1
HESI Med Surg V1 Exit Exam 2026 – Real Exam
Questions | Verified Expert Answers | 100% Graded
A+ and Updated
Cardiovascular Disorders (25 Questions)
1. A nurse is assessing a client with left-sided heart failure. Which finding is most
consistent with this diagnosis?
o A. Jugular vein distention
o B. Peripheral edema
o C. Hepatomegaly
o D. Crackles in the lung bases
o Answer: D
o Rationale: Left-sided heart failure causes pulmonary congestion because the left
ventricle cannot pump blood forward, leading to fluid backup into the pulmonary
circulation. Crackles (rales) are heard in the lung bases. JVD, peripheral edema, and
hepatomegaly are signs of right-sided heart failure.
2. A client is admitted with an acute myocardial infarction (MI). Which laboratory value is
the most specific indicator of myocardial damage?
o A. Creatine Kinase-MB (CK-MB)
o B. Troponin I
o C. Myoglobin
o D. C-reactive protein (CRP)
o Answer: B
o Rationale: Troponin I and T are the most specific cardiac markers for myocardial
necrosis, remaining elevated for up to 14 days. CK-MB rises and falls faster.
Myoglobin is early but nonspecific. CRP indicates inflammation.
3. A nurse is administering IV nitroglycerin to a client with unstable angina. What is the
priority assessment?
o A. Monitoring for headache
o B. Monitoring blood pressure continuously
o C. Assessing urinary output
o D. Checking for flushing
o Answer: B
, 2
o Rationale: IV nitroglycerin is a potent vasodilator; the most serious adverse effect is
severe hypotension. BP must be monitored continuously (every 5–10 minutes) during
titration.
4. A client is 12 hours post-cardiac catheterization via the femoral artery. The nurse finds
the groin site is bleeding. What is the immediate action?
o A. Apply a warm compress to the site
o B. Apply firm pressure 1 inch above the insertion site
o C. Elevate the leg on a pillow
o D. Assess the distal pulses
o Answer: B
o Rationale: The priority is to stop the bleeding by applying firm pressure proximal to
the insertion site to occlude the arterial puncture. The provider should be notified, and
vital signs and distal pulses assessed after bleeding is controlled.
5. A client is taking warfarin (Coumadin) for atrial fibrillation. Which statement by the
client indicates a need for further teaching?
o A. "I will avoid eating large amounts of leafy green vegetables."
o B. "I can take ibuprofen for my occasional headaches."
o C. "I will report any unusual bleeding or bruising."
o D. "I need to have my blood drawn regularly to check my INR."
o Answer: B
o Rationale: NSAIDs like ibuprofen increase bleeding risk and interact with warfarin,
increasing INR. Acetaminophen is safer. The other statements demonstrate correct
understanding.
6. A client is admitted with a blood pressure of 220/130 mmHg and reports a severe
headache and blurred vision. The nurse recognizes this as:
o A. Essential hypertension
o B. Hypertensive crisis
o C. Orthostatic hypotension
o D. Secondary hypertension
o Answer: B
o Rationale: Hypertensive crisis (emergency) is BP >180/120 with target organ
damage (headache, visual changes). Requires immediate IV antihypertensive
treatment.
7. A client with heart failure has an order for furosemide (Lasix). Which laboratory value
should the nurse monitor most closely?
o A. Sodium
o B. Potassium
o C. Calcium
o D. Magnesium
, 3
o Answer: B
o Rationale: Furosemide is a loop diuretic that causes significant potassium loss
(hypokalemia), which can increase risk of digoxin toxicity and cardiac dysrhythmias.
8. A client post-MI develops crackles, tachypnea, and frothy pink sputum. What condition
does the nurse suspect?
o A. Cardiogenic shock
o B. Pulmonary embolism
o C. Acute pericarditis
o D. Acute pulmonary edema
o Answer: D
o Rationale: Frothy pink sputum + crackles + tachypnea = acute pulmonary edema
from left ventricular failure. This is a medical emergency requiring rapid diuresis and
oxygen.
9. A client with hypertension is prescribed lisinopril (Prinivil). What adverse effect
requires immediate discontinuation?
o A. Dry cough
o B. Angioedema
o C. Dizziness
o D. Headache
o Answer: B
o Rationale: Angioedema (swelling of lips, tongue, airway) is a life-threatening ACE
inhibitor reaction requiring immediate discontinuation and emergency treatment. Dry
cough is common but not emergent.
10. A client with chronic venous insufficiency has an order for compression stockings.
When should the nurse apply them?
o A. Before getting out of bed in the morning
o B. After showering
o C. In the evening before bed
o D. Only when legs are swollen
o Answer: A
o Rationale: Compression stockings should be applied before the client gets out of bed
to prevent venous pooling and edema. Elevate the legs for 15-20 minutes before
applying if client has been upright.
11. A client is receiving a heparin infusion. Which laboratory value indicates the therapy is
therapeutic?
o A. INR 2.5
o B. aPTT 60 seconds (control 30 seconds)
o C. Platelets 50,000
, 4
o D. PT 12 seconds
o Answer: B
o Rationale: Heparin therapy is monitored by aPTT; therapeutic range is 1.5–2.5 times
the control. INR monitors warfarin. Low platelets may indicate HIT.
12. A client with chronic heart failure has a nursing diagnosis of "Activity intolerance."
What is the most appropriate intervention?
o A. Encourage bed rest until fatigue resolves
o B. Plan activities with frequent rest periods
o C. Increase activity level every day
o D. Limit fluids to prevent edema
o Answer: B
o Rationale: Activity intolerance in HF is managed by balancing activity and rest to
prevent overexertion while maintaining function.
13. A client after cardiac surgery has a chest tube with 150 mL bloody drainage in the first
hour. What action should the nurse take?
o A. Document as normal
o B. Clamp the chest tube
o C. Notify the provider immediately
o D. Decrease suction pressure
o Answer: C
o Rationale: Excessive drainage (>100 mL/hour) indicates possible postoperative
hemorrhage. Immediate provider notification is required.
14. A client is diagnosed with aortic stenosis. Which triad of symptoms is classic for this
condition?
o A. Syncope, dizziness, palpitations
o B. Chest pain, dyspnea on exertion, syncope
o C. Peripheral edema, ascites, JVD
o D. Fever, weight loss, night sweats
o Answer: B
o Rationale: Classic triad of aortic stenosis: angina, heart failure symptoms (dyspnea),
and syncope (due to fixed low cardiac output).
15. A client is taking digoxin (Lanoxin) and develops nausea, vomiting, and yellow vision.
What action should the nurse take first?
o A. Administer antiemetic
o B. Check digoxin level
o C. Hold the next dose and check apical pulse
o D. Give potassium supplement
HESI Med Surg V1 Exit Exam 2026 – Real Exam
Questions | Verified Expert Answers | 100% Graded
A+ and Updated
Cardiovascular Disorders (25 Questions)
1. A nurse is assessing a client with left-sided heart failure. Which finding is most
consistent with this diagnosis?
o A. Jugular vein distention
o B. Peripheral edema
o C. Hepatomegaly
o D. Crackles in the lung bases
o Answer: D
o Rationale: Left-sided heart failure causes pulmonary congestion because the left
ventricle cannot pump blood forward, leading to fluid backup into the pulmonary
circulation. Crackles (rales) are heard in the lung bases. JVD, peripheral edema, and
hepatomegaly are signs of right-sided heart failure.
2. A client is admitted with an acute myocardial infarction (MI). Which laboratory value is
the most specific indicator of myocardial damage?
o A. Creatine Kinase-MB (CK-MB)
o B. Troponin I
o C. Myoglobin
o D. C-reactive protein (CRP)
o Answer: B
o Rationale: Troponin I and T are the most specific cardiac markers for myocardial
necrosis, remaining elevated for up to 14 days. CK-MB rises and falls faster.
Myoglobin is early but nonspecific. CRP indicates inflammation.
3. A nurse is administering IV nitroglycerin to a client with unstable angina. What is the
priority assessment?
o A. Monitoring for headache
o B. Monitoring blood pressure continuously
o C. Assessing urinary output
o D. Checking for flushing
o Answer: B
, 2
o Rationale: IV nitroglycerin is a potent vasodilator; the most serious adverse effect is
severe hypotension. BP must be monitored continuously (every 5–10 minutes) during
titration.
4. A client is 12 hours post-cardiac catheterization via the femoral artery. The nurse finds
the groin site is bleeding. What is the immediate action?
o A. Apply a warm compress to the site
o B. Apply firm pressure 1 inch above the insertion site
o C. Elevate the leg on a pillow
o D. Assess the distal pulses
o Answer: B
o Rationale: The priority is to stop the bleeding by applying firm pressure proximal to
the insertion site to occlude the arterial puncture. The provider should be notified, and
vital signs and distal pulses assessed after bleeding is controlled.
5. A client is taking warfarin (Coumadin) for atrial fibrillation. Which statement by the
client indicates a need for further teaching?
o A. "I will avoid eating large amounts of leafy green vegetables."
o B. "I can take ibuprofen for my occasional headaches."
o C. "I will report any unusual bleeding or bruising."
o D. "I need to have my blood drawn regularly to check my INR."
o Answer: B
o Rationale: NSAIDs like ibuprofen increase bleeding risk and interact with warfarin,
increasing INR. Acetaminophen is safer. The other statements demonstrate correct
understanding.
6. A client is admitted with a blood pressure of 220/130 mmHg and reports a severe
headache and blurred vision. The nurse recognizes this as:
o A. Essential hypertension
o B. Hypertensive crisis
o C. Orthostatic hypotension
o D. Secondary hypertension
o Answer: B
o Rationale: Hypertensive crisis (emergency) is BP >180/120 with target organ
damage (headache, visual changes). Requires immediate IV antihypertensive
treatment.
7. A client with heart failure has an order for furosemide (Lasix). Which laboratory value
should the nurse monitor most closely?
o A. Sodium
o B. Potassium
o C. Calcium
o D. Magnesium
, 3
o Answer: B
o Rationale: Furosemide is a loop diuretic that causes significant potassium loss
(hypokalemia), which can increase risk of digoxin toxicity and cardiac dysrhythmias.
8. A client post-MI develops crackles, tachypnea, and frothy pink sputum. What condition
does the nurse suspect?
o A. Cardiogenic shock
o B. Pulmonary embolism
o C. Acute pericarditis
o D. Acute pulmonary edema
o Answer: D
o Rationale: Frothy pink sputum + crackles + tachypnea = acute pulmonary edema
from left ventricular failure. This is a medical emergency requiring rapid diuresis and
oxygen.
9. A client with hypertension is prescribed lisinopril (Prinivil). What adverse effect
requires immediate discontinuation?
o A. Dry cough
o B. Angioedema
o C. Dizziness
o D. Headache
o Answer: B
o Rationale: Angioedema (swelling of lips, tongue, airway) is a life-threatening ACE
inhibitor reaction requiring immediate discontinuation and emergency treatment. Dry
cough is common but not emergent.
10. A client with chronic venous insufficiency has an order for compression stockings.
When should the nurse apply them?
o A. Before getting out of bed in the morning
o B. After showering
o C. In the evening before bed
o D. Only when legs are swollen
o Answer: A
o Rationale: Compression stockings should be applied before the client gets out of bed
to prevent venous pooling and edema. Elevate the legs for 15-20 minutes before
applying if client has been upright.
11. A client is receiving a heparin infusion. Which laboratory value indicates the therapy is
therapeutic?
o A. INR 2.5
o B. aPTT 60 seconds (control 30 seconds)
o C. Platelets 50,000
, 4
o D. PT 12 seconds
o Answer: B
o Rationale: Heparin therapy is monitored by aPTT; therapeutic range is 1.5–2.5 times
the control. INR monitors warfarin. Low platelets may indicate HIT.
12. A client with chronic heart failure has a nursing diagnosis of "Activity intolerance."
What is the most appropriate intervention?
o A. Encourage bed rest until fatigue resolves
o B. Plan activities with frequent rest periods
o C. Increase activity level every day
o D. Limit fluids to prevent edema
o Answer: B
o Rationale: Activity intolerance in HF is managed by balancing activity and rest to
prevent overexertion while maintaining function.
13. A client after cardiac surgery has a chest tube with 150 mL bloody drainage in the first
hour. What action should the nurse take?
o A. Document as normal
o B. Clamp the chest tube
o C. Notify the provider immediately
o D. Decrease suction pressure
o Answer: C
o Rationale: Excessive drainage (>100 mL/hour) indicates possible postoperative
hemorrhage. Immediate provider notification is required.
14. A client is diagnosed with aortic stenosis. Which triad of symptoms is classic for this
condition?
o A. Syncope, dizziness, palpitations
o B. Chest pain, dyspnea on exertion, syncope
o C. Peripheral edema, ascites, JVD
o D. Fever, weight loss, night sweats
o Answer: B
o Rationale: Classic triad of aortic stenosis: angina, heart failure symptoms (dyspnea),
and syncope (due to fixed low cardiac output).
15. A client is taking digoxin (Lanoxin) and develops nausea, vomiting, and yellow vision.
What action should the nurse take first?
o A. Administer antiemetic
o B. Check digoxin level
o C. Hold the next dose and check apical pulse
o D. Give potassium supplement
