,HESI Med-Surg Exam 2026 | Comprehensive Test Bank | Questions
And Answers
TABLE OF CONTENTS
1. Cardiovascular & Peripheral Vascular Disorders — Q1–Q35
2. Respiratory Disorders — Q36–Q65
3. Neurologic Disorders — Q66–Q95
4. Renal & Urinary Disorders — Q96–Q120
5. Gastrointestinal, Hepatic & Pancreatic Disorders — Q121–Q155
6. Endocrine & Metabolic Disorders — Q156–Q190
7. Musculoskeletal Disorders — Q191–Q215
8. Hematologic & Oncologic Disorders — Q216–Q240
9. Immune & Infectious Disorders — Q241–Q255
10. Integumentary Disorders — Q256–Q270
11. Fluid, Electrolyte & Acid-Base Disorders — Q271–Q285
12. Perioperative Care, Emergencies, Prioritization & Delegation —
Q286–Q300
CARDIOVASCULAR & PERIPHERAL VASCULAR DISORDERS
Q1. A client with acute left-sided heart failure develops severe
dyspnea, bilateral crackles, and an oxygen saturation of 84%. Which
intervention should be implemented first?
A) Encourage oral fluid intake
B) Place the client in high-Fowler position and administer oxygen
C) Obtain the client's daily weight
D) Apply sequential compression devices
Correct Answer: B) Place the client in high-Fowler position and administer
oxygen
Rationale: Pulmonary congestion from left-sided heart failure impairs gas
exchange. Upright positioning reduces venous return and promotes lung
expansion, while supplemental oxygen treats hypoxemia. Assessment data
such as daily weight remain important but do not take priority over
immediate respiratory compromise.
,Q2. Which finding in a client with heart failure most strongly
suggests worsening fluid retention?
A) Weight gain of 2 kg (4.4 lb) in 48 hours
B) Heart rate of 88 beats/min
C) Blood pressure of 128/76 mm Hg
D) Urine specific gravity of 1.015
Correct Answer: A) Weight gain of 2 kg (4.4 lb) in 48 hours
Rationale: Rapid weight gain is a sensitive indicator of fluid accumulation in
heart failure. Approximately 1 kg of body-weight change may represent
about 1 L of retained fluid. Daily weights taken under consistent conditions
help identify deterioration before severe edema or respiratory symptoms
appear.
Q3. A client receiving IV furosemide for pulmonary edema reports
muscle weakness and palpitations. Which laboratory value requires
the most immediate attention?
A) Sodium 137 mEq/L
B) Calcium 9.2 mg/dL
C) Potassium 2.9 mEq/L
D) Magnesium 2.0 mg/dL
Correct Answer: C) Potassium 2.9 mEq/L
Rationale: Loop diuretics increase urinary potassium loss. Significant
hypokalemia can cause muscle weakness and dangerous cardiac
dysrhythmias. The combination of palpitations and a potassium
concentration of 2.9 mEq/L requires prompt correction and cardiac
monitoring.
Q4. A client with stable angina asks when prescribed sublingual
nitroglycerin should be used. Which instruction is most appropriate?
A) Take one tablet every morning regardless of symptoms
B) Swallow the tablet with water after meals
C) Use the medication only after chest pain has lasted 15 minutes
D) Place one dose under the tongue at the onset of chest discomfort
Correct Answer: D) Place one dose under the tongue at the onset of chest
discomfort
, Rationale: Sublingual nitroglycerin should be taken promptly when anginal
discomfort begins because rapid vasodilation reduces myocardial oxygen
demand and can relieve ischemia. Waiting for persistent pain may delay
treatment of potentially significant myocardial ischemia.
Q5. Four hours after a femoral cardiac catheterization, which finding
requires immediate intervention?
A) Small area of bruising at the insertion site
B) Sudden back pain with hypotension
C) Mild tenderness at the puncture site
D) Heart rate of 78 beats/min
Correct Answer: B) Sudden back pain with hypotension
Rationale: Sudden back or flank pain with hypotension after femoral
catheterization can indicate retroperitoneal hemorrhage, a potentially life-
threatening complication. The client requires rapid assessment,
hemodynamic support, and notification of the appropriate provider.
Q6. Which assessment finding is most characteristic of right-sided
heart failure?
A) Inspiratory crackles
B) Orthopnea
C) Jugular venous distention and dependent edema
D) Pink frothy sputum
Correct Answer: C) Jugular venous distention and dependent edema
Rationale: Right ventricular failure causes systemic venous congestion,
producing jugular venous distention, peripheral edema, hepatomegaly, and
weight gain. Crackles, orthopnea, and pink frothy sputum primarily reflect
pulmonary congestion associated with left ventricular dysfunction.
Q7. The cardiac monitor shows atrial fibrillation with a ventricular
rate of 146 beats/min. The client is hypotensive, diaphoretic, and
reports chest discomfort. Which intervention should the nurse
anticipate?
A) Synchronized cardioversion
B) Ambulation to improve circulation
C) Oral potassium supplementation
D) Observation for spontaneous conversion
And Answers
TABLE OF CONTENTS
1. Cardiovascular & Peripheral Vascular Disorders — Q1–Q35
2. Respiratory Disorders — Q36–Q65
3. Neurologic Disorders — Q66–Q95
4. Renal & Urinary Disorders — Q96–Q120
5. Gastrointestinal, Hepatic & Pancreatic Disorders — Q121–Q155
6. Endocrine & Metabolic Disorders — Q156–Q190
7. Musculoskeletal Disorders — Q191–Q215
8. Hematologic & Oncologic Disorders — Q216–Q240
9. Immune & Infectious Disorders — Q241–Q255
10. Integumentary Disorders — Q256–Q270
11. Fluid, Electrolyte & Acid-Base Disorders — Q271–Q285
12. Perioperative Care, Emergencies, Prioritization & Delegation —
Q286–Q300
CARDIOVASCULAR & PERIPHERAL VASCULAR DISORDERS
Q1. A client with acute left-sided heart failure develops severe
dyspnea, bilateral crackles, and an oxygen saturation of 84%. Which
intervention should be implemented first?
A) Encourage oral fluid intake
B) Place the client in high-Fowler position and administer oxygen
C) Obtain the client's daily weight
D) Apply sequential compression devices
Correct Answer: B) Place the client in high-Fowler position and administer
oxygen
Rationale: Pulmonary congestion from left-sided heart failure impairs gas
exchange. Upright positioning reduces venous return and promotes lung
expansion, while supplemental oxygen treats hypoxemia. Assessment data
such as daily weight remain important but do not take priority over
immediate respiratory compromise.
,Q2. Which finding in a client with heart failure most strongly
suggests worsening fluid retention?
A) Weight gain of 2 kg (4.4 lb) in 48 hours
B) Heart rate of 88 beats/min
C) Blood pressure of 128/76 mm Hg
D) Urine specific gravity of 1.015
Correct Answer: A) Weight gain of 2 kg (4.4 lb) in 48 hours
Rationale: Rapid weight gain is a sensitive indicator of fluid accumulation in
heart failure. Approximately 1 kg of body-weight change may represent
about 1 L of retained fluid. Daily weights taken under consistent conditions
help identify deterioration before severe edema or respiratory symptoms
appear.
Q3. A client receiving IV furosemide for pulmonary edema reports
muscle weakness and palpitations. Which laboratory value requires
the most immediate attention?
A) Sodium 137 mEq/L
B) Calcium 9.2 mg/dL
C) Potassium 2.9 mEq/L
D) Magnesium 2.0 mg/dL
Correct Answer: C) Potassium 2.9 mEq/L
Rationale: Loop diuretics increase urinary potassium loss. Significant
hypokalemia can cause muscle weakness and dangerous cardiac
dysrhythmias. The combination of palpitations and a potassium
concentration of 2.9 mEq/L requires prompt correction and cardiac
monitoring.
Q4. A client with stable angina asks when prescribed sublingual
nitroglycerin should be used. Which instruction is most appropriate?
A) Take one tablet every morning regardless of symptoms
B) Swallow the tablet with water after meals
C) Use the medication only after chest pain has lasted 15 minutes
D) Place one dose under the tongue at the onset of chest discomfort
Correct Answer: D) Place one dose under the tongue at the onset of chest
discomfort
, Rationale: Sublingual nitroglycerin should be taken promptly when anginal
discomfort begins because rapid vasodilation reduces myocardial oxygen
demand and can relieve ischemia. Waiting for persistent pain may delay
treatment of potentially significant myocardial ischemia.
Q5. Four hours after a femoral cardiac catheterization, which finding
requires immediate intervention?
A) Small area of bruising at the insertion site
B) Sudden back pain with hypotension
C) Mild tenderness at the puncture site
D) Heart rate of 78 beats/min
Correct Answer: B) Sudden back pain with hypotension
Rationale: Sudden back or flank pain with hypotension after femoral
catheterization can indicate retroperitoneal hemorrhage, a potentially life-
threatening complication. The client requires rapid assessment,
hemodynamic support, and notification of the appropriate provider.
Q6. Which assessment finding is most characteristic of right-sided
heart failure?
A) Inspiratory crackles
B) Orthopnea
C) Jugular venous distention and dependent edema
D) Pink frothy sputum
Correct Answer: C) Jugular venous distention and dependent edema
Rationale: Right ventricular failure causes systemic venous congestion,
producing jugular venous distention, peripheral edema, hepatomegaly, and
weight gain. Crackles, orthopnea, and pink frothy sputum primarily reflect
pulmonary congestion associated with left ventricular dysfunction.
Q7. The cardiac monitor shows atrial fibrillation with a ventricular
rate of 146 beats/min. The client is hypotensive, diaphoretic, and
reports chest discomfort. Which intervention should the nurse
anticipate?
A) Synchronized cardioversion
B) Ambulation to improve circulation
C) Oral potassium supplementation
D) Observation for spontaneous conversion
