HESI
Med-Surg II – Set 2 | Questions & Answers with
Detailed Rationales | Nursing Study Guide 2026
RESOURCE FEATURES
• Med-Surg II HESI Set 2 practice questions
• Answers for self-assessment
• Detailed rationales and explanations
• Clinical scenario-based practice
• Priority and delegation questions
• Adult medical-surgical review
• NCLEX-style clinical judgment
• 2026 exam preparation
, Med-Surg II HESI – Set 2 | Questions &
Answers with Detailed Rationales | Nursing
Study Guide 2026
1. The nurse is assessing a 48-year-old client with a history of smoking
during a routine clinic visit. The client, who exercises regularly,
reports having pain in the calf during exercise that disappears at rest.
Which of the following findings requires further evaluation?
1. Heart rate 57 bpm.
2. SpO₂ of 94% on room air.
3. Blood pressure 134/82.
4. Ankle-brachial index of 0.65.
Correct Answer: 4
Rationale: An ABI of 0.65 is significantly below the normal range (1.0–1.4)
and indicates moderate-to-severe peripheral arterial disease. The calf pain
with exercise that resolves with rest (intermittent claudication) is classic for
PAD, but the ABI provides objective evidence. The other findings are within
acceptable limits (heart rate 57 can be normal in a fit person; SpO₂ 94% is
acceptable; BP 134/82 is prehypertension but not the priority).
2. A client with peripheral vascular disease has undergone a right
femoral-popliteal bypass graft. The blood pressure has decreased
from 124/80 to 94/62. What should the nurse assess first?
, 1. IV fluid solution.
2. Pedal pulses.
3. Nasal cannula flow rate.
4. Capillary refill.
Correct Answer: 2
Rationale: A drop in blood pressure after vascular surgery may indicate
hemorrhage or graft occlusion. The priority is to assess distal perfusion by
palpating pedal pulses. If pulses are absent or diminished, the graft may be
thrombosed, requiring immediate intervention. IV fluid and oxygen are
important but come after a focused vascular assessment.
3. An overweight client taking warfarin (Coumadin) has dry skin due
to decreased arterial blood flow. What should the nurse instruct the
client to do? Select all that apply.
1. Apply lanolin or petroleum jelly to intact skin.
2. Follow a reduced-calorie, reduced-fat diet.
3. Inspect the involved areas daily for new ulcerations.
4. Instruct the client to limit activities of daily living (ADLs).
5. Use an electric razor to shave.
Correct Answers: 1, 2, 3, 5
Rationale:
• 1: Emollients help prevent skin cracking and infection.
• 2: Weight loss reduces cardiovascular risk and improves lipid profiles.
• 3: Daily skin inspection is essential to catch early ulcers.
, • 4: Limiting ADLs is incorrect; moderate activity (especially walking) is
encouraged for PAD.
• 5: Electric razors reduce the risk of cuts and bleeding in a client on
warfarin.
4. The nurse is caring for a client with peripheral artery disease who
has recently been prescribed clopidogrel (Plavix). The nurse
understands that more teaching is needed when the client states:
1. "I should not be surprised if I bruise easier or if my gums bleed a little
when brushing my teeth."
2. "It doesn't really matter if I take this medicine with or without food,
whatever works best for my stomach."
3. "I should stop taking Plavix if it makes me feel weak and dizzy."
4. "The doctor prescribed this medicine to make my platelets less likely
to stick together and help prevent clots from forming."
Correct Answer: 3
Rationale: Weakness and dizziness may indicate bleeding (e.g.,
gastrointestinal bleed) or other adverse effects, but the client
should not stop Plavix abruptly; they should notify the healthcare provider
immediately. Stopping an antiplatelet agent increases the risk of
thrombosis. The other statements are correct: bruising/bleeding gums are
expected; food does not affect absorption; and the action is antiplatelet.
5. A client is receiving Cilostazol (Pletal) for peripheral arterial disease
causing intermittent claudication. The nurse determines this
Med-Surg II – Set 2 | Questions & Answers with
Detailed Rationales | Nursing Study Guide 2026
RESOURCE FEATURES
• Med-Surg II HESI Set 2 practice questions
• Answers for self-assessment
• Detailed rationales and explanations
• Clinical scenario-based practice
• Priority and delegation questions
• Adult medical-surgical review
• NCLEX-style clinical judgment
• 2026 exam preparation
, Med-Surg II HESI – Set 2 | Questions &
Answers with Detailed Rationales | Nursing
Study Guide 2026
1. The nurse is assessing a 48-year-old client with a history of smoking
during a routine clinic visit. The client, who exercises regularly,
reports having pain in the calf during exercise that disappears at rest.
Which of the following findings requires further evaluation?
1. Heart rate 57 bpm.
2. SpO₂ of 94% on room air.
3. Blood pressure 134/82.
4. Ankle-brachial index of 0.65.
Correct Answer: 4
Rationale: An ABI of 0.65 is significantly below the normal range (1.0–1.4)
and indicates moderate-to-severe peripheral arterial disease. The calf pain
with exercise that resolves with rest (intermittent claudication) is classic for
PAD, but the ABI provides objective evidence. The other findings are within
acceptable limits (heart rate 57 can be normal in a fit person; SpO₂ 94% is
acceptable; BP 134/82 is prehypertension but not the priority).
2. A client with peripheral vascular disease has undergone a right
femoral-popliteal bypass graft. The blood pressure has decreased
from 124/80 to 94/62. What should the nurse assess first?
, 1. IV fluid solution.
2. Pedal pulses.
3. Nasal cannula flow rate.
4. Capillary refill.
Correct Answer: 2
Rationale: A drop in blood pressure after vascular surgery may indicate
hemorrhage or graft occlusion. The priority is to assess distal perfusion by
palpating pedal pulses. If pulses are absent or diminished, the graft may be
thrombosed, requiring immediate intervention. IV fluid and oxygen are
important but come after a focused vascular assessment.
3. An overweight client taking warfarin (Coumadin) has dry skin due
to decreased arterial blood flow. What should the nurse instruct the
client to do? Select all that apply.
1. Apply lanolin or petroleum jelly to intact skin.
2. Follow a reduced-calorie, reduced-fat diet.
3. Inspect the involved areas daily for new ulcerations.
4. Instruct the client to limit activities of daily living (ADLs).
5. Use an electric razor to shave.
Correct Answers: 1, 2, 3, 5
Rationale:
• 1: Emollients help prevent skin cracking and infection.
• 2: Weight loss reduces cardiovascular risk and improves lipid profiles.
• 3: Daily skin inspection is essential to catch early ulcers.
, • 4: Limiting ADLs is incorrect; moderate activity (especially walking) is
encouraged for PAD.
• 5: Electric razors reduce the risk of cuts and bleeding in a client on
warfarin.
4. The nurse is caring for a client with peripheral artery disease who
has recently been prescribed clopidogrel (Plavix). The nurse
understands that more teaching is needed when the client states:
1. "I should not be surprised if I bruise easier or if my gums bleed a little
when brushing my teeth."
2. "It doesn't really matter if I take this medicine with or without food,
whatever works best for my stomach."
3. "I should stop taking Plavix if it makes me feel weak and dizzy."
4. "The doctor prescribed this medicine to make my platelets less likely
to stick together and help prevent clots from forming."
Correct Answer: 3
Rationale: Weakness and dizziness may indicate bleeding (e.g.,
gastrointestinal bleed) or other adverse effects, but the client
should not stop Plavix abruptly; they should notify the healthcare provider
immediately. Stopping an antiplatelet agent increases the risk of
thrombosis. The other statements are correct: bruising/bleeding gums are
expected; food does not affect absorption; and the action is antiplatelet.
5. A client is receiving Cilostazol (Pletal) for peripheral arterial disease
causing intermittent claudication. The nurse determines this
