Med-Surg HESI RN Exam – 2026/2027
Complete Questions and Correct Answers
with Rationales
Question 1
A client with heart failure has an ejection fraction of 25%. The nurse understands this
indicates:
A) Normal cardiac function
B) Mildly reduced function
C) Severely reduced systolic function
D) Preserved ejection fraction heart failure
Answer: C - Normal ejection fraction is 55-70%. An EF of 25% indicates severely
impaired systolic function.
Question 2
A client with heart failure is prescribed furosemide. Which food should the nurse
encourage the client to increase in the diet?
A) Cheese
B) Bananas
C) White rice
D) Applesauce
Answer: B - Furosemide causes potassium loss. Bananas are rich in potassium and help
prevent hypokalemia.
Question 3
A client with a history of myocardial infarction is prescribed atorvastatin. The nurse
should teach the client that this medication:
,A) Is taken only when chest pain occurs
B) Lowers cholesterol and reduces the risk of future cardiac events
C) Replaces the need for a heart-healthy diet
D) Should be taken on an empty stomach for best absorption
Answer: B - Statins lower LDL cholesterol and reduce cardiovascular risk. They are taken
daily regardless of symptoms and work best with a heart-healthy diet.
Question 4
A client with deep vein thrombosis (DVT) is started on a heparin infusion. The nurse
should have which antidote available?
A) Vitamin K
B) Protamine sulfate
C) Naloxone
D) Flumazenil
Answer: B - Protamine sulfate is the antidote for heparin. Vitamin K reverses warfarin.
Naloxone reverses opioids. Flumazenil reverses benzodiazepines.
Question 5
The nurse is assessing a client with chest pressure unrelieved by rest. The client appears
agitated. The nurse recognizes agitation as:
A) A normal response to pain
B) An early sign of hypoperfusion
C) A medication side effect
D) A psychological reaction
Answer: B - Agitation in a client with chest pressure is a critical sign of hypoperfusion,
indicating decreased oxygenation to the brain and requiring immediate intervention.
Question 6
A client with heart failure is prescribed digoxin. The nurse should instruct the client to
report which symptom?
,A) Increased appetite
B) Nausea, vomiting, and yellow-green halos around lights
C) Weight loss
D) Increased energy
Answer: B - These are classic signs of digoxin toxicity. Other signs include bradycardia,
anorexia, and confusion.
Question 7
A client with dyspnea has a pulse oximetry reading of 85% and is tachypneic. What is
the priority nursing action?
A) Administer oxygen
B) Position the client in high Fowler's
C) Notify the healthcare provider
D) Assess lung sounds
Answer: A - Oxygen saturation of 85% indicates severe hypoxemia requiring immediate
oxygen administration.
Question 8
A client with hypertension is prescribed a low-sodium diet. Which food choice indicates
understanding of the teaching?
A) Canned soup
B) Fresh grilled chicken breast
C) Processed cheese
D) Pickled vegetables
Answer: B - Fresh, unprocessed foods are naturally low in sodium. Canned soups,
processed cheeses, and pickled foods are high in sodium and should be avoided.
Question 9
A client is receiving a blood transfusion and develops urticaria and itching. What is the
priority nursing action?
, A) Stop the transfusion immediately
B) Slow the transfusion and administer diphenhydramine as ordered
C) Increase the transfusion rate
D) Administer epinephrine immediately
Answer: B - Urticaria and itching indicate a mild allergic reaction. The transfusion
should be slowed, and diphenhydramine administered as ordered. Stop if symptoms
worsen.
Question 10
A client with chronic kidney disease is prescribed sevelamer. The nurse should explain
that this medication:
A) Increases calcium absorption
B) Binds dietary phosphate in the gastrointestinal tract
C) Stimulates erythropoietin production
D) Lowers blood pressure
Answer: B - Sevelamer is a phosphate binder that prevents absorption of dietary
phosphate, helping manage hyperphosphatemia in chronic kidney disease.
Question 11
A client with a history of myocardial infarction is prescribed aspirin daily. The nurse
understands that the purpose of this medication is to:
A) Relieve chest pain
B) Prevent platelet aggregation
C) Reduce inflammation
D) Lower blood pressure
Answer: B - Low-dose aspirin is prescribed for its antiplatelet effect, reducing the risk of
thrombus formation and preventing recurrent myocardial infarction.
Complete Questions and Correct Answers
with Rationales
Question 1
A client with heart failure has an ejection fraction of 25%. The nurse understands this
indicates:
A) Normal cardiac function
B) Mildly reduced function
C) Severely reduced systolic function
D) Preserved ejection fraction heart failure
Answer: C - Normal ejection fraction is 55-70%. An EF of 25% indicates severely
impaired systolic function.
Question 2
A client with heart failure is prescribed furosemide. Which food should the nurse
encourage the client to increase in the diet?
A) Cheese
B) Bananas
C) White rice
D) Applesauce
Answer: B - Furosemide causes potassium loss. Bananas are rich in potassium and help
prevent hypokalemia.
Question 3
A client with a history of myocardial infarction is prescribed atorvastatin. The nurse
should teach the client that this medication:
,A) Is taken only when chest pain occurs
B) Lowers cholesterol and reduces the risk of future cardiac events
C) Replaces the need for a heart-healthy diet
D) Should be taken on an empty stomach for best absorption
Answer: B - Statins lower LDL cholesterol and reduce cardiovascular risk. They are taken
daily regardless of symptoms and work best with a heart-healthy diet.
Question 4
A client with deep vein thrombosis (DVT) is started on a heparin infusion. The nurse
should have which antidote available?
A) Vitamin K
B) Protamine sulfate
C) Naloxone
D) Flumazenil
Answer: B - Protamine sulfate is the antidote for heparin. Vitamin K reverses warfarin.
Naloxone reverses opioids. Flumazenil reverses benzodiazepines.
Question 5
The nurse is assessing a client with chest pressure unrelieved by rest. The client appears
agitated. The nurse recognizes agitation as:
A) A normal response to pain
B) An early sign of hypoperfusion
C) A medication side effect
D) A psychological reaction
Answer: B - Agitation in a client with chest pressure is a critical sign of hypoperfusion,
indicating decreased oxygenation to the brain and requiring immediate intervention.
Question 6
A client with heart failure is prescribed digoxin. The nurse should instruct the client to
report which symptom?
,A) Increased appetite
B) Nausea, vomiting, and yellow-green halos around lights
C) Weight loss
D) Increased energy
Answer: B - These are classic signs of digoxin toxicity. Other signs include bradycardia,
anorexia, and confusion.
Question 7
A client with dyspnea has a pulse oximetry reading of 85% and is tachypneic. What is
the priority nursing action?
A) Administer oxygen
B) Position the client in high Fowler's
C) Notify the healthcare provider
D) Assess lung sounds
Answer: A - Oxygen saturation of 85% indicates severe hypoxemia requiring immediate
oxygen administration.
Question 8
A client with hypertension is prescribed a low-sodium diet. Which food choice indicates
understanding of the teaching?
A) Canned soup
B) Fresh grilled chicken breast
C) Processed cheese
D) Pickled vegetables
Answer: B - Fresh, unprocessed foods are naturally low in sodium. Canned soups,
processed cheeses, and pickled foods are high in sodium and should be avoided.
Question 9
A client is receiving a blood transfusion and develops urticaria and itching. What is the
priority nursing action?
, A) Stop the transfusion immediately
B) Slow the transfusion and administer diphenhydramine as ordered
C) Increase the transfusion rate
D) Administer epinephrine immediately
Answer: B - Urticaria and itching indicate a mild allergic reaction. The transfusion
should be slowed, and diphenhydramine administered as ordered. Stop if symptoms
worsen.
Question 10
A client with chronic kidney disease is prescribed sevelamer. The nurse should explain
that this medication:
A) Increases calcium absorption
B) Binds dietary phosphate in the gastrointestinal tract
C) Stimulates erythropoietin production
D) Lowers blood pressure
Answer: B - Sevelamer is a phosphate binder that prevents absorption of dietary
phosphate, helping manage hyperphosphatemia in chronic kidney disease.
Question 11
A client with a history of myocardial infarction is prescribed aspirin daily. The nurse
understands that the purpose of this medication is to:
A) Relieve chest pain
B) Prevent platelet aggregation
C) Reduce inflammation
D) Lower blood pressure
Answer: B - Low-dose aspirin is prescribed for its antiplatelet effect, reducing the risk of
thrombus formation and preventing recurrent myocardial infarction.
