HESI Adult Health Exam Prep Document 2026/2027
| Medical-Surgical Nursing, NCLEX Readiness &
NGN Clinical Judgment | 150 Verified Questions
with Detailed Rationales
SECTION 1: CARDIOVASCULAR DISORDERS
1. A client with left-sided heart failure is being assessed. Which clinical
manifestation should the nurse expect to find?
• A) Jugular vein distention
• B) Crackles in the lung bases
• C) Peripheral edema
• D) Ascites
Correct Answer: B) Crackles in the lung bases
Rationale: Left-sided heart failure causes blood to back up into the pulmonary
system, leading to pulmonary congestion. Crackles (rales) in the lung bases are a
classic sign of this condition. Jugular vein distention, peripheral edema, and ascites
are signs of right-sided heart failure .
2. A client with heart failure is prescribed furosemide (Lasix) and digoxin
(Lanoxin). Which laboratory value is most important to monitor?
• A) Serum calcium
• B) Serum potassium
• C) Serum sodium
• D) Serum magnesium
Correct Answer: B) Serum potassium
,Rationale: Furosemide is a potassium-wasting diuretic, and hypokalemia increases
the risk of digoxin toxicity. The nurse must monitor potassium levels closely and
report abnormalities. Potassium levels below 3.5 mEq/L require intervention .
3. A client with heart failure has crackles in the lungs, dyspnea, and peripheral
edema. Which intervention should the nurse implement first?
• A) Administer digoxin as prescribed
• B) Elevate the client's legs
• C) Place the client in high-Fowler's position
• D) Restrict oral fluids to 1,500 mL/day
Correct Answer: C) Place the client in high-Fowler's position
Rationale: High-Fowler's position uses gravity to reduce pulmonary congestion,
easing the work of breathing. This is a priority, non-pharmacologic intervention for
a client with fluid overload and dyspnea. Digoxin and fluid restriction are
important but secondary .
4. A client with a new prescription for sublingual nitroglycerin should be
instructed to:
• A) Swallow the tablet whole
• B) Take the tablet with a full glass of water
• C) Place the tablet under the tongue every 5 minutes up to 3 doses
• D) Chew the tablet for faster action
Correct Answer: C) Place the tablet under the tongue every 5 minutes up to 3
doses
Rationale: Nitroglycerin should be placed under the tongue every 5 minutes, up to
3 doses. If pain persists after 3 doses, emergency care is needed. The client should
sit or lie down to prevent hypotension. The tablet dissolves sublingually and is
absorbed through the oral mucosa .
,5. A patient receiving warfarin has an INR of 5.0 (therapeutic range 2-3). Which
action should the nurse take?
• A) Administer vitamin K 10 mg IM
• B) Hold the warfarin and notify the provider
• C) Increase the warfarin dose
• D) Administer protamine sulfate
Correct Answer: B) Hold the warfarin and notify the provider
Rationale: An INR of 5.0 is above the therapeutic range and increases bleeding
risk. The nurse should hold the warfarin and notify the provider. Vitamin K may be
ordered for significant bleeding or very high INR (>10). Protamine sulfate is the
antidote for heparin .
6. A patient with acute myocardial infarction is receiving morphine IV. The nurse
should monitor for which adverse effect?
• A) Hypotension
• B) Tachycardia
• C) Respiratory depression
• D) All of the above
Correct Answer: D) All of the above
Rationale: Morphine can cause hypotension (venodilation), bradycardia, and
respiratory depression. It should be administered slowly, and the nurse should
monitor vital signs and respiratory status. Naloxone should be available for
reversal .
7. A client is prescribed lisinopril for hypertension. Which side effect should the
nurse include in patient teaching?
• A) Bradycardia
• B) Dry cough
, • C) Tachycardia
• D) Constipation
Correct Answer: B) Dry cough
Rationale: A persistent, dry, nonproductive cough is a common adverse effect of
ACE inhibitors (lisinopril). It is caused by bradykinin accumulation. If the cough is
bothersome, the provider may switch to an ARB. Bradycardia is more common
with beta-blockers .
8. A patient with acute coronary syndrome is prescribed clopidogrel. The nurse
should monitor for which adverse effect?
• A) Bleeding
• B) Hypotension
• C) Tachycardia
• D) Hyperkalemia
Correct Answer: A) Bleeding
Rationale: Clopidogrel is an antiplatelet agent that prevents platelet aggregation.
The primary adverse effect is bleeding. The nurse should monitor for signs of
bleeding (ecchymosis, melena, hematuria). Aspirin is often prescribed with
clopidogrel for dual antiplatelet therapy .
9. A patient 2 days post-operative from a total hip replacement reports sudden
dyspnea, pleuritic chest pain, and hemoptysis. What is the priority action?
• A) Administer pain medication
• B) Elevate the head of the bed and administer oxygen
• C) Apply sequential compression devices
• D) Ambulate the client to the bathroom
Correct Answer: B) Elevate the head of the bed and administer oxygen
| Medical-Surgical Nursing, NCLEX Readiness &
NGN Clinical Judgment | 150 Verified Questions
with Detailed Rationales
SECTION 1: CARDIOVASCULAR DISORDERS
1. A client with left-sided heart failure is being assessed. Which clinical
manifestation should the nurse expect to find?
• A) Jugular vein distention
• B) Crackles in the lung bases
• C) Peripheral edema
• D) Ascites
Correct Answer: B) Crackles in the lung bases
Rationale: Left-sided heart failure causes blood to back up into the pulmonary
system, leading to pulmonary congestion. Crackles (rales) in the lung bases are a
classic sign of this condition. Jugular vein distention, peripheral edema, and ascites
are signs of right-sided heart failure .
2. A client with heart failure is prescribed furosemide (Lasix) and digoxin
(Lanoxin). Which laboratory value is most important to monitor?
• A) Serum calcium
• B) Serum potassium
• C) Serum sodium
• D) Serum magnesium
Correct Answer: B) Serum potassium
,Rationale: Furosemide is a potassium-wasting diuretic, and hypokalemia increases
the risk of digoxin toxicity. The nurse must monitor potassium levels closely and
report abnormalities. Potassium levels below 3.5 mEq/L require intervention .
3. A client with heart failure has crackles in the lungs, dyspnea, and peripheral
edema. Which intervention should the nurse implement first?
• A) Administer digoxin as prescribed
• B) Elevate the client's legs
• C) Place the client in high-Fowler's position
• D) Restrict oral fluids to 1,500 mL/day
Correct Answer: C) Place the client in high-Fowler's position
Rationale: High-Fowler's position uses gravity to reduce pulmonary congestion,
easing the work of breathing. This is a priority, non-pharmacologic intervention for
a client with fluid overload and dyspnea. Digoxin and fluid restriction are
important but secondary .
4. A client with a new prescription for sublingual nitroglycerin should be
instructed to:
• A) Swallow the tablet whole
• B) Take the tablet with a full glass of water
• C) Place the tablet under the tongue every 5 minutes up to 3 doses
• D) Chew the tablet for faster action
Correct Answer: C) Place the tablet under the tongue every 5 minutes up to 3
doses
Rationale: Nitroglycerin should be placed under the tongue every 5 minutes, up to
3 doses. If pain persists after 3 doses, emergency care is needed. The client should
sit or lie down to prevent hypotension. The tablet dissolves sublingually and is
absorbed through the oral mucosa .
,5. A patient receiving warfarin has an INR of 5.0 (therapeutic range 2-3). Which
action should the nurse take?
• A) Administer vitamin K 10 mg IM
• B) Hold the warfarin and notify the provider
• C) Increase the warfarin dose
• D) Administer protamine sulfate
Correct Answer: B) Hold the warfarin and notify the provider
Rationale: An INR of 5.0 is above the therapeutic range and increases bleeding
risk. The nurse should hold the warfarin and notify the provider. Vitamin K may be
ordered for significant bleeding or very high INR (>10). Protamine sulfate is the
antidote for heparin .
6. A patient with acute myocardial infarction is receiving morphine IV. The nurse
should monitor for which adverse effect?
• A) Hypotension
• B) Tachycardia
• C) Respiratory depression
• D) All of the above
Correct Answer: D) All of the above
Rationale: Morphine can cause hypotension (venodilation), bradycardia, and
respiratory depression. It should be administered slowly, and the nurse should
monitor vital signs and respiratory status. Naloxone should be available for
reversal .
7. A client is prescribed lisinopril for hypertension. Which side effect should the
nurse include in patient teaching?
• A) Bradycardia
• B) Dry cough
, • C) Tachycardia
• D) Constipation
Correct Answer: B) Dry cough
Rationale: A persistent, dry, nonproductive cough is a common adverse effect of
ACE inhibitors (lisinopril). It is caused by bradykinin accumulation. If the cough is
bothersome, the provider may switch to an ARB. Bradycardia is more common
with beta-blockers .
8. A patient with acute coronary syndrome is prescribed clopidogrel. The nurse
should monitor for which adverse effect?
• A) Bleeding
• B) Hypotension
• C) Tachycardia
• D) Hyperkalemia
Correct Answer: A) Bleeding
Rationale: Clopidogrel is an antiplatelet agent that prevents platelet aggregation.
The primary adverse effect is bleeding. The nurse should monitor for signs of
bleeding (ecchymosis, melena, hematuria). Aspirin is often prescribed with
clopidogrel for dual antiplatelet therapy .
9. A patient 2 days post-operative from a total hip replacement reports sudden
dyspnea, pleuritic chest pain, and hemoptysis. What is the priority action?
• A) Administer pain medication
• B) Elevate the head of the bed and administer oxygen
• C) Apply sequential compression devices
• D) Ambulate the client to the bathroom
Correct Answer: B) Elevate the head of the bed and administer oxygen
