HESI RN Medical-Surgical Exam 2025/2026 – 100% Correct Answers & Verified Rationales

1




HESI RN Medical-Surgical
Exam 2025/2026 – 100%
Correct Answers & Verified
Rationales
1. A nurse is caring for a client with acute coronary syndrome who is
scheduled for percutaneous coronary intervention (PCI). Which of the
following should the nurse administer prior to the procedure?
o A. Metoprolol
o B. Clopidogrel
o C. Lisinopril
o D. Atorvastatin Rationale: Clopidogrel inhibits platelet aggregation,
reducing stent thrombosis risk during PCI; prioritizing antiplatelet
therapy ensures immediate coronary reperfusion stability per AHA
2025 ACS guidelines.
2. A nurse is assessing a client with chronic heart failure receiving furosemide.
Which of the following laboratory findings should the nurse report?
o A. Sodium 142 mEq/L
o B. Potassium 3.0 mEq/L
o C. BUN 18 mg/dL
o D. Creatinine 0.9 mg/dL Rationale: Hypokalemia from loop diuretics
risks ventricular arrhythmias; monitoring electrolytes maintains
cardiac conduction stability and prevents decompensation in heart
failure management.
3. A nurse is teaching a client with hypertension about the DASH diet. Which
of the following foods should the nurse recommend?
o A. Processed meats
o B. Leafy green vegetables
o C. Full-fat dairy
o D. Sugary cereals Rationale: Potassium-rich greens counteract
sodium retention, stabilizing blood pressure and reducing vascular
strain per JNC 8 dietary guidelines for long-term endothelial health.
4. A nurse is monitoring a client receiving warfarin for atrial fibrillation.
Which of the following values indicates therapeutic anticoagulation?

, 2


o A. INR 1.0-1.5
o B. INR 2.0-3.0
o C. aPTT 30 seconds
o D. Platelet count 400,000/mm³ Rationale: Target INR prevents
thromboembolic stroke while minimizing bleeding; consistent
monitoring ensures hemostatic balance stability in AFib per AHA
anticoagulation protocols.
5. A nurse is preparing a client for cardiac catheterization via femoral
approach. Which of the following should the nurse perform first?
o A. Obtain baseline ECG
o B. Assess pedal pulses bilaterally
o C. Administer midazolam
o D. Shave the groin Rationale: Pre-procedure vascular assessment
establishes perfusion baseline, detecting complications like occlusion
for limb stability per SCAI cath lab guidelines.
6. A nurse is caring for a client postoperative from CABG. Which of the
following findings should the nurse identify as mediastinal shift?
o A. Equal breath sounds
o B. Tracheal deviation
o C. Stable vital signs
o D. Clear chest x-ray Rationale: Deviation signals pneumothorax from
graft harvest, requiring chest tube for mediastinal stability and
ventilation per STS postoperative CABG care.
7. A nurse is assessing a client with peripheral vascular disease. Which of the
following should the nurse recommend for claudication?
o A. Elevate legs horizontally
o B. Supervised walking program
o C. Apply direct heat
o D. Restrict activity Rationale: Interval walking builds collateral
circulation, improving ischemic tolerance for tissue perfusion stability
per AHA PAD exercise therapy.
8. A nurse is administering heparin to a client with DVT. Which of the
following should indicate effectiveness?
o A. INR 2.0
o B. aPTT 1.5-2 times control
o C. PT 12 seconds
o D. Platelet count 150,000/mm³ Rationale: Prolonged aPTT confirms
anticoagulation, preventing propagation for venous patency stability
per ACCP VTE treatment.

, 3


9. A nurse is teaching a client with a bioprosthetic valve about endocarditis
prophylaxis. Which of the following should the nurse include?
o A. "Required for all dental procedures."
o B. "Not routinely needed."
o C. "Amoxicillin for cleanings."
o D. "Lifelong antibiotics." Rationale: Low-risk valves omit
prophylaxis, reducing resistance while maintaining cardiac stability
per AHA 2025 IE prevention.
10.A nurse is caring for a client in cardiogenic shock. Which of the following
should the nurse anticipate?
o A. Dopamine infusion
o B. Intra-aortic balloon pump
o C. Fluid challenge 1 L
o D. Norepinephrine first Rationale: IABP augments diastolic
perfusion, stabilizing CO in refractory shock per SCCM shock
guidelines.
11.A nurse is assessing a client with pneumonia. Which of the following should
the nurse auscultate?
o A. Clear lungs
o B. Crackles in lower lobes
o C. Wheezes
o D. Rhonchi absent Rationale: Crackles indicate alveolar
consolidation, guiding antibiotics for gas exchange stability per IDSA
CAP.
12.A nurse is administering levofloxacin to a client with CAP. Which of the
following should the nurse monitor?
o A. QT prolongation
o B. Tendon rupture risk
o C. Hyperglycemia
o D. Constipation Rationale: Fluoroquinolones weaken tendons,
especially in elderly; activity caution ensures musculoskeletal stability
per FDA black box warning.
13.A nurse is teaching a client with asthma about inhaled corticosteroids.
Which of the following should the nurse include?
o A. "Use PRN for attacks."
o B. "Daily for maintenance."
o C. "Rinse mouth unnecessary."
o D. "Combine with oral steroids." Rationale: Controller meds reduce
inflammation, preventing exacerbations for airway stability per GINA
2025 asthma.