1
,HESI RN Med-Surg Exams 2026 | Most Tested
Questions & Verified Answers | Latest
Update | Graded A+
1. A client with heart failure has crackles in both lung
bases, 2+ pitting edema, and a weight gain of 3 lbs in
24 hours. Which medication does the nurse expect to
administer first?
A. Digoxin
B. Furosemide
C. Metoprolol
D. Lisinopril
Answer: B. Furosemide
Rationale: Furosemide is a loop diuretic that rapidly
reduces preload, relieving pulmonary congestion. Digoxin
increases contractility but is not first for acute fluid
overload. Metoprolol is a beta-blocker for chronic HF.
Lisinopril is an ACE inhibitor for long-term remodeling.
2
,2. A client post-MI has chest pain unrelieved by
nitroglycerin. Morphine sulfate is prescribed. What is the
primary action of morphine in this situation?
A. Sedation to reduce anxiety
B. Vasodilation to reduce preload and oxygen demand
C. Antiplatelet aggregation
D. Direct coronary artery dilation
Answer: B. Vasodilation to reduce preload and oxygen
demand
Rationale: Morphine reduces preload and afterload,
decreasing myocardial oxygen demand. It also reduces
anxiety but that is secondary. It does not have
antiplatelet or direct coronary vasodilator effects
(nitrates do that).
3. A client with atrial fibrillation is prescribed warfarin.
Which lab value requires immediate follow-up?
A. INR 2.5
3
, B. aPTT 35 seconds
C. Platelets 150,000
D. INR 4.8
Answer: D. INR 4.8
Rationale: Target INR for atrial fibrillation is 2-3. INR 4.8
significantly increases bleeding risk. aPTT monitors
heparin, not warfarin. Platelets are normal.
4. A client with unstable angina is started on a heparin
infusion. The nurse notes petechiae on the client’s trunk
and a sudden drop in platelets from 220,000 to 80,000.
What is the priority action?
A. Continue heparin and monitor
B. Stop heparin immediately
C. Give platelets
D. Increase heparin to prevent clots
Answer: B. Stop heparin immediately
Rationale: Suspect heparin-induced thrombocytopenia
4
,HESI RN Med-Surg Exams 2026 | Most Tested
Questions & Verified Answers | Latest
Update | Graded A+
1. A client with heart failure has crackles in both lung
bases, 2+ pitting edema, and a weight gain of 3 lbs in
24 hours. Which medication does the nurse expect to
administer first?
A. Digoxin
B. Furosemide
C. Metoprolol
D. Lisinopril
Answer: B. Furosemide
Rationale: Furosemide is a loop diuretic that rapidly
reduces preload, relieving pulmonary congestion. Digoxin
increases contractility but is not first for acute fluid
overload. Metoprolol is a beta-blocker for chronic HF.
Lisinopril is an ACE inhibitor for long-term remodeling.
2
,2. A client post-MI has chest pain unrelieved by
nitroglycerin. Morphine sulfate is prescribed. What is the
primary action of morphine in this situation?
A. Sedation to reduce anxiety
B. Vasodilation to reduce preload and oxygen demand
C. Antiplatelet aggregation
D. Direct coronary artery dilation
Answer: B. Vasodilation to reduce preload and oxygen
demand
Rationale: Morphine reduces preload and afterload,
decreasing myocardial oxygen demand. It also reduces
anxiety but that is secondary. It does not have
antiplatelet or direct coronary vasodilator effects
(nitrates do that).
3. A client with atrial fibrillation is prescribed warfarin.
Which lab value requires immediate follow-up?
A. INR 2.5
3
, B. aPTT 35 seconds
C. Platelets 150,000
D. INR 4.8
Answer: D. INR 4.8
Rationale: Target INR for atrial fibrillation is 2-3. INR 4.8
significantly increases bleeding risk. aPTT monitors
heparin, not warfarin. Platelets are normal.
4. A client with unstable angina is started on a heparin
infusion. The nurse notes petechiae on the client’s trunk
and a sudden drop in platelets from 220,000 to 80,000.
What is the priority action?
A. Continue heparin and monitor
B. Stop heparin immediately
C. Give platelets
D. Increase heparin to prevent clots
Answer: B. Stop heparin immediately
Rationale: Suspect heparin-induced thrombocytopenia
4
