EVOLVE ELSEVIER HESI MED SURG ACTUAL EXAM
WITH 150 REAL EXAM QUESTIONS AND CORRECT
ANSWERS WITH WELL-ELABORATED RATIONALES/
EVOLVE HESI MEDICAL SURGICAL LATEST EXAM 2026
(BRAND NEW!!)
The HESI Med-Surg Exam is a high-stakes, comprehensive assessment used in nursing programs to
evaluate students’ clinical readiness for licensure and practice. This 2025 updated version offers 150
actual-style exam questions that reflect HESI’s rigorous format, including prioritization and clinical
decision-making questions. Each item includes a thorough rationale, helping students not only select the
correct answer but understand the "why" behind it—a key to building clinical judgment and confidence.
Key Content Areas:
• Cardiovascular & Respiratory Disorders
• Neurological & Endocrine Conditions
• Renal & GI System Care
• Musculoskeletal & Immune Disorders
• Wound Care & Integumentary Conditions
• Electrolyte & Fluid Imbalances
• Nursing Prioritization & Delegation
• Lab Value Interpretation & Critical Thinking
Best For:
• Nursing students preparing for the HESI Exit or Mid-Curricular Exam
• NCLEX candidates wanting additional Med-Surg-focused prep
• Students aiming to master clinical scenarios and real-world application
• Faculty and tutors seeking reliable HESI-aligned content
,When educating a client after a total laryngectomy, which instruction would be most important for the
nurse to include in the discharge teaching?
A. Recommend that the client carry suction equipment at all times.
B. Instruct the client to have writing materials with him at all times.
C. Tell the client to carry a medical alert card that explains his condition.
D. Caution the client not to travel outside the United States alone.
C
Rationale: Neck breathers carry a medical alert card that notifies health care personnel of the need to
use mouth to stoma breathing in the event of a cardiac arrest in this client. Mouth to mouth
resuscitation will not establish a patent airway. Options A and D are not necessary. There are many
alternative means of communication for clients who have had a laryngectomy; dependence on writing
messages is probably the least effective.
The nurse is caring for a client with a fractured right elbow. Which assessment finding has the highest
priority and requires immediate intervention?
A.Ecchymosis over the right elbow area B.Deep
unrelenting pain in the right armC.
An edematous right elbowD.
The presence of crepitus in the right elbow
B
Rationale: Compartment syndrome is a condition involving increased pressure and constriction of the
nerves and vessels within an anatomic compartment, causing pain uncontrolled by opioids and
neurovascular compromise. Option A is an expected finding. Option C related to compartment syndrome
cannot be seen, and any visible edema is an expected finding related to the injury. Option D is an
expected finding.
A 43-year-old homeless, malnourished female client with a history of alcoholism is transferred to the
ICU. She is placed on telemetry, and the rhythm strip shown is obtained. The nurse palpates a heart rate
of 160 beats/min, and the client's blood pressure is 90/54 mm Hg. Based on these findings, which IV
medication should the nurse administer?
A.Amiodarone (Cordarone)
B.Magnesium sulfate
C.Lidocaine (Xylocaine)
,D.Procainamide (Pronestyl)
B
Rationale: Because the client has chronic alcoholism, she is likely to have hypomagnesemia. Option B is
the recommended drug for torsades de pointes, which is a form of polymorphic ventricular tachycardia
(VT) usually associated with a prolonged QT interval that occurs with hypomagnesemia. Options A and D
increase the QT interval, which can cause the torsades to worsen. Option C is the antiarrhythmic of
choice in most cases of drug-induced monomorphic VT, not torsades.
We have an expert-written solution to this problem!
The nurse is caring for a client who is one day post-acute myocardial infarction. The client is receiving
oxygen at 2 L/min via nasal cannula and has a peripheral saline lock. The nurse notes that the client is
having eight premature ventricular contractions (PVCs) per minute. Which intervention should the nurse
implement first?
A.Obtain an IV pump for antiarrhythmic infusion.
B.Increase the client's oxygen flow rate.
C.Prepare for immediate countershock.
D.Gather equipment for endotracheal intubation.
B
Rationale: Increasing the oxygen flow rate provides more oxygen to the client's myocardium and may
decrease myocardial irritability as manifested by the frequent PVCs. Option A can be delegated and is a
lower priority action than option B. Defibrillation may eventually be necessary, but option C is not the
immediate treatment for frequent PVCs. Option D may become necessary if the client stops breathing
but is not indicated at this time.
The nurse is caring for a client with a chest tube to water seal drainage that was inserted 10 days ago
because of a ruptured bullae and pneumothorax. Which finding should the nurse report to the health
care provider before the chest tube is removed? A.
Tidaling of water in water seal chamber B.
Bilateral mufled breath sounds at bases C.
, Temperature of 101° F D.
Absence of chest tube drainage for 2 days
A
Rationale: Tidaling (rising and falling of water with respirations) in the water seal chamber should be
reported to the health care provider before the chest tube is removed to rule out an unresolved
pneumothorax or persistent air leak, which is characteristic of a ruptured bullae caused by abnormally
wide changes in negative intrathoracic pressure. Option B may indicate hypoventilation from chest tube
discomfort and usually improves when the chest tube is removed. Option C usually indicates an
infection, which may not be related to the chest tube. Option D is an expected finding.
A 77-year-old female client is admitted to the hospital with confusion and anorexia of several days'
duration. She has symptoms of nausea and vomiting and is currently complaining of a headache. The
client's pulse rate is 43 beats/min. The nurse is most concerned about the client's history related to
which medication?
A.
Warfarin
B.
Ibuprofen
C.
Nitroglycerin D.
Digoxin
D
Rationale: Older persons are particularly susceptible to the buildup of cardiac glycosides, such as digoxin
or digitoxin (medications derived from digitalis), to a toxic level in their systems. Toxicity can cause
anorexia, nausea, vomiting, diarrhea, headache, and fatigue. Options A, B, and C are unlikely to result in
the symptoms described.
WITH 150 REAL EXAM QUESTIONS AND CORRECT
ANSWERS WITH WELL-ELABORATED RATIONALES/
EVOLVE HESI MEDICAL SURGICAL LATEST EXAM 2026
(BRAND NEW!!)
The HESI Med-Surg Exam is a high-stakes, comprehensive assessment used in nursing programs to
evaluate students’ clinical readiness for licensure and practice. This 2025 updated version offers 150
actual-style exam questions that reflect HESI’s rigorous format, including prioritization and clinical
decision-making questions. Each item includes a thorough rationale, helping students not only select the
correct answer but understand the "why" behind it—a key to building clinical judgment and confidence.
Key Content Areas:
• Cardiovascular & Respiratory Disorders
• Neurological & Endocrine Conditions
• Renal & GI System Care
• Musculoskeletal & Immune Disorders
• Wound Care & Integumentary Conditions
• Electrolyte & Fluid Imbalances
• Nursing Prioritization & Delegation
• Lab Value Interpretation & Critical Thinking
Best For:
• Nursing students preparing for the HESI Exit or Mid-Curricular Exam
• NCLEX candidates wanting additional Med-Surg-focused prep
• Students aiming to master clinical scenarios and real-world application
• Faculty and tutors seeking reliable HESI-aligned content
,When educating a client after a total laryngectomy, which instruction would be most important for the
nurse to include in the discharge teaching?
A. Recommend that the client carry suction equipment at all times.
B. Instruct the client to have writing materials with him at all times.
C. Tell the client to carry a medical alert card that explains his condition.
D. Caution the client not to travel outside the United States alone.
C
Rationale: Neck breathers carry a medical alert card that notifies health care personnel of the need to
use mouth to stoma breathing in the event of a cardiac arrest in this client. Mouth to mouth
resuscitation will not establish a patent airway. Options A and D are not necessary. There are many
alternative means of communication for clients who have had a laryngectomy; dependence on writing
messages is probably the least effective.
The nurse is caring for a client with a fractured right elbow. Which assessment finding has the highest
priority and requires immediate intervention?
A.Ecchymosis over the right elbow area B.Deep
unrelenting pain in the right armC.
An edematous right elbowD.
The presence of crepitus in the right elbow
B
Rationale: Compartment syndrome is a condition involving increased pressure and constriction of the
nerves and vessels within an anatomic compartment, causing pain uncontrolled by opioids and
neurovascular compromise. Option A is an expected finding. Option C related to compartment syndrome
cannot be seen, and any visible edema is an expected finding related to the injury. Option D is an
expected finding.
A 43-year-old homeless, malnourished female client with a history of alcoholism is transferred to the
ICU. She is placed on telemetry, and the rhythm strip shown is obtained. The nurse palpates a heart rate
of 160 beats/min, and the client's blood pressure is 90/54 mm Hg. Based on these findings, which IV
medication should the nurse administer?
A.Amiodarone (Cordarone)
B.Magnesium sulfate
C.Lidocaine (Xylocaine)
,D.Procainamide (Pronestyl)
B
Rationale: Because the client has chronic alcoholism, she is likely to have hypomagnesemia. Option B is
the recommended drug for torsades de pointes, which is a form of polymorphic ventricular tachycardia
(VT) usually associated with a prolonged QT interval that occurs with hypomagnesemia. Options A and D
increase the QT interval, which can cause the torsades to worsen. Option C is the antiarrhythmic of
choice in most cases of drug-induced monomorphic VT, not torsades.
We have an expert-written solution to this problem!
The nurse is caring for a client who is one day post-acute myocardial infarction. The client is receiving
oxygen at 2 L/min via nasal cannula and has a peripheral saline lock. The nurse notes that the client is
having eight premature ventricular contractions (PVCs) per minute. Which intervention should the nurse
implement first?
A.Obtain an IV pump for antiarrhythmic infusion.
B.Increase the client's oxygen flow rate.
C.Prepare for immediate countershock.
D.Gather equipment for endotracheal intubation.
B
Rationale: Increasing the oxygen flow rate provides more oxygen to the client's myocardium and may
decrease myocardial irritability as manifested by the frequent PVCs. Option A can be delegated and is a
lower priority action than option B. Defibrillation may eventually be necessary, but option C is not the
immediate treatment for frequent PVCs. Option D may become necessary if the client stops breathing
but is not indicated at this time.
The nurse is caring for a client with a chest tube to water seal drainage that was inserted 10 days ago
because of a ruptured bullae and pneumothorax. Which finding should the nurse report to the health
care provider before the chest tube is removed? A.
Tidaling of water in water seal chamber B.
Bilateral mufled breath sounds at bases C.
, Temperature of 101° F D.
Absence of chest tube drainage for 2 days
A
Rationale: Tidaling (rising and falling of water with respirations) in the water seal chamber should be
reported to the health care provider before the chest tube is removed to rule out an unresolved
pneumothorax or persistent air leak, which is characteristic of a ruptured bullae caused by abnormally
wide changes in negative intrathoracic pressure. Option B may indicate hypoventilation from chest tube
discomfort and usually improves when the chest tube is removed. Option C usually indicates an
infection, which may not be related to the chest tube. Option D is an expected finding.
A 77-year-old female client is admitted to the hospital with confusion and anorexia of several days'
duration. She has symptoms of nausea and vomiting and is currently complaining of a headache. The
client's pulse rate is 43 beats/min. The nurse is most concerned about the client's history related to
which medication?
A.
Warfarin
B.
Ibuprofen
C.
Nitroglycerin D.
Digoxin
D
Rationale: Older persons are particularly susceptible to the buildup of cardiac glycosides, such as digoxin
or digitoxin (medications derived from digitalis), to a toxic level in their systems. Toxicity can cause
anorexia, nausea, vomiting, diarrhea, headache, and fatigue. Options A, B, and C are unlikely to result in
the symptoms described.
