Med-Surg II HESI (Elsevier) 2026/2027
Original Exam Mastery 2026/2027
100 original practice questions • clinical judgment • detailed rationales • high-yield review
Original-resource notice: This study guide is independently authored. It does not reproduce HESI/Elsevier exam questions, the
paid Stuvia document, or a proprietary test bank.
How to use this guide
Approach each item like a clinical-judgment question: identify the unstable finding, connect it to the underlying pathophysiology,
determine the safest priority action, and reassess. When a medication or intervention is involved, check the relevant vital signs,
laboratory data, contraindications, and response.
Scope
The supplied Stuvia listing is a 54-page paid Med-Surg II HESI resource for the 2025/2026 academic year. Its public preview
identifies cardiovascular disorders as Section 1 and describes coverage of cardiovascular, respiratory, gastrointestinal, renal,
endocrine, neurological, and emergency-care concepts. The questions below are original and expand the subject matter rather
than reproducing the preview.
Med-Surg II HESI • Original Exam Mastery 2026/2027 • Page 1
,100 Original Practice Questions
1. Cardiovascular
A client receiving IV furosemide has which finding that requires the most immediate attention?
A. Potassium 2.8 mEq/L
B. Sodium 136 mEq/L
C. Weight loss of 0.5 kg
D. BP 128/76 mm Hg
Answer: A
Rationale: Marked hypokalemia can precipitate dangerous dysrhythmias, especially with loop diuretic therapy.
2. Cardiovascular
A client with acute pulmonary edema is severely dyspneic and producing pink frothy sputum. Which action is priority?
A. Place supine
B. Position upright and support oxygenation
C. Encourage oral fluids
D. Obtain a routine weight
Answer: B
Rationale: Upright positioning improves ventilation and reduces venous return while immediate oxygenation support addresses the life threat.
3. Cardiovascular
A client with atrial fibrillation is prescribed apixaban. Which assessment is most important?
A. Signs of bleeding
B. Bowel sounds only
C. Visual acuity
D. Skin turgor only
Answer: A
Rationale: Anticoagulation increases bleeding risk; assess for overt and occult bleeding and follow ordered monitoring.
4. Cardiovascular
A client reports crushing substernal chest pressure with diaphoresis. What should the nurse do first?
A. Obtain immediate focused assessment and activate the acute chest-pain response
B. Offer a meal
C. Encourage ambulation
D. Schedule a routine clinic visit
Answer: A
Rationale: Potential acute coronary syndrome is time-sensitive and requires immediate assessment and escalation.
5. Cardiovascular
A client with right-sided heart failure is most likely to demonstrate:
A. Peripheral edema and jugular venous distention
B. Unilateral wheezing only
C. Hemoptysis only
D. Severe hyperventilation only
Answer: A
Rationale: Right-sided failure produces systemic venous congestion, commonly causing JVD and peripheral edema.
Med-Surg II HESI • Original Exam Mastery 2026/2027 • Page 2
, 6. Cardiovascular
Which finding after femoral cardiac catheterization requires immediate action?
A. Small stable bruising
B. New absent pedal pulse
C. Mild tenderness
D. Fatigue
Answer: B
Rationale: Loss of distal perfusion may indicate arterial occlusion or another vascular complication threatening limb viability.
7. Cardiovascular
A client taking an ACE inhibitor should be monitored closely for:
A. Hyperkalemia and renal-function changes
B. Severe hypoglycemia in every case
C. Hypercalcemia
D. Increased platelet count
Answer: A
Rationale: ACE inhibitors can increase potassium and affect renal function, especially in susceptible clients.
8. Cardiovascular
A client with peripheral arterial disease reports ischemic rest pain. Which position generally supports arterial perfusion?
A. Legs dependent
B. Legs elevated high above the heart
C. Trendelenburg
D. Knees tightly flexed
Answer: A
Rationale: Dependent positioning can improve gravity-assisted arterial flow; excessive elevation may worsen ischemic symptoms.
9. Cardiovascular
Which rhythm is a pulseless emergency requiring immediate defibrillation?
A. Ventricular fibrillation
B. Sinus bradycardia with a pulse
C. Atrial flutter with a pulse
D. Sinus rhythm
Answer: A
Rationale: Ventricular fibrillation produces no effective cardiac output and is treated with immediate unsynchronized defibrillation plus CPR.
10. Cardiovascular
A client with suspected infective endocarditis has fever and a new murmur. Which order should the nurse anticipate before
antibiotics when feasible?
A. Multiple blood cultures
B. Routine stool culture
C. Skin biopsy
D. Spirometry
Answer: A
Rationale: Blood cultures help identify the causative organism and guide antimicrobial therapy; cultures should be obtained before antibiotics
when clinically feasible.
Med-Surg II HESI • Original Exam Mastery 2026/2027 • Page 3
Original Exam Mastery 2026/2027
100 original practice questions • clinical judgment • detailed rationales • high-yield review
Original-resource notice: This study guide is independently authored. It does not reproduce HESI/Elsevier exam questions, the
paid Stuvia document, or a proprietary test bank.
How to use this guide
Approach each item like a clinical-judgment question: identify the unstable finding, connect it to the underlying pathophysiology,
determine the safest priority action, and reassess. When a medication or intervention is involved, check the relevant vital signs,
laboratory data, contraindications, and response.
Scope
The supplied Stuvia listing is a 54-page paid Med-Surg II HESI resource for the 2025/2026 academic year. Its public preview
identifies cardiovascular disorders as Section 1 and describes coverage of cardiovascular, respiratory, gastrointestinal, renal,
endocrine, neurological, and emergency-care concepts. The questions below are original and expand the subject matter rather
than reproducing the preview.
Med-Surg II HESI • Original Exam Mastery 2026/2027 • Page 1
,100 Original Practice Questions
1. Cardiovascular
A client receiving IV furosemide has which finding that requires the most immediate attention?
A. Potassium 2.8 mEq/L
B. Sodium 136 mEq/L
C. Weight loss of 0.5 kg
D. BP 128/76 mm Hg
Answer: A
Rationale: Marked hypokalemia can precipitate dangerous dysrhythmias, especially with loop diuretic therapy.
2. Cardiovascular
A client with acute pulmonary edema is severely dyspneic and producing pink frothy sputum. Which action is priority?
A. Place supine
B. Position upright and support oxygenation
C. Encourage oral fluids
D. Obtain a routine weight
Answer: B
Rationale: Upright positioning improves ventilation and reduces venous return while immediate oxygenation support addresses the life threat.
3. Cardiovascular
A client with atrial fibrillation is prescribed apixaban. Which assessment is most important?
A. Signs of bleeding
B. Bowel sounds only
C. Visual acuity
D. Skin turgor only
Answer: A
Rationale: Anticoagulation increases bleeding risk; assess for overt and occult bleeding and follow ordered monitoring.
4. Cardiovascular
A client reports crushing substernal chest pressure with diaphoresis. What should the nurse do first?
A. Obtain immediate focused assessment and activate the acute chest-pain response
B. Offer a meal
C. Encourage ambulation
D. Schedule a routine clinic visit
Answer: A
Rationale: Potential acute coronary syndrome is time-sensitive and requires immediate assessment and escalation.
5. Cardiovascular
A client with right-sided heart failure is most likely to demonstrate:
A. Peripheral edema and jugular venous distention
B. Unilateral wheezing only
C. Hemoptysis only
D. Severe hyperventilation only
Answer: A
Rationale: Right-sided failure produces systemic venous congestion, commonly causing JVD and peripheral edema.
Med-Surg II HESI • Original Exam Mastery 2026/2027 • Page 2
, 6. Cardiovascular
Which finding after femoral cardiac catheterization requires immediate action?
A. Small stable bruising
B. New absent pedal pulse
C. Mild tenderness
D. Fatigue
Answer: B
Rationale: Loss of distal perfusion may indicate arterial occlusion or another vascular complication threatening limb viability.
7. Cardiovascular
A client taking an ACE inhibitor should be monitored closely for:
A. Hyperkalemia and renal-function changes
B. Severe hypoglycemia in every case
C. Hypercalcemia
D. Increased platelet count
Answer: A
Rationale: ACE inhibitors can increase potassium and affect renal function, especially in susceptible clients.
8. Cardiovascular
A client with peripheral arterial disease reports ischemic rest pain. Which position generally supports arterial perfusion?
A. Legs dependent
B. Legs elevated high above the heart
C. Trendelenburg
D. Knees tightly flexed
Answer: A
Rationale: Dependent positioning can improve gravity-assisted arterial flow; excessive elevation may worsen ischemic symptoms.
9. Cardiovascular
Which rhythm is a pulseless emergency requiring immediate defibrillation?
A. Ventricular fibrillation
B. Sinus bradycardia with a pulse
C. Atrial flutter with a pulse
D. Sinus rhythm
Answer: A
Rationale: Ventricular fibrillation produces no effective cardiac output and is treated with immediate unsynchronized defibrillation plus CPR.
10. Cardiovascular
A client with suspected infective endocarditis has fever and a new murmur. Which order should the nurse anticipate before
antibiotics when feasible?
A. Multiple blood cultures
B. Routine stool culture
C. Skin biopsy
D. Spirometry
Answer: A
Rationale: Blood cultures help identify the causative organism and guide antimicrobial therapy; cultures should be obtained before antibiotics
when clinically feasible.
Med-Surg II HESI • Original Exam Mastery 2026/2027 • Page 3
