BSN 266 HESI MED-SURG EXAM - 350
PRACTICE QUESTIONS WITH ANSWERS
& RATIONALES
CARDIOVASCULAR SYSTEM (Questions 1-70)
---
Question 1
A patient with heart failure is prescribed furosemide (Lasix). Which
electrolyte imbalance should the nurse monitor most closely?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypermagnesemia
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting,
leading to hypokalemia, which increases the risk of digoxin toxicity and
arrhythmias.
---
,Question 2
A patient with heart failure with reduced ejection fraction (HFrEF) should be
prescribed which first-line medications?
A) ACE inhibitor and beta-blocker
B) Calcium channel blocker and loop diuretic
C) Digoxin and spironolactone
D) Hydralazine and isosorbide dinitrate
Correct Answer: A
Rationale: ACE inhibitors and beta-blockers are the cornerstone of HFrEF
therapy, improving mortality and morbidity.
---
Question 3
A patient with acute decompensated heart failure is given IV furosemide. The
primary purpose is to:
A) Increase contractility
B) Reduce preload
C) Decrease afterload
D) Increase heart rate
Correct Answer: B
Rationale: Furosemide reduces preload by promoting diuresis and decreasing
blood volume.
,---
Question 4
A client presents to the emergency department reporting chest pain that
radiates to the left arm, shortness of breath, and diaphoresis. Which
medication should the nurse anticipate being prescribed?
A) Fentanyl
B) Hydromorphone
C) Oxycodone
D) Morphine
Correct Answer: D
Rationale: Morphine is the analgesic of choice for acute myocardial infarction
because it reduces pain, preload, and myocardial oxygen demand.
---
Question 5
What laboratory test result should a client with a diagnosis of myocardial
infarction ten hours ago exhibit?
A) Elevated creatine kinase-MB
B) Elevated troponin
C) Elevated LDH
D) Elevated myoglobin
Correct Answer: C
, Rationale: LDH begins to rise 8-12 hours after MI and peaks at 24-48 hours,
making it detectable at 10 hours post-MI.
---
Question 6
A client with atrial fibrillation should be prepared for which treatment
protocol based on analysis?
A) Anticoagulation therapy
B) Antiarrhythmic therapy
C) Pacemaker insertion
D) Cardiac ablation
Correct Answer: A
Rationale: Atrial fibrillation increases the risk of thrombus formation and
stroke; anticoagulation therapy is the priority treatment.
---
Question 7
Three weeks post-MI, a client reports his wife moved to a separate bedroom
and states, "I guess we will never have sex again." What is the nurse's best
response?
A) "Sexual activity has similar cardiac workload as climbing two flights of
stairs and can be resumed like other activities."
B) "You should avoid sexual activity for at least six months."
C) "This is a common fear; I will notify the physician."
PRACTICE QUESTIONS WITH ANSWERS
& RATIONALES
CARDIOVASCULAR SYSTEM (Questions 1-70)
---
Question 1
A patient with heart failure is prescribed furosemide (Lasix). Which
electrolyte imbalance should the nurse monitor most closely?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypermagnesemia
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting,
leading to hypokalemia, which increases the risk of digoxin toxicity and
arrhythmias.
---
,Question 2
A patient with heart failure with reduced ejection fraction (HFrEF) should be
prescribed which first-line medications?
A) ACE inhibitor and beta-blocker
B) Calcium channel blocker and loop diuretic
C) Digoxin and spironolactone
D) Hydralazine and isosorbide dinitrate
Correct Answer: A
Rationale: ACE inhibitors and beta-blockers are the cornerstone of HFrEF
therapy, improving mortality and morbidity.
---
Question 3
A patient with acute decompensated heart failure is given IV furosemide. The
primary purpose is to:
A) Increase contractility
B) Reduce preload
C) Decrease afterload
D) Increase heart rate
Correct Answer: B
Rationale: Furosemide reduces preload by promoting diuresis and decreasing
blood volume.
,---
Question 4
A client presents to the emergency department reporting chest pain that
radiates to the left arm, shortness of breath, and diaphoresis. Which
medication should the nurse anticipate being prescribed?
A) Fentanyl
B) Hydromorphone
C) Oxycodone
D) Morphine
Correct Answer: D
Rationale: Morphine is the analgesic of choice for acute myocardial infarction
because it reduces pain, preload, and myocardial oxygen demand.
---
Question 5
What laboratory test result should a client with a diagnosis of myocardial
infarction ten hours ago exhibit?
A) Elevated creatine kinase-MB
B) Elevated troponin
C) Elevated LDH
D) Elevated myoglobin
Correct Answer: C
, Rationale: LDH begins to rise 8-12 hours after MI and peaks at 24-48 hours,
making it detectable at 10 hours post-MI.
---
Question 6
A client with atrial fibrillation should be prepared for which treatment
protocol based on analysis?
A) Anticoagulation therapy
B) Antiarrhythmic therapy
C) Pacemaker insertion
D) Cardiac ablation
Correct Answer: A
Rationale: Atrial fibrillation increases the risk of thrombus formation and
stroke; anticoagulation therapy is the priority treatment.
---
Question 7
Three weeks post-MI, a client reports his wife moved to a separate bedroom
and states, "I guess we will never have sex again." What is the nurse's best
response?
A) "Sexual activity has similar cardiac workload as climbing two flights of
stairs and can be resumed like other activities."
B) "You should avoid sexual activity for at least six months."
C) "This is a common fear; I will notify the physician."
