1
HESI MED-SURG V1 TEST BANK 2026/2027 | Version 1
Verified Q&A | Complete Med-Surg Exam Bank | Pass
Guaranteed - A+ Graded
Section 1: Cardiovascular Foundations (Questions 1-17)
Q1. A patient with chest pain receives three sublingual nitroglycerin tablets 5 minutes
apart without relief. The 12-lead ECG shows ST-segment elevation in leads V1-V4.
Which interpretation is most accurate?
A. Stable angina requiring rest
B. Unstable angina without myocardial damage
C. Acute anterior ST-elevation myocardial infarction
D. Prinzmetal angina
C. Acute anterior ST-elevation myocardial infarction [CORRECT]
Rationale: Chest pain unrelieved by nitroglycerin with ST-segment elevation indicates
acute STEMI; angina is typically relieved by nitroglycerin and does not cause
persistent ST elevation. Correct Answer: C
Q2. Which cardiac biomarker rises within 3-6 hours after myocardial infarction, peaks
at 12-24 hours, and is the primary marker used to diagnose MI?
A. Creatine kinase-MB (CK-MB)
B. Myoglobin
C. Troponin I or T
D. LDH
C. Troponin I or T [CORRECT]
Rationale: Troponin is highly specific for cardiac muscle injury, rises within 3-6 hours,
peaks at 12-24 hours, and remains elevated for up to 10-14 days. Correct Answer: C
,2
Q3. A patient has a blood pressure of 138/88 mmHg on three separate occasions
with no comorbidities. According to current ACC/AHA guidelines, how is this blood
pressure classified?
A. Normal
B. Elevated
C. Stage 1 hypertension
D. Stage 2 hypertension
C. Stage 1 hypertension [CORRECT]
Rationale: ACC/AHA guidelines classify systolic 130-139 or diastolic 80-89 as Stage 1
hypertension; normal is <120/80 and elevated is 120-129/<80. Correct Answer: C
Q4. A nurse is teaching lifestyle modifications to a patient newly diagnosed with
Stage 1 hypertension. Which patient statement indicates understanding of the DASH
eating plan?
A. "I will increase my sodium intake to prevent dehydration."
B. "I should eat more red meat and full-fat dairy products."
C. "I will increase fruits, vegetables, whole grains, and low-fat dairy while reducing
sodium."
D. "I should avoid all carbohydrates and focus only on protein."
C. "I will increase fruits, vegetables, whole grains, and low-fat dairy while
reducing sodium." [CORRECT]
Rationale: The DASH diet emphasizes fruits, vegetables, whole grains, low-fat dairy,
lean protein, and reduced sodium; high sodium and saturated fat are discouraged.
Correct Answer: C
Q5. A patient prescribed hydrochlorothiazide for hypertension reports muscle
weakness and fatigue. Which laboratory value should the nurse check first?
,3
A. Blood urea nitrogen (BUN)
B. Serum potassium
C. Serum calcium
D. Hemoglobin
B. Serum potassium [CORRECT]
Rationale: Thiazide diuretics promote potassium wasting and can cause hypokalemia,
which manifests as muscle weakness and fatigue; monitoring potassium is essential.
Correct Answer: B
Q6. A patient taking lisinopril develops a dry, nonproductive cough. Which
medication class would the provider likely prescribe as an alternative?
A. Beta-blocker
B. Angiotensin II receptor blocker (ARB)
C. Calcium channel blocker
D. Loop diuretic
B. Angiotensin II receptor blocker (ARB) [CORRECT]
Rationale: ACE inhibitors cause bradykinin accumulation leading to cough; ARBs
block angiotensin II without affecting bradykinin and are the preferred alternative.
Correct Answer: B
Q7. Which side effect is most specific to angiotensin-converting enzyme (ACE)
inhibitors and requires immediate discontinuation of the drug?
A. Hypokalemia
B. Hyperkalemia
C. Angioedema
D. Hyperglycemia
C. Angioedema [CORRECT]
, 4
Rationale: Angioedema (swelling of face, lips, tongue, airway) is a rare but life-
threatening side effect of ACE inhibitors requiring immediate drug discontinuation
and emergency intervention. Correct Answer: C
Q8. A patient with heart failure is instructed to weigh daily. The patient calls the clinic
reporting a 3-pound weight gain in 24 hours. What is the nurse's best instruction?
A. "Continue your current medications and call back in one week."
B. "Restrict fluids to 500 mL per day until you see your doctor."
C. "Contact your provider today because this may indicate fluid retention requiring
medication adjustment."
D. "Stop taking your diuretic until the swelling goes down."
C. "Contact your provider today because this may indicate fluid retention
requiring medication adjustment." [CORRECT]
Rationale: A weight gain of 2-3 pounds in 24 hours or 5 pounds in a week indicates
fluid retention in heart failure and requires prompt provider notification for possible
diuretic adjustment. Correct Answer: C
Q9. A patient with atrial fibrillation is prescribed warfarin. Which laboratory test
monitors the therapeutic effect of this medication?
A. Activated partial thromboplastin time (aPTT)
B. International normalized ratio (INR)
C. Prothrombin time (PT) alone
D. Platelet count
B. International normalized ratio (INR) [CORRECT]
Rationale: Warfarin therapy is monitored using INR, which standardizes PT results;
therapeutic INR for atrial fibrillation is typically 2.0-3.0. Correct Answer: B
HESI MED-SURG V1 TEST BANK 2026/2027 | Version 1
Verified Q&A | Complete Med-Surg Exam Bank | Pass
Guaranteed - A+ Graded
Section 1: Cardiovascular Foundations (Questions 1-17)
Q1. A patient with chest pain receives three sublingual nitroglycerin tablets 5 minutes
apart without relief. The 12-lead ECG shows ST-segment elevation in leads V1-V4.
Which interpretation is most accurate?
A. Stable angina requiring rest
B. Unstable angina without myocardial damage
C. Acute anterior ST-elevation myocardial infarction
D. Prinzmetal angina
C. Acute anterior ST-elevation myocardial infarction [CORRECT]
Rationale: Chest pain unrelieved by nitroglycerin with ST-segment elevation indicates
acute STEMI; angina is typically relieved by nitroglycerin and does not cause
persistent ST elevation. Correct Answer: C
Q2. Which cardiac biomarker rises within 3-6 hours after myocardial infarction, peaks
at 12-24 hours, and is the primary marker used to diagnose MI?
A. Creatine kinase-MB (CK-MB)
B. Myoglobin
C. Troponin I or T
D. LDH
C. Troponin I or T [CORRECT]
Rationale: Troponin is highly specific for cardiac muscle injury, rises within 3-6 hours,
peaks at 12-24 hours, and remains elevated for up to 10-14 days. Correct Answer: C
,2
Q3. A patient has a blood pressure of 138/88 mmHg on three separate occasions
with no comorbidities. According to current ACC/AHA guidelines, how is this blood
pressure classified?
A. Normal
B. Elevated
C. Stage 1 hypertension
D. Stage 2 hypertension
C. Stage 1 hypertension [CORRECT]
Rationale: ACC/AHA guidelines classify systolic 130-139 or diastolic 80-89 as Stage 1
hypertension; normal is <120/80 and elevated is 120-129/<80. Correct Answer: C
Q4. A nurse is teaching lifestyle modifications to a patient newly diagnosed with
Stage 1 hypertension. Which patient statement indicates understanding of the DASH
eating plan?
A. "I will increase my sodium intake to prevent dehydration."
B. "I should eat more red meat and full-fat dairy products."
C. "I will increase fruits, vegetables, whole grains, and low-fat dairy while reducing
sodium."
D. "I should avoid all carbohydrates and focus only on protein."
C. "I will increase fruits, vegetables, whole grains, and low-fat dairy while
reducing sodium." [CORRECT]
Rationale: The DASH diet emphasizes fruits, vegetables, whole grains, low-fat dairy,
lean protein, and reduced sodium; high sodium and saturated fat are discouraged.
Correct Answer: C
Q5. A patient prescribed hydrochlorothiazide for hypertension reports muscle
weakness and fatigue. Which laboratory value should the nurse check first?
,3
A. Blood urea nitrogen (BUN)
B. Serum potassium
C. Serum calcium
D. Hemoglobin
B. Serum potassium [CORRECT]
Rationale: Thiazide diuretics promote potassium wasting and can cause hypokalemia,
which manifests as muscle weakness and fatigue; monitoring potassium is essential.
Correct Answer: B
Q6. A patient taking lisinopril develops a dry, nonproductive cough. Which
medication class would the provider likely prescribe as an alternative?
A. Beta-blocker
B. Angiotensin II receptor blocker (ARB)
C. Calcium channel blocker
D. Loop diuretic
B. Angiotensin II receptor blocker (ARB) [CORRECT]
Rationale: ACE inhibitors cause bradykinin accumulation leading to cough; ARBs
block angiotensin II without affecting bradykinin and are the preferred alternative.
Correct Answer: B
Q7. Which side effect is most specific to angiotensin-converting enzyme (ACE)
inhibitors and requires immediate discontinuation of the drug?
A. Hypokalemia
B. Hyperkalemia
C. Angioedema
D. Hyperglycemia
C. Angioedema [CORRECT]
, 4
Rationale: Angioedema (swelling of face, lips, tongue, airway) is a rare but life-
threatening side effect of ACE inhibitors requiring immediate drug discontinuation
and emergency intervention. Correct Answer: C
Q8. A patient with heart failure is instructed to weigh daily. The patient calls the clinic
reporting a 3-pound weight gain in 24 hours. What is the nurse's best instruction?
A. "Continue your current medications and call back in one week."
B. "Restrict fluids to 500 mL per day until you see your doctor."
C. "Contact your provider today because this may indicate fluid retention requiring
medication adjustment."
D. "Stop taking your diuretic until the swelling goes down."
C. "Contact your provider today because this may indicate fluid retention
requiring medication adjustment." [CORRECT]
Rationale: A weight gain of 2-3 pounds in 24 hours or 5 pounds in a week indicates
fluid retention in heart failure and requires prompt provider notification for possible
diuretic adjustment. Correct Answer: C
Q9. A patient with atrial fibrillation is prescribed warfarin. Which laboratory test
monitors the therapeutic effect of this medication?
A. Activated partial thromboplastin time (aPTT)
B. International normalized ratio (INR)
C. Prothrombin time (PT) alone
D. Platelet count
B. International normalized ratio (INR) [CORRECT]
Rationale: Warfarin therapy is monitored using INR, which standardizes PT results;
therapeutic INR for atrial fibrillation is typically 2.0-3.0. Correct Answer: B
