HESI PN MEDICAL SURGICAL NGN EXAM
QUESTIONS AND CORRECT ANSWERS
|2026/2027 UPDATED |GUARANTEED PASS.
Question 1
A practical nurse is caring for a client with heart failure (HF). Which assessment finding
requires immediate intervention?
A) Weight gain of 2 pounds in 24 hours
B) Crackles in the lung bases
C) 2+ pitting edema in the lower extremities
D) Jugular vein distention when sitting upright
Answer: B
Rationale: Crackles in the lung bases indicate pulmonary congestion (fluid in the
alveoli), a sign of worsening heart failure that requires immediate intervention (e.g.,
diuretics, oxygen) to prevent respiratory failure. Weight gain and edema are signs of
fluid overload but are less emergent than pulmonary congestion. JVD may be present in
HF but is not as urgent as crackles .
Question 2
A client with hypertension is prescribed hydrochlorothiazide (HCTZ). Which instruction
should the PN include in discharge teaching?
A) Take the medication at bedtime to avoid dizziness
B) Increase intake of potassium-rich foods (bananas, oranges)
C) Limit fluid intake to 1 liter per day
D) Take the medication with a high-fat meal
Answer: B
Rationale: HCTZ is a thiazide diuretic that can cause hypokalemia (low potassium).
Clients should increase intake of potassium-rich foods (bananas, oranges, potatoes,
spinach). HCTZ should be taken in the morning to avoid nocturia. Fluid restriction is not
indicated .
,Question 3
A client with angina is prescribed a transdermal nitroglycerin patch. Which instruction
should the PN include?
A) Apply the patch to the same site daily for consistent absorption
B) Remove the patch for 10–12 hours each day to prevent tolerance
C) Apply the patch directly over the chest bone (sternum)
D) Use the patch immediately if chest pain occurs
Answer: B
Rationale: To prevent nitrate tolerance, the patch should be removed for 10–12 hours
each day (usually at night). The site should be rotated to prevent skin irritation. The
patch is not for acute pain relief; sublingual nitroglycerin is used for that .
Question 4
A client with peripheral artery disease (PAD) reports leg pain when walking that resolves
with rest. The PN recognizes this as:
A) Rest pain
B) Intermittent claudication
C) Venous stasis
D) Neuropathy
Answer: B
Rationale: Intermittent claudication is muscle pain (cramping) in the legs with exercise
that resolves with rest, caused by inadequate blood flow due to atherosclerosis. Rest
pain indicates severe PAD. Venous stasis causes edema and skin changes .
Question 5
A client who had a myocardial infarction (MI) 2 days ago reports sudden onset of
shortness of breath and crackles in both lungs. What should the PN do first?
A) Administer sublingual nitroglycerin as prescribed
B) Raise the head of the bed to high Fowler's position
,C) Notify the healthcare provider immediately
D) Check the client's telemetry monitor for arrhythmias
Answer: B
Rationale: Raising the head of the bed reduces venous return (preload) to the heart and
decreases pulmonary congestion. This is a rapid, independent nursing intervention that
alleviates breathing difficulty. After positioning, the PN should notify the provider .
Question 6
A client with hypertension is prescribed lisinopril (an ACE inhibitor). Which adverse effect
should the PN teach the client to report immediately?
A) Dry cough
B) Swelling of the lips, tongue, or face (angioedema)
C) Dizziness
D) Fatigue
Answer: B
Rationale: Angioedema (swelling of lips, tongue, pharynx) is a life-threatening adverse
effect of ACE inhibitors. Stop the medication and seek emergency care. Dry cough is
common but not life-threatening. Dizziness (first-dose hypotension) can occur but is not
an emergency .
Question 7
A client with a deep vein thrombosis (DVT) is on heparin therapy. Which finding
indicates a possible adverse effect of heparin?
A) Bruising at the IV site
B) Hematuria (blood in urine)
C) Petechiae on the chest
D) All of the above
Answer: D
, Rationale: Heparin is an anticoagulant that can cause bleeding. Signs include bruising,
hematuria, petechiae, bleeding gums, and black tarry stools. Report any signs of
bleeding immediately .
Question 8
A client with heart failure has a prescription for digoxin. Which finding indicates digoxin
toxicity?
A) Heart rate of 68 bpm
B) Nausea, vomiting, and yellow-green halos around lights
C) Serum digoxin level of 1.2 ng/mL (therapeutic range 0.8–2.0)
D) Constipation
Answer: B
Rationale: Signs of digoxin toxicity include: nausea, vomiting, anorexia, blurred or
yellow-green vision (halos), bradycardia, and cardiac dysrhythmias. A therapeutic
digoxin level is 0.8–2.0 ng/mL. Levels above 2.0 indicate toxicity .
Question 9
The PN is teaching a client with coronary artery disease (CAD) about lifestyle changes.
Which statement indicates understanding?
A) "I will limit my saturated fat intake and exercise 30 minutes most days."
B) "I can continue smoking but will reduce to 5 cigarettes per day."
C) "I only need to take my medication when I have chest pain."
D) "I will avoid all physical activity to prevent a heart attack."
Answer: A
Rationale: Lifestyle modifications for CAD include limiting saturated fat, exercising
regularly (30 minutes most days), smoking cessation, and taking medications as
prescribed. Smoking cessation is critical, not reduction. Medications must be taken
consistently, not only when symptoms occur .
QUESTIONS AND CORRECT ANSWERS
|2026/2027 UPDATED |GUARANTEED PASS.
Question 1
A practical nurse is caring for a client with heart failure (HF). Which assessment finding
requires immediate intervention?
A) Weight gain of 2 pounds in 24 hours
B) Crackles in the lung bases
C) 2+ pitting edema in the lower extremities
D) Jugular vein distention when sitting upright
Answer: B
Rationale: Crackles in the lung bases indicate pulmonary congestion (fluid in the
alveoli), a sign of worsening heart failure that requires immediate intervention (e.g.,
diuretics, oxygen) to prevent respiratory failure. Weight gain and edema are signs of
fluid overload but are less emergent than pulmonary congestion. JVD may be present in
HF but is not as urgent as crackles .
Question 2
A client with hypertension is prescribed hydrochlorothiazide (HCTZ). Which instruction
should the PN include in discharge teaching?
A) Take the medication at bedtime to avoid dizziness
B) Increase intake of potassium-rich foods (bananas, oranges)
C) Limit fluid intake to 1 liter per day
D) Take the medication with a high-fat meal
Answer: B
Rationale: HCTZ is a thiazide diuretic that can cause hypokalemia (low potassium).
Clients should increase intake of potassium-rich foods (bananas, oranges, potatoes,
spinach). HCTZ should be taken in the morning to avoid nocturia. Fluid restriction is not
indicated .
,Question 3
A client with angina is prescribed a transdermal nitroglycerin patch. Which instruction
should the PN include?
A) Apply the patch to the same site daily for consistent absorption
B) Remove the patch for 10–12 hours each day to prevent tolerance
C) Apply the patch directly over the chest bone (sternum)
D) Use the patch immediately if chest pain occurs
Answer: B
Rationale: To prevent nitrate tolerance, the patch should be removed for 10–12 hours
each day (usually at night). The site should be rotated to prevent skin irritation. The
patch is not for acute pain relief; sublingual nitroglycerin is used for that .
Question 4
A client with peripheral artery disease (PAD) reports leg pain when walking that resolves
with rest. The PN recognizes this as:
A) Rest pain
B) Intermittent claudication
C) Venous stasis
D) Neuropathy
Answer: B
Rationale: Intermittent claudication is muscle pain (cramping) in the legs with exercise
that resolves with rest, caused by inadequate blood flow due to atherosclerosis. Rest
pain indicates severe PAD. Venous stasis causes edema and skin changes .
Question 5
A client who had a myocardial infarction (MI) 2 days ago reports sudden onset of
shortness of breath and crackles in both lungs. What should the PN do first?
A) Administer sublingual nitroglycerin as prescribed
B) Raise the head of the bed to high Fowler's position
,C) Notify the healthcare provider immediately
D) Check the client's telemetry monitor for arrhythmias
Answer: B
Rationale: Raising the head of the bed reduces venous return (preload) to the heart and
decreases pulmonary congestion. This is a rapid, independent nursing intervention that
alleviates breathing difficulty. After positioning, the PN should notify the provider .
Question 6
A client with hypertension is prescribed lisinopril (an ACE inhibitor). Which adverse effect
should the PN teach the client to report immediately?
A) Dry cough
B) Swelling of the lips, tongue, or face (angioedema)
C) Dizziness
D) Fatigue
Answer: B
Rationale: Angioedema (swelling of lips, tongue, pharynx) is a life-threatening adverse
effect of ACE inhibitors. Stop the medication and seek emergency care. Dry cough is
common but not life-threatening. Dizziness (first-dose hypotension) can occur but is not
an emergency .
Question 7
A client with a deep vein thrombosis (DVT) is on heparin therapy. Which finding
indicates a possible adverse effect of heparin?
A) Bruising at the IV site
B) Hematuria (blood in urine)
C) Petechiae on the chest
D) All of the above
Answer: D
, Rationale: Heparin is an anticoagulant that can cause bleeding. Signs include bruising,
hematuria, petechiae, bleeding gums, and black tarry stools. Report any signs of
bleeding immediately .
Question 8
A client with heart failure has a prescription for digoxin. Which finding indicates digoxin
toxicity?
A) Heart rate of 68 bpm
B) Nausea, vomiting, and yellow-green halos around lights
C) Serum digoxin level of 1.2 ng/mL (therapeutic range 0.8–2.0)
D) Constipation
Answer: B
Rationale: Signs of digoxin toxicity include: nausea, vomiting, anorexia, blurred or
yellow-green vision (halos), bradycardia, and cardiac dysrhythmias. A therapeutic
digoxin level is 0.8–2.0 ng/mL. Levels above 2.0 indicate toxicity .
Question 9
The PN is teaching a client with coronary artery disease (CAD) about lifestyle changes.
Which statement indicates understanding?
A) "I will limit my saturated fat intake and exercise 30 minutes most days."
B) "I can continue smoking but will reduce to 5 cigarettes per day."
C) "I only need to take my medication when I have chest pain."
D) "I will avoid all physical activity to prevent a heart attack."
Answer: A
Rationale: Lifestyle modifications for CAD include limiting saturated fat, exercising
regularly (30 minutes most days), smoking cessation, and taking medications as
prescribed. Smoking cessation is critical, not reduction. Medications must be taken
consistently, not only when symptoms occur .
