HESI MEDICAL-SURGICAL NGN
EXAM 2026|||questions and answers
with rationales/graded A+/2026
update/100% correct /instant
download
80+ Questions | Updated for 2026 NGN Formats | With Rationales
SECTION A: Cardiovascular Disorders (Questions 1–12)
1. A client with heart failure is prescribed furosemide 40 mg IV push. Which
assessment finding requires immediate action?
A. Serum potassium 3.8 mEq/L
B. Blood pressure 100/60 mm Hg
C. Jugular venous distention
D. Urine output 30 mL/hr
Rationale: JVD indicates worsening fluid overload and possible right-sided heart
failure, requiring immediate intervention. Furosemide is given to reduce preload.
2. A nurse assesses a client post-–myocardial infarction who reports sudden
sharp chest pain worsened by inspiration. The nurse suspects:
A. Pericarditis
B. Pulmonary embolism
C. Angina
D. Aortic dissection
Rationale: Post-MI pericarditis (Dressler’s syndrome) presents with pleuritic chest
pain, friction rub, and fever.
,3. A client with atrial fibrillation has a heart rate of 140 bpm. Which
medication should the nurse anticipate?
A. Adenosine
B. Diltiazem
C. Epinephrine
D. Atropine
Rationale: Diltiazem (calcium channel blocker) controls ventricular rate in atrial
fibrillation.
4. Select all that apply: Signs of left-sided heart failure include:
☐ Crackles in lung bases
☐ Paroxysmal nocturnal dyspnea
☐ Jugular venous distention
☐ S3 heart sound
☐ Peripheral edema
Rationale: Left-sided failure causes pulmonary congestion (crackles, PND, S3).
JVD and edema are right-sided.
5. A client post-cardiac catheterization reports groin swelling and ecchymosis.
The nurse’s priority action is:
A. Apply warm compress
B. Apply firm pressure 1 inch above the site
C. Elevate the leg
D. Administer heparin
Rationale: Manual pressure above the site (to compress the arterial puncture) is
critical to prevent hematoma expansion.
6. A client with hypertension is started on lisinopril. Which adverse effect
requires teaching?
A. Dry cough
B. Hyperkalemia
C. Angioedema
D. All of the above
Rationale: ACE inhibitors can cause dry cough (common), hyperkalemia, and life-
threatening angioedema.
, 7. A client with infective endocarditis presents with splinter hemorrhages,
Osler nodes, and fever. The nurse prioritizes:
A. Pain management
B. Blood cultures before antibiotics
C. Bed rest
D. Anticoagulation therapy
Rationale: Blood cultures must be obtained before starting antibiotics to identify
the causative organism.
8. A client’s telemetry shows a regular rhythm with no P waves and wide QRS
complexes. The nurse interprets:
A. Atrial fibrillation
B. Ventricular tachycardia
C. Sinus bradycardia
D. First-degree AV block
Rationale: Wide QRS, no P waves, regular rhythm → ventricular tachycardia.
9. A client with an abdominal aortic aneurysm reports sudden severe back
pain and hypotension. The nurse suspects:
A. Renal colic
B. Ruptured aneurysm
C. Pancreatitis
D. Musculoskeletal strain
Rationale: Triad of pain, hypotension, pulsatile abdominal mass indicates rupture
— surgical emergency.
10. A client on warfarin has an INR of 4.5 without bleeding. The nurse
anticipates:
A. Protamine sulfate
B. Hold warfarin and monitor
C. Vitamin K 10 mg IV
D. Fresh frozen plasma
Rationale: INR 4.5 without bleeding → hold warfarin; Vitamin K reserved for
bleeding or very high INR >10.
11. A nurse teaches a client with peripheral artery disease. Which statement
indicates understanding?
EXAM 2026|||questions and answers
with rationales/graded A+/2026
update/100% correct /instant
download
80+ Questions | Updated for 2026 NGN Formats | With Rationales
SECTION A: Cardiovascular Disorders (Questions 1–12)
1. A client with heart failure is prescribed furosemide 40 mg IV push. Which
assessment finding requires immediate action?
A. Serum potassium 3.8 mEq/L
B. Blood pressure 100/60 mm Hg
C. Jugular venous distention
D. Urine output 30 mL/hr
Rationale: JVD indicates worsening fluid overload and possible right-sided heart
failure, requiring immediate intervention. Furosemide is given to reduce preload.
2. A nurse assesses a client post-–myocardial infarction who reports sudden
sharp chest pain worsened by inspiration. The nurse suspects:
A. Pericarditis
B. Pulmonary embolism
C. Angina
D. Aortic dissection
Rationale: Post-MI pericarditis (Dressler’s syndrome) presents with pleuritic chest
pain, friction rub, and fever.
,3. A client with atrial fibrillation has a heart rate of 140 bpm. Which
medication should the nurse anticipate?
A. Adenosine
B. Diltiazem
C. Epinephrine
D. Atropine
Rationale: Diltiazem (calcium channel blocker) controls ventricular rate in atrial
fibrillation.
4. Select all that apply: Signs of left-sided heart failure include:
☐ Crackles in lung bases
☐ Paroxysmal nocturnal dyspnea
☐ Jugular venous distention
☐ S3 heart sound
☐ Peripheral edema
Rationale: Left-sided failure causes pulmonary congestion (crackles, PND, S3).
JVD and edema are right-sided.
5. A client post-cardiac catheterization reports groin swelling and ecchymosis.
The nurse’s priority action is:
A. Apply warm compress
B. Apply firm pressure 1 inch above the site
C. Elevate the leg
D. Administer heparin
Rationale: Manual pressure above the site (to compress the arterial puncture) is
critical to prevent hematoma expansion.
6. A client with hypertension is started on lisinopril. Which adverse effect
requires teaching?
A. Dry cough
B. Hyperkalemia
C. Angioedema
D. All of the above
Rationale: ACE inhibitors can cause dry cough (common), hyperkalemia, and life-
threatening angioedema.
, 7. A client with infective endocarditis presents with splinter hemorrhages,
Osler nodes, and fever. The nurse prioritizes:
A. Pain management
B. Blood cultures before antibiotics
C. Bed rest
D. Anticoagulation therapy
Rationale: Blood cultures must be obtained before starting antibiotics to identify
the causative organism.
8. A client’s telemetry shows a regular rhythm with no P waves and wide QRS
complexes. The nurse interprets:
A. Atrial fibrillation
B. Ventricular tachycardia
C. Sinus bradycardia
D. First-degree AV block
Rationale: Wide QRS, no P waves, regular rhythm → ventricular tachycardia.
9. A client with an abdominal aortic aneurysm reports sudden severe back
pain and hypotension. The nurse suspects:
A. Renal colic
B. Ruptured aneurysm
C. Pancreatitis
D. Musculoskeletal strain
Rationale: Triad of pain, hypotension, pulsatile abdominal mass indicates rupture
— surgical emergency.
10. A client on warfarin has an INR of 4.5 without bleeding. The nurse
anticipates:
A. Protamine sulfate
B. Hold warfarin and monitor
C. Vitamin K 10 mg IV
D. Fresh frozen plasma
Rationale: INR 4.5 without bleeding → hold warfarin; Vitamin K reserved for
bleeding or very high INR >10.
11. A nurse teaches a client with peripheral artery disease. Which statement
indicates understanding?
