HESI RN MED SURG 2025
COMPLETE LEARNING REVIEW
& STUDY GUIDE || UPDATED
VERSION
Section 1: Cardiovascular (15 Questions)
1. A client with heart failure is prescribed furosemide (Lasix). The nurse should monitor for
which electrolyte imbalance?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypercalcemia
2. The priority assessment for a client receiving intravenous nitroglycerin for chest pain is:
A. Lung sounds
B. Blood pressure
C. Heart rate
D. Pain level
3. A client with an acute myocardial infarction (MI) suddenly becomes tachycardic,
hypotensive, and has jugular venous distension. The nurse suspects:
A. Pulmonary embolism
B. Cardiogenic shock
C. Ventricular septal rupture
D. Aortic dissection
4. Which food choice by a client on a warfarin (Coumadin) diet indicates understanding of
teaching?
A. "I'll have a large spinach salad daily."
B. "I enjoy grilled chicken and steamed carrots."
,C. "I take a vitamin K supplement for energy."
D. "I drink cranberry juice every morning."
5. The hallmark symptom of left-sided heart failure is:
A. Peripheral edema
B. Jugular venous distension
C. Pulmonary congestion
D. Hepatic congestion
6. For a client with atrial fibrillation, the nurse anticipates administering which medication to
control ventricular rate?
A. Amiodarone
B. Diltiazem
C. Lidocaine
D. Atropine
7. Post-permanent pacemaker insertion, the most important discharge instruction is:
A. "You can resume swimming in 2 weeks."
B. "Avoid contact with microwave ovens."
C. "Keep your cell phone in the pocket on the opposite side."
D. "You may lift your arm above your shoulder immediately."
8. A client with deep vein thrombosis (DVT) is on a heparin infusion. The therapeutic
laboratory value is:
A. aPTT 1.5 to 2.5 times the control
B. INR between 2.0 and 3.0
C. Platelet count >150,000
D. PT within normal range
9. The most common early symptom of abdominal aortic aneurysm (AAA) is:
A. Pulsating abdominal mass
B. Severe back pain
C. Absent pedal pulses
D. Often asymptomatic
10. A client with Raynaud's disease should be taught to:
A. Soak hands in warm water during an attack
B. Massage fingers vigorously during vasospasm
C. Use nicotine gum to manage stress
D. Avoid all hand and finger exercises
,11. Which finding is a late sign of pericardial tamponade?
A. Tachycardia
B. Pulsus paradoxus
C. Muffled heart sounds
D. Hypotension
12. The primary treatment goal for hypertensive urgency is to:
A. Lower BP to normal within 1 hour
B. Lower BP gradually over 24-48 hours
C. Administer sublingual nifedipine
D. Reduce systolic BP by 25% in the first hour
13. After a cardiac catheterization via the right femoral artery, the nurse should:
A. Keep the leg flexed for 6 hours
B. Check pedal pulses and site for hematoma
C. Assist the client to ambulate immediately
D. Apply a heating pad to the site for comfort
14. Beta-blocker therapy for heart failure requires the nurse to monitor for:
A. Hypertension and bradycardia
B. Bradycardia and hypotension
C. Hyperglycemia and weight loss
D. Tachycardia and dry cough
15. The priority nursing diagnosis for a client with pulmonary edema is:
A. Impaired Gas Exchange
B. Activity Intolerance
C. Excess Fluid Volume
D. Anxiety
Section 2: Respiratory (15 Questions)
16. A client with COPD is prescribed long-term oxygen at 2 L/min. The rationale for low-flow
oxygen is to:
A. Prevent oxygen-induced hyperventilation
B. Prevent suppression of the hypoxic drive
C. Conserve oxygen resources
D. Reduce risk of combustion
, 17. The nurse should place a client with a pulmonary embolism in which position?
A. High Fowler's
B. Semi-Fowler's with legs dependent
C. Left lateral recumbent
D. High Fowler's, or as tolerated for dyspnea
18. A key assessment finding in a tension pneumothorax is:
A. Tracheal deviation to the opposite side
B. Bilateral wheezing
C. Increased breath sounds on the affected side
D. Bradypnea
19. Following a thoracentesis, the nurse's priority is to assess for:
A. Pain relief
B. Signs of pneumothorax
C. Sputum characteristics
D. Blood glucose levels
20. The best method to confirm placement of a newly inserted nasogastric (NG) tube is:
A. Auscultation of air insufflated over the stomach
B. Radiographic examination (X-ray)
C. Testing pH of aspirated fluid
D. Observing for bubbling in water
21. A client with cystic fibrosis is most at risk for deficiency of which vitamins?
A. A, D, E, K
B. B1, B6, B12
C. C and Folate
D. B12 and Iron
22. The primary reason for using a "triangular pillow" or having a client hug a pillow after a
thoracotomy is to:
A. Reduce incisional pain during coughing and movement
B. Promote lung expansion
C. Provide psychological comfort
D. Decrease risk of infection
23. A client with ARDS (Acute Respiratory Distress Syndrome) would exhibit:
A. Severe hypoxemia refractory to oxygen therapy
B. Respiratory alkalosis
COMPLETE LEARNING REVIEW
& STUDY GUIDE || UPDATED
VERSION
Section 1: Cardiovascular (15 Questions)
1. A client with heart failure is prescribed furosemide (Lasix). The nurse should monitor for
which electrolyte imbalance?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypercalcemia
2. The priority assessment for a client receiving intravenous nitroglycerin for chest pain is:
A. Lung sounds
B. Blood pressure
C. Heart rate
D. Pain level
3. A client with an acute myocardial infarction (MI) suddenly becomes tachycardic,
hypotensive, and has jugular venous distension. The nurse suspects:
A. Pulmonary embolism
B. Cardiogenic shock
C. Ventricular septal rupture
D. Aortic dissection
4. Which food choice by a client on a warfarin (Coumadin) diet indicates understanding of
teaching?
A. "I'll have a large spinach salad daily."
B. "I enjoy grilled chicken and steamed carrots."
,C. "I take a vitamin K supplement for energy."
D. "I drink cranberry juice every morning."
5. The hallmark symptom of left-sided heart failure is:
A. Peripheral edema
B. Jugular venous distension
C. Pulmonary congestion
D. Hepatic congestion
6. For a client with atrial fibrillation, the nurse anticipates administering which medication to
control ventricular rate?
A. Amiodarone
B. Diltiazem
C. Lidocaine
D. Atropine
7. Post-permanent pacemaker insertion, the most important discharge instruction is:
A. "You can resume swimming in 2 weeks."
B. "Avoid contact with microwave ovens."
C. "Keep your cell phone in the pocket on the opposite side."
D. "You may lift your arm above your shoulder immediately."
8. A client with deep vein thrombosis (DVT) is on a heparin infusion. The therapeutic
laboratory value is:
A. aPTT 1.5 to 2.5 times the control
B. INR between 2.0 and 3.0
C. Platelet count >150,000
D. PT within normal range
9. The most common early symptom of abdominal aortic aneurysm (AAA) is:
A. Pulsating abdominal mass
B. Severe back pain
C. Absent pedal pulses
D. Often asymptomatic
10. A client with Raynaud's disease should be taught to:
A. Soak hands in warm water during an attack
B. Massage fingers vigorously during vasospasm
C. Use nicotine gum to manage stress
D. Avoid all hand and finger exercises
,11. Which finding is a late sign of pericardial tamponade?
A. Tachycardia
B. Pulsus paradoxus
C. Muffled heart sounds
D. Hypotension
12. The primary treatment goal for hypertensive urgency is to:
A. Lower BP to normal within 1 hour
B. Lower BP gradually over 24-48 hours
C. Administer sublingual nifedipine
D. Reduce systolic BP by 25% in the first hour
13. After a cardiac catheterization via the right femoral artery, the nurse should:
A. Keep the leg flexed for 6 hours
B. Check pedal pulses and site for hematoma
C. Assist the client to ambulate immediately
D. Apply a heating pad to the site for comfort
14. Beta-blocker therapy for heart failure requires the nurse to monitor for:
A. Hypertension and bradycardia
B. Bradycardia and hypotension
C. Hyperglycemia and weight loss
D. Tachycardia and dry cough
15. The priority nursing diagnosis for a client with pulmonary edema is:
A. Impaired Gas Exchange
B. Activity Intolerance
C. Excess Fluid Volume
D. Anxiety
Section 2: Respiratory (15 Questions)
16. A client with COPD is prescribed long-term oxygen at 2 L/min. The rationale for low-flow
oxygen is to:
A. Prevent oxygen-induced hyperventilation
B. Prevent suppression of the hypoxic drive
C. Conserve oxygen resources
D. Reduce risk of combustion
, 17. The nurse should place a client with a pulmonary embolism in which position?
A. High Fowler's
B. Semi-Fowler's with legs dependent
C. Left lateral recumbent
D. High Fowler's, or as tolerated for dyspnea
18. A key assessment finding in a tension pneumothorax is:
A. Tracheal deviation to the opposite side
B. Bilateral wheezing
C. Increased breath sounds on the affected side
D. Bradypnea
19. Following a thoracentesis, the nurse's priority is to assess for:
A. Pain relief
B. Signs of pneumothorax
C. Sputum characteristics
D. Blood glucose levels
20. The best method to confirm placement of a newly inserted nasogastric (NG) tube is:
A. Auscultation of air insufflated over the stomach
B. Radiographic examination (X-ray)
C. Testing pH of aspirated fluid
D. Observing for bubbling in water
21. A client with cystic fibrosis is most at risk for deficiency of which vitamins?
A. A, D, E, K
B. B1, B6, B12
C. C and Folate
D. B12 and Iron
22. The primary reason for using a "triangular pillow" or having a client hug a pillow after a
thoracotomy is to:
A. Reduce incisional pain during coughing and movement
B. Promote lung expansion
C. Provide psychological comfort
D. Decrease risk of infection
23. A client with ARDS (Acute Respiratory Distress Syndrome) would exhibit:
A. Severe hypoxemia refractory to oxygen therapy
B. Respiratory alkalosis
