HESI Med-Surg V1 exam Questions and
Answers With Rationales 2026\2027
update
This Exam contains:
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Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
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1. A client with heart failure is receiving furosemide (Lasix) 40 mg
IV. Which assessment finding indicates the medication is effective?
A) Blood pressure increases from 110/70 to 130/80 mmHg
B) Urine output of 50 mL within the first hour
C) Jugular venous distension becomes more prominent
D) Weight increases by 0.5 kg overnight
Answer: B
Rationale: Furosemide is a loop diuretic. Effective response is
demonstrated by increased urine output. Jugular venous distension
and weight gain indicate fluid retention (treatment failure). An
increase in blood pressure is not the expected therapeutic response.
2. A nurse is assessing a client with left-sided heart failure. Which
finding is most expected?
A) Peripheral edema
B) Hepatomegaly
C) Crackles in the lungs
D) Jugular venous distension
Answer: C
Rationale: Left-sided heart failure causes pulmonary congestion,
resulting in crackles on auscultation. Peripheral edema,
hepatomegaly, and JVD are signs of right-sided heart failure.
3. A client with atrial fibrillation is prescribed warfarin (Coumadin).
Which INR value indicates therapeutic effect?
A) 1.0
B) 1.5
C) 2.5
D) 4.0
,Answer: C
Rationale: The therapeutic INR for atrial fibrillation is 2.0–3.0. An
INR of 1.0 is normal. An INR of 4.0 is too high and places the client
at risk for bleeding.
4. A client is being discharged after a myocardial infarction. Which
statement by the client indicates a need for further teaching?
A) "I will take my nitroglycerin sublingually if I have chest pain."
B) "I will stop exercising if I experience dizziness or chest pain."
C) "I can drink one glass of wine with dinner every night."
D) "I will call 911 if chest pain is not relieved after one nitroglycerin
dose."
Answer: C
Rationale: Alcohol can interact with medications, increase blood
pressure, and worsen heart failure. Clients post-MI should avoid
alcohol or limit it significantly. The other statements demonstrate
appropriate understanding.
5. A nurse is caring for a client receiving heparin drip. Which
laboratory value requires immediate notification of the healthcare
provider?
A) aPTT of 45 seconds
B) aPTT of 80 seconds
C) Platelet count of 200,000/mm³
D) Hemoglobin of 12 g/dL
Answer: B
Rationale: The therapeutic aPTT for heparin therapy is typically 1.5–
2.5 times the control value (approximately 46–70 seconds). An aPTT
of 80 seconds is above the therapeutic range and increases the risk
of bleeding.
, 6. A client with hypertensive crisis has a blood pressure of 210/120
mmHg. What is the priority nursing action?
A) Administer acetaminophen for headache
B) Administer IV antihypertensive medication as prescribed
C) Encourage the client to rest quietly
D) Apply a warm blanket for diaphoresis
Answer: B
Rationale: Hypertensive crisis is a medical emergency requiring
immediate IV antihypertensive therapy to prevent end-organ damage
(stroke, MI, renal failure). While comfort measures are important,
medication administration is the priority.
7. A client has a permanent pacemaker inserted. Which instruction is
most important to include in discharge teaching?
A) Avoid going through airport security
B) Keep the affected arm below shoulder level for 4–6 weeks
C) Do not use a microwave oven
D) Avoid magnetic resonance imaging (MRI) scans
Answer: D
Rationale: MRI scans are contraindicated for clients with pacemakers
because the magnetic field can interfere with device function.
Airport security is safe (walk through normally). Microwaves are
safe. The affected arm should be avoided from overhead
positioning, but "below shoulder level at all times" is overly
restrictive.
8. A client with endocarditis develops a new murmur and embolic
symptoms. Which complication is most likely occurring?
A) Heart failure
B) Myocardial infarction
C) Valve destruction with vegetation embolization
D) Pericarditis
Answers With Rationales 2026\2027
update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
─
1. A client with heart failure is receiving furosemide (Lasix) 40 mg
IV. Which assessment finding indicates the medication is effective?
A) Blood pressure increases from 110/70 to 130/80 mmHg
B) Urine output of 50 mL within the first hour
C) Jugular venous distension becomes more prominent
D) Weight increases by 0.5 kg overnight
Answer: B
Rationale: Furosemide is a loop diuretic. Effective response is
demonstrated by increased urine output. Jugular venous distension
and weight gain indicate fluid retention (treatment failure). An
increase in blood pressure is not the expected therapeutic response.
2. A nurse is assessing a client with left-sided heart failure. Which
finding is most expected?
A) Peripheral edema
B) Hepatomegaly
C) Crackles in the lungs
D) Jugular venous distension
Answer: C
Rationale: Left-sided heart failure causes pulmonary congestion,
resulting in crackles on auscultation. Peripheral edema,
hepatomegaly, and JVD are signs of right-sided heart failure.
3. A client with atrial fibrillation is prescribed warfarin (Coumadin).
Which INR value indicates therapeutic effect?
A) 1.0
B) 1.5
C) 2.5
D) 4.0
,Answer: C
Rationale: The therapeutic INR for atrial fibrillation is 2.0–3.0. An
INR of 1.0 is normal. An INR of 4.0 is too high and places the client
at risk for bleeding.
4. A client is being discharged after a myocardial infarction. Which
statement by the client indicates a need for further teaching?
A) "I will take my nitroglycerin sublingually if I have chest pain."
B) "I will stop exercising if I experience dizziness or chest pain."
C) "I can drink one glass of wine with dinner every night."
D) "I will call 911 if chest pain is not relieved after one nitroglycerin
dose."
Answer: C
Rationale: Alcohol can interact with medications, increase blood
pressure, and worsen heart failure. Clients post-MI should avoid
alcohol or limit it significantly. The other statements demonstrate
appropriate understanding.
5. A nurse is caring for a client receiving heparin drip. Which
laboratory value requires immediate notification of the healthcare
provider?
A) aPTT of 45 seconds
B) aPTT of 80 seconds
C) Platelet count of 200,000/mm³
D) Hemoglobin of 12 g/dL
Answer: B
Rationale: The therapeutic aPTT for heparin therapy is typically 1.5–
2.5 times the control value (approximately 46–70 seconds). An aPTT
of 80 seconds is above the therapeutic range and increases the risk
of bleeding.
, 6. A client with hypertensive crisis has a blood pressure of 210/120
mmHg. What is the priority nursing action?
A) Administer acetaminophen for headache
B) Administer IV antihypertensive medication as prescribed
C) Encourage the client to rest quietly
D) Apply a warm blanket for diaphoresis
Answer: B
Rationale: Hypertensive crisis is a medical emergency requiring
immediate IV antihypertensive therapy to prevent end-organ damage
(stroke, MI, renal failure). While comfort measures are important,
medication administration is the priority.
7. A client has a permanent pacemaker inserted. Which instruction is
most important to include in discharge teaching?
A) Avoid going through airport security
B) Keep the affected arm below shoulder level for 4–6 weeks
C) Do not use a microwave oven
D) Avoid magnetic resonance imaging (MRI) scans
Answer: D
Rationale: MRI scans are contraindicated for clients with pacemakers
because the magnetic field can interfere with device function.
Airport security is safe (walk through normally). Microwaves are
safe. The affected arm should be avoided from overhead
positioning, but "below shoulder level at all times" is overly
restrictive.
8. A client with endocarditis develops a new murmur and embolic
symptoms. Which complication is most likely occurring?
A) Heart failure
B) Myocardial infarction
C) Valve destruction with vegetation embolization
D) Pericarditis
