HESI | Med-Surg Final
OBJECTIVE ASSESSMENT - EXAM
Med Surg Final Hesi 2026/2027
Actual Exam All Questions And
Well Elaborated Answers
Updated Version || Complete A+
Guide
Medical-Surgical Nursing Board Exam
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Heart Failure & Cardiogenic Shock Management COPD, Pneumonia & Mechanical Ventilation
Stroke, Seizures & Increased ICP GI Bleeding, Liver Failure & Renal Disease
Diabetes Mellitus & Thyroid Disorders Wound Care, Burns & Orthopedic Surgery
COVER PAGE - 1
, SECTION 1 | Cardiovascular and Hematologic | Q1-Q25 | Med Surg Final Hesi 2026/2027 Actual Exam All Questions A
Q1 Question 1 of 100
A 68-year-old male is admitted with acute chest pain radiating to his left arm. His
blood pressure is 88/52 mmHg, heart rate 112 bpm, and he is diaphoretic. A 12-lead
ECG shows ST-segment elevation in leads V1-V4. Which intervention should the
nurse prioritize before any other?
A. Administer sublingual nitroglycerin 0.4 mg
B. Initiate aspirin 325 mg chewable per protocol
C. Obtain a stat complete blood count and metabolic panel
D. Prepare the patient for immediate cardiac catheterization
Correct Answer: B
Rationale:
For a patient with STEMI, aspirin administration is the highest priority because it reduces mortality by inhibiting
platelet aggregation and preventing further coronary artery occlusion. While cardiac catheterization is
definitive, aspirin must be given first per protocol. Nitroglycerin is contraindicated if systolic BP is below 90
mmHg.
Q2 Question 2 of 100
ed Surg Final Hesi 2026/2027 Actual Exam All Questions And Well Elaborated Answers Updated Version || Complete A+ Guide - 2026/2027 | Passing Score: 80% | Page 2 of
, SECTION 1 | Cardiovascular and Hematologic | Q1-Q25 | Med Surg Final Hesi 2026/2027 Actual Exam All Questions A
A 55-year-old female with a history of atrial fibrillation is prescribed warfarin 5 mg
daily. Her INR today is 4.2, and she reports dark tarry stools. Which action by the
nurse is most appropriate at this time?
A. Hold the next dose of warfarin and notify the provider immediately
B. Administer vitamin K 10 mg subcutaneously without consulting the provider
C. Increase the warfarin dose to 7.5 mg to stabilize the INR
D. Instruct the patient to take the scheduled dose and recheck INR in one week
Correct Answer: A
Rationale:
An INR of 4.2 with signs of GI bleeding (dark tarry stools) indicates supratherapeutic anticoagulation with
active bleeding. The nurse must hold the next warfarin dose and notify the provider immediately for further
orders, which may include vitamin K or fresh frozen plasma. Administering vitamin K independently is outside
nursing scope without an order.
Q3 Question 3 of 100
ed Surg Final Hesi 2026/2027 Actual Exam All Questions And Well Elaborated Answers Updated Version || Complete A+ Guide - 2026/2027 | Passing Score: 80% | Page 3 of
, SECTION 1 | Cardiovascular and Hematologic | Q1-Q25 | Med Surg Final Hesi 2026/2027 Actual Exam All Questions A
A 72-year-old patient with chronic heart failure is receiving furosemide 40 mg IV twice
daily. The nurse notes a weight gain of 3 kg over 48 hours, crackles in the lung bases,
and jugular venous distention. Which additional assessment finding would most
confirm acute decompensated heart failure?
A. A new S3 heart sound on auscultation
B. A blood pressure of 142/88 mmHg
C. Decreased bowel sounds in all four quadrants
D. A respiratory rate of 18 breaths per minute
Correct Answer: A
Rationale:
An S3 gallop is a classic finding in acute decompensated heart failure caused by rapid ventricular filling into a
stiff, dilated ventricle. While JVD, crackles, and weight gain suggest fluid overload, the S3 sound specifically
indicates ventricular dysfunction. An elevated BP and normal respiratory rate do not confirm decompensation.
Q4 Question 4 of 100
ed Surg Final Hesi 2026/2027 Actual Exam All Questions And Well Elaborated Answers Updated Version || Complete A+ Guide - 2026/2027 | Passing Score: 80% | Page 4 of
OBJECTIVE ASSESSMENT - EXAM
Med Surg Final Hesi 2026/2027
Actual Exam All Questions And
Well Elaborated Answers
Updated Version || Complete A+
Guide
Medical-Surgical Nursing Board Exam
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Heart Failure & Cardiogenic Shock Management COPD, Pneumonia & Mechanical Ventilation
Stroke, Seizures & Increased ICP GI Bleeding, Liver Failure & Renal Disease
Diabetes Mellitus & Thyroid Disorders Wound Care, Burns & Orthopedic Surgery
COVER PAGE - 1
, SECTION 1 | Cardiovascular and Hematologic | Q1-Q25 | Med Surg Final Hesi 2026/2027 Actual Exam All Questions A
Q1 Question 1 of 100
A 68-year-old male is admitted with acute chest pain radiating to his left arm. His
blood pressure is 88/52 mmHg, heart rate 112 bpm, and he is diaphoretic. A 12-lead
ECG shows ST-segment elevation in leads V1-V4. Which intervention should the
nurse prioritize before any other?
A. Administer sublingual nitroglycerin 0.4 mg
B. Initiate aspirin 325 mg chewable per protocol
C. Obtain a stat complete blood count and metabolic panel
D. Prepare the patient for immediate cardiac catheterization
Correct Answer: B
Rationale:
For a patient with STEMI, aspirin administration is the highest priority because it reduces mortality by inhibiting
platelet aggregation and preventing further coronary artery occlusion. While cardiac catheterization is
definitive, aspirin must be given first per protocol. Nitroglycerin is contraindicated if systolic BP is below 90
mmHg.
Q2 Question 2 of 100
ed Surg Final Hesi 2026/2027 Actual Exam All Questions And Well Elaborated Answers Updated Version || Complete A+ Guide - 2026/2027 | Passing Score: 80% | Page 2 of
, SECTION 1 | Cardiovascular and Hematologic | Q1-Q25 | Med Surg Final Hesi 2026/2027 Actual Exam All Questions A
A 55-year-old female with a history of atrial fibrillation is prescribed warfarin 5 mg
daily. Her INR today is 4.2, and she reports dark tarry stools. Which action by the
nurse is most appropriate at this time?
A. Hold the next dose of warfarin and notify the provider immediately
B. Administer vitamin K 10 mg subcutaneously without consulting the provider
C. Increase the warfarin dose to 7.5 mg to stabilize the INR
D. Instruct the patient to take the scheduled dose and recheck INR in one week
Correct Answer: A
Rationale:
An INR of 4.2 with signs of GI bleeding (dark tarry stools) indicates supratherapeutic anticoagulation with
active bleeding. The nurse must hold the next warfarin dose and notify the provider immediately for further
orders, which may include vitamin K or fresh frozen plasma. Administering vitamin K independently is outside
nursing scope without an order.
Q3 Question 3 of 100
ed Surg Final Hesi 2026/2027 Actual Exam All Questions And Well Elaborated Answers Updated Version || Complete A+ Guide - 2026/2027 | Passing Score: 80% | Page 3 of
, SECTION 1 | Cardiovascular and Hematologic | Q1-Q25 | Med Surg Final Hesi 2026/2027 Actual Exam All Questions A
A 72-year-old patient with chronic heart failure is receiving furosemide 40 mg IV twice
daily. The nurse notes a weight gain of 3 kg over 48 hours, crackles in the lung bases,
and jugular venous distention. Which additional assessment finding would most
confirm acute decompensated heart failure?
A. A new S3 heart sound on auscultation
B. A blood pressure of 142/88 mmHg
C. Decreased bowel sounds in all four quadrants
D. A respiratory rate of 18 breaths per minute
Correct Answer: A
Rationale:
An S3 gallop is a classic finding in acute decompensated heart failure caused by rapid ventricular filling into a
stiff, dilated ventricle. While JVD, crackles, and weight gain suggest fluid overload, the S3 sound specifically
indicates ventricular dysfunction. An elevated BP and normal respiratory rate do not confirm decompensation.
Q4 Question 4 of 100
ed Surg Final Hesi 2026/2027 Actual Exam All Questions And Well Elaborated Answers Updated Version || Complete A+ Guide - 2026/2027 | Passing Score: 80% | Page 4 of
