HESI Med Surg 1 questions and answers
2026\2027 A+ Grade
The nurse observes ventricular fibrillation on telemetry and, on entering the client's bathroom, finds the
client unconscious on the floor. Which intervention should the nurse implement first?
A.
Administer an antidysrhythmic medication.
B.
Start cardiopulmonary resuscitation.
C.
Defibrillate the client at 200 J.
D.
Assess the client's pulse oximetry.
- correct answer B.
Start cardiopulmonary resuscitation.
Rationale:
Ventricular fibrillation is a life-threatening dysrhythmia, and CPR should be started immediately (B). (A
and C) are appropriate, but CPR is the priority action. The client is dying, and (D) does not address the
seriousness of this situation.
The nurse assesses a client who has been prescribed furosemide (Lasix) for cardiac disease. Which
electrocardiographic change would be a concern for a client taking a diuretic?
A.
Tall, spiked T waves
B.
A prolonged QT interval
C.
,A widening QRS complex
D.
Presence of a U wave
- correct answer D.
Presence of a U wave
Rationale:
A U wave (D) is a positive deflection following the T wave and is often present with hypokalemia (low
potassium level). (A, B, and C) are all signs of hyperkalemia.
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)
- correct answer B.
Magnesium sulfate
Rationale:
Because the client has chronic alcoholism, she is likely to have hypomagnesemia. (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. (A and D) increase
the QT interval, which can cause the torsades to worsen. (C) is the antiarrhythmic of choice in most
cases of drug-induced monomorphic VT, not torsades.
,When developing a discharge teaching plan for a client after the insertion of a permanent pacemaker,
the nurse writes a goal of "The client will verbalize symptoms of pacemaker failure." Which behavior
indicates that the goal has been met?
A.
The client demonstrates the procedures to change the rate of the pacemaker using a magnet.
B.
The client carries a card in his wallet stating the type and serial number of the pacemaker.
C.
The client tells the nurse that it is important to report redness and tenderness at the insertion site.
D.
The client states that changes in the pulse and feelings of dizziness are significant changes.
- correct answer D.
The client states that changes in the pulse and feelings of dizziness are significant changes.
Rationale:
Changes in pulse rate and/or rhythm may indicate pacer failure. Feelings of dizziness may be caused by a
decreased heart rate, leading to decreased cardiac output (D). The rate of a pacemaker is not changed
by a client, although the client may be familiar with this procedure as explained by his health care
provider (A). (B) is an important step in preparing the client for discharge but does not demonstrate
knowledge of the symptoms of pacer failure. (C) indicates symptoms of possible incisional infection or
irritation but do not indicate pacer failure.
The nurse teaches a client with type 2 diabetes nutritional strategies to decrease obesity. Which food
item(s) chosen by the client indicates understanding of the teaching? (Select all that apply.)
A.
White bread
B.
Salmon
C.
Broccoli
D.
Whole milk
, E.
Banana
- correct answer B
Salmon
C
Broccoli
E.
Banana
Rationale:
(B, C, and E) provide fresh fruits, lean meats and fish, vegetables, whole grains, and low-fat dairy
products. All are recommended by the American Diabetes Association (ADA) and are a part of the My
Plate guidelines recommended by the U.S. Department of Agriculture (USDA). Whole milk (D) is high in
fat and is not recommended by ADA. White bread is milled, a process that removes the essential
nutrients. It should be avoided for weight loss and is a poor choice for the client with diabetes (A).
A client diagnosed with angina pectoris complains of chest pain while ambulating in the hallway. Which
action should the nurse implement first?
A.
Support the client to a sitting position.
B.
Ask the client to walk slowly back to the room.
C.
Administer a sublingual nitroglycerin tablet.
D.
Provide oxygen via nasal cannula.
- correct answer A.
Support the client to a sitting position.
2026\2027 A+ Grade
The nurse observes ventricular fibrillation on telemetry and, on entering the client's bathroom, finds the
client unconscious on the floor. Which intervention should the nurse implement first?
A.
Administer an antidysrhythmic medication.
B.
Start cardiopulmonary resuscitation.
C.
Defibrillate the client at 200 J.
D.
Assess the client's pulse oximetry.
- correct answer B.
Start cardiopulmonary resuscitation.
Rationale:
Ventricular fibrillation is a life-threatening dysrhythmia, and CPR should be started immediately (B). (A
and C) are appropriate, but CPR is the priority action. The client is dying, and (D) does not address the
seriousness of this situation.
The nurse assesses a client who has been prescribed furosemide (Lasix) for cardiac disease. Which
electrocardiographic change would be a concern for a client taking a diuretic?
A.
Tall, spiked T waves
B.
A prolonged QT interval
C.
,A widening QRS complex
D.
Presence of a U wave
- correct answer D.
Presence of a U wave
Rationale:
A U wave (D) is a positive deflection following the T wave and is often present with hypokalemia (low
potassium level). (A, B, and C) are all signs of hyperkalemia.
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)
- correct answer B.
Magnesium sulfate
Rationale:
Because the client has chronic alcoholism, she is likely to have hypomagnesemia. (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. (A and D) increase
the QT interval, which can cause the torsades to worsen. (C) is the antiarrhythmic of choice in most
cases of drug-induced monomorphic VT, not torsades.
,When developing a discharge teaching plan for a client after the insertion of a permanent pacemaker,
the nurse writes a goal of "The client will verbalize symptoms of pacemaker failure." Which behavior
indicates that the goal has been met?
A.
The client demonstrates the procedures to change the rate of the pacemaker using a magnet.
B.
The client carries a card in his wallet stating the type and serial number of the pacemaker.
C.
The client tells the nurse that it is important to report redness and tenderness at the insertion site.
D.
The client states that changes in the pulse and feelings of dizziness are significant changes.
- correct answer D.
The client states that changes in the pulse and feelings of dizziness are significant changes.
Rationale:
Changes in pulse rate and/or rhythm may indicate pacer failure. Feelings of dizziness may be caused by a
decreased heart rate, leading to decreased cardiac output (D). The rate of a pacemaker is not changed
by a client, although the client may be familiar with this procedure as explained by his health care
provider (A). (B) is an important step in preparing the client for discharge but does not demonstrate
knowledge of the symptoms of pacer failure. (C) indicates symptoms of possible incisional infection or
irritation but do not indicate pacer failure.
The nurse teaches a client with type 2 diabetes nutritional strategies to decrease obesity. Which food
item(s) chosen by the client indicates understanding of the teaching? (Select all that apply.)
A.
White bread
B.
Salmon
C.
Broccoli
D.
Whole milk
, E.
Banana
- correct answer B
Salmon
C
Broccoli
E.
Banana
Rationale:
(B, C, and E) provide fresh fruits, lean meats and fish, vegetables, whole grains, and low-fat dairy
products. All are recommended by the American Diabetes Association (ADA) and are a part of the My
Plate guidelines recommended by the U.S. Department of Agriculture (USDA). Whole milk (D) is high in
fat and is not recommended by ADA. White bread is milled, a process that removes the essential
nutrients. It should be avoided for weight loss and is a poor choice for the client with diabetes (A).
A client diagnosed with angina pectoris complains of chest pain while ambulating in the hallway. Which
action should the nurse implement first?
A.
Support the client to a sitting position.
B.
Ask the client to walk slowly back to the room.
C.
Administer a sublingual nitroglycerin tablet.
D.
Provide oxygen via nasal cannula.
- correct answer A.
Support the client to a sitting position.
