HESI RN Med-Surg Exam | Actual 2026/2027
Exam Version | All UPDATED Questions with
Correct Answers and Rationales | Professor
Verified and A+ Graded
Question 1: A client with heart failure calls the clinic and reports that he cannot put his
shoes on because they are too tight. Which additional information should the nurse
obtain?
A. What time did he take his medication?
B. Has his weight changed in the last several days?
C. Is he still able to tighten his belt buckle?
D. How many hours did he sleep last night?
Answer: B
Rationale: Tight-fitting shoes (edema) in a client with heart failure suggest fluid
retention. Daily weights are the most sensitive indicator of fluid volume status. A weight
gain of 2-3 pounds in 24 hours or 5 pounds in a week indicates worsening heart failure
and requires immediate intervention .
Question 2: A male client with a history of heart failure is admitted with complaints of
shortness of breath and edema. Which laboratory value should the nurse monitor most
closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Answer: B
Rationale: Heart failure clients are often treated with loop diuretics (furosemide), which
cause potassium wasting. Hypokalemia can lead to cardiac dysrhythmias and increases
,the risk of digoxin toxicity. Potassium levels should be monitored closely, especially in
clients on digoxin.
Question 3: A cardiac catheterization of a client with heart disease indicates the
following blockages: 95% proximal left anterior descending (LAD), 99% proximal
circumflex, and 95% proximal right coronary artery (RCA). The client later asks the nurse,
"What does all of that mean for me?" What information should the nurse provide?
A. The blockages are in non-critical areas of the heart.
B. Three main arteries have major blockages, with only 1-5% of the blood flow
getting through to the heart muscle.
C. The blockages are in the veins, not the arteries.
D. The blockages are minor and can be treated with medication.
Answer: B
Rationale: The LAD, circumflex, and RCA are the three main coronary arteries. Blockages
of 95-99% in all three arteries indicate severe coronary artery disease with minimal
blood flow reaching the heart muscle. This places the client at high risk for myocardial
infarction and requires prompt intervention .
Question 4: Which finding in a client with heart failure indicates improved cardiac
output?
A. Jugular venous distension (JVD)
B. Peripheral edema
C. Decreased dyspnea
D. Weight gain of 2 kg in 24 hours
Answer: C
Rationale: Decreased dyspnea indicates reduced pulmonary congestion and improved
cardiac output. JVD, peripheral edema, and rapid weight gain indicate worsening heart
failure.
,Question 5: 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. The supine position worsens the pain.
Question 6: 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 dissolving existing
clots.
Question 7: A client is receiving IV heparin and develops a sudden drop in platelet
count. The nurse suspects:
A. Anemia
B. Heparin-induced thrombocytopenia (HIT)
C. Infection
D. Liver disease
Answer: B
, Rationale: A platelet drop >50% or <150,000 during heparin therapy indicates HIT.
Heparin should be stopped immediately, and a direct thrombin inhibitor (argatroban)
may be ordered.
Question 8: A client on warfarin has an INR of 4.5. What is the priority action?
A. Continue warfarin as ordered.
B. Increase warfarin dose.
C. Hold warfarin and notify provider.
D. Administer vitamin K immediately.
Answer: C
Rationale: INR of 4.5 is supratherapeutic and increases bleeding risk. The medication
should be held and the provider notified. Vitamin K may be ordered for higher INR or
bleeding.
Question 9: The nurse is preparing to administer a blood transfusion. Which action is
the priority to ensure patient safety?
A. Obtain the client's vital signs.
B. Verify the client's blood type with another nurse.
C. Prime the tubing with dextrose 5% in water.
D. Ask the client to sign a consent form.
Answer: B
Rationale: Two-nurse verification of blood type and unit number is essential before
transfusion to prevent fatal hemolytic reactions. This is the most critical safety step.
Question 10: A client is receiving a blood transfusion and develops fever, chills, and
hypotension. What is the priority action?
A. Stop the transfusion immediately.
B. Slow the infusion rate.
Exam Version | All UPDATED Questions with
Correct Answers and Rationales | Professor
Verified and A+ Graded
Question 1: A client with heart failure calls the clinic and reports that he cannot put his
shoes on because they are too tight. Which additional information should the nurse
obtain?
A. What time did he take his medication?
B. Has his weight changed in the last several days?
C. Is he still able to tighten his belt buckle?
D. How many hours did he sleep last night?
Answer: B
Rationale: Tight-fitting shoes (edema) in a client with heart failure suggest fluid
retention. Daily weights are the most sensitive indicator of fluid volume status. A weight
gain of 2-3 pounds in 24 hours or 5 pounds in a week indicates worsening heart failure
and requires immediate intervention .
Question 2: A male client with a history of heart failure is admitted with complaints of
shortness of breath and edema. Which laboratory value should the nurse monitor most
closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Answer: B
Rationale: Heart failure clients are often treated with loop diuretics (furosemide), which
cause potassium wasting. Hypokalemia can lead to cardiac dysrhythmias and increases
,the risk of digoxin toxicity. Potassium levels should be monitored closely, especially in
clients on digoxin.
Question 3: A cardiac catheterization of a client with heart disease indicates the
following blockages: 95% proximal left anterior descending (LAD), 99% proximal
circumflex, and 95% proximal right coronary artery (RCA). The client later asks the nurse,
"What does all of that mean for me?" What information should the nurse provide?
A. The blockages are in non-critical areas of the heart.
B. Three main arteries have major blockages, with only 1-5% of the blood flow
getting through to the heart muscle.
C. The blockages are in the veins, not the arteries.
D. The blockages are minor and can be treated with medication.
Answer: B
Rationale: The LAD, circumflex, and RCA are the three main coronary arteries. Blockages
of 95-99% in all three arteries indicate severe coronary artery disease with minimal
blood flow reaching the heart muscle. This places the client at high risk for myocardial
infarction and requires prompt intervention .
Question 4: Which finding in a client with heart failure indicates improved cardiac
output?
A. Jugular venous distension (JVD)
B. Peripheral edema
C. Decreased dyspnea
D. Weight gain of 2 kg in 24 hours
Answer: C
Rationale: Decreased dyspnea indicates reduced pulmonary congestion and improved
cardiac output. JVD, peripheral edema, and rapid weight gain indicate worsening heart
failure.
,Question 5: 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. The supine position worsens the pain.
Question 6: 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 dissolving existing
clots.
Question 7: A client is receiving IV heparin and develops a sudden drop in platelet
count. The nurse suspects:
A. Anemia
B. Heparin-induced thrombocytopenia (HIT)
C. Infection
D. Liver disease
Answer: B
, Rationale: A platelet drop >50% or <150,000 during heparin therapy indicates HIT.
Heparin should be stopped immediately, and a direct thrombin inhibitor (argatroban)
may be ordered.
Question 8: A client on warfarin has an INR of 4.5. What is the priority action?
A. Continue warfarin as ordered.
B. Increase warfarin dose.
C. Hold warfarin and notify provider.
D. Administer vitamin K immediately.
Answer: C
Rationale: INR of 4.5 is supratherapeutic and increases bleeding risk. The medication
should be held and the provider notified. Vitamin K may be ordered for higher INR or
bleeding.
Question 9: The nurse is preparing to administer a blood transfusion. Which action is
the priority to ensure patient safety?
A. Obtain the client's vital signs.
B. Verify the client's blood type with another nurse.
C. Prime the tubing with dextrose 5% in water.
D. Ask the client to sign a consent form.
Answer: B
Rationale: Two-nurse verification of blood type and unit number is essential before
transfusion to prevent fatal hemolytic reactions. This is the most critical safety step.
Question 10: A client is receiving a blood transfusion and develops fever, chills, and
hypotension. What is the priority action?
A. Stop the transfusion immediately.
B. Slow the infusion rate.
