EVOLVE ELSEVIER HESI MEDICAL-
SURGICAL EXAM | Questions And Answers
Plus Rationales | Instant Pdf Download
2026
SECTION 1: Cardiovascular Disorders (Questions 1–20)
1. A client with heart failure reports a weight gain of 5
pounds in 3 days. What is the nurse's priority action?
a) Encourage the client to increase fluid intake
b) Notify the healthcare provider immediately
c) Document the finding as normal
d) Restrict sodium intake only
Answer: b) Notify the healthcare provider immediately
Rationale: Rapid weight gain (2-3 lbs in 24 hours or 5 lbs in a
week) indicates fluid retention and worsening heart failure;
requires immediate intervention (diuretic adjustment).
,2. A client with angina pectoris is prescribed nitroglycerin
sublingual. Which instruction should the nurse provide?
a) "Take one tablet every 5 minutes for up to 3 doses; call 911 if
pain is not relieved."
b) "Swallow the tablet with a full glass of water."
c) "Store the bottle in the refrigerator."
d) "Take one tablet daily to prevent angina."
Answer: a) "Take one tablet every 5 minutes for up to 3 doses;
call 911 if pain is not relieved."
Rationale: Nitroglycerin protocol: one tablet SL q5min ×3; if pain
persists after 3 doses, seek emergency care.
3. A client with hypertension is prescribed lisinopril
(Zestril). Which adverse effect requires immediate
discontinuation?
a) Dry cough
b) Swelling of the lips, tongue, or face (angioedema)
c) Dizziness
d) Headache
Answer: b) Swelling of the lips, tongue, or face (angioedema)
Rationale: Angioedema is a life-threatening allergic reaction to
,ACE inhibitors; requires immediate discontinuation and
emergency treatment.
4. A client with peripheral artery disease (PAD) complains
of leg pain when walking that resolves with rest. The nurse
documents this finding as:
a) Rest pain
b) Intermittent claudication
c) Venous stasis
d) Neuropathy
Answer: b) Intermittent claudication
Rationale: Intermittent claudication is muscle pain/cramping
with exercise that resolves with rest, caused by inadequate
arterial blood flow.
5. A client with deep vein thrombosis (DVT) is receiving
heparin IV. Which laboratory value indicates a therapeutic
effect?
a) INR 2.5
b) aPTT 60 seconds (control 30 seconds)
c) Platelets 150,000/mm³
d) PT 15 seconds
, Answer: b) aPTT 60 seconds (control 30 seconds)
Rationale: Therapeutic aPTT for heparin is 1.5–2.5 times control
(e.g., 45–75 seconds).
6. A client with chronic heart failure is prescribed
furosemide (Lasix). Which electrolyte imbalance is the
priority to monitor?
a) Hyperkalemia
b) Hypokalemia
c) Hyponatremia
d) Hypercalcemia
Answer: b) Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium
wasting; hypokalemia increases risk of digoxin toxicity and
cardiac arrhythmias.
7. A client after a myocardial infarction (MI) has an order
for low-dose aspirin daily. The nurse explains that aspirin is
given to:
a) Relieve chest pain
b) Prevent further clot formation
c) Lower blood pressure
d) Reduce cholesterol
SURGICAL EXAM | Questions And Answers
Plus Rationales | Instant Pdf Download
2026
SECTION 1: Cardiovascular Disorders (Questions 1–20)
1. A client with heart failure reports a weight gain of 5
pounds in 3 days. What is the nurse's priority action?
a) Encourage the client to increase fluid intake
b) Notify the healthcare provider immediately
c) Document the finding as normal
d) Restrict sodium intake only
Answer: b) Notify the healthcare provider immediately
Rationale: Rapid weight gain (2-3 lbs in 24 hours or 5 lbs in a
week) indicates fluid retention and worsening heart failure;
requires immediate intervention (diuretic adjustment).
,2. A client with angina pectoris is prescribed nitroglycerin
sublingual. Which instruction should the nurse provide?
a) "Take one tablet every 5 minutes for up to 3 doses; call 911 if
pain is not relieved."
b) "Swallow the tablet with a full glass of water."
c) "Store the bottle in the refrigerator."
d) "Take one tablet daily to prevent angina."
Answer: a) "Take one tablet every 5 minutes for up to 3 doses;
call 911 if pain is not relieved."
Rationale: Nitroglycerin protocol: one tablet SL q5min ×3; if pain
persists after 3 doses, seek emergency care.
3. A client with hypertension is prescribed lisinopril
(Zestril). Which adverse effect requires immediate
discontinuation?
a) Dry cough
b) Swelling of the lips, tongue, or face (angioedema)
c) Dizziness
d) Headache
Answer: b) Swelling of the lips, tongue, or face (angioedema)
Rationale: Angioedema is a life-threatening allergic reaction to
,ACE inhibitors; requires immediate discontinuation and
emergency treatment.
4. A client with peripheral artery disease (PAD) complains
of leg pain when walking that resolves with rest. The nurse
documents this finding as:
a) Rest pain
b) Intermittent claudication
c) Venous stasis
d) Neuropathy
Answer: b) Intermittent claudication
Rationale: Intermittent claudication is muscle pain/cramping
with exercise that resolves with rest, caused by inadequate
arterial blood flow.
5. A client with deep vein thrombosis (DVT) is receiving
heparin IV. Which laboratory value indicates a therapeutic
effect?
a) INR 2.5
b) aPTT 60 seconds (control 30 seconds)
c) Platelets 150,000/mm³
d) PT 15 seconds
, Answer: b) aPTT 60 seconds (control 30 seconds)
Rationale: Therapeutic aPTT for heparin is 1.5–2.5 times control
(e.g., 45–75 seconds).
6. A client with chronic heart failure is prescribed
furosemide (Lasix). Which electrolyte imbalance is the
priority to monitor?
a) Hyperkalemia
b) Hypokalemia
c) Hyponatremia
d) Hypercalcemia
Answer: b) Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium
wasting; hypokalemia increases risk of digoxin toxicity and
cardiac arrhythmias.
7. A client after a myocardial infarction (MI) has an order
for low-dose aspirin daily. The nurse explains that aspirin is
given to:
a) Relieve chest pain
b) Prevent further clot formation
c) Lower blood pressure
d) Reduce cholesterol
