NURS 319 HESI MED-SURG ADULT HEALTH] QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027
SECTION ONE: QUESTIONS 1-100
1. A client with heart failure is prescribed furosemide. Which assessment finding indicates that the
medication is having the desired therapeutic effect?
A. Increased jugular venous distention
B. Weight loss of 2 kg in 24 hours
C. Heart rate of 110 beats per minute
D. Blood pressure of 90/60 mm Hg
🟢 B. Weight loss of 2 kg in 24 hours
🔴 RATIONALE: Furosemide is a loop diuretic used to reduce fluid volume overload in heart failure. A weight
loss of 1-2 kg in 24 hours indicates effective diuresis and a reduction in total body fluid, which is a primary
therapeutic goal. Increased JVD, tachycardia, and hypotension are signs of worsening failure or potential
adverse effects.
2. A nurse is caring for a client with cirrhosis who has ascites. Which dietary modification is most important
for this client?
A. High-protein diet
B. Low-sodium diet
C. High-carbohydrate diet
D. Low-fat diet
,🟢 B. Low-sodium diet
🔴 RATIONALE: Ascites, the accumulation of fluid in the peritoneal cavity, is a complication of cirrhosis and
portal hypertension. A low-sodium diet is crucial to minimize fluid retention, which can exacerbate ascites and
edema. Restricting sodium helps prevent further fluid accumulation and reduces the workload on the liver and
kidneys.
3. A postoperative client reports sudden chest pain and shortness of breath. The nurse notes a pulse
oximetry reading of 88% on room air. What is the nurse's priority action?
A. Administer a PRN dose of morphine.
B. Apply a nasal cannula at 2 L/min.
C. Prepare for immediate intubation.
D. Notify the physician and assess for DVT symptoms.
🟢 D. Notify the physician and assess for DVT symptoms.
🔴 RATIONALE: The sudden onset of chest pain, dyspnea, and hypoxia in a postoperative client is a classic
presentation for a pulmonary embolism (PE). The priority is to notify the physician immediately to initiate a
rapid diagnostic workup and treatment while continuing to assess for other signs of PE, such as unilateral leg
swelling or calf pain (DVT symptoms). High-flow oxygen should be applied, not just 2 L/min, but the immediate
notification is the priority action.
4. A client with type 1 diabetes mellitus is found unresponsive. Which action should the nurse take first?
A. Administer 50% dextrose IV push.
B. Check the client's blood glucose level.
C. Administer glucagon intramuscularly.
D. Call a code blue.
,🟢 B. Check the client's blood glucose level.
🔴 RATIONALE: For an unresponsive client with type 1 diabetes, the first action is to assess the blood glucose
level to differentiate between hypoglycemia and hyperglycemia. While hypoglycemia is common, treatment
must be based on evidence. Immediately administering dextrose or glucagon without a blood glucose level is
unsafe if the cause is hyperglycemia or another event.
5. A client with chronic obstructive pulmonary disease (COPD) has an arterial blood gas (ABG) result showing
pH 7.31, PaCO2 58 mm Hg, and HCO3- 26 mEq/L. Which interpretation is correct?
A. Uncompensated metabolic acidosis
B. Uncompensated respiratory acidosis
C. Partially compensated respiratory acidosis
D. Fully compensated respiratory acidosis
🟢 C. Partially compensated respiratory acidosis
🔴 RATIONALE: The ABG shows a low pH (acidemia) and elevated PaCO2, indicating a respiratory acidosis. The
HCO3- is elevated (above 24 mEq/L), indicating the kidneys are attempting to compensate. However, the pH is
not yet in the normal range, so this is a partially compensated respiratory acidosis.
6. The nurse is teaching a client about warfarin therapy. Which statement by the client indicates a need for
further teaching?
A. "I will avoid eating large amounts of leafy green vegetables."
B. "I will use a soft-bristled toothbrush to prevent bleeding."
C. "I can take ibuprofen for my occasional headaches."
D. "I will get my blood drawn regularly to check my INR."
🟢 C. "I can take ibuprofen for my occasional headaches."
🔴 RATIONALE: Warfarin is an anticoagulant that increases the risk of bleeding. Ibuprofen is an NSAID that also
, has antiplatelet effects and can further increase the risk of gastrointestinal bleeding and potentiate warfarin's
effects. Clients on warfarin should avoid NSAIDs and use acetaminophen for pain or headache if approved by
their provider.
7. A client with acute pancreatitis is complaining of severe abdominal pain. What is the most appropriate
intervention for pain management?
A. Morphine sulfate administered via IV push.
B. Meperidine (Demerol) administered intramuscularly.
C. Application of a heating pad to the abdomen.
D. Encouraging oral fluids to dilute gastric acid.
🟢 A. Morphine sulfate administered via IV push.
🔴 RATIONALE: Pain management is a critical aspect of caring for a client with acute pancreatitis. IV
administration of morphine is preferred because it provides rapid and effective pain relief, and the IV route is
safe when the client is NPO. Meperidine is no longer the drug of choice due to its neurotoxic metabolite. Heat
to the abdomen is not effective and can cause burns. Oral fluids are withheld initially to rest the pancreas.
8. A nurse is providing discharge teaching to a client with a new ileostomy. Which instruction should the
nurse include?
A. "You need to irrigate your stoma daily to maintain patency."
B. "You should change the entire ostomy appliance at least once a week."
C. "You need to take enteric-coated medications as prescribed."
D. "You should avoid high-fiber foods to prevent blockage."
🟢 D. "You should avoid high-fiber foods to prevent blockage."
🔴 RATIONALE: An ileostomy is located in the small intestine, which has a narrow lumen. High-fiber foods, such
PLUS RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027
SECTION ONE: QUESTIONS 1-100
1. A client with heart failure is prescribed furosemide. Which assessment finding indicates that the
medication is having the desired therapeutic effect?
A. Increased jugular venous distention
B. Weight loss of 2 kg in 24 hours
C. Heart rate of 110 beats per minute
D. Blood pressure of 90/60 mm Hg
🟢 B. Weight loss of 2 kg in 24 hours
🔴 RATIONALE: Furosemide is a loop diuretic used to reduce fluid volume overload in heart failure. A weight
loss of 1-2 kg in 24 hours indicates effective diuresis and a reduction in total body fluid, which is a primary
therapeutic goal. Increased JVD, tachycardia, and hypotension are signs of worsening failure or potential
adverse effects.
2. A nurse is caring for a client with cirrhosis who has ascites. Which dietary modification is most important
for this client?
A. High-protein diet
B. Low-sodium diet
C. High-carbohydrate diet
D. Low-fat diet
,🟢 B. Low-sodium diet
🔴 RATIONALE: Ascites, the accumulation of fluid in the peritoneal cavity, is a complication of cirrhosis and
portal hypertension. A low-sodium diet is crucial to minimize fluid retention, which can exacerbate ascites and
edema. Restricting sodium helps prevent further fluid accumulation and reduces the workload on the liver and
kidneys.
3. A postoperative client reports sudden chest pain and shortness of breath. The nurse notes a pulse
oximetry reading of 88% on room air. What is the nurse's priority action?
A. Administer a PRN dose of morphine.
B. Apply a nasal cannula at 2 L/min.
C. Prepare for immediate intubation.
D. Notify the physician and assess for DVT symptoms.
🟢 D. Notify the physician and assess for DVT symptoms.
🔴 RATIONALE: The sudden onset of chest pain, dyspnea, and hypoxia in a postoperative client is a classic
presentation for a pulmonary embolism (PE). The priority is to notify the physician immediately to initiate a
rapid diagnostic workup and treatment while continuing to assess for other signs of PE, such as unilateral leg
swelling or calf pain (DVT symptoms). High-flow oxygen should be applied, not just 2 L/min, but the immediate
notification is the priority action.
4. A client with type 1 diabetes mellitus is found unresponsive. Which action should the nurse take first?
A. Administer 50% dextrose IV push.
B. Check the client's blood glucose level.
C. Administer glucagon intramuscularly.
D. Call a code blue.
,🟢 B. Check the client's blood glucose level.
🔴 RATIONALE: For an unresponsive client with type 1 diabetes, the first action is to assess the blood glucose
level to differentiate between hypoglycemia and hyperglycemia. While hypoglycemia is common, treatment
must be based on evidence. Immediately administering dextrose or glucagon without a blood glucose level is
unsafe if the cause is hyperglycemia or another event.
5. A client with chronic obstructive pulmonary disease (COPD) has an arterial blood gas (ABG) result showing
pH 7.31, PaCO2 58 mm Hg, and HCO3- 26 mEq/L. Which interpretation is correct?
A. Uncompensated metabolic acidosis
B. Uncompensated respiratory acidosis
C. Partially compensated respiratory acidosis
D. Fully compensated respiratory acidosis
🟢 C. Partially compensated respiratory acidosis
🔴 RATIONALE: The ABG shows a low pH (acidemia) and elevated PaCO2, indicating a respiratory acidosis. The
HCO3- is elevated (above 24 mEq/L), indicating the kidneys are attempting to compensate. However, the pH is
not yet in the normal range, so this is a partially compensated respiratory acidosis.
6. The nurse is teaching a client about warfarin therapy. Which statement by the client indicates a need for
further teaching?
A. "I will avoid eating large amounts of leafy green vegetables."
B. "I will use a soft-bristled toothbrush to prevent bleeding."
C. "I can take ibuprofen for my occasional headaches."
D. "I will get my blood drawn regularly to check my INR."
🟢 C. "I can take ibuprofen for my occasional headaches."
🔴 RATIONALE: Warfarin is an anticoagulant that increases the risk of bleeding. Ibuprofen is an NSAID that also
, has antiplatelet effects and can further increase the risk of gastrointestinal bleeding and potentiate warfarin's
effects. Clients on warfarin should avoid NSAIDs and use acetaminophen for pain or headache if approved by
their provider.
7. A client with acute pancreatitis is complaining of severe abdominal pain. What is the most appropriate
intervention for pain management?
A. Morphine sulfate administered via IV push.
B. Meperidine (Demerol) administered intramuscularly.
C. Application of a heating pad to the abdomen.
D. Encouraging oral fluids to dilute gastric acid.
🟢 A. Morphine sulfate administered via IV push.
🔴 RATIONALE: Pain management is a critical aspect of caring for a client with acute pancreatitis. IV
administration of morphine is preferred because it provides rapid and effective pain relief, and the IV route is
safe when the client is NPO. Meperidine is no longer the drug of choice due to its neurotoxic metabolite. Heat
to the abdomen is not effective and can cause burns. Oral fluids are withheld initially to rest the pancreas.
8. A nurse is providing discharge teaching to a client with a new ileostomy. Which instruction should the
nurse include?
A. "You need to irrigate your stoma daily to maintain patency."
B. "You should change the entire ostomy appliance at least once a week."
C. "You need to take enteric-coated medications as prescribed."
D. "You should avoid high-fiber foods to prevent blockage."
🟢 D. "You should avoid high-fiber foods to prevent blockage."
🔴 RATIONALE: An ileostomy is located in the small intestine, which has a narrow lumen. High-fiber foods, such
