HESI MED SURG 1 QUESTIONS AND ANSWERS 2025
The nurse observes ventricular fibrillation on telemetry and, on entering the client's
bathroom, finds the client unconscious on the floor. Which intervention should the nurse
implement first?
A.
Administer an antidysrhythmic medication.
B.
Start cardiopulmonary resuscitation.
C.
Defibrillate the client at 200 J.
D.
Assess the client's pulse oximetry. - CORRECT ANSWER-B.
Start cardiopulmonary resuscitation.
Rationale:
Ventricular fibrillation is a life-threatening dysrhythmia, and CPR should be started
immediately (B). (A and C) are appropriate, but CPR is the priority action. The client is
dying, and (D) does not address the seriousness of this situation.
The nurse assesses a client who has been prescribed furosemide (Lasix) for cardiac
disease. Which electrocardiographic change would be a concern for a client taking a
diuretic?
A.
Tall, spiked T waves
B.
A prolonged QT interval
C.
A widening QRS complex
D.
Presence of a U wave - CORRECT ANSWER-D.
Presence of a U wave
Rationale:
A U wave (D) is a positive deflection following the T wave and is often present with
hypokalemia (low potassium level). (A, B, and C) are all signs of hyperkalemia.
A 43-year-old homeless, malnourished female client with a history of alcoholism is
transferred to the ICU. She is placed on telemetry, and the rhythm strip shown is
,obtained. The nurse palpates a heart rate of 160 beats/min, and the client's blood
pressure is 90/54 mm Hg. Based on these findings, which IV medication should the
nurse administer?
A.
Amiodarone (Cordarone)
B.
Magnesium sulfate
C.
Lidocaine (Xylocaine)
D.
Procainamide (Pronestyl) - CORRECT ANSWER-B.
Magnesium sulfate
Rationale:
Because the client has chronic alcoholism, she is likely to have hypomagnesemia. (B) is
the recommended drug for torsades de pointes, which is a form of polymorphic
ventricular tachycardia (VT) usually associated with a prolonged QT interval that occurs
with hypomagnesemia. (A and D) increase the QT interval, which can cause the
torsades to worsen. (C) is the antiarrhythmic of choice in most cases of drug-induced
monomorphic VT, not torsades.
When developing a discharge teaching plan for a client after the insertion of a
permanent pacemaker, the nurse writes a goal of "The client will verbalize symptoms of
pacemaker failure." Which behavior indicates that the goal has been met?
A.
The client demonstrates the procedures to change the rate of the pacemaker using a
magnet.
B.
The client carries a card in his wallet stating the type and serial number of the
pacemaker.
C.
The client tells the nurse that it is important to report redness and tenderness at the
insertion site.
D.
The client states that changes in the pulse and feelings of dizziness are significant
changes. - CORRECT ANSWER-D.
The client states that changes in the pulse and feelings of dizziness are significant
changes.
Rationale:
,Changes in pulse rate and/or rhythm may indicate pacer failure. Feelings of dizziness
may be caused by a decreased heart rate, leading to decreased cardiac output (D). The
rate of a pacemaker is not changed by a client, although the client may be familiar with
this procedure as explained by his health care provider (A). (B) is an important step in
preparing the client for discharge but does not demonstrate knowledge of the symptoms
of pacer failure. (C) indicates symptoms of possible incisional infection or irritation but
do not indicate pacer failure.
The nurse teaches a client with type 2 diabetes nutritional strategies to decrease
obesity. Which food item(s) chosen by the client indicates understanding of the
teaching? (Select all that apply.)
A.
White bread
B.
Salmon
C.
Broccoli
D.
Whole milk
E.
Banana - CORRECT ANSWER-B
Salmon
C
Broccoli
E.
Banana
Rationale:
(B, C, and E) provide fresh fruits, lean meats and fish, vegetables, whole grains, and
low-fat dairy products. All are recommended by the American Diabetes Association
(ADA) and are a part of the My Plate guidelines recommended by the U.S. Department
of Agriculture (USDA). Whole milk (D) is high in fat and is not recommended by ADA.
White bread is milled, a process that removes the essential nutrients. It should be
avoided for weight loss and is a poor choice for the client with diabetes (A).
A client diagnosed with angina pectoris complains of chest pain while ambulating in the
hallway. Which action should the nurse implement first?
A.
, Support the client to a sitting position.
B.
Ask the client to walk slowly back to the room.
C.
Administer a sublingual nitroglycerin tablet.
D.
Provide oxygen via nasal cannula. - CORRECT ANSWER-A.
Support the client to a sitting position.
Rationale:
The nurse should safely assist the client to a resting position (A) and then perform (C
and D). The client must cease all activity immediately, which will decrease the oxygen
requirement of the myocardial muscle. After these interventions are implemented, the
client can be escorted back to the room via wheelchair or stretcher (B).
After attending a class on reducing cancer risk factors, a client selects bran flakes with
2% milk and orange slices from a breakfast menu. In evaluating the client's learning, the
nurse affirms that the client has made good choices and makes what additional
recommendation?
A.
Switch to skim milk.
B.
Switch to orange juice.
C.
Add a source of protein.
D.
Add herbal tea. - CORRECT ANSWER-A.
Switch to skim milk.
Rationale:
Dietary recommendations to reduce cancer risk include reduced consumption of fats,
with increased consumption of fruits, vegetables, and fiber. (A) promotes reduced fat
consumption. Orange slices provide more fiber than orange juice (B, C, and D) are not
standard recommendations for reducing cancer risk.
A nurse is assisting an 82-year-old client with ambulation and is concerned that the
client may fall. Which area contains the older person's center of gravity?
A.
Head and neck
B.
The nurse observes ventricular fibrillation on telemetry and, on entering the client's
bathroom, finds the client unconscious on the floor. Which intervention should the nurse
implement first?
A.
Administer an antidysrhythmic medication.
B.
Start cardiopulmonary resuscitation.
C.
Defibrillate the client at 200 J.
D.
Assess the client's pulse oximetry. - CORRECT ANSWER-B.
Start cardiopulmonary resuscitation.
Rationale:
Ventricular fibrillation is a life-threatening dysrhythmia, and CPR should be started
immediately (B). (A and C) are appropriate, but CPR is the priority action. The client is
dying, and (D) does not address the seriousness of this situation.
The nurse assesses a client who has been prescribed furosemide (Lasix) for cardiac
disease. Which electrocardiographic change would be a concern for a client taking a
diuretic?
A.
Tall, spiked T waves
B.
A prolonged QT interval
C.
A widening QRS complex
D.
Presence of a U wave - CORRECT ANSWER-D.
Presence of a U wave
Rationale:
A U wave (D) is a positive deflection following the T wave and is often present with
hypokalemia (low potassium level). (A, B, and C) are all signs of hyperkalemia.
A 43-year-old homeless, malnourished female client with a history of alcoholism is
transferred to the ICU. She is placed on telemetry, and the rhythm strip shown is
,obtained. The nurse palpates a heart rate of 160 beats/min, and the client's blood
pressure is 90/54 mm Hg. Based on these findings, which IV medication should the
nurse administer?
A.
Amiodarone (Cordarone)
B.
Magnesium sulfate
C.
Lidocaine (Xylocaine)
D.
Procainamide (Pronestyl) - CORRECT ANSWER-B.
Magnesium sulfate
Rationale:
Because the client has chronic alcoholism, she is likely to have hypomagnesemia. (B) is
the recommended drug for torsades de pointes, which is a form of polymorphic
ventricular tachycardia (VT) usually associated with a prolonged QT interval that occurs
with hypomagnesemia. (A and D) increase the QT interval, which can cause the
torsades to worsen. (C) is the antiarrhythmic of choice in most cases of drug-induced
monomorphic VT, not torsades.
When developing a discharge teaching plan for a client after the insertion of a
permanent pacemaker, the nurse writes a goal of "The client will verbalize symptoms of
pacemaker failure." Which behavior indicates that the goal has been met?
A.
The client demonstrates the procedures to change the rate of the pacemaker using a
magnet.
B.
The client carries a card in his wallet stating the type and serial number of the
pacemaker.
C.
The client tells the nurse that it is important to report redness and tenderness at the
insertion site.
D.
The client states that changes in the pulse and feelings of dizziness are significant
changes. - CORRECT ANSWER-D.
The client states that changes in the pulse and feelings of dizziness are significant
changes.
Rationale:
,Changes in pulse rate and/or rhythm may indicate pacer failure. Feelings of dizziness
may be caused by a decreased heart rate, leading to decreased cardiac output (D). The
rate of a pacemaker is not changed by a client, although the client may be familiar with
this procedure as explained by his health care provider (A). (B) is an important step in
preparing the client for discharge but does not demonstrate knowledge of the symptoms
of pacer failure. (C) indicates symptoms of possible incisional infection or irritation but
do not indicate pacer failure.
The nurse teaches a client with type 2 diabetes nutritional strategies to decrease
obesity. Which food item(s) chosen by the client indicates understanding of the
teaching? (Select all that apply.)
A.
White bread
B.
Salmon
C.
Broccoli
D.
Whole milk
E.
Banana - CORRECT ANSWER-B
Salmon
C
Broccoli
E.
Banana
Rationale:
(B, C, and E) provide fresh fruits, lean meats and fish, vegetables, whole grains, and
low-fat dairy products. All are recommended by the American Diabetes Association
(ADA) and are a part of the My Plate guidelines recommended by the U.S. Department
of Agriculture (USDA). Whole milk (D) is high in fat and is not recommended by ADA.
White bread is milled, a process that removes the essential nutrients. It should be
avoided for weight loss and is a poor choice for the client with diabetes (A).
A client diagnosed with angina pectoris complains of chest pain while ambulating in the
hallway. Which action should the nurse implement first?
A.
, Support the client to a sitting position.
B.
Ask the client to walk slowly back to the room.
C.
Administer a sublingual nitroglycerin tablet.
D.
Provide oxygen via nasal cannula. - CORRECT ANSWER-A.
Support the client to a sitting position.
Rationale:
The nurse should safely assist the client to a resting position (A) and then perform (C
and D). The client must cease all activity immediately, which will decrease the oxygen
requirement of the myocardial muscle. After these interventions are implemented, the
client can be escorted back to the room via wheelchair or stretcher (B).
After attending a class on reducing cancer risk factors, a client selects bran flakes with
2% milk and orange slices from a breakfast menu. In evaluating the client's learning, the
nurse affirms that the client has made good choices and makes what additional
recommendation?
A.
Switch to skim milk.
B.
Switch to orange juice.
C.
Add a source of protein.
D.
Add herbal tea. - CORRECT ANSWER-A.
Switch to skim milk.
Rationale:
Dietary recommendations to reduce cancer risk include reduced consumption of fats,
with increased consumption of fruits, vegetables, and fiber. (A) promotes reduced fat
consumption. Orange slices provide more fiber than orange juice (B, C, and D) are not
standard recommendations for reducing cancer risk.
A nurse is assisting an 82-year-old client with ambulation and is concerned that the
client may fall. Which area contains the older person's center of gravity?
A.
Head and neck
B.
