BSN 266 HESI Med-Surg Exam Prep
Practice Questions with Answers &
Rationales
## Section 1: Cardiovascular Disorders
### Question 1
A 77-year-old female client is admitted to the hospital. She is confused,
has no appetite, is nauseated and vomiting, and is complaining of a
headache. Her pulse rate is 43 beats per minute. Which question is a
priority for the nurse to ask this client or her family on admission?
A. "Does the client have her own teeth or dentures?"
B. "Does the client take aspirin and if so, how much?"
C. "Does the client take nitroglycerin?"
D. "Does the client take digitalis?"
**Answer: D. "Does the client take digitalis?"**
,**Rationale:** Symptoms such as confusion, nausea, vomiting,
headache, and bradycardia are classic signs of digitalis (digoxin) toxicity,
especially in elderly clients. Prompt assessment of medication history is
critical for identifying this potentially life-threatening condition .
---
### Question 2
When should a nurse withhold a dose of digoxin in a client with
congestive heart failure?
A. If the radial pulse is less than 60 bpm
B. If the apical pulse is less than 60 bpm
C. If the apical pulse is absent
D. If the client reports nausea
**Answer: C. If the apical pulse is absent**
**Rationale:** Digoxin should be withheld if the apical pulse is absent
or significantly below the prescribed parameter (typically <60 bpm in
adults), as this may indicate toxicity or severe bradycardia requiring
immediate healthcare provider notification .
---
,### Question 3
A client with a diagnosis of myocardial infarction ten hours ago should
exhibit which laboratory test result?
A. Elevated troponin I
B. Elevated LDH
C. Elevated CK-MB
D. All of the above
**Answer: A. Elevated troponin I**
**Rationale:** Cardiac troponin I begins to rise within 3-4 hours of
myocardial infarction and is the most specific and sensitive marker for
cardiac injury. LDH and CK-MB are less specific and may be elevated in
other conditions .
---
### Question 4
The nurse is assessing a client with left-sided heart failure. Which
finding is most consistent with this condition?
, A. Peripheral edema
B. Jugular venous distention
C. Crackles in the lungs
D. Hepatomegaly
**Answer: C. Crackles in the lungs**
**Rationale:** Left-sided heart failure causes pulmonary congestion
due to backup of blood in the pulmonary circulation, leading to
crackles, dyspnea, and orthopnea. Peripheral edema, JVD, and
hepatomegaly are signs of right-sided heart failure .
---
### Question 5
A client is prescribed warfarin (Coumadin). Which laboratory value
should the nurse monitor to evaluate therapeutic effectiveness?
A. Platelet count
B. INR (International Normalized Ratio)
C. PTT (Partial Thromboplastin Time)
D. Hemoglobin
Practice Questions with Answers &
Rationales
## Section 1: Cardiovascular Disorders
### Question 1
A 77-year-old female client is admitted to the hospital. She is confused,
has no appetite, is nauseated and vomiting, and is complaining of a
headache. Her pulse rate is 43 beats per minute. Which question is a
priority for the nurse to ask this client or her family on admission?
A. "Does the client have her own teeth or dentures?"
B. "Does the client take aspirin and if so, how much?"
C. "Does the client take nitroglycerin?"
D. "Does the client take digitalis?"
**Answer: D. "Does the client take digitalis?"**
,**Rationale:** Symptoms such as confusion, nausea, vomiting,
headache, and bradycardia are classic signs of digitalis (digoxin) toxicity,
especially in elderly clients. Prompt assessment of medication history is
critical for identifying this potentially life-threatening condition .
---
### Question 2
When should a nurse withhold a dose of digoxin in a client with
congestive heart failure?
A. If the radial pulse is less than 60 bpm
B. If the apical pulse is less than 60 bpm
C. If the apical pulse is absent
D. If the client reports nausea
**Answer: C. If the apical pulse is absent**
**Rationale:** Digoxin should be withheld if the apical pulse is absent
or significantly below the prescribed parameter (typically <60 bpm in
adults), as this may indicate toxicity or severe bradycardia requiring
immediate healthcare provider notification .
---
,### Question 3
A client with a diagnosis of myocardial infarction ten hours ago should
exhibit which laboratory test result?
A. Elevated troponin I
B. Elevated LDH
C. Elevated CK-MB
D. All of the above
**Answer: A. Elevated troponin I**
**Rationale:** Cardiac troponin I begins to rise within 3-4 hours of
myocardial infarction and is the most specific and sensitive marker for
cardiac injury. LDH and CK-MB are less specific and may be elevated in
other conditions .
---
### Question 4
The nurse is assessing a client with left-sided heart failure. Which
finding is most consistent with this condition?
, A. Peripheral edema
B. Jugular venous distention
C. Crackles in the lungs
D. Hepatomegaly
**Answer: C. Crackles in the lungs**
**Rationale:** Left-sided heart failure causes pulmonary congestion
due to backup of blood in the pulmonary circulation, leading to
crackles, dyspnea, and orthopnea. Peripheral edema, JVD, and
hepatomegaly are signs of right-sided heart failure .
---
### Question 5
A client is prescribed warfarin (Coumadin). Which laboratory value
should the nurse monitor to evaluate therapeutic effectiveness?
A. Platelet count
B. INR (International Normalized Ratio)
C. PTT (Partial Thromboplastin Time)
D. Hemoglobin
