MED SURG FINAL HESI EXAM (NEW UPDATED VERSION) LATEST ACTUAL
EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED QUESTIONS AND
ANSWERS) | GUARANTEED PASS A+ [2026]
2 HESI EXAMS VERSIONS
1. A patient with a history of MI reports chest pain radiating to the left arm. What is the priority
action?
A. Administer aspirin per protocol
B. Take vital signs and document
C. Encourage rest
D. Give IV fluids
Answer: A
Rationale: Aspirin is critical to reduce platelet aggregation and limit infarct size; this is the
priority intervention.
2. Which ECG change indicates myocardial ischemia?
A. ST-segment depression
B. Peaked T waves
C. U waves
D. Shortened QT interval
Answer: A
Rationale: ST-segment depression or T-wave inversion indicates ischemia.
3. A patient with heart failure has crackles in the lungs, edema, and JVD. Which drug is first-line
to reduce preload?
A. Furosemide
B. Digoxin
C. Metoprolol
D. Lisinopril
Answer: A
Rationale: Loop diuretics reduce fluid overload and pulmonary congestion.
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2026 Graded A+ EXAM
, 4. Which lab result indicates myocardial injury?
A. Elevated troponin
B. Elevated BUN
C. Low sodium
D. Elevated WBC
Answer: A
Rationale: Troponin is highly specific for myocardial cell damage.
5. Which assessment finding is most concerning in a patient on digoxin?
A. Heart rate 48 bpm
B. BP 130/80 mmHg
C. Respiratory rate 18
D. Temperature 37°C
Answer: A
Rationale: Digoxin toxicity can cause bradycardia; HR <60 bpm requires intervention.
6. A patient is on nitroglycerin infusion for angina. What is the priority nursing assessment?
A. Blood pressure
B. Heart rate
C. Respiratory rate
D. Temperature
Answer: A
Rationale: Nitroglycerin can cause hypotension; BP monitoring is critical.
7. Which symptom indicates left-sided heart failure?
A. Pulmonary congestion and dyspnea
B. Peripheral edema
C. Jugular vein distention
D. Hepatomegaly
Answer: A
Rationale: Left-sided HF leads to pulmonary venous congestion causing dyspnea and crackles.
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2026 Graded A+ EXAM
, 8. Which symptom indicates right-sided heart failure?
A. Peripheral edema and JVD
B. Dyspnea
C. Pulmonary crackles
D. Orthopnea
Answer: A
Rationale: Right-sided HF causes systemic venous congestion, leading to edema and JVD.
9. Which drug is used to treat acute hypertensive crisis in the hospital?
A. IV nitroprusside
B. Oral lisinopril
C. Furosemide
D. Aspirin
Answer: A
Rationale: IV nitroprusside rapidly reduces BP in emergencies.
10. Which ECG change is associated with hyperkalemia?
A. Peaked T waves
B. ST-segment depression
C. U waves
D. Short QT interval
Answer: A
Rationale: Hyperkalemia alters cardiac conduction, producing peaked T waves.
11. Which lab is elevated in heart failure and indicates ventricular stretch?
A. BNP
B. Hemoglobin
C. Platelet count
D. Sodium
Answer: A
Rationale: BNP is released when ventricular pressure increases, indicating HF severity.
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2026 Graded A+ EXAM
, 12. Which symptom indicates worsening cardiac output?
A. Confusion and hypotension
B. Mild headache
C. Flushed skin
D. Low-grade fever
Answer: A
Rationale: Decreased perfusion leads to CNS changes and hypotension.
13. Which is a priority action for suspected cardiac tamponade?
A. Notify provider immediately
B. Administer IV fluids only
C. Encourage deep breathing
D. Monitor vital signs
Answer: A
Rationale: Cardiac tamponade is life-threatening; urgent intervention is required.
14. Which action is priority for a patient with acute chest pain?
A. Administer oxygen, ECG, and pain meds as ordered
B. Document symptoms
C. Encourage ambulation
D. Monitor temperature
Answer: A
Rationale: Rapid assessment and intervention reduce risk of myocardial injury.
15. Which intervention reduces preload in HF?
A. Administer diuretics
B. Give IV fluids
C. Encourage oral intake
D. Administer beta-blockers only
Answer: A
Rationale: Diuretics decrease volume overload, reducing pulmonary and systemic congestion.
4
Page
2026 Graded A+ EXAM
EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED QUESTIONS AND
ANSWERS) | GUARANTEED PASS A+ [2026]
2 HESI EXAMS VERSIONS
1. A patient with a history of MI reports chest pain radiating to the left arm. What is the priority
action?
A. Administer aspirin per protocol
B. Take vital signs and document
C. Encourage rest
D. Give IV fluids
Answer: A
Rationale: Aspirin is critical to reduce platelet aggregation and limit infarct size; this is the
priority intervention.
2. Which ECG change indicates myocardial ischemia?
A. ST-segment depression
B. Peaked T waves
C. U waves
D. Shortened QT interval
Answer: A
Rationale: ST-segment depression or T-wave inversion indicates ischemia.
3. A patient with heart failure has crackles in the lungs, edema, and JVD. Which drug is first-line
to reduce preload?
A. Furosemide
B. Digoxin
C. Metoprolol
D. Lisinopril
Answer: A
Rationale: Loop diuretics reduce fluid overload and pulmonary congestion.
1
Page
2026 Graded A+ EXAM
, 4. Which lab result indicates myocardial injury?
A. Elevated troponin
B. Elevated BUN
C. Low sodium
D. Elevated WBC
Answer: A
Rationale: Troponin is highly specific for myocardial cell damage.
5. Which assessment finding is most concerning in a patient on digoxin?
A. Heart rate 48 bpm
B. BP 130/80 mmHg
C. Respiratory rate 18
D. Temperature 37°C
Answer: A
Rationale: Digoxin toxicity can cause bradycardia; HR <60 bpm requires intervention.
6. A patient is on nitroglycerin infusion for angina. What is the priority nursing assessment?
A. Blood pressure
B. Heart rate
C. Respiratory rate
D. Temperature
Answer: A
Rationale: Nitroglycerin can cause hypotension; BP monitoring is critical.
7. Which symptom indicates left-sided heart failure?
A. Pulmonary congestion and dyspnea
B. Peripheral edema
C. Jugular vein distention
D. Hepatomegaly
Answer: A
Rationale: Left-sided HF leads to pulmonary venous congestion causing dyspnea and crackles.
2
Page
2026 Graded A+ EXAM
, 8. Which symptom indicates right-sided heart failure?
A. Peripheral edema and JVD
B. Dyspnea
C. Pulmonary crackles
D. Orthopnea
Answer: A
Rationale: Right-sided HF causes systemic venous congestion, leading to edema and JVD.
9. Which drug is used to treat acute hypertensive crisis in the hospital?
A. IV nitroprusside
B. Oral lisinopril
C. Furosemide
D. Aspirin
Answer: A
Rationale: IV nitroprusside rapidly reduces BP in emergencies.
10. Which ECG change is associated with hyperkalemia?
A. Peaked T waves
B. ST-segment depression
C. U waves
D. Short QT interval
Answer: A
Rationale: Hyperkalemia alters cardiac conduction, producing peaked T waves.
11. Which lab is elevated in heart failure and indicates ventricular stretch?
A. BNP
B. Hemoglobin
C. Platelet count
D. Sodium
Answer: A
Rationale: BNP is released when ventricular pressure increases, indicating HF severity.
3
Page
2026 Graded A+ EXAM
, 12. Which symptom indicates worsening cardiac output?
A. Confusion and hypotension
B. Mild headache
C. Flushed skin
D. Low-grade fever
Answer: A
Rationale: Decreased perfusion leads to CNS changes and hypotension.
13. Which is a priority action for suspected cardiac tamponade?
A. Notify provider immediately
B. Administer IV fluids only
C. Encourage deep breathing
D. Monitor vital signs
Answer: A
Rationale: Cardiac tamponade is life-threatening; urgent intervention is required.
14. Which action is priority for a patient with acute chest pain?
A. Administer oxygen, ECG, and pain meds as ordered
B. Document symptoms
C. Encourage ambulation
D. Monitor temperature
Answer: A
Rationale: Rapid assessment and intervention reduce risk of myocardial injury.
15. Which intervention reduces preload in HF?
A. Administer diuretics
B. Give IV fluids
C. Encourage oral intake
D. Administer beta-blockers only
Answer: A
Rationale: Diuretics decrease volume overload, reducing pulmonary and systemic congestion.
4
Page
2026 Graded A+ EXAM
