Nightingale College BSN 246 HESI Med-Surg Exam (pdf) | 2026/2027
| HESI Q&A | Med-Surg Nursing
1. A nurse is assessing a client with chest pain. The ECG shows ST-segment
elevation in leads II, III, and aVF. Which coronary artery is most likely
occluded?
A) Left anterior descending artery
B) Left circumflex artery
C) Right coronary artery
D) Posterior descending artery
Correct Answer: Right coronary artery
Rationale: Leads II, III, and aVF represent the inferior wall of the heart, which
is supplied by the right coronary artery (RCA). Anterior wall MI (V1-V4) is
supplied by the LAD, and lateral wall MI (I, aVL, V5-V6) is supplied by the left
circumflex artery.
2. A client with heart failure has a new prescription for carvedilol. The nurse
should monitor for which adverse effect?
A) Tachycardia
B) Hyperglycemia
C) Bradycardia
D) Hypokalemia
Correct Answer: Bradycardia
Rationale: Carvedilol is a beta-blocker. Common adverse effects include
bradycardia, hypotension, dizziness, and fatigue. Beta-blockers can mask
signs of hypoglycemia but do not directly cause hyperglycemia.
,3. A client is receiving a continuous heparin infusion for a deep vein
thrombosis (DVT). The nurse notes that the client's activated partial
thromboplastin time (aPTT) is 110 seconds (normal ~30-40). The nurse
should first:
A) Increase the heparin rate
B) Stop the heparin infusion
C) Notify the healthcare provider
D) Assess the client for bleeding
Correct Answer: Stop the heparin infusion
Rationale: An aPTT of 110 seconds is significantly elevated and indicates a
high risk of bleeding. The priority action is to stop the infusion and assess the
client for signs of bleeding before notifying the provider.
4. A nurse is assessing a client with left-sided heart failure. Which finding is
most indicative of this condition?
A) Jugular vein distention
B) Peripheral edema
C) Bibasilar crackles
D) Hepatomegaly
Correct Answer: Bibasilar crackles
Rationale: Left-sided heart failure leads to pulmonary congestion, resulting in
crackles (rales) in the lung bases. JVD, peripheral edema, and hepatomegaly
are signs of right-sided heart failure.
,5. A client with peripheral artery disease (PAD) reports leg pain that starts
after walking for 10 minutes and stops with rest. The nurse documents this
finding as:
A) Rest pain
B) Neuropathic pain
C) Intermittent claudication
D) Venous insufficiency
Correct Answer: Intermittent claudication
Rationale: Intermittent claudication is muscle pain that occurs with exercise
and is relieved by rest, characteristic of peripheral artery disease. Rest pain
indicates severe ischemia.
6. A client who had a myocardial infarction is prescribed aspirin. The nurse
understands that the primary purpose of aspirin therapy is to:
A) Relieve chest pain
B) Prevent further clot formation
C) Lower blood pressure
D) Reduce inflammation
Correct Answer: Prevent further clot formation
Rationale: Aspirin inhibits platelet aggregation, reducing the risk of further
thrombus formation in clients with coronary artery disease. It is not a primary
analgesic for chest pain.
7. A client is receiving furosemide (Lasix) for heart failure. Which laboratory
value is most important for the nurse to monitor?
, A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum glucose
Correct Answer: Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium wasting,
leading to hypokalemia. Hypokalemia can precipitate cardiac dysrhythmias,
especially in clients taking digoxin.
8. The nurse is caring for a client with a new diagnosis of hypertension.
Which lifestyle modification should the nurse recommend first?
A) Increase dietary sodium intake
B) Begin a regular exercise program
C) Reduce dietary sodium intake
D) Increase caffeine intake
Correct Answer: Reduce dietary sodium intake
Rationale: Reducing dietary sodium intake is one of the most effective
lifestyle modifications for managing hypertension. The DASH diet and sodium
restriction are first-line recommendations.
9. A client with angina is prescribed sublingual nitroglycerin. Which
instruction should the nurse include in the teaching?
A) "Swallow the tablet with water."
B) "Place the tablet under your tongue and allow it to dissolve."
C) "Chew the tablet for faster absorption."
| HESI Q&A | Med-Surg Nursing
1. A nurse is assessing a client with chest pain. The ECG shows ST-segment
elevation in leads II, III, and aVF. Which coronary artery is most likely
occluded?
A) Left anterior descending artery
B) Left circumflex artery
C) Right coronary artery
D) Posterior descending artery
Correct Answer: Right coronary artery
Rationale: Leads II, III, and aVF represent the inferior wall of the heart, which
is supplied by the right coronary artery (RCA). Anterior wall MI (V1-V4) is
supplied by the LAD, and lateral wall MI (I, aVL, V5-V6) is supplied by the left
circumflex artery.
2. A client with heart failure has a new prescription for carvedilol. The nurse
should monitor for which adverse effect?
A) Tachycardia
B) Hyperglycemia
C) Bradycardia
D) Hypokalemia
Correct Answer: Bradycardia
Rationale: Carvedilol is a beta-blocker. Common adverse effects include
bradycardia, hypotension, dizziness, and fatigue. Beta-blockers can mask
signs of hypoglycemia but do not directly cause hyperglycemia.
,3. A client is receiving a continuous heparin infusion for a deep vein
thrombosis (DVT). The nurse notes that the client's activated partial
thromboplastin time (aPTT) is 110 seconds (normal ~30-40). The nurse
should first:
A) Increase the heparin rate
B) Stop the heparin infusion
C) Notify the healthcare provider
D) Assess the client for bleeding
Correct Answer: Stop the heparin infusion
Rationale: An aPTT of 110 seconds is significantly elevated and indicates a
high risk of bleeding. The priority action is to stop the infusion and assess the
client for signs of bleeding before notifying the provider.
4. A nurse is assessing a client with left-sided heart failure. Which finding is
most indicative of this condition?
A) Jugular vein distention
B) Peripheral edema
C) Bibasilar crackles
D) Hepatomegaly
Correct Answer: Bibasilar crackles
Rationale: Left-sided heart failure leads to pulmonary congestion, resulting in
crackles (rales) in the lung bases. JVD, peripheral edema, and hepatomegaly
are signs of right-sided heart failure.
,5. A client with peripheral artery disease (PAD) reports leg pain that starts
after walking for 10 minutes and stops with rest. The nurse documents this
finding as:
A) Rest pain
B) Neuropathic pain
C) Intermittent claudication
D) Venous insufficiency
Correct Answer: Intermittent claudication
Rationale: Intermittent claudication is muscle pain that occurs with exercise
and is relieved by rest, characteristic of peripheral artery disease. Rest pain
indicates severe ischemia.
6. A client who had a myocardial infarction is prescribed aspirin. The nurse
understands that the primary purpose of aspirin therapy is to:
A) Relieve chest pain
B) Prevent further clot formation
C) Lower blood pressure
D) Reduce inflammation
Correct Answer: Prevent further clot formation
Rationale: Aspirin inhibits platelet aggregation, reducing the risk of further
thrombus formation in clients with coronary artery disease. It is not a primary
analgesic for chest pain.
7. A client is receiving furosemide (Lasix) for heart failure. Which laboratory
value is most important for the nurse to monitor?
, A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum glucose
Correct Answer: Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium wasting,
leading to hypokalemia. Hypokalemia can precipitate cardiac dysrhythmias,
especially in clients taking digoxin.
8. The nurse is caring for a client with a new diagnosis of hypertension.
Which lifestyle modification should the nurse recommend first?
A) Increase dietary sodium intake
B) Begin a regular exercise program
C) Reduce dietary sodium intake
D) Increase caffeine intake
Correct Answer: Reduce dietary sodium intake
Rationale: Reducing dietary sodium intake is one of the most effective
lifestyle modifications for managing hypertension. The DASH diet and sodium
restriction are first-line recommendations.
9. A client with angina is prescribed sublingual nitroglycerin. Which
instruction should the nurse include in the teaching?
A) "Swallow the tablet with water."
B) "Place the tablet under your tongue and allow it to dissolve."
C) "Chew the tablet for faster absorption."
