HESI MED-SURG EXAM REVIEW -ALL QUESTIONS AND
ANSWERS PLUS DETAILED RATIONALES | COMPLETE
STUDYGUIDE| GUARANTEED PASS | DOWNLOAD
INSTANT PDF 2027-2028
1. A nurse is caring for a client admitted with acute exacerbation of heart failure. The
client is sitting upright, has severe dyspnea, and has an oxygen saturation of 84%. Which
action should the nurse take first?
A. Encourage oral fluids
B. Place the client in high-Fowler's position and initiate prescribed oxygen therapy
C. Obtain the client's daily weight
D. Teach the client about a low-sodium diet
Answer: B
High-Fowler's positioning promotes lung expansion, while prescribed oxygen addresses the
immediate hypoxemia. Teaching and routine assessments can occur after the client's
respiratory status is stabilized.
2. A client with heart failure reports gaining 2.5 kg (5.5 lb) in four days. Which
interpretation by the nurse is most appropriate?
A. The client has likely increased muscle mass
B. The finding indicates improved nutritional status
C. The client may be retaining fluid and experiencing worsening heart failure
D. The weight change is expected with aging
Answer: C
Rapid weight gain over several days is more consistent with fluid retention than tissue gain. In
heart failure, this may indicate worsening volume overload and should be reported according
to the care plan.
3. Which assessment finding is most characteristic of left-sided heart failure?
A. Pulmonary crackles and dyspnea
B. Dependent peripheral edema only
C. Enlarged liver
D. Jugular venous distention without respiratory symptoms
,Answer: A
Left-sided heart failure causes pulmonary congestion, producing findings such as dyspnea,
orthopnea, crackles, and impaired oxygenation. Right-sided failure more commonly causes
systemic venous congestion.
4. A client with chronic heart failure is prescribed furosemide. Which laboratory value
should the nurse monitor closely?
A. Potassium
B. Hemoglobin A1c
C. Platelet count
D. Bilirubin
Answer: A
Furosemide is a loop diuretic that can increase urinary potassium loss. Significant
hypokalemia can cause muscle weakness and potentially dangerous cardiac dysrhythmias.
5. A client reports crushing chest pain radiating to the left arm with diaphoresis and
nausea. Which action should the nurse take first?
A. Offer the client a meal
B. Encourage ambulation
C. Perform a focused assessment and initiate the facility's acute chest-pain protocol
D. Ask the client to return later if the pain persists
Answer: C
The symptoms are concerning for acute coronary syndrome. Rapid assessment and activation
of the appropriate emergency protocol are essential to reduce myocardial injury and identify
time-sensitive treatment needs.
6. A client experiencing an acute myocardial infarction suddenly becomes hypotensive,
cool, and confused. Which complication should the nurse suspect?
A. Cardiogenic shock
B. Mild dehydration
C. Stable angina
D. Chronic venous insufficiency
,Answer: A
Hypotension, cool skin, and altered mental status following myocardial infarction suggest
inadequate cardiac output and possible cardiogenic shock, which requires immediate
intervention.
7. A client with angina asks how to distinguish stable angina from an acute myocardial
infarction. Which response is most appropriate?
A. “Stable angina usually resolves with rest or prescribed treatment, whereas persistent or
worsening chest pain requires urgent evaluation.”
B. “Angina always lasts longer than a myocardial infarction.”
C. “A myocardial infarction never causes sweating.”
D. “Stable angina occurs only during sleep.”
Answer: A
Stable angina typically follows a predictable pattern and improves with rest or prescribed
therapy. New, severe, persistent, or changing chest pain should be treated as potentially acute
coronary syndrome.
8. A client with atrial fibrillation is prescribed an anticoagulant. What is the primary
reason for this therapy?
A. To increase heart rate
B. To reduce the risk of thromboembolic stroke
C. To improve oxygen saturation
D. To eliminate all dysrhythmias
Answer: B
Atrial fibrillation promotes blood stasis in the atria, increasing thrombus formation and
embolic stroke risk. Anticoagulation reduces this risk in appropriate clients.
9. A client taking warfarin reports black, tarry stools. Which action should the nurse take?
A. Encourage the client to take aspirin
B. Reassure the client that this is expected
C. Recognize possible gastrointestinal bleeding and promptly notify the healthcare provider
D. Tell the client to increase the warfarin dose
, Answer: C
Melena can indicate gastrointestinal bleeding. Because warfarin increases bleeding risk, this
finding requires prompt assessment and evaluation.
10. A client receiving an anticoagulant asks which finding should be reported immediately.
Which response is best?
A. “Mild hunger before meals”
B. “Occasional thirst”
C. “A small bruise that has remained unchanged for several weeks”
D. “Vomiting blood or passing black, tarry stools”
Answer: D
Hematemesis and melena can indicate significant gastrointestinal bleeding and require
immediate evaluation, particularly in clients receiving anticoagulants.
11. A client with COPD is receiving oxygen therapy and becomes increasingly drowsy.
Which assessment is the nurse's priority?
A. Respiratory effort, rate, oxygenation, and mental status
B. Appetite
C. Bowel sounds
D. Skin turgor only
Answer: A
Increasing drowsiness in a client with severe COPD can indicate worsening gas exchange,
hypercapnia, or respiratory fatigue. A comprehensive respiratory assessment is essential.
12. A client with COPD has thick respiratory secretions and difficulty clearing them.
Which intervention is most appropriate when not contraindicated?
A. Restrict fluids
B. Encourage appropriate hydration and effective coughing techniques
C. Maintain continuous bed rest
D. Discourage coughing
Answer: B
ANSWERS PLUS DETAILED RATIONALES | COMPLETE
STUDYGUIDE| GUARANTEED PASS | DOWNLOAD
INSTANT PDF 2027-2028
1. A nurse is caring for a client admitted with acute exacerbation of heart failure. The
client is sitting upright, has severe dyspnea, and has an oxygen saturation of 84%. Which
action should the nurse take first?
A. Encourage oral fluids
B. Place the client in high-Fowler's position and initiate prescribed oxygen therapy
C. Obtain the client's daily weight
D. Teach the client about a low-sodium diet
Answer: B
High-Fowler's positioning promotes lung expansion, while prescribed oxygen addresses the
immediate hypoxemia. Teaching and routine assessments can occur after the client's
respiratory status is stabilized.
2. A client with heart failure reports gaining 2.5 kg (5.5 lb) in four days. Which
interpretation by the nurse is most appropriate?
A. The client has likely increased muscle mass
B. The finding indicates improved nutritional status
C. The client may be retaining fluid and experiencing worsening heart failure
D. The weight change is expected with aging
Answer: C
Rapid weight gain over several days is more consistent with fluid retention than tissue gain. In
heart failure, this may indicate worsening volume overload and should be reported according
to the care plan.
3. Which assessment finding is most characteristic of left-sided heart failure?
A. Pulmonary crackles and dyspnea
B. Dependent peripheral edema only
C. Enlarged liver
D. Jugular venous distention without respiratory symptoms
,Answer: A
Left-sided heart failure causes pulmonary congestion, producing findings such as dyspnea,
orthopnea, crackles, and impaired oxygenation. Right-sided failure more commonly causes
systemic venous congestion.
4. A client with chronic heart failure is prescribed furosemide. Which laboratory value
should the nurse monitor closely?
A. Potassium
B. Hemoglobin A1c
C. Platelet count
D. Bilirubin
Answer: A
Furosemide is a loop diuretic that can increase urinary potassium loss. Significant
hypokalemia can cause muscle weakness and potentially dangerous cardiac dysrhythmias.
5. A client reports crushing chest pain radiating to the left arm with diaphoresis and
nausea. Which action should the nurse take first?
A. Offer the client a meal
B. Encourage ambulation
C. Perform a focused assessment and initiate the facility's acute chest-pain protocol
D. Ask the client to return later if the pain persists
Answer: C
The symptoms are concerning for acute coronary syndrome. Rapid assessment and activation
of the appropriate emergency protocol are essential to reduce myocardial injury and identify
time-sensitive treatment needs.
6. A client experiencing an acute myocardial infarction suddenly becomes hypotensive,
cool, and confused. Which complication should the nurse suspect?
A. Cardiogenic shock
B. Mild dehydration
C. Stable angina
D. Chronic venous insufficiency
,Answer: A
Hypotension, cool skin, and altered mental status following myocardial infarction suggest
inadequate cardiac output and possible cardiogenic shock, which requires immediate
intervention.
7. A client with angina asks how to distinguish stable angina from an acute myocardial
infarction. Which response is most appropriate?
A. “Stable angina usually resolves with rest or prescribed treatment, whereas persistent or
worsening chest pain requires urgent evaluation.”
B. “Angina always lasts longer than a myocardial infarction.”
C. “A myocardial infarction never causes sweating.”
D. “Stable angina occurs only during sleep.”
Answer: A
Stable angina typically follows a predictable pattern and improves with rest or prescribed
therapy. New, severe, persistent, or changing chest pain should be treated as potentially acute
coronary syndrome.
8. A client with atrial fibrillation is prescribed an anticoagulant. What is the primary
reason for this therapy?
A. To increase heart rate
B. To reduce the risk of thromboembolic stroke
C. To improve oxygen saturation
D. To eliminate all dysrhythmias
Answer: B
Atrial fibrillation promotes blood stasis in the atria, increasing thrombus formation and
embolic stroke risk. Anticoagulation reduces this risk in appropriate clients.
9. A client taking warfarin reports black, tarry stools. Which action should the nurse take?
A. Encourage the client to take aspirin
B. Reassure the client that this is expected
C. Recognize possible gastrointestinal bleeding and promptly notify the healthcare provider
D. Tell the client to increase the warfarin dose
, Answer: C
Melena can indicate gastrointestinal bleeding. Because warfarin increases bleeding risk, this
finding requires prompt assessment and evaluation.
10. A client receiving an anticoagulant asks which finding should be reported immediately.
Which response is best?
A. “Mild hunger before meals”
B. “Occasional thirst”
C. “A small bruise that has remained unchanged for several weeks”
D. “Vomiting blood or passing black, tarry stools”
Answer: D
Hematemesis and melena can indicate significant gastrointestinal bleeding and require
immediate evaluation, particularly in clients receiving anticoagulants.
11. A client with COPD is receiving oxygen therapy and becomes increasingly drowsy.
Which assessment is the nurse's priority?
A. Respiratory effort, rate, oxygenation, and mental status
B. Appetite
C. Bowel sounds
D. Skin turgor only
Answer: A
Increasing drowsiness in a client with severe COPD can indicate worsening gas exchange,
hypercapnia, or respiratory fatigue. A comprehensive respiratory assessment is essential.
12. A client with COPD has thick respiratory secretions and difficulty clearing them.
Which intervention is most appropriate when not contraindicated?
A. Restrict fluids
B. Encourage appropriate hydration and effective coughing techniques
C. Maintain continuous bed rest
D. Discourage coughing
Answer: B
