HESI Case Studies — Exam Questions with
Correct Answers (VerifiedAnswers) Plus
Rationales 2026 Q&A Instant Download PDF
Case Study 1: Acute Heart Failure
A 72-year-old client with a history of hypertension and heart
failure presents to the emergency department with worsening
shortness of breath for 2 days. The client reports gaining 4 lb
over the past week. Assessment findings include bilateral
crackles, 2+ pitting edema of the lower extremities, respiratory
rate of 30/min, oxygen saturation of 86% on room air, and
blood pressure of 168/94 mm Hg.
Question 1
Which assessment finding requires the nurse's priority
intervention?
A. 2+ bilateral lower-extremity edema
B. 4-lb weight gain
C. Respiratory rate of 30/min with oxygen saturation of 86%
D. Blood pressure of 168/94 mm Hg
Correct answer: C. Respiratory rate of 30/min with oxygen
saturation of 86%
,The client's severe hypoxemia and tachypnea indicate impaired
oxygenation and possible acute pulmonary edema. Airway and
breathing take priority over fluid retention and hypertension.
The nurse should immediately support oxygenation, position the
client upright, assess respiratory status, and initiate prescribed
oxygen therapy. The edema and weight gain are important
indicators of worsening heart failure, but they are not as
immediately life-threatening as inadequate oxygenation.
Question 2
Which position should the nurse place the client in initially?
A. Supine with the legs elevated
B. High-Fowler's position
C. Trendelenburg position
D. Prone position
Correct answer: B. High-Fowler's position
High-Fowler's position promotes lung expansion and decreases
venous return to the heart, which can reduce pulmonary
congestion. A supine position may worsen dyspnea, while
Trendelenburg increases venous return and can aggravate
pulmonary congestion. Prone positioning is not the routine
initial intervention for a client experiencing acute heart-failure-
related dyspnea.
Question 3
,The provider prescribes IV furosemide. Which finding best
indicates that the medication is producing the desired effect?
A. Increased peripheral edema
B. Increased urine output and improved oxygen saturation
C. Increased blood pressure
D. Decreased serum sodium concentration
Correct answer: B. Increased urine output and improved
oxygen saturation
Furosemide is a loop diuretic that promotes rapid renal
excretion of sodium and water. Removing excess fluid decreases
intravascular volume and pulmonary congestion, which should
improve respiratory status and oxygenation. Increased urine
output is an expected therapeutic response. The nurse should
also monitor potassium, sodium, renal function, blood pressure,
daily weight, and fluid balance because excessive diuresis can
cause dehydration, hypotension, and electrolyte abnormalities.
Question 4
Which laboratory value is particularly important for the nurse to
monitor after administering repeated doses of furosemide?
A. Potassium
B. Hemoglobin A1c
C. Platelet count
D. Amylase
, Correct answer: A. Potassium
Loop diuretics can increase urinary potassium loss and place the
client at risk for hypokalemia. Low potassium levels can cause
muscle weakness and potentially dangerous cardiac
dysrhythmias. The nurse should monitor serum potassium and
assess for manifestations such as weakness, muscle cramps,
palpitations, and dysrhythmias. Renal function and other
electrolytes should also be monitored during aggressive
diuresis.
Question 5
Which statement by the client indicates a need for additional
discharge teaching?
A. "I will weigh myself at approximately the same time each
morning."
B. "I will report a sudden increase in my weight."
C. "I can stop taking my heart medications when my breathing
improves."
D. "I will follow the prescribed sodium restriction."
Correct answer: C. "I can stop taking my heart medications
when my breathing improves."
Heart failure is a chronic condition requiring ongoing
management. Prescribed medications should not be
discontinued simply because symptoms improve. Abruptly
Correct Answers (VerifiedAnswers) Plus
Rationales 2026 Q&A Instant Download PDF
Case Study 1: Acute Heart Failure
A 72-year-old client with a history of hypertension and heart
failure presents to the emergency department with worsening
shortness of breath for 2 days. The client reports gaining 4 lb
over the past week. Assessment findings include bilateral
crackles, 2+ pitting edema of the lower extremities, respiratory
rate of 30/min, oxygen saturation of 86% on room air, and
blood pressure of 168/94 mm Hg.
Question 1
Which assessment finding requires the nurse's priority
intervention?
A. 2+ bilateral lower-extremity edema
B. 4-lb weight gain
C. Respiratory rate of 30/min with oxygen saturation of 86%
D. Blood pressure of 168/94 mm Hg
Correct answer: C. Respiratory rate of 30/min with oxygen
saturation of 86%
,The client's severe hypoxemia and tachypnea indicate impaired
oxygenation and possible acute pulmonary edema. Airway and
breathing take priority over fluid retention and hypertension.
The nurse should immediately support oxygenation, position the
client upright, assess respiratory status, and initiate prescribed
oxygen therapy. The edema and weight gain are important
indicators of worsening heart failure, but they are not as
immediately life-threatening as inadequate oxygenation.
Question 2
Which position should the nurse place the client in initially?
A. Supine with the legs elevated
B. High-Fowler's position
C. Trendelenburg position
D. Prone position
Correct answer: B. High-Fowler's position
High-Fowler's position promotes lung expansion and decreases
venous return to the heart, which can reduce pulmonary
congestion. A supine position may worsen dyspnea, while
Trendelenburg increases venous return and can aggravate
pulmonary congestion. Prone positioning is not the routine
initial intervention for a client experiencing acute heart-failure-
related dyspnea.
Question 3
,The provider prescribes IV furosemide. Which finding best
indicates that the medication is producing the desired effect?
A. Increased peripheral edema
B. Increased urine output and improved oxygen saturation
C. Increased blood pressure
D. Decreased serum sodium concentration
Correct answer: B. Increased urine output and improved
oxygen saturation
Furosemide is a loop diuretic that promotes rapid renal
excretion of sodium and water. Removing excess fluid decreases
intravascular volume and pulmonary congestion, which should
improve respiratory status and oxygenation. Increased urine
output is an expected therapeutic response. The nurse should
also monitor potassium, sodium, renal function, blood pressure,
daily weight, and fluid balance because excessive diuresis can
cause dehydration, hypotension, and electrolyte abnormalities.
Question 4
Which laboratory value is particularly important for the nurse to
monitor after administering repeated doses of furosemide?
A. Potassium
B. Hemoglobin A1c
C. Platelet count
D. Amylase
, Correct answer: A. Potassium
Loop diuretics can increase urinary potassium loss and place the
client at risk for hypokalemia. Low potassium levels can cause
muscle weakness and potentially dangerous cardiac
dysrhythmias. The nurse should monitor serum potassium and
assess for manifestations such as weakness, muscle cramps,
palpitations, and dysrhythmias. Renal function and other
electrolytes should also be monitored during aggressive
diuresis.
Question 5
Which statement by the client indicates a need for additional
discharge teaching?
A. "I will weigh myself at approximately the same time each
morning."
B. "I will report a sudden increase in my weight."
C. "I can stop taking my heart medications when my breathing
improves."
D. "I will follow the prescribed sodium restriction."
Correct answer: C. "I can stop taking my heart medications
when my breathing improves."
Heart failure is a chronic condition requiring ongoing
management. Prescribed medications should not be
discontinued simply because symptoms improve. Abruptly
