Page 1 of 143
TEST BANK FOR HESI MED SURG NURSING
COMPREHENSIVE PRACTICE QUESTION
BANK
2026–2027 ACADEMIC YEAR | ALIGNED WITH
HESI BLUEPRINT & NCSBN CJMM
ITSJEREGUIDES
# SECTION 1.0: CARDIOVASCULAR DISORDERS
## 1.1 Heart Failure & Hypertension
**Question 1**
The nurse is caring for a client with heart failure. Which nursing intervention is most appropriate
to monitor fluid status?
A. Encourage excessive sodium intake
B. Monitor daily weights and fluid status
C. Delay prescribed treatments
D. Avoid documenting assessment findings
**Correct Answer: B. Monitor daily weights and fluid status**
**Rationale:** Clients with heart failure require careful monitoring of daily weights and fluid
status to detect fluid retention early. A weight gain of 2–3 pounds in 24 hours or 5 pounds in a
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week indicates worsening fluid overload requiring intervention . Daily weights should be taken
at the same time each day, using the same scale, with the client wearing similar clothing. Sodium
intake should be restricted, not encouraged, and documentation is essential for tracking trends.
---
**Question 2**
The nurse is assessing a client with right-sided heart failure. Which finding is most consistent
with this diagnosis?
A. Pulmonary crackles
B. Jugular venous distention (JVD)
C. Orthopnea
D. Paroxysmal nocturnal dyspnea
**Correct Answer: B. Jugular venous distention (JVD)**
**Rationale:** Right-sided heart failure presents with signs of systemic venous congestion,
including JVD, peripheral edema, hepatomegaly, and ascites. Pulmonary crackles (A), orthopnea
(C), and paroxysmal nocturnal dyspnea (D) are classic findings of left-sided heart failure due to
pulmonary congestion . Understanding the distinction between right and left heart failure is
essential for targeted nursing interventions.
---
**Question 3**
A client with hypertension is prescribed a thiazide diuretic. Which laboratory value should the
nurse monitor closely?
A. Serum sodium
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B. Serum potassium
C. Serum calcium
D. Serum glucose
**Correct Answer: B. Serum potassium**
**Rationale:** Thiazide diuretics can cause hypokalemia (potassium depletion) due to increased
potassium excretion in the distal tubule. Serum potassium should be monitored regularly,
especially in clients taking digitalis, as hypokalemia increases the risk of digitalis toxicity. While
sodium, calcium, and glucose may also be affected, potassium is the most critical parameter to
monitor.
---
**Question 4**
The nurse is caring for a client with acute decompensated heart failure. The client is receiving
intravenous furosemide (Lasix). Which finding indicates the medication is effective?
A. Decreased urine output
B. Weight gain
C. Increased peripheral edema
D. Decreased dyspnea and crackles
**Correct Answer: D. Decreased dyspnea and crackles**
**Rationale:** Furosemide is a loop diuretic that reduces fluid volume, decreasing pulmonary
congestion. Effectiveness is evidenced by decreased dyspnea, diminished crackles on lung
auscultation, and increased urine output. Decreased urine output (A), weight gain (B), and
increased edema (C) indicate worsening fluid overload and ineffective treatment.
, Page 4 of 143
**Question 5**
The nurse is teaching a client with heart failure about dietary modifications. Which statement
indicates the client understands the teaching?
A. "I can add salt to my food when cooking."
B. "I should limit my fluid intake to 2 liters per day."
C. "I can eat canned soups and frozen dinners."
D. "I don't need to worry about my weight."
**Correct Answer: B. "I should limit my fluid intake to 2 liters per day."**
**Rationale:** Clients with heart failure are typically placed on a sodium-restricted diet (2
grams or less per day) and fluid restriction (often 2 liters per day) to reduce fluid volume
overload. Canned soups and frozen dinners are high in sodium. Daily weight monitoring is
essential to detect early signs of fluid retention.
---
**Question 6**
A client with chronic heart failure is prescribed carvedilol (Coreg), a beta-blocker. What is the
most important assessment before administering this medication?
A. Blood pressure and heart rate
B. Serum potassium level
C. Urine output
D. Respiratory rate
**Correct Answer: A. Blood pressure and heart rate**
TEST BANK FOR HESI MED SURG NURSING
COMPREHENSIVE PRACTICE QUESTION
BANK
2026–2027 ACADEMIC YEAR | ALIGNED WITH
HESI BLUEPRINT & NCSBN CJMM
ITSJEREGUIDES
# SECTION 1.0: CARDIOVASCULAR DISORDERS
## 1.1 Heart Failure & Hypertension
**Question 1**
The nurse is caring for a client with heart failure. Which nursing intervention is most appropriate
to monitor fluid status?
A. Encourage excessive sodium intake
B. Monitor daily weights and fluid status
C. Delay prescribed treatments
D. Avoid documenting assessment findings
**Correct Answer: B. Monitor daily weights and fluid status**
**Rationale:** Clients with heart failure require careful monitoring of daily weights and fluid
status to detect fluid retention early. A weight gain of 2–3 pounds in 24 hours or 5 pounds in a
,Page 2 of 143
week indicates worsening fluid overload requiring intervention . Daily weights should be taken
at the same time each day, using the same scale, with the client wearing similar clothing. Sodium
intake should be restricted, not encouraged, and documentation is essential for tracking trends.
---
**Question 2**
The nurse is assessing a client with right-sided heart failure. Which finding is most consistent
with this diagnosis?
A. Pulmonary crackles
B. Jugular venous distention (JVD)
C. Orthopnea
D. Paroxysmal nocturnal dyspnea
**Correct Answer: B. Jugular venous distention (JVD)**
**Rationale:** Right-sided heart failure presents with signs of systemic venous congestion,
including JVD, peripheral edema, hepatomegaly, and ascites. Pulmonary crackles (A), orthopnea
(C), and paroxysmal nocturnal dyspnea (D) are classic findings of left-sided heart failure due to
pulmonary congestion . Understanding the distinction between right and left heart failure is
essential for targeted nursing interventions.
---
**Question 3**
A client with hypertension is prescribed a thiazide diuretic. Which laboratory value should the
nurse monitor closely?
A. Serum sodium
,Page 3 of 143
B. Serum potassium
C. Serum calcium
D. Serum glucose
**Correct Answer: B. Serum potassium**
**Rationale:** Thiazide diuretics can cause hypokalemia (potassium depletion) due to increased
potassium excretion in the distal tubule. Serum potassium should be monitored regularly,
especially in clients taking digitalis, as hypokalemia increases the risk of digitalis toxicity. While
sodium, calcium, and glucose may also be affected, potassium is the most critical parameter to
monitor.
---
**Question 4**
The nurse is caring for a client with acute decompensated heart failure. The client is receiving
intravenous furosemide (Lasix). Which finding indicates the medication is effective?
A. Decreased urine output
B. Weight gain
C. Increased peripheral edema
D. Decreased dyspnea and crackles
**Correct Answer: D. Decreased dyspnea and crackles**
**Rationale:** Furosemide is a loop diuretic that reduces fluid volume, decreasing pulmonary
congestion. Effectiveness is evidenced by decreased dyspnea, diminished crackles on lung
auscultation, and increased urine output. Decreased urine output (A), weight gain (B), and
increased edema (C) indicate worsening fluid overload and ineffective treatment.
, Page 4 of 143
**Question 5**
The nurse is teaching a client with heart failure about dietary modifications. Which statement
indicates the client understands the teaching?
A. "I can add salt to my food when cooking."
B. "I should limit my fluid intake to 2 liters per day."
C. "I can eat canned soups and frozen dinners."
D. "I don't need to worry about my weight."
**Correct Answer: B. "I should limit my fluid intake to 2 liters per day."**
**Rationale:** Clients with heart failure are typically placed on a sodium-restricted diet (2
grams or less per day) and fluid restriction (often 2 liters per day) to reduce fluid volume
overload. Canned soups and frozen dinners are high in sodium. Daily weight monitoring is
essential to detect early signs of fluid retention.
---
**Question 6**
A client with chronic heart failure is prescribed carvedilol (Coreg), a beta-blocker. What is the
most important assessment before administering this medication?
A. Blood pressure and heart rate
B. Serum potassium level
C. Urine output
D. Respiratory rate
**Correct Answer: A. Blood pressure and heart rate**
