HESI RN Medical-Surgical Exam
2025/2026 – Practice Test 90 Multiple-
Choice Questions with Verified Correct
Answers and Explanations
Question 1
A client on telemetry exhibits uncontrolled atrial fibrillation with a rapid ventricular response.
Which intervention does the nurse anticipate? A. Administer lidocaine 75 mg IV push B.
Perform synchronized cardioversion C. Defibrillate the client immediately D. Administer
atropine 0.4 mg IV push
B. Perform synchronized cardioversion Rationale: Synchronized cardioversion is the
treatment of choice for unstable atrial fibrillation to restore normal sinus rhythm. Lidocaine is for
ventricular dysrhythmias (A), defibrillation for ventricular fibrillation (C), and atropine for
bradycardia (D). (Source: ANCC Med-Surg Guidelines)**
Question 2
The nurse is teaching a client diagnosed with GERD. Which instruction should be included? A.
Sleep without pillows B. Eat three full meals daily with no snacks C. Wear loose comfortable
clothing D. Avoid all aerobic exercise
C. Wear loose comfortable clothing Rationale: Loose clothing minimizes abdominal pressure,
reducing reflux. Pillows elevate the head (A), small frequent meals are preferred (B), and
moderate exercise is encouraged (D). (Updated 2025 AORN GI Guidelines)**
Question 3
After hospitalization for SIADH, a client develops pontine myelinolysis. Which electrolyte
imbalance is most associated? A. Hypernatremia B. Hypokalemia C. Rapid correction of
hyponatremia D. Hyperkalemia
,C. Rapid correction of hyponatremia Rationale: Pontine myelinolysis results from overly
rapid sodium correction in SIADH. Other imbalances do not directly cause this (A, B, D). (2025
Endocrine Nursing Updates)**
Question 4
A client post-colon surgery has wound dehiscence. The nurse moistens a sterile dressing and
covers the wound. What is the next action? A. Bring additional sterile dressings B. Prepare for
OR return C. Obtain drainage sample for lab D. Document the event
B. Prepare for OR return Rationale: Dehiscence with evisceration requires immediate surgical
repair. Other actions follow stabilization (A, C, D). (AORN 2025 Wound Care Guidelines)**
Question 5
An overweight client with type 2 DM pre-hernia repair feels weak and jittery. Which actions
should the nurse implement? (Select all that apply) A. Check fingerstick glucose B. Assess skin
temperature and moisture C. Measure pulse and BP D. Document anxiety on checklist E.
Administer insulin
A, B, C Rationale: Symptoms suggest hypoglycemia; assess glucose (A), autonomic signs (B),
and vital signs (C). Anxiety documentation (D) and insulin (E) are inappropriate without
confirmation. (2025 ADA DM Guidelines)**
Question 6
A client with cholelithiasis has a gallstone in the common bile duct and nausea/vomiting with
meals. Which finding requires reporting? A. Belching B. Amber urine C. Yellow sclera D. Clay-
colored stools
C. Yellow sclera Rationale: Jaundice (yellow sclera) indicates biliary obstruction. Belching (A)
is common, amber urine normal (B), clay stools expected (D). (2025 Hepatology Updates)**
Question 7
The nurse assesses a client with acute pancreatitis. Which finding requires immediate
intervention? A. Amylase three times normal B. Severe abdominal pain C. Nausea and vomiting
D. Low-grade fever
, B. Severe abdominal pain Rationale: Uncontrolled pain can lead to complications; manage
first. Labs (A), symptoms (C), and fever (D) are expected but less urgent. (ANCC 2025 Pain
Management)**
Question 8
During admission interview for a client with Parkinson disease, which question elicits key
manifestations? A. Have you experienced paralysis? B. Do you have tremors at rest? C. Have
you fallen recently? D. Do you have constipation?
B. Do you have tremors at rest? Rationale: Resting tremors are hallmark; assess severity.
Paralysis is not typical (A), falls/constipation secondary (C, D). (2025 Neurology Guidelines)**
Question 9
A 55-year-old with COPD asks about risk factors. Which is most significant? A. Family history
B. Smoking history C. Obesity D. Age alone
B. Smoking history Rationale: Smoking is the primary modifiable risk for COPD. Others
contribute but are less direct (A, C, D). (2025 GOLD COPD Guidelines)**
Question 10
Post-liver biopsy, which intervention is most important? A. Position on left side with pillow B.
Assist with immediate voiding C. Monitor vital signs hourly D. Administer pain medication
A. Position on left side with pillow Rationale: Left-side positioning compresses biopsy site to
prevent bleeding. Others are routine (B, C, D). (AORN 2025 Procedure Guidelines)**
Question 11
A client with heart failure reports tight shoes. What additional information is needed? A.
Medication timing B. Recent weight change C. Diet intake D. Activity level
B. Recent weight change Rationale: Weight gain indicates fluid retention/edema. Others less
relevant acutely (A, C, D). (2025 AHA HF Guidelines)**
2025/2026 – Practice Test 90 Multiple-
Choice Questions with Verified Correct
Answers and Explanations
Question 1
A client on telemetry exhibits uncontrolled atrial fibrillation with a rapid ventricular response.
Which intervention does the nurse anticipate? A. Administer lidocaine 75 mg IV push B.
Perform synchronized cardioversion C. Defibrillate the client immediately D. Administer
atropine 0.4 mg IV push
B. Perform synchronized cardioversion Rationale: Synchronized cardioversion is the
treatment of choice for unstable atrial fibrillation to restore normal sinus rhythm. Lidocaine is for
ventricular dysrhythmias (A), defibrillation for ventricular fibrillation (C), and atropine for
bradycardia (D). (Source: ANCC Med-Surg Guidelines)**
Question 2
The nurse is teaching a client diagnosed with GERD. Which instruction should be included? A.
Sleep without pillows B. Eat three full meals daily with no snacks C. Wear loose comfortable
clothing D. Avoid all aerobic exercise
C. Wear loose comfortable clothing Rationale: Loose clothing minimizes abdominal pressure,
reducing reflux. Pillows elevate the head (A), small frequent meals are preferred (B), and
moderate exercise is encouraged (D). (Updated 2025 AORN GI Guidelines)**
Question 3
After hospitalization for SIADH, a client develops pontine myelinolysis. Which electrolyte
imbalance is most associated? A. Hypernatremia B. Hypokalemia C. Rapid correction of
hyponatremia D. Hyperkalemia
,C. Rapid correction of hyponatremia Rationale: Pontine myelinolysis results from overly
rapid sodium correction in SIADH. Other imbalances do not directly cause this (A, B, D). (2025
Endocrine Nursing Updates)**
Question 4
A client post-colon surgery has wound dehiscence. The nurse moistens a sterile dressing and
covers the wound. What is the next action? A. Bring additional sterile dressings B. Prepare for
OR return C. Obtain drainage sample for lab D. Document the event
B. Prepare for OR return Rationale: Dehiscence with evisceration requires immediate surgical
repair. Other actions follow stabilization (A, C, D). (AORN 2025 Wound Care Guidelines)**
Question 5
An overweight client with type 2 DM pre-hernia repair feels weak and jittery. Which actions
should the nurse implement? (Select all that apply) A. Check fingerstick glucose B. Assess skin
temperature and moisture C. Measure pulse and BP D. Document anxiety on checklist E.
Administer insulin
A, B, C Rationale: Symptoms suggest hypoglycemia; assess glucose (A), autonomic signs (B),
and vital signs (C). Anxiety documentation (D) and insulin (E) are inappropriate without
confirmation. (2025 ADA DM Guidelines)**
Question 6
A client with cholelithiasis has a gallstone in the common bile duct and nausea/vomiting with
meals. Which finding requires reporting? A. Belching B. Amber urine C. Yellow sclera D. Clay-
colored stools
C. Yellow sclera Rationale: Jaundice (yellow sclera) indicates biliary obstruction. Belching (A)
is common, amber urine normal (B), clay stools expected (D). (2025 Hepatology Updates)**
Question 7
The nurse assesses a client with acute pancreatitis. Which finding requires immediate
intervention? A. Amylase three times normal B. Severe abdominal pain C. Nausea and vomiting
D. Low-grade fever
, B. Severe abdominal pain Rationale: Uncontrolled pain can lead to complications; manage
first. Labs (A), symptoms (C), and fever (D) are expected but less urgent. (ANCC 2025 Pain
Management)**
Question 8
During admission interview for a client with Parkinson disease, which question elicits key
manifestations? A. Have you experienced paralysis? B. Do you have tremors at rest? C. Have
you fallen recently? D. Do you have constipation?
B. Do you have tremors at rest? Rationale: Resting tremors are hallmark; assess severity.
Paralysis is not typical (A), falls/constipation secondary (C, D). (2025 Neurology Guidelines)**
Question 9
A 55-year-old with COPD asks about risk factors. Which is most significant? A. Family history
B. Smoking history C. Obesity D. Age alone
B. Smoking history Rationale: Smoking is the primary modifiable risk for COPD. Others
contribute but are less direct (A, C, D). (2025 GOLD COPD Guidelines)**
Question 10
Post-liver biopsy, which intervention is most important? A. Position on left side with pillow B.
Assist with immediate voiding C. Monitor vital signs hourly D. Administer pain medication
A. Position on left side with pillow Rationale: Left-side positioning compresses biopsy site to
prevent bleeding. Others are routine (B, C, D). (AORN 2025 Procedure Guidelines)**
Question 11
A client with heart failure reports tight shoes. What additional information is needed? A.
Medication timing B. Recent weight change C. Diet intake D. Activity level
B. Recent weight change Rationale: Weight gain indicates fluid retention/edema. Others less
relevant acutely (A, C, D). (2025 AHA HF Guidelines)**
