HESI RN Med-Surg Comprehensive Exam Complete Exam with NGN Next

HESI RN Med-Surg Comprehensive Exam 2025/2026 | Complete Exam with NGN (Next Generation NCLEX) Questions & Correct Answers​ HESI RN Medical-Surgical Comprehensive Exam | Key Concepts: Adult Health, Complex Disease Management, Pharmacology, Diagnostic Testing, Priority Nursing Interventions, Patient Safety, Critical Care, and NGN Case Studies | Expert-Verified Q&A | Clinical & Exam-Ready

Introduction​ This updated 2025/2026 HESI RN Med-Surg Comprehensive Exam resource includes 180 fully verified questions with 100% correct answers, featuring NGN-style case studies and alternate item formats. Content covers critical areas of adult health nursing including pathophysiology, pharmacologic management, diagnostics, evidence-based interventions, safety protocols, and priority setting. All answers are graded A+ and ensure complete preparation for both HESI and NGN exam success.Answer Format​ All correct answers are highlighted in bold and green, with rationales that explain nursing priorities, reinforce clinical reasoning, and strengthen decision-making for NGN readiness.

HESI RN Med-Surg Comprehensive Exam Practice Questions (1–180)

• A client with chronic kidney disease is experiencing hyperkalemia. Which

food should the nurse instruct the client to avoid?​

a) Apples​

b) Bananas​

c) Carrots​

d) Broccoli​

b) Bananas​

Rationale: Bananas are high in potassium, which should be avoided in hyperkalemia to prevent cardiac complications.

• A client is admitted with acute pancreatitis. Which laboratory value is

most indicative of this diagnosis?​

a) Elevated serum amylase​

b) Decreased white blood cell count​

c) Elevated hemoglobin​

d) Decreased serum glucose​ 1 / 4

a) Elevated serum amylase​

Rationale: Elevated serum amylase is a key diagnostic marker for acute pancreatitis.

• A client with a history of heart failure is prescribed furosemide. Which

electrolyte imbalance should the nurse monitor for?​

a) Hyperkalemia​

b) Hypokalemia​

c) Hypernatremia​

d) Hyponatremia​

b) Hypokalemia​

Rationale: Furosemide, a loop diuretic, causes potassium loss, leading to hypokalemia.

• A client is receiving heparin therapy. Which laboratory value should the

nurse monitor?​

a) INR​

• aPTT​

c) PT​

d) Platelet count​

• aPTT​

Rationale: aPTT is used to monitor heparin therapy, with a therapeutic range of 1.5–2.5 times baseline.

• A client with diabetes mellitus is experiencing hypoglycemia. Which

symptom is most indicative?​

a) Polyuria​

b) Tremors​

c) Polydipsia​

d) Weight gain​

b) Tremors​

Rationale: Tremors are a common symptom of hypoglycemia due to sympathetic activation.

• A client is admitted with a suspected myocardial infarction. Which

enzyme is most specific for diagnosis?​

a) CK-MB​

b) Troponin I​

c) LDH​

d) AST​

b) Troponin I​

Rationale: Troponin I is the most specific marker for myocardial infarction, with high sensitivity.

• A client with COPD is experiencing an exacerbation. Which medication

should the nurse expect to administer?​

a) Albuterol nebulizer​

b) Furosemide​

c) Heparin​ 2 / 4

d) Insulin​

a) Albuterol nebulizer​

Rationale: Albuterol, a bronchodilator, is first-line for COPD exacerbations to relieve bronchospasm.

• A client is postoperative day 1 after abdominal surgery. Which

assessment finding indicates a complication?​

a) Clear lung sounds​

b) Absent bowel sounds​

c) Urine output of 50 mL/hr​

d) Temperature of 98.6°F​

b) Absent bowel sounds​

Rationale: Absent bowel sounds may indicate paralytic ileus, a common postoperative complication.

• A client with a peptic ulcer is prescribed omeprazole. What is the purpose

of this medication?​

a) Increase gastric acid production​

b) Reduce gastric acid production​

c) Coat the stomach lining​

d) Kill H. pylori bacteria​

b) Reduce gastric acid production​

Rationale: Omeprazole, a proton pump inhibitor, reduces gastric acid production to promote ulcer healing.

• A client with cirrhosis is experiencing ascites. Which medication should

the nurse expect to administer?​

a) Furosemide​

b) Spironolactone​

c) Mannitol​

d) Acetaminophen​

b) Spironolactone​

Rationale: Spironolactone, a potassium-sparing diuretic, is first-line for ascites in cirrhosis to reduce fluid retention.

• A client with atrial fibrillation is prescribed warfarin. Which dietary

recommendation should the nurse provide?​

a) Increase intake of leafy green vegetables​

b) Maintain consistent intake of vitamin K-rich foods​

c) Avoid all dairy products​

d) Eliminate carbohydrates​

b) Maintain consistent intake of vitamin K-rich foods​

Rationale: Warfarin’s anticoagulant effect is influenced by vitamin K. Consistent intake of vitamin K-rich foods ensures stable INR levels. 3 / 4

• A client with a suspected pulmonary embolism is admitted. Which

diagnostic test should the nurse expect to be ordered?​

a) Chest X-ray​

b) CT pulmonary angiography​

c) ECG​

d) ABG analysis​

b) CT pulmonary angiography​

Rationale: CT pulmonary angiography is the gold standard for diagnosing pulmonary embolism.

• A client with type 2 diabetes is prescribed metformin. Which side effect

should the nurse monitor for?​

a) Hypoglycemia​

b) Lactic acidosis​

c) Hyperkalemia​

d) Weight gain​

b) Lactic acidosis​

Rationale: Metformin can rarely cause lactic acidosis, a serious side effect, especially in renal impairment.

• A client with a history of stroke presents with dysphagia. Which nursing

intervention is the priority?​

a) Administer oral medications​

b) Perform a swallow evaluation​

c) Encourage fluid intake​

d) Place in a high Fowler’s position​

b) Perform a swallow evaluation​

Rationale: A swallow evaluation is critical to prevent aspiration in clients with dysphagia.

• A client is receiving chemotherapy and reports nausea. Which

medication should the nurse anticipate?​

a) Ondansetron​

b) Diphenhydramine​

c) Lorazepam​

d) Morphine​

a) Ondansetron​

Rationale: Ondansetron, a 5-HT3 receptor antagonist, is first-line for chemotherapy-induced nausea.

• A client with a fractured femur is in traction. Which assessment finding

requires immediate intervention?​

a) Pain at the fracture site​

b) Numbness in the toes​

c) Localized swelling​

d) Mild muscle spasms​

• / 4