ACTUAL NSG 233 HESI FINAL EXAM – COMPLETE LATEST
UPDATED VERSION Real Questions – Correct Answers –
100% Verified – Pass Guaranteed - A+ Graded
Cardiovascular and Hematologic Disorders
Q1: A 68-year-old patient with a history of heart failure is admitted with increasing
shortness of breath. Assessment reveals bilateral crackles in the lung bases, 3+ pitting
edema in both lower extremities, and jugular venous distension. The patient is anxious
and speaking in short sentences. What action should the nurse take first?
A. Administer IV furosemide 40 mg as ordered
B. Insert a Foley catheter to monitor hourly output
C. Place the patient in high-Fowler's position and assess oxygen saturation [CORRECT]
D. Call the rapid response team immediately
Correct Answer: C
Rationale: The best answer is C because when a heart failure patient shows signs of
fluid overload with respiratory compromise, your first priority is always airway and
breathing. High-Fowler's position decreases venous return to the heart and makes
breathing easier, while checking the oxygen saturation tells you how urgently you need
to intervene with supplemental oxygen.
Q2: A patient returns to the unit after a cardiac catheterization with a right femoral
approach. Two hours after sheath removal, the patient reports numbness and tingling in
the right foot. The dorsalis pedis pulse is weak compared to the left. What should the
nurse do first?
A. Apply a warm compress to the groin site
B. Assess the groin for expanding hematoma and notify the provider immediately
[CORRECT]
C. Elevate the right leg above heart level
D. Administer IV morphine for pain
Correct Answer: B
,Rationale: The best answer is B because numbness, tingling, and a weak distal pulse
after femoral access suggest compromised circulation, possibly from a retroperitoneal
bleed or arterial occlusion from a hematoma. You need to look at the site and get the
provider involved right away.
Q3: A patient on long-term warfarin therapy has an INR of 4.2. The therapeutic range for
this patient is 2.0 to 3.0. What is the nurse's priority action?
A. Hold the next warfarin dose and notify the provider [CORRECT]
B. Administer vitamin K immediately without contacting the provider
C. Increase the warfarin dose to bring the INR down
D. Document the result and continue the current therapy
Correct Answer: A
Rationale: The best answer is A because an INR of 4.2 is above the therapeutic range
and increases bleeding risk. The nurse should hold the next scheduled dose and notify
the provider, who will decide if vitamin K or other interventions are needed.
Q4: A 72-year-old patient is admitted with new-onset atrial fibrillation. The heart rate is
150 beats per minute and the blood pressure is 100/70 mmHg. The patient is mildly
diaphoretic. What is the nurse's priority?
A. Administer metoprolol immediately
B. Assess for signs of hemodynamic instability and prepare for possible synchronized
cardioversion [CORRECT]
C. Start a heparin drip per protocol
D. Have the patient perform a Valsalva maneuver
Correct Answer: B
Rationale: The best answer is B because a heart rate of 150 with a borderline blood
pressure and diaphoresis suggests the patient may be unstable. Unstable atrial
fibrillation with rapid ventricular response may require synchronized cardioversion, so
you need to recognize instability early and be ready.
Q5: A patient with severe anemia has a hemoglobin of 7.2 g/dL and hematocrit of 22%.
The patient reports extreme fatigue and dyspnea when walking to the bathroom. Which
finding requires immediate intervention by the nurse?
, A. Pale conjunctiva and nail beds
B. Heart rate 118 and blood pressure 90/58 [CORRECT]
C. Desire to rest after minimal activity
D. Spoon-shaped fingernails
Correct Answer: B
Rationale: The best answer is B because tachycardia and hypotension in the setting of
severe anemia indicate the cardiovascular system can no longer compensate for the
reduced oxygen-carrying capacity. This signals impending shock and requires
immediate provider notification.
Q6: A patient is post-myocardial infarction, day 3. The nurse is planning activity
progression. Which activity is most appropriate for this stage of recovery?
A. Ambulate to the bathroom independently without monitoring
B. Perform range-of-motion exercises while sitting in a chair [CORRECT]
C. Lift light weights with the upper extremities
D. Jog in place at the bedside to build endurance
Correct Answer: B
Rationale: The best answer is B because post-MI patients progress gradually through
cardiac rehabilitation. Sitting in a chair and performing light range-of-motion is
appropriate for day 3, while strenuous activity or unsupervised ambulation could stress
the healing heart.
Q7: A patient with hypertension is prescribed lisinopril. Which teaching point is most
important for the nurse to include?
A. "Take the medication with a high-potassium diet"
B. "Rise slowly from sitting or lying to prevent dizziness" [CORRECT]
C. "Stop the medication immediately if you develop a dry cough"
D. "Take a double dose if you miss one pill"
Correct Answer: B
Rationale: The best answer is B because ACE inhibitors like lisinopril can cause
orthostatic hypotension, especially when first starting the medication. Teaching
patients to rise slowly prevents falls and injury.
UPDATED VERSION Real Questions – Correct Answers –
100% Verified – Pass Guaranteed - A+ Graded
Cardiovascular and Hematologic Disorders
Q1: A 68-year-old patient with a history of heart failure is admitted with increasing
shortness of breath. Assessment reveals bilateral crackles in the lung bases, 3+ pitting
edema in both lower extremities, and jugular venous distension. The patient is anxious
and speaking in short sentences. What action should the nurse take first?
A. Administer IV furosemide 40 mg as ordered
B. Insert a Foley catheter to monitor hourly output
C. Place the patient in high-Fowler's position and assess oxygen saturation [CORRECT]
D. Call the rapid response team immediately
Correct Answer: C
Rationale: The best answer is C because when a heart failure patient shows signs of
fluid overload with respiratory compromise, your first priority is always airway and
breathing. High-Fowler's position decreases venous return to the heart and makes
breathing easier, while checking the oxygen saturation tells you how urgently you need
to intervene with supplemental oxygen.
Q2: A patient returns to the unit after a cardiac catheterization with a right femoral
approach. Two hours after sheath removal, the patient reports numbness and tingling in
the right foot. The dorsalis pedis pulse is weak compared to the left. What should the
nurse do first?
A. Apply a warm compress to the groin site
B. Assess the groin for expanding hematoma and notify the provider immediately
[CORRECT]
C. Elevate the right leg above heart level
D. Administer IV morphine for pain
Correct Answer: B
,Rationale: The best answer is B because numbness, tingling, and a weak distal pulse
after femoral access suggest compromised circulation, possibly from a retroperitoneal
bleed or arterial occlusion from a hematoma. You need to look at the site and get the
provider involved right away.
Q3: A patient on long-term warfarin therapy has an INR of 4.2. The therapeutic range for
this patient is 2.0 to 3.0. What is the nurse's priority action?
A. Hold the next warfarin dose and notify the provider [CORRECT]
B. Administer vitamin K immediately without contacting the provider
C. Increase the warfarin dose to bring the INR down
D. Document the result and continue the current therapy
Correct Answer: A
Rationale: The best answer is A because an INR of 4.2 is above the therapeutic range
and increases bleeding risk. The nurse should hold the next scheduled dose and notify
the provider, who will decide if vitamin K or other interventions are needed.
Q4: A 72-year-old patient is admitted with new-onset atrial fibrillation. The heart rate is
150 beats per minute and the blood pressure is 100/70 mmHg. The patient is mildly
diaphoretic. What is the nurse's priority?
A. Administer metoprolol immediately
B. Assess for signs of hemodynamic instability and prepare for possible synchronized
cardioversion [CORRECT]
C. Start a heparin drip per protocol
D. Have the patient perform a Valsalva maneuver
Correct Answer: B
Rationale: The best answer is B because a heart rate of 150 with a borderline blood
pressure and diaphoresis suggests the patient may be unstable. Unstable atrial
fibrillation with rapid ventricular response may require synchronized cardioversion, so
you need to recognize instability early and be ready.
Q5: A patient with severe anemia has a hemoglobin of 7.2 g/dL and hematocrit of 22%.
The patient reports extreme fatigue and dyspnea when walking to the bathroom. Which
finding requires immediate intervention by the nurse?
, A. Pale conjunctiva and nail beds
B. Heart rate 118 and blood pressure 90/58 [CORRECT]
C. Desire to rest after minimal activity
D. Spoon-shaped fingernails
Correct Answer: B
Rationale: The best answer is B because tachycardia and hypotension in the setting of
severe anemia indicate the cardiovascular system can no longer compensate for the
reduced oxygen-carrying capacity. This signals impending shock and requires
immediate provider notification.
Q6: A patient is post-myocardial infarction, day 3. The nurse is planning activity
progression. Which activity is most appropriate for this stage of recovery?
A. Ambulate to the bathroom independently without monitoring
B. Perform range-of-motion exercises while sitting in a chair [CORRECT]
C. Lift light weights with the upper extremities
D. Jog in place at the bedside to build endurance
Correct Answer: B
Rationale: The best answer is B because post-MI patients progress gradually through
cardiac rehabilitation. Sitting in a chair and performing light range-of-motion is
appropriate for day 3, while strenuous activity or unsupervised ambulation could stress
the healing heart.
Q7: A patient with hypertension is prescribed lisinopril. Which teaching point is most
important for the nurse to include?
A. "Take the medication with a high-potassium diet"
B. "Rise slowly from sitting or lying to prevent dizziness" [CORRECT]
C. "Stop the medication immediately if you develop a dry cough"
D. "Take a double dose if you miss one pill"
Correct Answer: B
Rationale: The best answer is B because ACE inhibitors like lisinopril can cause
orthostatic hypotension, especially when first starting the medication. Teaching
patients to rise slowly prevents falls and injury.
