HESI MEDSURG1 CERTIFICATION
EVALUATION 2026 COMPLETE
QUESTIONS AND ACCURATE
ANSWERS GRADE A+
◉ The nurse assesses a client who has been prescribed furosemide
(Lasix) for cardiac disease. Which electrocardiographic change would be
a concern for a client taking a diuretic?
A.
Tall, spiked T waves
B.
A prolonged QT interval
C.
A widening QRS complex
D.
Presence of a U wave Answer: D.
Presence of a U wave
Rationale:
A U wave (D) is a positive deflection following the T wave and is often
present with hypokalemia (low potassium level). (A, B, and C) are all
signs of hyperkalemia.
◉ A 43-year-old homeless, malnourished female client with a history of
alcoholism is transferred to the ICU. She is placed on telemetry, and the
,rhythm strip shown is obtained. The nurse palpates a heart rate of 160
beats/min, and the client's blood pressure is 90/54 mm Hg. Based on
these findings, which IV medication should the nurse administer?
A.
Amiodarone (Cordarone)
B.
Magnesium sulfate
C.
Lidocaine (Xylocaine)
D.
Procainamide (Pronestyl) Answer: B.
Magnesium sulfate
Rationale:
Because the client has chronic alcoholism, she is likely to have
hypomagnesemia. (B) is the recommended drug for torsades de pointes,
which is a form of polymorphic ventricular tachycardia (VT) usually
associated with a prolonged QT interval that occurs with
hypomagnesemia. (A and D) increase the QT interval, which can cause
the torsades to worsen. (C) is the antiarrhythmic of choice in most cases
of drug-induced monomorphic VT, not torsades.
◉ When developing a discharge teaching plan for a client after the
insertion of a permanent pacemaker, the nurse writes a goal of "The
client will verbalize symptoms of pacemaker failure." Which behavior
indicates that the goal has been met?
,A.
The client demonstrates the procedures to change the rate of the
pacemaker using a magnet.
B.
The client carries a card in his wallet stating the type and serial number
of the pacemaker.
C.
The client tells the nurse that it is important to report redness and
tenderness at the insertion site.
D.
The client states that changes in the pulse and feelings of dizziness are
significant changes. Answer: D.
The client states that changes in the pulse and feelings of dizziness are
significant changes.
Rationale:
Changes in pulse rate and/or rhythm may indicate pacer failure. Feelings
of dizziness may be caused by a decreased heart rate, leading to
decreased cardiac output (D). The rate of a pacemaker is not changed by
a client, although the client may be familiar with this procedure as
explained by his health care provider (A). (B) is an important step in
preparing the client for discharge but does not demonstrate knowledge
of the symptoms of pacer failure. (C) indicates symptoms of possible
incisional infection or irritation but do not indicate pacer failure.
, ◉ The nurse teaches a client with type 2 diabetes nutritional strategies to
decrease obesity. Which food item(s) chosen by the client indicates
understanding of the teaching? (Select all that apply.)
A.
White bread
B.
Salmon
C.
Broccoli
D.
Whole milk
E.
Banana Answer: B
Salmon
C
Broccoli
E.
Banana
Rationale:
(B, C, and E) provide fresh fruits, lean meats and fish, vegetables, whole
grains, and low-fat dairy products. All are recommended by the
EVALUATION 2026 COMPLETE
QUESTIONS AND ACCURATE
ANSWERS GRADE A+
◉ The nurse assesses a client who has been prescribed furosemide
(Lasix) for cardiac disease. Which electrocardiographic change would be
a concern for a client taking a diuretic?
A.
Tall, spiked T waves
B.
A prolonged QT interval
C.
A widening QRS complex
D.
Presence of a U wave Answer: D.
Presence of a U wave
Rationale:
A U wave (D) is a positive deflection following the T wave and is often
present with hypokalemia (low potassium level). (A, B, and C) are all
signs of hyperkalemia.
◉ A 43-year-old homeless, malnourished female client with a history of
alcoholism is transferred to the ICU. She is placed on telemetry, and the
,rhythm strip shown is obtained. The nurse palpates a heart rate of 160
beats/min, and the client's blood pressure is 90/54 mm Hg. Based on
these findings, which IV medication should the nurse administer?
A.
Amiodarone (Cordarone)
B.
Magnesium sulfate
C.
Lidocaine (Xylocaine)
D.
Procainamide (Pronestyl) Answer: B.
Magnesium sulfate
Rationale:
Because the client has chronic alcoholism, she is likely to have
hypomagnesemia. (B) is the recommended drug for torsades de pointes,
which is a form of polymorphic ventricular tachycardia (VT) usually
associated with a prolonged QT interval that occurs with
hypomagnesemia. (A and D) increase the QT interval, which can cause
the torsades to worsen. (C) is the antiarrhythmic of choice in most cases
of drug-induced monomorphic VT, not torsades.
◉ When developing a discharge teaching plan for a client after the
insertion of a permanent pacemaker, the nurse writes a goal of "The
client will verbalize symptoms of pacemaker failure." Which behavior
indicates that the goal has been met?
,A.
The client demonstrates the procedures to change the rate of the
pacemaker using a magnet.
B.
The client carries a card in his wallet stating the type and serial number
of the pacemaker.
C.
The client tells the nurse that it is important to report redness and
tenderness at the insertion site.
D.
The client states that changes in the pulse and feelings of dizziness are
significant changes. Answer: D.
The client states that changes in the pulse and feelings of dizziness are
significant changes.
Rationale:
Changes in pulse rate and/or rhythm may indicate pacer failure. Feelings
of dizziness may be caused by a decreased heart rate, leading to
decreased cardiac output (D). The rate of a pacemaker is not changed by
a client, although the client may be familiar with this procedure as
explained by his health care provider (A). (B) is an important step in
preparing the client for discharge but does not demonstrate knowledge
of the symptoms of pacer failure. (C) indicates symptoms of possible
incisional infection or irritation but do not indicate pacer failure.
, ◉ The nurse teaches a client with type 2 diabetes nutritional strategies to
decrease obesity. Which food item(s) chosen by the client indicates
understanding of the teaching? (Select all that apply.)
A.
White bread
B.
Salmon
C.
Broccoli
D.
Whole milk
E.
Banana Answer: B
Salmon
C
Broccoli
E.
Banana
Rationale:
(B, C, and E) provide fresh fruits, lean meats and fish, vegetables, whole
grains, and low-fat dairy products. All are recommended by the
