RN HESI Med-Surg V2 Exam 2026/2027 |
Complete Exam with 200+ Verified
Questions and 100% Correct Answers
(Rated A+)
Question 1: A client with heart failure is prescribed furosemide 40 mg IV push. Which
assessment finding requires immediate action?
A. Serum potassium 3.8 mEq/L
B. Urine output 30 mL/hour
C. Bilateral crackles in lung bases
D. Blood pressure 90/60 mm Hg
Answer: D
Rationale: Hypotension (90/60 mm Hg) indicates potential hypovolemia or excessive
vasodilation. Furosemide is a loop diuretic that reduces preload; giving it when BP is
already low can cause further hypotension, leading to decreased organ perfusion
(kidneys, brain). Crackles are expected in heart failure. Potassium 3.8 is normal. Urine
output 30 mL/hour is acceptable .
Question 2: The nurse is caring for a client post-cardiac catheterization via the femoral
artery. The client reports severe groin pain and a drop in hemoglobin. What is the
priority action?
A. Administer prescribed PRN acetaminophen
B. Assess the groin site for hematoma
C. Apply manual pressure above the insertion site
D. Document the findings
Answer: C
Rationale: Severe groin pain plus a drop in hemoglobin after femoral artery
catheterization suggests retroperitoneal bleeding, a life-threatening complication.
,Manual pressure above the insertion site (toward the abdomen) compresses the femoral
artery to control bleeding .
Question 3: A client with heart failure has jugular venous distention, 3+ pitting edema,
and crackles in the lung bases. Which medication should the nurse prepare to
administer FIRST?
A. Digoxin
B. Furosemide
C. Metoprolol
D. Spironolactone
Answer: B
Rationale: Furosemide is a loop diuretic that rapidly reduces preload and relieves
pulmonary congestion. Digoxin and beta-blockers are chronic therapies; spironolactone
is a potassium-sparing diuretic used as an adjunct. For clients with fluid overload,
furosemide is the priority to reduce fluid volume .
Question 4: A client with heart failure is prescribed furosemide (Lasix). Which laboratory
value should the nurse monitor MOST closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia
can lead to cardiac dysrhythmias and increases the risk of digoxin toxicity. Potassium
levels should be monitored closely, especially in clients on digoxin .
Question 5: A client is prescribed digoxin 0.25 mg daily. Which finding would
indicate digoxin toxicity?
,A. Heart rate 72 bpm
B. Yellow-green halos around vision
C. Blood pressure 120/80 mmHg
D. Urine output 50 mL/hour
Answer: B
Rationale: Visual disturbances (yellow-green halos, blurred vision) are classic signs of
digoxin toxicity. Other signs include nausea, vomiting, anorexia, and bradycardia .
Question 6: A client with hypertension is prescribed hydrochlorothiazide. The nurse
should monitor for which adverse effect?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypoglycemia
Answer: B
Rationale: Thiazide diuretics (hydrochlorothiazide) cause potassium loss, leading to
hypokalemia. Signs include muscle weakness, fatigue, and ECG changes (U waves) .
Question 7: Which ECG finding is most characteristic of hyperkalemia?
A. Narrow QRS
B. Tall peaked T waves
C. ST segment elevation
D. Prolonged PR interval with flat P waves
Answer: B
Rationale: Tall, peaked (tented) T waves are the earliest ECG sign of hyperkalemia. As
potassium rises, QRS widens, P waves flatten/disappear, and eventually a sine wave
pattern leads to cardiac arrest .
, Question 8: A client with atrial fibrillation is prescribed warfarin. The nurse understands
that the target INR for non-valvular atrial fibrillation is:
A. 1.0-2.0
B. 2.0-3.0
C. 3.5-4.5
D. 4.0-5.0
Answer: B
Rationale: For atrial fibrillation (non-valvular), the target INR is 2.0-3.0. Mechanical heart
valves require 2.5-3.5. Lower INR increases stroke risk; higher INR increases bleeding
risk .
Question 9: Which client has the highest risk for developing a deep vein thrombosis
(DVT)?
A. Client 1 day post-op total knee replacement
B. Client with heart failure on bed rest
C. Young adult with ankle sprain on bed rest
D. Client with pneumonia ambulating with assistance
Answer: A
Rationale: Major orthopedic surgery (knee replacement) plus postoperative
immobilization creates Virchow's triad: venous stasis, hypercoagulability, and vessel wall
damage. This is the highest DVT risk. Heart failure has some risk but less than major
surgery .
Question 10: A client with peripheral artery disease (PAD) reports leg pain when walking
that resolves with rest. This is called:
A. Rest pain
B. Intermittent claudication
C. Venous stasis
D. Neuropathy
Complete Exam with 200+ Verified
Questions and 100% Correct Answers
(Rated A+)
Question 1: A client with heart failure is prescribed furosemide 40 mg IV push. Which
assessment finding requires immediate action?
A. Serum potassium 3.8 mEq/L
B. Urine output 30 mL/hour
C. Bilateral crackles in lung bases
D. Blood pressure 90/60 mm Hg
Answer: D
Rationale: Hypotension (90/60 mm Hg) indicates potential hypovolemia or excessive
vasodilation. Furosemide is a loop diuretic that reduces preload; giving it when BP is
already low can cause further hypotension, leading to decreased organ perfusion
(kidneys, brain). Crackles are expected in heart failure. Potassium 3.8 is normal. Urine
output 30 mL/hour is acceptable .
Question 2: The nurse is caring for a client post-cardiac catheterization via the femoral
artery. The client reports severe groin pain and a drop in hemoglobin. What is the
priority action?
A. Administer prescribed PRN acetaminophen
B. Assess the groin site for hematoma
C. Apply manual pressure above the insertion site
D. Document the findings
Answer: C
Rationale: Severe groin pain plus a drop in hemoglobin after femoral artery
catheterization suggests retroperitoneal bleeding, a life-threatening complication.
,Manual pressure above the insertion site (toward the abdomen) compresses the femoral
artery to control bleeding .
Question 3: A client with heart failure has jugular venous distention, 3+ pitting edema,
and crackles in the lung bases. Which medication should the nurse prepare to
administer FIRST?
A. Digoxin
B. Furosemide
C. Metoprolol
D. Spironolactone
Answer: B
Rationale: Furosemide is a loop diuretic that rapidly reduces preload and relieves
pulmonary congestion. Digoxin and beta-blockers are chronic therapies; spironolactone
is a potassium-sparing diuretic used as an adjunct. For clients with fluid overload,
furosemide is the priority to reduce fluid volume .
Question 4: A client with heart failure is prescribed furosemide (Lasix). Which laboratory
value should the nurse monitor MOST closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia
can lead to cardiac dysrhythmias and increases the risk of digoxin toxicity. Potassium
levels should be monitored closely, especially in clients on digoxin .
Question 5: A client is prescribed digoxin 0.25 mg daily. Which finding would
indicate digoxin toxicity?
,A. Heart rate 72 bpm
B. Yellow-green halos around vision
C. Blood pressure 120/80 mmHg
D. Urine output 50 mL/hour
Answer: B
Rationale: Visual disturbances (yellow-green halos, blurred vision) are classic signs of
digoxin toxicity. Other signs include nausea, vomiting, anorexia, and bradycardia .
Question 6: A client with hypertension is prescribed hydrochlorothiazide. The nurse
should monitor for which adverse effect?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypoglycemia
Answer: B
Rationale: Thiazide diuretics (hydrochlorothiazide) cause potassium loss, leading to
hypokalemia. Signs include muscle weakness, fatigue, and ECG changes (U waves) .
Question 7: Which ECG finding is most characteristic of hyperkalemia?
A. Narrow QRS
B. Tall peaked T waves
C. ST segment elevation
D. Prolonged PR interval with flat P waves
Answer: B
Rationale: Tall, peaked (tented) T waves are the earliest ECG sign of hyperkalemia. As
potassium rises, QRS widens, P waves flatten/disappear, and eventually a sine wave
pattern leads to cardiac arrest .
, Question 8: A client with atrial fibrillation is prescribed warfarin. The nurse understands
that the target INR for non-valvular atrial fibrillation is:
A. 1.0-2.0
B. 2.0-3.0
C. 3.5-4.5
D. 4.0-5.0
Answer: B
Rationale: For atrial fibrillation (non-valvular), the target INR is 2.0-3.0. Mechanical heart
valves require 2.5-3.5. Lower INR increases stroke risk; higher INR increases bleeding
risk .
Question 9: Which client has the highest risk for developing a deep vein thrombosis
(DVT)?
A. Client 1 day post-op total knee replacement
B. Client with heart failure on bed rest
C. Young adult with ankle sprain on bed rest
D. Client with pneumonia ambulating with assistance
Answer: A
Rationale: Major orthopedic surgery (knee replacement) plus postoperative
immobilization creates Virchow's triad: venous stasis, hypercoagulability, and vessel wall
damage. This is the highest DVT risk. Heart failure has some risk but less than major
surgery .
Question 10: A client with peripheral artery disease (PAD) reports leg pain when walking
that resolves with rest. This is called:
A. Rest pain
B. Intermittent claudication
C. Venous stasis
D. Neuropathy
