Med-Surg HESI Exam REVIEW 2026/2027 MOST
RECENT QUESTIONS AND SOLUTIONS
• The nurse is assessing a 48-year-old client with a history of smoking during a
routine clinic visit. The client, who exercises regularly, reports having pain in the
calf during exercise that disappears at rest. Which of the following findings
requires further evaluation?
1. Heart rate 57 bpm.
2. SpO2 of 94% on room air.
3. Blood pressure 134/82.
4. Ankle-brachial index of 0.65. . CORRECT ANSWER: 4
An Ankle-Brachial Index of 0.65 suggests moderate arterial vascular disease in a
client who is experiencing intermittent claudication. A Doppler ultrasound is
indicated for further evaluation. The bradycardic heart rate is acceptable in an
athletic client with a normal blood pressure. The SpO2 is acceptable; the client has
a smoking history.
• An overweight client taking warfarin (Coumadin) has dry skin due to decreased
arterial blood flow. What should the nurse instruct the client to do? Select all that
apply.
1. Apply lanolin or petroleum jelly to intact skin.
2. Follow a reduced-calorie, reduced-fat diet.
3. Inspect the involved areas daily for new ulcerations.
4. Instruct the client to limit activities of daily living (ADLs).
5.Use an electric razor to shave . CORRECT ANSWER: 1,2,3,5
,Maintaining skin integrity is important in preventing chronic ulcers and infections.
The client should be taught to inspect the skin on a daily basis. The client
should reduce weight to promote circulation; a diet lower in calories and fat is
appropriate. Because the client is receiving Coumadin, the client is at risk for
bleeding from cuts. To decrease the risk of cuts, the nurse should suggest that the
client use an electric razor. The client with decreased arterial blood flow should be
encouraged to participate in ADLs. In fact, the client should be encouraged to
consult an exercise
physiologist for an exercise program that enhances the aerobic capacity of the
body.
• A client with peripheral vascular disease has undergone a right femoral-popliteal
bypass graft. The blood pressure has decreased from 124/80 to 94/62. What should
the nurse assess first?
1. IV fluid solution.
2. Pedal pulses.
3. Nasal cannula flow rate.
4. Capillary refill . CORRECT ANSWER: 2
With each set of vital signs, the nurse should assess the dorsalis pedis and posterior
tibial pulses. The nurse needs to ensure adequate perfusion to the lower
extremity with the drop in blood pressure. IV fluids, nasal cannula setting, and
capillary refill are important to assess; however, priority is to determine the cause
of drop in blood pressure and that adequate perfusion through the new graft is
maintained.
• The nurse is caring for a client with peripheral artery disease who has recently
been prescribed clopidogrel (Plavix). The nurse understands that more teaching is
necessary when the client states which of the following:
,1. "I should not be surprised if I bruise easier or if my gums bleed a little when
brushing my teeth."
2. "It doesn't really matter if I take this medicine with or without food, whatever
works best for my stomach."
3. "I should stop taking Plavix if it makes me feel weak and dizzy."
4. "The doctor prescribed this medicine to make my platelets less likely to stick
together and help prevent clots from forming." . CORRECT ANSWER: 3
Weakness, dizziness, and headache are common adverse effects of Plavix and the
client should report these to the physician if they are problematic; in order to
decrease risk of clot formation, Plavix must be taken regularly and should not be
stopped or taken intermittently. The main adverse effect of Plavix is bleeding,
which often occurs as increased bruising or bleeding when brushing teeth. Plavix is
well absorbed, and while food may help decrease potential gastrointestinal upset,
Plavix may be taken with or without food. Plavix is an antiplatelet agent used to
prevent clot formation in clients who have experienced or are at risk for
myocardial infarction, ischemic stroke, peripheral artery disease, or acute coronary
syndrome.
• A client is receiving Cilostazol (Pletal) for peripheral arterial disease causing
intermittent claudication. The nurse determines this medication is effective when
the client reports which of the following?
1. "I am having fewer aches and pains."
2. "I do not have headaches anymore."
3. "I am able to walk further without leg pain."
4. "My toes are turning grayish black in color." . CORRECT ANSWER: 3
Cilostazol is indicated for management of intermittent claudication. Symptoms
usually improve within 2 to 4 weeks of therapy. Intermittent claudication prevents
, clients from walking for long periods of time. Cilostazol inhibits platelet
aggregation induced by various stimuli and improving blood flow to the muscles
and allowing the client to walk long distances without pain. Peripheral arterial
disease causes pain mainly of the leg muscles. "Aches and pains" does not specify
exactly where the pain is occurring. Headaches may occur as a side effect of this
drug, and the client should report this information to the health care provider.
Peripheral arterial disease causes decreased blood supply to the peripheral tissues
and may cause gangrene of the toes; the drug is effective when the toes are warm
to the touch and the color of the toes is similar to the color of the body.
• The client admitted with peripheral vascular disease (PVD) asks the nurse why
her legs hurt when she walks. The nurse bases a response on the knowledge that
the main characteristic of PVD is:
1. Decreased blood flow.
2. Increased blood flow.
3. Slow blood flow.
4. Thrombus formation. . CORRECT ANSWER: 1
Decreased blood flow is a common characteristic of all PVD. When the demand
for oxygen to the working muscles becomes greater than the supply, pain is the
outcome. Slow blood flow throughout the circulatory system may suggest pump
failure. Thrombus formation can result from stasis or damage to the intima of the
vessels.
• The nurse is planning care for a client who is diagnosed with peripheral vascular
disease (PVD) and has a history of heart failure. The nurse should develop a plan
of care that is based on the fact that the client may have a low tolerance for
exercise related to:
RECENT QUESTIONS AND SOLUTIONS
• The nurse is assessing a 48-year-old client with a history of smoking during a
routine clinic visit. The client, who exercises regularly, reports having pain in the
calf during exercise that disappears at rest. Which of the following findings
requires further evaluation?
1. Heart rate 57 bpm.
2. SpO2 of 94% on room air.
3. Blood pressure 134/82.
4. Ankle-brachial index of 0.65. . CORRECT ANSWER: 4
An Ankle-Brachial Index of 0.65 suggests moderate arterial vascular disease in a
client who is experiencing intermittent claudication. A Doppler ultrasound is
indicated for further evaluation. The bradycardic heart rate is acceptable in an
athletic client with a normal blood pressure. The SpO2 is acceptable; the client has
a smoking history.
• An overweight client taking warfarin (Coumadin) has dry skin due to decreased
arterial blood flow. What should the nurse instruct the client to do? Select all that
apply.
1. Apply lanolin or petroleum jelly to intact skin.
2. Follow a reduced-calorie, reduced-fat diet.
3. Inspect the involved areas daily for new ulcerations.
4. Instruct the client to limit activities of daily living (ADLs).
5.Use an electric razor to shave . CORRECT ANSWER: 1,2,3,5
,Maintaining skin integrity is important in preventing chronic ulcers and infections.
The client should be taught to inspect the skin on a daily basis. The client
should reduce weight to promote circulation; a diet lower in calories and fat is
appropriate. Because the client is receiving Coumadin, the client is at risk for
bleeding from cuts. To decrease the risk of cuts, the nurse should suggest that the
client use an electric razor. The client with decreased arterial blood flow should be
encouraged to participate in ADLs. In fact, the client should be encouraged to
consult an exercise
physiologist for an exercise program that enhances the aerobic capacity of the
body.
• A client with peripheral vascular disease has undergone a right femoral-popliteal
bypass graft. The blood pressure has decreased from 124/80 to 94/62. What should
the nurse assess first?
1. IV fluid solution.
2. Pedal pulses.
3. Nasal cannula flow rate.
4. Capillary refill . CORRECT ANSWER: 2
With each set of vital signs, the nurse should assess the dorsalis pedis and posterior
tibial pulses. The nurse needs to ensure adequate perfusion to the lower
extremity with the drop in blood pressure. IV fluids, nasal cannula setting, and
capillary refill are important to assess; however, priority is to determine the cause
of drop in blood pressure and that adequate perfusion through the new graft is
maintained.
• The nurse is caring for a client with peripheral artery disease who has recently
been prescribed clopidogrel (Plavix). The nurse understands that more teaching is
necessary when the client states which of the following:
,1. "I should not be surprised if I bruise easier or if my gums bleed a little when
brushing my teeth."
2. "It doesn't really matter if I take this medicine with or without food, whatever
works best for my stomach."
3. "I should stop taking Plavix if it makes me feel weak and dizzy."
4. "The doctor prescribed this medicine to make my platelets less likely to stick
together and help prevent clots from forming." . CORRECT ANSWER: 3
Weakness, dizziness, and headache are common adverse effects of Plavix and the
client should report these to the physician if they are problematic; in order to
decrease risk of clot formation, Plavix must be taken regularly and should not be
stopped or taken intermittently. The main adverse effect of Plavix is bleeding,
which often occurs as increased bruising or bleeding when brushing teeth. Plavix is
well absorbed, and while food may help decrease potential gastrointestinal upset,
Plavix may be taken with or without food. Plavix is an antiplatelet agent used to
prevent clot formation in clients who have experienced or are at risk for
myocardial infarction, ischemic stroke, peripheral artery disease, or acute coronary
syndrome.
• A client is receiving Cilostazol (Pletal) for peripheral arterial disease causing
intermittent claudication. The nurse determines this medication is effective when
the client reports which of the following?
1. "I am having fewer aches and pains."
2. "I do not have headaches anymore."
3. "I am able to walk further without leg pain."
4. "My toes are turning grayish black in color." . CORRECT ANSWER: 3
Cilostazol is indicated for management of intermittent claudication. Symptoms
usually improve within 2 to 4 weeks of therapy. Intermittent claudication prevents
, clients from walking for long periods of time. Cilostazol inhibits platelet
aggregation induced by various stimuli and improving blood flow to the muscles
and allowing the client to walk long distances without pain. Peripheral arterial
disease causes pain mainly of the leg muscles. "Aches and pains" does not specify
exactly where the pain is occurring. Headaches may occur as a side effect of this
drug, and the client should report this information to the health care provider.
Peripheral arterial disease causes decreased blood supply to the peripheral tissues
and may cause gangrene of the toes; the drug is effective when the toes are warm
to the touch and the color of the toes is similar to the color of the body.
• The client admitted with peripheral vascular disease (PVD) asks the nurse why
her legs hurt when she walks. The nurse bases a response on the knowledge that
the main characteristic of PVD is:
1. Decreased blood flow.
2. Increased blood flow.
3. Slow blood flow.
4. Thrombus formation. . CORRECT ANSWER: 1
Decreased blood flow is a common characteristic of all PVD. When the demand
for oxygen to the working muscles becomes greater than the supply, pain is the
outcome. Slow blood flow throughout the circulatory system may suggest pump
failure. Thrombus formation can result from stasis or damage to the intima of the
vessels.
• The nurse is planning care for a client who is diagnosed with peripheral vascular
disease (PVD) and has a history of heart failure. The nurse should develop a plan
of care that is based on the fact that the client may have a low tolerance for
exercise related to:
