HESI Medical-Surgical Nursing
HESI / Elsevier | Academic Year 2026/2027
Medical-Surgical Nursing Comprehensive Examination
Original practice questions for study and preparation. These are not actual or recalled
HESI/Elsevier examination questions.
Questions 1–25: Cardiovascular & Respiratory Nursing
1. A patient reports crushing substernal chest pain radiating to the left arm with diaphoresis.
What is the nurse's priority action?
A. Encourage the patient to ambulate
B. Obtain a meal tray
C. Initiate immediate cardiac assessment and emergency management
D. Reassure the patient that the symptoms are probably anxiety
Answer: C. Initiate immediate cardiac assessment and emergency management
2. Which assessment finding is most concerning in a patient with heart failure?
A. Mild fatigue after activity
B. New-onset severe dyspnea at rest
C. Occasional dry skin
D. Increased appetite
Answer: B. New-onset severe dyspnea at rest
,3. A patient with heart failure has bilateral crackles and increasing oxygen requirements.
Which complication should the nurse suspect?
A. Pulmonary edema
B. Hypoglycemia
C. Appendicitis
D. Hypothyroidism
Answer: A. Pulmonary edema
4. Which medication is a loop diuretic commonly used in patients with fluid overload?
A. Furosemide
B. Metformin
C. Levothyroxine
D. Omeprazole
Answer: A. Furosemide
5. Which laboratory value should be monitored closely in a patient receiving furosemide?
A. Potassium
B. Hemoglobin A1c
C. Bilirubin only
D. Amylase only
Answer: A. Potassium
6. A patient receiving digoxin has nausea, visual disturbances, and an irregular pulse. What
should the nurse do?
,A. Administer another dose immediately
B. Hold the medication and notify the provider
C. Encourage increased sodium intake
D. Give an antacid and continue the medication
Answer: B. Hold the medication and notify the provider
7. Which finding is characteristic of left-sided heart failure?
A. Pulmonary congestion
B. Ascites only
C. Enlarged liver only
D. Peripheral edema without respiratory symptoms
Answer: A. Pulmonary congestion
8. Which finding is commonly associated with right-sided heart failure?
A. Peripheral edema
B. Pulmonary crackles only
C. Hemoptysis
D. Hyperventilation only
Answer: A. Peripheral edema
9. A patient with atrial fibrillation is prescribed an anticoagulant. What is the primary
purpose?
A. Reduce the risk of thromboembolic stroke
B. Increase heart rate
, C. Treat pulmonary edema
D. Increase platelet production
Answer: A. Reduce the risk of thromboembolic stroke
10. Which symptom may indicate peripheral arterial disease?
A. Intermittent claudication
B. Bilateral dependent edema only
C. Warm flushed feet
D. Increased pedal pulses
Answer: A. Intermittent claudication
11. Which assessment finding is typical of chronic obstructive pulmonary disease?
A. Prolonged expiration
B. Severe bradycardia in every patient
C. Sudden abdominal rigidity
D. Increased bowel sounds
Answer: A. Prolonged expiration
12. Which intervention is appropriate for a patient experiencing an acute asthma
exacerbation?
A. Administer the prescribed short-acting bronchodilator
B. Encourage cigarette smoking
C. Place the patient flat
D. Restrict all fluids permanently
HESI / Elsevier | Academic Year 2026/2027
Medical-Surgical Nursing Comprehensive Examination
Original practice questions for study and preparation. These are not actual or recalled
HESI/Elsevier examination questions.
Questions 1–25: Cardiovascular & Respiratory Nursing
1. A patient reports crushing substernal chest pain radiating to the left arm with diaphoresis.
What is the nurse's priority action?
A. Encourage the patient to ambulate
B. Obtain a meal tray
C. Initiate immediate cardiac assessment and emergency management
D. Reassure the patient that the symptoms are probably anxiety
Answer: C. Initiate immediate cardiac assessment and emergency management
2. Which assessment finding is most concerning in a patient with heart failure?
A. Mild fatigue after activity
B. New-onset severe dyspnea at rest
C. Occasional dry skin
D. Increased appetite
Answer: B. New-onset severe dyspnea at rest
,3. A patient with heart failure has bilateral crackles and increasing oxygen requirements.
Which complication should the nurse suspect?
A. Pulmonary edema
B. Hypoglycemia
C. Appendicitis
D. Hypothyroidism
Answer: A. Pulmonary edema
4. Which medication is a loop diuretic commonly used in patients with fluid overload?
A. Furosemide
B. Metformin
C. Levothyroxine
D. Omeprazole
Answer: A. Furosemide
5. Which laboratory value should be monitored closely in a patient receiving furosemide?
A. Potassium
B. Hemoglobin A1c
C. Bilirubin only
D. Amylase only
Answer: A. Potassium
6. A patient receiving digoxin has nausea, visual disturbances, and an irregular pulse. What
should the nurse do?
,A. Administer another dose immediately
B. Hold the medication and notify the provider
C. Encourage increased sodium intake
D. Give an antacid and continue the medication
Answer: B. Hold the medication and notify the provider
7. Which finding is characteristic of left-sided heart failure?
A. Pulmonary congestion
B. Ascites only
C. Enlarged liver only
D. Peripheral edema without respiratory symptoms
Answer: A. Pulmonary congestion
8. Which finding is commonly associated with right-sided heart failure?
A. Peripheral edema
B. Pulmonary crackles only
C. Hemoptysis
D. Hyperventilation only
Answer: A. Peripheral edema
9. A patient with atrial fibrillation is prescribed an anticoagulant. What is the primary
purpose?
A. Reduce the risk of thromboembolic stroke
B. Increase heart rate
, C. Treat pulmonary edema
D. Increase platelet production
Answer: A. Reduce the risk of thromboembolic stroke
10. Which symptom may indicate peripheral arterial disease?
A. Intermittent claudication
B. Bilateral dependent edema only
C. Warm flushed feet
D. Increased pedal pulses
Answer: A. Intermittent claudication
11. Which assessment finding is typical of chronic obstructive pulmonary disease?
A. Prolonged expiration
B. Severe bradycardia in every patient
C. Sudden abdominal rigidity
D. Increased bowel sounds
Answer: A. Prolonged expiration
12. Which intervention is appropriate for a patient experiencing an acute asthma
exacerbation?
A. Administer the prescribed short-acting bronchodilator
B. Encourage cigarette smoking
C. Place the patient flat
D. Restrict all fluids permanently
