HESI Exit Exam 2026 — Med Surg Questions with Verified Answers & Rationales

The HESI RN Med Surg Exit Exam is a comprehensive assessment covering all medical surgical nursing topics. Here are the most tested questions for 2026. ## Most Tested HESI Med Surg Topics ### Cardiovascular Q: A client with heart failure has crackles in the lungs, 3+ pitting edema, and shortness of breath. What position should the nurse place the client in? A: High Fowlers position (90 degrees) — maximizes chest expansion and reduces venous return to decrease preload. Q: A client is prescribed digoxin. Before administering, what should the nurse assess? A: Apical pulse for one full minute. Hold digoxin if pulse is below 60 bpm and notify provider. Also check potassium level — hypokalemia increases digoxin toxicity. ### Respiratory Q: A client with COPD has oxygen ordered at 2-4 L/min. The client is confused and restless. SpO2 is 92%. What should the nurse do? A: Maintain O2 at 2 L/min — in COPD patients, high-flow oxygen suppresses the hypoxic drive. 92% is acceptable for COPD patients. Q: A nurse is suctioning a client with a tracheostomy. How long should each suction pass last? A: No longer than 10-15 seconds — prolonged suctioning causes hypoxia. ### Neurological Q: A client is admitted with a suspected stroke. What is the priority assessment? A: Time of symptom onset — tPA can be given within 3-4.5 hours of symptom onset in eligible patients. Q: A client has increased intracranial pressure (ICP). Which position is most appropriate? A: Head of bed elevated 30-45 degrees with head in neutral position — promotes venous drainage from the brain. ### Endocrine Q: A client with Type 1 diabetes has blood glucose of 48 mg/dL and is conscious. What should the nurse do first? A: Give 15 grams of fast-acting carbohydrates (4 oz juice, glucose tablets) — the 15-15 rule for conscious hypoglycemic patients. Q: A client in DKA has K+ of 3.2. IV insulin is ordered. What should the nurse do? A: Hold insulin and notify provider — potassium must be corrected before insulin administration because insulin drives potassium into cells causing fatal hypokalemia. ### Musculoskeletal Q: A client has a cast applied 4 hours ago. The client reports severe pain and tingling. What is the priority action? A: Notify the provider immediately — these are signs of compartment syndrome, a surgical emergency. ## Priority Drug Knowledge for HESI Med Surg - **Digoxin toxicity signs**: nausea, vomiting, yellow-green halos, bradycardia - **Heparin antidote**: Protamine sulfate - **Warfarin antidote**: Vitamin K (phytonadione) - **Opioid antidote**: Naloxone (Narcan) - **Acetaminophen antidote**: N-acetylcysteine (Mucomyst) - **Benzodiazepine antidote**: Flumazenil Browse verified HESI Med Surg Exit Exam study materials on Studyrift — download instantly! 💊