HESI RN MED SURG EXAM (2 VERSIONS EACH
CONTAINS 100 Q&A) || BRAND NEW EXAM NEWEST
ACTUAL EXAM COMPREHENSIVE QUESTIONS AND
VERIFIED ANSWERS GRADED A+ || 100% PASS ||
2026/2027 UPDATE!!
Question 1: 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) "You should avoid sexual activity for at least six months."
B) "Sexual activity has similar cardiac workload as climbing two flights of stairs
and can be resumed like other activities."
C) "This is a common fear; I will notify the physician."
D) "Your wife should attend cardiac rehab for education."
Answer: B
Rationale: Sexual activity, in stable patients post-MI, generally exerts a moderate
cardiac workload comparable to mild exercise (climbing two flights of stairs) and can be
safely resumed after risk stratification and recovery. Education should address the
patient's fears and provide accurate information about resuming normal activities.
Question 2: A client with an acute myocardial infarction is given a thrombolytic
medication, aspirin, and IV heparin in the emergency department. Which finding
indicates the client is having a satisfactory response?
A) Activated partial thromboplastin (aPTT) time is two times the control value.
B) Cardiac tracing shows 1.2 mm wide Q waves half the height of the complex.
C) Guaiac test of the stools is positive.
D) S3 heart sounds are present with auscultation.
Answer: A
,Rationale: The therapeutic aPTT for heparin is 1.5 to 2.5 times the control value. Q
waves indicate tissue necrosis; positive guaiac suggests bleeding; S3 suggests heart
failure.
Question 3: A client is receiving IV heparin for a pulmonary embolism. The nurse notes
the aPTT is 110 seconds (normal 25-35 seconds). What is the priority action?
A) Continue the infusion as ordered.
B) Increase the infusion rate.
C) Hold the infusion and notify the provider.
D) Administer protamine sulfate.
Answer: C
Rationale: An aPTT of 110 seconds indicates excessive anticoagulation and increased
bleeding risk. The infusion should be held and the provider notified.
Question 4: A client with peripheral artery disease (PAD) reports leg pain when walking
that resolves with rest. This is called:
A) Rest pain
B) Intermittent claudication
C) Venous stasis
D) Neuropathy
Answer: B
Rationale: Intermittent claudication is muscle pain/cramping in the legs with exercise
that resolves with rest, caused by inadequate blood flow due to atherosclerosis.
Question 5: A client with hypertension has a blood pressure of 180/110 mmHg and
reports headache and blurred vision. What is the nurse's priority action?
A) Administer prescribed antihypertensive medication.
B) Recheck blood pressure in 15 minutes.
,C) Notify the healthcare provider immediately.
D) Place the client in a supine position.
Answer: C
Rationale: A blood pressure of 180/110 mmHg with symptoms indicates hypertensive
urgency/emergency requiring immediate medical intervention to prevent target organ
damage.
Question 6: Which ECG finding is most concerning in a client with chest pain after
cardiac stenting?
A) ST-segment depression
B) Normal troponin
C) ST-segment elevation
D) Sinus bradycardia
Answer: C
Rationale: ST-segment elevation indicates acute myocardial injury, which is highly
concerning in a client with recent stenting. ST depression suggests ischemia but is less
immediately life-threatening.
Question 7: A client with heart failure has jugular venous distention, 3+ pitting edema,
and crackles in the lung bases. Which medication should the nurse prepare to
administer FIRST?
A) Digoxin
B) Furosemide
C) Metoprolol
D) Spironolactone
Answer: B
Rationale: Furosemide is a loop diuretic that rapidly reduces preload and relieves
pulmonary congestion. Digoxin and beta-blockers are chronic therapies.
, Question 8: A client is prescribed digoxin 0.25 mg daily. Which finding would
indicate digoxin toxicity?
A) Heart rate 72 bpm
B) Yellow-green halos around vision
C) Blood pressure 120/80 mmHg
D) Urine output 50 mL/hour
Answer: B
Rationale: Visual disturbances (yellow-green halos, blurred vision) are classic signs of
digoxin toxicity. Other signs include nausea, vomiting, anorexia, and bradycardia.
Question 9: A client with pericarditis reports sharp chest pain that worsens when lying
flat. What position should the nurse encourage?
A) Supine position
B) Prone position
C) Sitting upright and leaning forward
D) Left lateral position
Answer: C
Rationale: Pericarditis pain is relieved by sitting upright and leaning forward, which
reduces pressure on the pericardium. Supine position worsens the pain.
Question 10: A client with a history of DVT is prescribed enoxaparin (Lovenox) post-
operatively. What is the most important teaching for this client?
A) "Take this medication with food."
B) "Monitor your blood glucose daily."
C) "Report any unusual bleeding or bruising."
D) "This medication will dissolve existing clots."
Answer: C
Rationale: Enoxaparin is an anticoagulant; monitoring for bleeding (hematuria, melena,
epistaxis, bruising) is essential. It prevents new clot formation, not dissolve existing clots.
CONTAINS 100 Q&A) || BRAND NEW EXAM NEWEST
ACTUAL EXAM COMPREHENSIVE QUESTIONS AND
VERIFIED ANSWERS GRADED A+ || 100% PASS ||
2026/2027 UPDATE!!
Question 1: 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) "You should avoid sexual activity for at least six months."
B) "Sexual activity has similar cardiac workload as climbing two flights of stairs
and can be resumed like other activities."
C) "This is a common fear; I will notify the physician."
D) "Your wife should attend cardiac rehab for education."
Answer: B
Rationale: Sexual activity, in stable patients post-MI, generally exerts a moderate
cardiac workload comparable to mild exercise (climbing two flights of stairs) and can be
safely resumed after risk stratification and recovery. Education should address the
patient's fears and provide accurate information about resuming normal activities.
Question 2: A client with an acute myocardial infarction is given a thrombolytic
medication, aspirin, and IV heparin in the emergency department. Which finding
indicates the client is having a satisfactory response?
A) Activated partial thromboplastin (aPTT) time is two times the control value.
B) Cardiac tracing shows 1.2 mm wide Q waves half the height of the complex.
C) Guaiac test of the stools is positive.
D) S3 heart sounds are present with auscultation.
Answer: A
,Rationale: The therapeutic aPTT for heparin is 1.5 to 2.5 times the control value. Q
waves indicate tissue necrosis; positive guaiac suggests bleeding; S3 suggests heart
failure.
Question 3: A client is receiving IV heparin for a pulmonary embolism. The nurse notes
the aPTT is 110 seconds (normal 25-35 seconds). What is the priority action?
A) Continue the infusion as ordered.
B) Increase the infusion rate.
C) Hold the infusion and notify the provider.
D) Administer protamine sulfate.
Answer: C
Rationale: An aPTT of 110 seconds indicates excessive anticoagulation and increased
bleeding risk. The infusion should be held and the provider notified.
Question 4: A client with peripheral artery disease (PAD) reports leg pain when walking
that resolves with rest. This is called:
A) Rest pain
B) Intermittent claudication
C) Venous stasis
D) Neuropathy
Answer: B
Rationale: Intermittent claudication is muscle pain/cramping in the legs with exercise
that resolves with rest, caused by inadequate blood flow due to atherosclerosis.
Question 5: A client with hypertension has a blood pressure of 180/110 mmHg and
reports headache and blurred vision. What is the nurse's priority action?
A) Administer prescribed antihypertensive medication.
B) Recheck blood pressure in 15 minutes.
,C) Notify the healthcare provider immediately.
D) Place the client in a supine position.
Answer: C
Rationale: A blood pressure of 180/110 mmHg with symptoms indicates hypertensive
urgency/emergency requiring immediate medical intervention to prevent target organ
damage.
Question 6: Which ECG finding is most concerning in a client with chest pain after
cardiac stenting?
A) ST-segment depression
B) Normal troponin
C) ST-segment elevation
D) Sinus bradycardia
Answer: C
Rationale: ST-segment elevation indicates acute myocardial injury, which is highly
concerning in a client with recent stenting. ST depression suggests ischemia but is less
immediately life-threatening.
Question 7: A client with heart failure has jugular venous distention, 3+ pitting edema,
and crackles in the lung bases. Which medication should the nurse prepare to
administer FIRST?
A) Digoxin
B) Furosemide
C) Metoprolol
D) Spironolactone
Answer: B
Rationale: Furosemide is a loop diuretic that rapidly reduces preload and relieves
pulmonary congestion. Digoxin and beta-blockers are chronic therapies.
, Question 8: A client is prescribed digoxin 0.25 mg daily. Which finding would
indicate digoxin toxicity?
A) Heart rate 72 bpm
B) Yellow-green halos around vision
C) Blood pressure 120/80 mmHg
D) Urine output 50 mL/hour
Answer: B
Rationale: Visual disturbances (yellow-green halos, blurred vision) are classic signs of
digoxin toxicity. Other signs include nausea, vomiting, anorexia, and bradycardia.
Question 9: A client with pericarditis reports sharp chest pain that worsens when lying
flat. What position should the nurse encourage?
A) Supine position
B) Prone position
C) Sitting upright and leaning forward
D) Left lateral position
Answer: C
Rationale: Pericarditis pain is relieved by sitting upright and leaning forward, which
reduces pressure on the pericardium. Supine position worsens the pain.
Question 10: A client with a history of DVT is prescribed enoxaparin (Lovenox) post-
operatively. What is the most important teaching for this client?
A) "Take this medication with food."
B) "Monitor your blood glucose daily."
C) "Report any unusual bleeding or bruising."
D) "This medication will dissolve existing clots."
Answer: C
Rationale: Enoxaparin is an anticoagulant; monitoring for bleeding (hematuria, melena,
epistaxis, bruising) is essential. It prevents new clot formation, not dissolve existing clots.
