HESI Med Surg Exam (20 Versions, 1500+ Q
and A, Latest-2021) / Med Surg HESI Exam
|Perfect Guide for HESI Exam
Section 1: Cardiovascular System
1. A nurse is assessing a client with heart failure who reports increasing shortness of breath
and fatigue over the past week. Which assessment finding requires immediate intervention?
A. Weight gain of 2 kg (4.4 lb) in 3 days
B. Heart rate of 92 beats/min
C. Blood pressure of 118/72 mm Hg
D. Bilateral crackles at the lung bases
Correct Answer: A
Rationale: A weight gain of 2 kg (4.4 lb) in 3 days indicates significant fluid retention and
worsening heart failure, requiring immediate intervention. While bilateral crackles (D) also
indicate fluid overload, the rapid weight gain is the earliest and most sensitive indicator of
decompensation. Options B and C are within acceptable limits.
2. A client is prescribed digoxin (Lanoxin). Which assessment finding indicates possible digoxin
toxicity?
A. Heart rate of 88 beats/min
B. Serum potassium level of 4.0 mEq/L
C. Nausea, vomiting, and visual disturbances
D. Blood pressure of 130/80 mm Hg
Correct Answer: C
Rationale: Nausea, vomiting, and visual disturbances (yellow-green halos) are classic signs
of digoxin toxicity. Hypokalemia increases the risk of toxicity, but a potassium level of 4.0 mEq/L
is normal. Heart rate of 88 and BP of 130/80 are within normal limits.
,3. A nurse is caring for a client following a myocardial infarction. Which complication is the
client at highest risk for within the first 24 hours?
A. Ventricular dysrhythmias
B. Pericarditis
C. Heart failure
D. Cardiogenic shock
Correct Answer: A
Rationale: Ventricular dysrhythmias, particularly ventricular fibrillation, are the most
common cause of sudden death within the first 24 hours after MI. Pericarditis typically occurs
2–3 days post-MI, while heart failure and cardiogenic shock may develop later.
4. A client with atrial fibrillation is prescribed warfarin (Coumadin). Which instruction should
the nurse include in the teaching plan?
A. "Increase your intake of green leafy vegetables."
B. "Use a soft toothbrush and electric razor."
C. "Take aspirin for headaches."
D. "Double the dose if you miss a day."
Correct Answer: B
Rationale: Warfarin increases bleeding risk, so clients should use soft toothbrushes and
electric razors to minimize bleeding. Green leafy vegetables contain vitamin K, which
antagonizes warfarin and should be kept consistent, not increased. Aspirin increases bleeding
risk and should be avoided. Doubling doses is never appropriate.
5. A nurse is assessing a client with peripheral arterial disease (PAD). Which finding is
expected?
A. Warm, swollen extremities
B. Bounding pedal pulses
C. Cool, pale extremities with absent or diminished pulses
D. Dependent rubor relieved by elevation
Correct Answer: C
, Rationale: PAD results from arterial insufficiency, causing cool, pale extremities with
diminished or absent pulses. Warm, swollen extremities and bounding pulses suggest venous
insufficiency or infection. Dependent rubor is associated with PAD but is not relieved by
elevation—it worsens.
6. SATA: A nurse is teaching a client about modifiable risk factors for coronary artery disease
(CAD). Which factors should the nurse include? (Select all that apply.)
A. Smoking
B. Hypertension
C. Family history
D. Diabetes mellitus
E. Age
F. Obesity
Correct Answers: A, B, D, F
Rationale: Modifiable risk factors for CAD include smoking, hypertension, diabetes mellitus,
and obesity. Family history (C) and age (E) are non-modifiable risk factors.
7. A client is admitted with an abdominal aortic aneurysm (AAA). Which finding is most
concerning?
A. Blood pressure of 150/90 mm Hg
B. Severe, sudden abdominal or back pain
C. Bruit heard over the abdomen
D. Heart rate of 100 beats/min
Correct Answer: B
Rationale: Severe, sudden abdominal or back pain may indicate aneurysm rupture or
impending rupture, a life-threatening emergency. A bruit is common with AAA but not
immediately dangerous. Elevated BP and heart rate require monitoring but are not as urgent as
signs of rupture.
8. A nurse is caring for a client with deep vein thrombosis (DVT) in the left leg. Which
intervention is priority?
, A. Massage the affected leg to improve circulation.
B. Apply warm compresses to the leg.
C. Maintain bed rest and elevate the affected extremity.
D. Encourage ambulation every 2 hours.
Correct Answer: C
Rationale: For DVT, bed rest and elevation reduce the risk of clot dislodgement and
pulmonary embolism. Massaging the leg is contraindicated because it can dislodge the clot.
Warm compresses may be used for comfort but are not priority. Ambulation is encouraged after
anticoagulation is therapeutic, not immediately.
9. A client is prescribed furosemide (Lasix). Which laboratory value should the nurse monitor
most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss, leading to hypokalemia.
Potassium levels should be monitored closely. While sodium, calcium, and magnesium can also
be affected, potassium is the most critical due to the risk of dysrhythmias.
10. A nurse is assessing a client with left-sided heart failure. Which finding is most
characteristic?
A. Dependent edema
B. Jugular venous distention
C. Crackles in the lungs
D. Hepatomegaly
Correct Answer: C
Rationale: Left-sided heart failure causes pulmonary congestion, manifesting as crackles in
the lungs. Dependent edema, jugular venous distention, and hepatomegaly are signs of right-
sided heart failure.
and A, Latest-2021) / Med Surg HESI Exam
|Perfect Guide for HESI Exam
Section 1: Cardiovascular System
1. A nurse is assessing a client with heart failure who reports increasing shortness of breath
and fatigue over the past week. Which assessment finding requires immediate intervention?
A. Weight gain of 2 kg (4.4 lb) in 3 days
B. Heart rate of 92 beats/min
C. Blood pressure of 118/72 mm Hg
D. Bilateral crackles at the lung bases
Correct Answer: A
Rationale: A weight gain of 2 kg (4.4 lb) in 3 days indicates significant fluid retention and
worsening heart failure, requiring immediate intervention. While bilateral crackles (D) also
indicate fluid overload, the rapid weight gain is the earliest and most sensitive indicator of
decompensation. Options B and C are within acceptable limits.
2. A client is prescribed digoxin (Lanoxin). Which assessment finding indicates possible digoxin
toxicity?
A. Heart rate of 88 beats/min
B. Serum potassium level of 4.0 mEq/L
C. Nausea, vomiting, and visual disturbances
D. Blood pressure of 130/80 mm Hg
Correct Answer: C
Rationale: Nausea, vomiting, and visual disturbances (yellow-green halos) are classic signs
of digoxin toxicity. Hypokalemia increases the risk of toxicity, but a potassium level of 4.0 mEq/L
is normal. Heart rate of 88 and BP of 130/80 are within normal limits.
,3. A nurse is caring for a client following a myocardial infarction. Which complication is the
client at highest risk for within the first 24 hours?
A. Ventricular dysrhythmias
B. Pericarditis
C. Heart failure
D. Cardiogenic shock
Correct Answer: A
Rationale: Ventricular dysrhythmias, particularly ventricular fibrillation, are the most
common cause of sudden death within the first 24 hours after MI. Pericarditis typically occurs
2–3 days post-MI, while heart failure and cardiogenic shock may develop later.
4. A client with atrial fibrillation is prescribed warfarin (Coumadin). Which instruction should
the nurse include in the teaching plan?
A. "Increase your intake of green leafy vegetables."
B. "Use a soft toothbrush and electric razor."
C. "Take aspirin for headaches."
D. "Double the dose if you miss a day."
Correct Answer: B
Rationale: Warfarin increases bleeding risk, so clients should use soft toothbrushes and
electric razors to minimize bleeding. Green leafy vegetables contain vitamin K, which
antagonizes warfarin and should be kept consistent, not increased. Aspirin increases bleeding
risk and should be avoided. Doubling doses is never appropriate.
5. A nurse is assessing a client with peripheral arterial disease (PAD). Which finding is
expected?
A. Warm, swollen extremities
B. Bounding pedal pulses
C. Cool, pale extremities with absent or diminished pulses
D. Dependent rubor relieved by elevation
Correct Answer: C
, Rationale: PAD results from arterial insufficiency, causing cool, pale extremities with
diminished or absent pulses. Warm, swollen extremities and bounding pulses suggest venous
insufficiency or infection. Dependent rubor is associated with PAD but is not relieved by
elevation—it worsens.
6. SATA: A nurse is teaching a client about modifiable risk factors for coronary artery disease
(CAD). Which factors should the nurse include? (Select all that apply.)
A. Smoking
B. Hypertension
C. Family history
D. Diabetes mellitus
E. Age
F. Obesity
Correct Answers: A, B, D, F
Rationale: Modifiable risk factors for CAD include smoking, hypertension, diabetes mellitus,
and obesity. Family history (C) and age (E) are non-modifiable risk factors.
7. A client is admitted with an abdominal aortic aneurysm (AAA). Which finding is most
concerning?
A. Blood pressure of 150/90 mm Hg
B. Severe, sudden abdominal or back pain
C. Bruit heard over the abdomen
D. Heart rate of 100 beats/min
Correct Answer: B
Rationale: Severe, sudden abdominal or back pain may indicate aneurysm rupture or
impending rupture, a life-threatening emergency. A bruit is common with AAA but not
immediately dangerous. Elevated BP and heart rate require monitoring but are not as urgent as
signs of rupture.
8. A nurse is caring for a client with deep vein thrombosis (DVT) in the left leg. Which
intervention is priority?
, A. Massage the affected leg to improve circulation.
B. Apply warm compresses to the leg.
C. Maintain bed rest and elevate the affected extremity.
D. Encourage ambulation every 2 hours.
Correct Answer: C
Rationale: For DVT, bed rest and elevation reduce the risk of clot dislodgement and
pulmonary embolism. Massaging the leg is contraindicated because it can dislodge the clot.
Warm compresses may be used for comfort but are not priority. Ambulation is encouraged after
anticoagulation is therapeutic, not immediately.
9. A client is prescribed furosemide (Lasix). Which laboratory value should the nurse monitor
most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss, leading to hypokalemia.
Potassium levels should be monitored closely. While sodium, calcium, and magnesium can also
be affected, potassium is the most critical due to the risk of dysrhythmias.
10. A nurse is assessing a client with left-sided heart failure. Which finding is most
characteristic?
A. Dependent edema
B. Jugular venous distention
C. Crackles in the lungs
D. Hepatomegaly
Correct Answer: C
Rationale: Left-sided heart failure causes pulmonary congestion, manifesting as crackles in
the lungs. Dependent edema, jugular venous distention, and hepatomegaly are signs of right-
sided heart failure.
