HESI MED-SURG EXIT EXAM 2026/2027
WITH 150 PRACTICE QUESTIONS AND
EXPERT-VERIFIED CORRECT
ANSWERS | ALREADY GRADED A+ |
GUARANTEED SUCCESS
Cardiovascular
1. A patient with heart failure has an ejection fraction of 35%. This indicates:
A) Diastolic heart failure
B) Systolic heart failure
C) Normal cardiac function
D) Hypertrophic cardiomyopathy
Answer: B. An EF below 40% indicates systolic heart failure (HFrEF), where the
heart muscle does not contract effectively.
2. A 68-year-old man with HTN and DM is admitted with chest pain. Vital
signs: BP 88/50, HR 118, RR 26, SpO2 89%. 12-lead shows ST elevation in II,
III, aVF. He is diaphoretic and confused. Which action is priority?
A) Start high-flow O₂ via NRB
B) Insert a 14-gauge IV
C) Administer sublingual nitroglycerin
D) Obtain stat troponin
,Answer: A. In ACS with shock, ABC is always first—oxygenate, then access,
then meds.
3. A client who has heart failure is admitted with a serum potassium level of
2.9 mEq/L. Which action is most important for the nurse to implement?
A) Administer oral potassium supplement
B) Initiate continuous cardiac monitoring
C) Restrict dietary potassium
D) Prepare for dialysis
Answer: B. Hypokalemia increases the risk of cardiac dysrhythmias; continuous
cardiac monitoring is the priority.
4. A client experiencing uncontrolled atrial fibrillation is admitted to the
telemetry unit. What initial medication should the nurse anticipate
administering?
A) Amiodarone
B) Digoxin
C) Lidocaine
D) Adenosine
Answer: B. Digoxin is used to control ventricular rate in atrial fibrillation.
5. A client is admitted to the MICU with a diagnosis of myocardial infarction.
The infarction occurred ten hours ago. Which lab test result would the nurse
expect?
A) Elevated CK-MB
B) Elevated troponin only
C) Elevated BNP
D) Normal CK-MB
Answer: A. CK-MB rises 4-6 hours after MI, peaks at 12-24 hours.
6. The nurse working on a telemetry unit finds a client unconscious and in
pulseless ventricular tachycardia. The client has an implanted automatic
defibrillator. What action should the nurse implement?
A) Wait for the defibrillator to fire
B) Shock the client with 200 joules per hospital policy
C) Administer amiodarone IV
D) Begin CPR
Answer: B. In pulseless VT, defibrillation is the priority treatment.
,7. A client taking furosemide (Lasix) reports difficulty sleeping. What
question is important for the nurse to ask?
A) "Do you drink caffeine before bed?"
B) "At what time do you take your medication?"
C) "Do you have chest pain?"
D) "Have you gained weight?"
Answer: B. Furosemide taken late in the day can cause nocturia and sleep
disturbance.
8. A client taking a thiazide diuretic for six months has a serum potassium
level of 3.0. The nurse anticipates which change in prescription?
A) Discontinue the diuretic
B) A potassium supplement will be prescribed
C) Increase the diuretic dose
D) Add a loop diuretic
Answer: B. Thiazide diuretics can cause hypokalemia; potassium supplementation
is indicated.
9. When assessing a hypertensive client during ophthalmoscopic examination,
which finding indicates the severity of hypertension?
A) Papilledema
B) Amount of retinal vessel damage
C) Glaucoma
D) Cataracts
Answer: B. Retinal vessel damage (arteriovenous nicking, hemorrhages, exudates)
reflects the severity and duration of hypertension.
10. A client with chronic venous insufficiency: Which assessment finding
should the nurse anticipate?
A) Bilateral lower leg stasis dermatitis
B) Pallor on elevation
C) Intermittent claudication
D) Cool, pale extremities
Answer: A. Stasis dermatitis (brownish discoloration, skin changes) is
characteristic of chronic venous insufficiency.
11. A postoperative client reports sudden onset of chest pain and dyspnea,
appears anxious, restless, and mildly cyanotic. The nurse should further assess
for which condition?
, A) Pulmonary embolism
B) Myocardial infarction
C) Pneumothorax
D) Atelectasis
Answer: A. Sudden chest pain, dyspnea, anxiety, and cyanosis in a postoperative
patient suggest pulmonary embolism.
12. A male client with hypertension has which additional diagnosis that
presents the greatest risk for CVA?
A) Diabetes mellitus
B) Hyperlipidemia
C) Obesity
D) Gout
Answer: A. Diabetes mellitus significantly increases the risk of cerebrovascular
accident in hypertensive patients.
Respiratory
13. A patient with COPD is receiving oxygen via nasal cannula at 2 L/min.
The spouse asks why the flow is set so low. What is the best response?
A) "Higher oxygen will cause the patient to stop breathing."
B) "Low oxygen levels stimulate the hypoxic drive to breathe in these patients."
C) "Higher oxygen concentrations are toxic to lung tissue."
D) "This is the standard flow rate for all patients."
Answer: B. COPD patients with chronic hypercapnia rely on hypoxic drive; high
O₂ can suppress respiration.
14. A client with COPD has O₂ at 4 L/min via nasal cannula. Which
assessment finding indicates a problem?
A) Respiratory rate of 20
B) Oxygen saturation of 94%
C) The client is becoming lethargic
D) The client is sitting upright
Answer: C. Lethargy in a COPD patient on oxygen may indicate CO₂ narcosis
from excessive oxygen.
15. When teaching diaphragmatic breathing to a client with COPD, which
information should the nurse provide?
WITH 150 PRACTICE QUESTIONS AND
EXPERT-VERIFIED CORRECT
ANSWERS | ALREADY GRADED A+ |
GUARANTEED SUCCESS
Cardiovascular
1. A patient with heart failure has an ejection fraction of 35%. This indicates:
A) Diastolic heart failure
B) Systolic heart failure
C) Normal cardiac function
D) Hypertrophic cardiomyopathy
Answer: B. An EF below 40% indicates systolic heart failure (HFrEF), where the
heart muscle does not contract effectively.
2. A 68-year-old man with HTN and DM is admitted with chest pain. Vital
signs: BP 88/50, HR 118, RR 26, SpO2 89%. 12-lead shows ST elevation in II,
III, aVF. He is diaphoretic and confused. Which action is priority?
A) Start high-flow O₂ via NRB
B) Insert a 14-gauge IV
C) Administer sublingual nitroglycerin
D) Obtain stat troponin
,Answer: A. In ACS with shock, ABC is always first—oxygenate, then access,
then meds.
3. A client who has heart failure is admitted with a serum potassium level of
2.9 mEq/L. Which action is most important for the nurse to implement?
A) Administer oral potassium supplement
B) Initiate continuous cardiac monitoring
C) Restrict dietary potassium
D) Prepare for dialysis
Answer: B. Hypokalemia increases the risk of cardiac dysrhythmias; continuous
cardiac monitoring is the priority.
4. A client experiencing uncontrolled atrial fibrillation is admitted to the
telemetry unit. What initial medication should the nurse anticipate
administering?
A) Amiodarone
B) Digoxin
C) Lidocaine
D) Adenosine
Answer: B. Digoxin is used to control ventricular rate in atrial fibrillation.
5. A client is admitted to the MICU with a diagnosis of myocardial infarction.
The infarction occurred ten hours ago. Which lab test result would the nurse
expect?
A) Elevated CK-MB
B) Elevated troponin only
C) Elevated BNP
D) Normal CK-MB
Answer: A. CK-MB rises 4-6 hours after MI, peaks at 12-24 hours.
6. The nurse working on a telemetry unit finds a client unconscious and in
pulseless ventricular tachycardia. The client has an implanted automatic
defibrillator. What action should the nurse implement?
A) Wait for the defibrillator to fire
B) Shock the client with 200 joules per hospital policy
C) Administer amiodarone IV
D) Begin CPR
Answer: B. In pulseless VT, defibrillation is the priority treatment.
,7. A client taking furosemide (Lasix) reports difficulty sleeping. What
question is important for the nurse to ask?
A) "Do you drink caffeine before bed?"
B) "At what time do you take your medication?"
C) "Do you have chest pain?"
D) "Have you gained weight?"
Answer: B. Furosemide taken late in the day can cause nocturia and sleep
disturbance.
8. A client taking a thiazide diuretic for six months has a serum potassium
level of 3.0. The nurse anticipates which change in prescription?
A) Discontinue the diuretic
B) A potassium supplement will be prescribed
C) Increase the diuretic dose
D) Add a loop diuretic
Answer: B. Thiazide diuretics can cause hypokalemia; potassium supplementation
is indicated.
9. When assessing a hypertensive client during ophthalmoscopic examination,
which finding indicates the severity of hypertension?
A) Papilledema
B) Amount of retinal vessel damage
C) Glaucoma
D) Cataracts
Answer: B. Retinal vessel damage (arteriovenous nicking, hemorrhages, exudates)
reflects the severity and duration of hypertension.
10. A client with chronic venous insufficiency: Which assessment finding
should the nurse anticipate?
A) Bilateral lower leg stasis dermatitis
B) Pallor on elevation
C) Intermittent claudication
D) Cool, pale extremities
Answer: A. Stasis dermatitis (brownish discoloration, skin changes) is
characteristic of chronic venous insufficiency.
11. A postoperative client reports sudden onset of chest pain and dyspnea,
appears anxious, restless, and mildly cyanotic. The nurse should further assess
for which condition?
, A) Pulmonary embolism
B) Myocardial infarction
C) Pneumothorax
D) Atelectasis
Answer: A. Sudden chest pain, dyspnea, anxiety, and cyanosis in a postoperative
patient suggest pulmonary embolism.
12. A male client with hypertension has which additional diagnosis that
presents the greatest risk for CVA?
A) Diabetes mellitus
B) Hyperlipidemia
C) Obesity
D) Gout
Answer: A. Diabetes mellitus significantly increases the risk of cerebrovascular
accident in hypertensive patients.
Respiratory
13. A patient with COPD is receiving oxygen via nasal cannula at 2 L/min.
The spouse asks why the flow is set so low. What is the best response?
A) "Higher oxygen will cause the patient to stop breathing."
B) "Low oxygen levels stimulate the hypoxic drive to breathe in these patients."
C) "Higher oxygen concentrations are toxic to lung tissue."
D) "This is the standard flow rate for all patients."
Answer: B. COPD patients with chronic hypercapnia rely on hypoxic drive; high
O₂ can suppress respiration.
14. A client with COPD has O₂ at 4 L/min via nasal cannula. Which
assessment finding indicates a problem?
A) Respiratory rate of 20
B) Oxygen saturation of 94%
C) The client is becoming lethargic
D) The client is sitting upright
Answer: C. Lethargy in a COPD patient on oxygen may indicate CO₂ narcosis
from excessive oxygen.
15. When teaching diaphragmatic breathing to a client with COPD, which
information should the nurse provide?
