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HESI Med-Surg Final Exam Test bank with NGN
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VERIFIED ANSWERS - INSTANT PDF
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SECTION A: CARDIOVASCULAR DISORDERS
Question 1
A client who underwent cardiac stent placement 4 days ago arrives to the emergency
department reporting sudden onset chest pressure and shortness of breath. Which
action should the nurse take next?
A) Administer prescribed nitroglycerin sublingually
B) Obtain a 12-lead electrocardiogram (ECG) and begin continuous cardiac monitoring
C) Give oxygen at 2 liters per minute via nasal cannula
D) Prepare the client for immediate cardiac catheterization
Correct Answer: B) Obtain a 12-lead electrocardiogram (ECG) and begin
continuous cardiac monitoring
Rationale: In a post-stent patient with acute chest pressure and dyspnea, the priority is to
assess for acute coronary syndrome or stent thrombosis. ECG and continuous monitoring
provide rapid data to guide further interventions. Oxygen and nitroglycerin may follow but
assessment is the priority .
Question 2
Three weeks post-MI, a client reports his wife moved to a separate bedroom and states,
"I guess we will never have sex again." What is the nurse's best response?
,A) "Sexual activity has similar cardiac workload as climbing two flights of stairs and can
be resumed like other activities."
B) "You should avoid sexual activity for at least six months."
C) "This is a common fear; I will notify the physician."
D) "Your wife should attend cardiac rehab for education."
Correct Answer: A) "Sexual activity has similar cardiac workload as climbing two
flights of stairs and can be resumed like other activities."
Rationale: Sexual activity in stable post-MI patients exerts moderate cardiac workload
comparable to mild exercise. After risk stratification, it can be safely resumed. This
addresses the client's concern with accurate information .
Question 3
A client with heart failure is prescribed furosemide 40 mg IV push. Which assessment
finding requires immediate action?
A) Serum potassium 3.8 mEq/L
B) Blood pressure 100/60 mm Hg
C) Jugular venous distention
D) Urine output 30 mL/hr
Correct Answer: C) Jugular venous distention
Rationale: JVD indicates worsening fluid overload and possible right-sided heart failure,
requiring immediate intervention. Furosemide is given to reduce preload. Potassium of 3.8
is normal; urine output of 30 mL/hr is adequate .
Question 4
A client with atrial fibrillation has a heart rate of 140 bpm. Which medication should the
nurse anticipate?
A) Adenosine
B) Diltiazem
C) Epinephrine
D) Atropine
,Correct Answer: B) Diltiazem
Rationale: Diltiazem, a calcium channel blocker, is used to control ventricular rate in atrial
fibrillation. Adenosine is for SVT; epinephrine and atropine are for bradycardia/asystole .
Question 5
Select all that apply: Signs of left-sided heart failure include:
☐ Crackles in lung bases
☐ Paroxysmal nocturnal dyspnea
☐ Jugular venous distention
☐ S3 heart sound
☐ Peripheral edema
Correct Answer: Crackles in lung bases, Paroxysmal nocturnal dyspnea, S3 heart
sound
Rationale: Left-sided heart failure causes pulmonary congestion (crackles, PND, S3). JVD
and peripheral edema are signs of right-sided heart failure .
Question 6
A client post-cardiac catheterization reports groin swelling and ecchymosis. The nurse's
priority action is:
A) Apply warm compress
B) Apply firm pressure 1 inch above the site
C) Elevate the leg
D) Administer heparin
Correct Answer: B) Apply firm pressure 1 inch above the site
Rationale: Manual pressure above the arterial puncture site is critical to prevent
hematoma expansion and control bleeding. Warm compresses and elevation are not
priority interventions .
, Question 7
A client with hypertension is started on lisinopril. Which adverse effect requires
teaching?
A) Dry cough
B) Hyperkalemia
C) Angioedema
D) All of the above
Correct Answer: D) All of the above
Rationale: ACE inhibitors can cause dry cough (common), hyperkalemia, and life-
threatening angioedema. Clients should be taught to report swelling of face, lips, or
tongue immediately .
Question 8
A client with peripheral artery disease (PAD) has intermittent claudication. Which
instruction should the nurse provide?
A) "I will elevate my legs above my heart."
B) "I will walk until pain then rest, then resume."
C) "I will apply heating pads for pain."
D) "I will wear tight compression stockings."
Correct Answer: B) "I will walk until pain then rest, then resume."
Rationale: Walking to tolerance (pain then rest) improves collateral circulation and is the
recommended exercise for PAD. Elevation worsens ischemia; heating pads can cause
burns; compression stockings are for venous disease .
Question 9
NGN Case Study – Heart Failure: A 72-year-old with HF presents with dyspnea on
exertion, 2+ pedal edema, and fatigue. Medications: metoprolol, furosemide, lisinopril.
Part A: Which lab finding most concerns the nurse?
HESI Med-Surg Final Exam Test bank with NGN
TO-DATE EXAM QUESTIONS AND 100%
ACCURATE SOLUTIONS | Question And
VERIFIED ANSWERS - INSTANT PDF
DOWNLOAD.
SECTION A: CARDIOVASCULAR DISORDERS
Question 1
A client who underwent cardiac stent placement 4 days ago arrives to the emergency
department reporting sudden onset chest pressure and shortness of breath. Which
action should the nurse take next?
A) Administer prescribed nitroglycerin sublingually
B) Obtain a 12-lead electrocardiogram (ECG) and begin continuous cardiac monitoring
C) Give oxygen at 2 liters per minute via nasal cannula
D) Prepare the client for immediate cardiac catheterization
Correct Answer: B) Obtain a 12-lead electrocardiogram (ECG) and begin
continuous cardiac monitoring
Rationale: In a post-stent patient with acute chest pressure and dyspnea, the priority is to
assess for acute coronary syndrome or stent thrombosis. ECG and continuous monitoring
provide rapid data to guide further interventions. Oxygen and nitroglycerin may follow but
assessment is the priority .
Question 2
Three weeks post-MI, a client reports his wife moved to a separate bedroom and states,
"I guess we will never have sex again." What is the nurse's best response?
,A) "Sexual activity has similar cardiac workload as climbing two flights of stairs and can
be resumed like other activities."
B) "You should avoid sexual activity for at least six months."
C) "This is a common fear; I will notify the physician."
D) "Your wife should attend cardiac rehab for education."
Correct Answer: A) "Sexual activity has similar cardiac workload as climbing two
flights of stairs and can be resumed like other activities."
Rationale: Sexual activity in stable post-MI patients exerts moderate cardiac workload
comparable to mild exercise. After risk stratification, it can be safely resumed. This
addresses the client's concern with accurate information .
Question 3
A client with heart failure is prescribed furosemide 40 mg IV push. Which assessment
finding requires immediate action?
A) Serum potassium 3.8 mEq/L
B) Blood pressure 100/60 mm Hg
C) Jugular venous distention
D) Urine output 30 mL/hr
Correct Answer: C) Jugular venous distention
Rationale: JVD indicates worsening fluid overload and possible right-sided heart failure,
requiring immediate intervention. Furosemide is given to reduce preload. Potassium of 3.8
is normal; urine output of 30 mL/hr is adequate .
Question 4
A client with atrial fibrillation has a heart rate of 140 bpm. Which medication should the
nurse anticipate?
A) Adenosine
B) Diltiazem
C) Epinephrine
D) Atropine
,Correct Answer: B) Diltiazem
Rationale: Diltiazem, a calcium channel blocker, is used to control ventricular rate in atrial
fibrillation. Adenosine is for SVT; epinephrine and atropine are for bradycardia/asystole .
Question 5
Select all that apply: Signs of left-sided heart failure include:
☐ Crackles in lung bases
☐ Paroxysmal nocturnal dyspnea
☐ Jugular venous distention
☐ S3 heart sound
☐ Peripheral edema
Correct Answer: Crackles in lung bases, Paroxysmal nocturnal dyspnea, S3 heart
sound
Rationale: Left-sided heart failure causes pulmonary congestion (crackles, PND, S3). JVD
and peripheral edema are signs of right-sided heart failure .
Question 6
A client post-cardiac catheterization reports groin swelling and ecchymosis. The nurse's
priority action is:
A) Apply warm compress
B) Apply firm pressure 1 inch above the site
C) Elevate the leg
D) Administer heparin
Correct Answer: B) Apply firm pressure 1 inch above the site
Rationale: Manual pressure above the arterial puncture site is critical to prevent
hematoma expansion and control bleeding. Warm compresses and elevation are not
priority interventions .
, Question 7
A client with hypertension is started on lisinopril. Which adverse effect requires
teaching?
A) Dry cough
B) Hyperkalemia
C) Angioedema
D) All of the above
Correct Answer: D) All of the above
Rationale: ACE inhibitors can cause dry cough (common), hyperkalemia, and life-
threatening angioedema. Clients should be taught to report swelling of face, lips, or
tongue immediately .
Question 8
A client with peripheral artery disease (PAD) has intermittent claudication. Which
instruction should the nurse provide?
A) "I will elevate my legs above my heart."
B) "I will walk until pain then rest, then resume."
C) "I will apply heating pads for pain."
D) "I will wear tight compression stockings."
Correct Answer: B) "I will walk until pain then rest, then resume."
Rationale: Walking to tolerance (pain then rest) improves collateral circulation and is the
recommended exercise for PAD. Elevation worsens ischemia; heating pads can cause
burns; compression stockings are for venous disease .
Question 9
NGN Case Study – Heart Failure: A 72-year-old with HF presents with dyspnea on
exertion, 2+ pedal edema, and fatigue. Medications: metoprolol, furosemide, lisinopril.
Part A: Which lab finding most concerns the nurse?
