1,500+ HESI-STYLE MEDICAL-SURGICAL NURSING NCLEX-RN® TEST
BANK | 2025 EDITION | BASED ON “HESI COMPREHENSIVE REVIEW FOR
THE NCLEX-RN® EXAMINATION,” 6TH EDITION (ISBN:
9780323582451) BY ELSEVIER, 2023 | NCLEX & HESI EXIT EXAM
QUESTIONS WITH ANSWERS, RATIONALES, AND UPDATED CLINICAL
FOCUS.
,1. A client with chronic heart failure reports sudden weight gain and shortness of breath.
Which assessment finding is most concerning?
A. Weight gain of 2 lbs (0.9 kg) overnight
B. Bilateral ankle edema
C. Blood pressure of 88/54 mm Hg
D. S₃ heart sound on auscultation
-Answer-: C
Rationale: Hypotension indicates possible cardiogenic shock and reduced perfusion,
requiring immediate action.
Tag: Cardiovascular → Heart Failure
2. A client taking warfarin has an INR of 5.6. What is the most appropriate nursing
action?
A. Administer vitamin K
B. Continue the current dose
C. Recheck INR in 1 hour
D. Give an extra dose of warfarin
-Answer-: A
Rationale: An INR > 5 increases bleeding risk. Administer vitamin K to reverse
anticoagulation.
Tag: Cardiovascular → Anticoagulation
3. After a cardiac catheterization via the femoral artery, which finding should the nurse
report first?
A. Bruising at the site
B. Back pain
C. Weak pedal pulses
D. Chest discomfort
-Answer-: D
Rationale: Post-procedure chest pain may indicate re-occlusion or MI.
Tag: Cardiovascular → Post-Procedure Monitoring
4. The nurse is caring for a client with newly diagnosed hypertension. Which instruction is
most important to include?
, A. Reduce sodium intake to <2 g/day
B. Avoid all physical activity
C. Increase fluid intake to 3 L/day
D. Take antihypertensives only when symptoms occur
-Answer-: A
Rationale: Sodium restriction is a cornerstone in managing HTN.
Tag: Cardiovascular → Hypertension Education
5. A client with peripheral artery disease (PAD) reports leg pain when walking that
resolves at rest. What term best describes this?
A. Neuropathy
B. Claudication
C. Rest pain
D. Raynaud's
-Answer-: B
Rationale: Intermittent claudication is a hallmark sign of PAD.
Tag: Cardiovascular → PAD
6. The nurse finds a client's telemetry alarm sounding "no QRS detected." What is the
priority action?
A. Check for patient movement
B. Begin chest compressions
C. Silence the alarm
D. Call the code team
-Answer-: A
Rationale: Artifact from movement or lead disconnection is common; assess the patient
first.
Tag: Cardiovascular → Telemetry Alarms
7. A client on digoxin reports nausea and blurred vision. Which lab value is most
relevant?
A. Potassium 2.8 mEq/L
B. Calcium 9.5 mg/dL
C. Sodium 140 mEq/L
D. BUN 15 mg/dL
, -Answer-: A
Rationale: Hypokalemia increases digoxin toxicity risk.
Tag: Cardiovascular → Digoxin Toxicity
8. A client with atrial fibrillation is started on diltiazem. Which assessment is a priority?
A. Blood pressure
B. Visual acuity
C. Bowel sounds
D. Skin turgor
-Answer-: A
Rationale: Diltiazem may lower blood pressure and heart rate.
Tag: Cardiovascular → Atrial Fibrillation
9. A client with infective endocarditis is scheduled for dental surgery. What pre-op
measure is most important?
A. Administer prophylactic antibiotics
B. Restrict oral intake
C. Check capillary glucose
D. Obtain sputum culture
-Answer-: A
Rationale: Antibiotic prophylaxis prevents bacteremia and worsened valve infection.
Tag: Cardiovascular → Endocarditis
10. A client with a pacemaker reports dizziness. What is the nurse's priority?
A. Perform ECG
B. Take BP and HR
C. Reposition the client
D. Ask about medication compliance
-Answer-: B
Rationale: Symptomatic bradycardia can indicate pacemaker malfunction; assess vitals.
Tag: Cardiovascular → Pacemaker Complications
11. A client with COPD is using pursed-lip breathing. What does this technique do?
A. Increases oxygen absorption
BANK | 2025 EDITION | BASED ON “HESI COMPREHENSIVE REVIEW FOR
THE NCLEX-RN® EXAMINATION,” 6TH EDITION (ISBN:
9780323582451) BY ELSEVIER, 2023 | NCLEX & HESI EXIT EXAM
QUESTIONS WITH ANSWERS, RATIONALES, AND UPDATED CLINICAL
FOCUS.
,1. A client with chronic heart failure reports sudden weight gain and shortness of breath.
Which assessment finding is most concerning?
A. Weight gain of 2 lbs (0.9 kg) overnight
B. Bilateral ankle edema
C. Blood pressure of 88/54 mm Hg
D. S₃ heart sound on auscultation
-Answer-: C
Rationale: Hypotension indicates possible cardiogenic shock and reduced perfusion,
requiring immediate action.
Tag: Cardiovascular → Heart Failure
2. A client taking warfarin has an INR of 5.6. What is the most appropriate nursing
action?
A. Administer vitamin K
B. Continue the current dose
C. Recheck INR in 1 hour
D. Give an extra dose of warfarin
-Answer-: A
Rationale: An INR > 5 increases bleeding risk. Administer vitamin K to reverse
anticoagulation.
Tag: Cardiovascular → Anticoagulation
3. After a cardiac catheterization via the femoral artery, which finding should the nurse
report first?
A. Bruising at the site
B. Back pain
C. Weak pedal pulses
D. Chest discomfort
-Answer-: D
Rationale: Post-procedure chest pain may indicate re-occlusion or MI.
Tag: Cardiovascular → Post-Procedure Monitoring
4. The nurse is caring for a client with newly diagnosed hypertension. Which instruction is
most important to include?
, A. Reduce sodium intake to <2 g/day
B. Avoid all physical activity
C. Increase fluid intake to 3 L/day
D. Take antihypertensives only when symptoms occur
-Answer-: A
Rationale: Sodium restriction is a cornerstone in managing HTN.
Tag: Cardiovascular → Hypertension Education
5. A client with peripheral artery disease (PAD) reports leg pain when walking that
resolves at rest. What term best describes this?
A. Neuropathy
B. Claudication
C. Rest pain
D. Raynaud's
-Answer-: B
Rationale: Intermittent claudication is a hallmark sign of PAD.
Tag: Cardiovascular → PAD
6. The nurse finds a client's telemetry alarm sounding "no QRS detected." What is the
priority action?
A. Check for patient movement
B. Begin chest compressions
C. Silence the alarm
D. Call the code team
-Answer-: A
Rationale: Artifact from movement or lead disconnection is common; assess the patient
first.
Tag: Cardiovascular → Telemetry Alarms
7. A client on digoxin reports nausea and blurred vision. Which lab value is most
relevant?
A. Potassium 2.8 mEq/L
B. Calcium 9.5 mg/dL
C. Sodium 140 mEq/L
D. BUN 15 mg/dL
, -Answer-: A
Rationale: Hypokalemia increases digoxin toxicity risk.
Tag: Cardiovascular → Digoxin Toxicity
8. A client with atrial fibrillation is started on diltiazem. Which assessment is a priority?
A. Blood pressure
B. Visual acuity
C. Bowel sounds
D. Skin turgor
-Answer-: A
Rationale: Diltiazem may lower blood pressure and heart rate.
Tag: Cardiovascular → Atrial Fibrillation
9. A client with infective endocarditis is scheduled for dental surgery. What pre-op
measure is most important?
A. Administer prophylactic antibiotics
B. Restrict oral intake
C. Check capillary glucose
D. Obtain sputum culture
-Answer-: A
Rationale: Antibiotic prophylaxis prevents bacteremia and worsened valve infection.
Tag: Cardiovascular → Endocarditis
10. A client with a pacemaker reports dizziness. What is the nurse's priority?
A. Perform ECG
B. Take BP and HR
C. Reposition the client
D. Ask about medication compliance
-Answer-: B
Rationale: Symptomatic bradycardia can indicate pacemaker malfunction; assess vitals.
Tag: Cardiovascular → Pacemaker Complications
11. A client with COPD is using pursed-lip breathing. What does this technique do?
A. Increases oxygen absorption
