate in pulmonary rehabilitation."
(C) "I can stop using my medications when I feel better."
(D) "I should monitor my symptoms regularly."
Rationale: Ongoing management and rehabilitation are essential components of
effective COPD management, improving quality of life and functional status.
