HESI MED SURG Questions and Answers(3
Versions) (Total 600 Q/A) (NEW-2020/2021,
Answers)
SECTION 1: CARDIAC & VASCULAR DISORDERS (Q1–Q18)
1. The nurse is caring for a client with heart failure who is prescribed furosemide. Which
assessment finding requires immediate intervention?
A. Blood pressure 118/72 mm Hg
B. Potassium 2.8 mEq/L
C. Urine output 60 mL/hr
D. Weight loss of 0.5 kg since admission
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss. A potassium level of 2.8
mEq/L is critically low (normal 3.5–5.0) and predisposes the client to dysrhythmias, especially
with concurrent digoxin use. BP, urine output, and modest weight loss are expected findings.
2. A client with atrial fibrillation is prescribed warfarin. Which statement by the client
indicates understanding of teaching?
A. "I will increase my intake of green leafy vegetables."
B. "I will use a soft toothbrush and electric razor."
C. "I will take aspirin for headaches."
D. "I will stop the medication if I see any bruising."
Correct Answer: B
Rationale: Warfarin increases bleeding risk; soft toothbrush and electric razor reduce
trauma. Green leafy vegetables (vitamin K) should be kept consistent, not increased. Aspirin
increases bleeding risk. Bruising should be reported, not a reason to stop the drug abruptly.
3. The nurse is assessing a client with suspected myocardial infarction. Which finding is most
consistent with an inferior wall MI?
,A. ST elevation in leads V1–V4
B. ST elevation in leads II, III, and aVF
C. ST elevation in leads I, aVL, V5–V6
D. Diffuse ST depression
Correct Answer: B
Rationale: Inferior wall MI is reflected in leads II, III, and aVF. Anterior MI shows V1–V4.
Lateral MI shows I, aVL, V5–V6. Diffuse ST depression suggests ischemia or NSTEMI.
4. A client is admitted with acute pericarditis. Which position should the nurse encourage?
A. Supine with legs elevated
B. High-Fowler's
C. Sitting upright and leaning forward
D. Left lateral recumbent
Correct Answer: C
Rationale: Pericarditis pain is pleuritic and positional; sitting upright and leaning forward
reduces pressure on the pericardium and relieves pain. Supine and left lateral positions often
worsen it.
5. SATA: The nurse is teaching a client about digoxin. Which statements should be included?
(Select all that apply.)
A. "Take your pulse before each dose."
B. "Notify your provider if your pulse is below 60."
C. "Take the medication with an antacid if it upsets your stomach."
D. "Report visual disturbances such as yellow halos."
E. "Increase your potassium intake unless told otherwise."
Correct Answers: A, B, D
Rationale: Digoxin requires pulse assessment and holding for bradycardia <60. Visual
changes (yellow-green halos) indicate toxicity. Antacids decrease absorption. Potassium should
be maintained, not indiscriminately increased without provider orders.
6. A client with an abdominal aortic aneurysm (AAA) reports sudden severe back pain. What
is the nurse's priority action?
,A. Administer PRN morphine
B. Assess vital signs and notify the provider immediately
C. Apply a warm compress to the back
D. Encourage ambulation
Correct Answer: B
Rationale: Sudden severe back pain in AAA may indicate rupture, a life-threatening
emergency. Vital signs (hypotension, tachycardia) and immediate provider notification are
priority. Analgesia, heat, and ambulation are not appropriate until rupture is ruled out.
7. The nurse is caring for a client after coronary artery bypass graft (CABG). Which finding is
most concerning?
A. Chest tube drainage of 50 mL/hr for the first 2 hours
B. Temperature 37.8°C (100°F)
C. Sudden cessation of chest tube drainage with tachycardia and hypotension
D. Incisional pain rated 5/10
Correct Answer: C
Rationale: Sudden cessation of chest tube drainage with tachycardia and hypotension
suggests cardiac tamponade from clot obstruction. This is an emergency. Moderate drainage,
low-grade fever, and incisional pain are expected.
8. A client with hypertension is prescribed lisinopril. Which side effect should the nurse
monitor for?
A. Hyperkalemia
B. Hypokalemia
C. Bradycardia
D. Hypernatremia
Correct Answer: A
Rationale: ACE inhibitors such as lisinopril reduce aldosterone secretion, causing potassium
retention (hyperkalemia). They do not typically cause hypokalemia, bradycardia, or
hypernatremia.
9. The nurse is assessing a client with left-sided heart failure. Which finding is expected?
, A. Peripheral 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,
dyspnea, and orthopnea. Peripheral edema, JVD, and hepatomegaly are right-sided signs.
10. A client is prescribed enoxaparin. Which laboratory value should the nurse monitor?
A. INR
B. aPTT
C. Platelet count
D. Bleeding time
Correct Answer: C
Rationale: Enoxaparin (low-molecular-weight heparin) can cause heparin-induced
thrombocytopenia (HIT). Platelet counts should be monitored. INR monitors warfarin; aPTT
monitors unfractionated heparin.
11. SATA: Which clients are at increased risk for venous thromboembolism (VTE)? (Select all
that apply.)
A. A client on prolonged bed rest
B. A client with atrial fibrillation
C. A client who recently had orthopedic surgery
D. A client with active cancer
E. A client taking warfarin
Correct Answers: A, C, D
Rationale: Immobility, orthopedic surgery, and malignancy (Virchow's triad) increase VTE
risk. Atrial fibrillation increases risk of arterial thrombi/stroke, not typically DVT. Warfarin is
anticoagulant therapy, not a risk factor.
12. The nurse is caring for a client with a temporary pacemaker. Which finding indicates
failure to capture?
Versions) (Total 600 Q/A) (NEW-2020/2021,
Answers)
SECTION 1: CARDIAC & VASCULAR DISORDERS (Q1–Q18)
1. The nurse is caring for a client with heart failure who is prescribed furosemide. Which
assessment finding requires immediate intervention?
A. Blood pressure 118/72 mm Hg
B. Potassium 2.8 mEq/L
C. Urine output 60 mL/hr
D. Weight loss of 0.5 kg since admission
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss. A potassium level of 2.8
mEq/L is critically low (normal 3.5–5.0) and predisposes the client to dysrhythmias, especially
with concurrent digoxin use. BP, urine output, and modest weight loss are expected findings.
2. A client with atrial fibrillation is prescribed warfarin. Which statement by the client
indicates understanding of teaching?
A. "I will increase my intake of green leafy vegetables."
B. "I will use a soft toothbrush and electric razor."
C. "I will take aspirin for headaches."
D. "I will stop the medication if I see any bruising."
Correct Answer: B
Rationale: Warfarin increases bleeding risk; soft toothbrush and electric razor reduce
trauma. Green leafy vegetables (vitamin K) should be kept consistent, not increased. Aspirin
increases bleeding risk. Bruising should be reported, not a reason to stop the drug abruptly.
3. The nurse is assessing a client with suspected myocardial infarction. Which finding is most
consistent with an inferior wall MI?
,A. ST elevation in leads V1–V4
B. ST elevation in leads II, III, and aVF
C. ST elevation in leads I, aVL, V5–V6
D. Diffuse ST depression
Correct Answer: B
Rationale: Inferior wall MI is reflected in leads II, III, and aVF. Anterior MI shows V1–V4.
Lateral MI shows I, aVL, V5–V6. Diffuse ST depression suggests ischemia or NSTEMI.
4. A client is admitted with acute pericarditis. Which position should the nurse encourage?
A. Supine with legs elevated
B. High-Fowler's
C. Sitting upright and leaning forward
D. Left lateral recumbent
Correct Answer: C
Rationale: Pericarditis pain is pleuritic and positional; sitting upright and leaning forward
reduces pressure on the pericardium and relieves pain. Supine and left lateral positions often
worsen it.
5. SATA: The nurse is teaching a client about digoxin. Which statements should be included?
(Select all that apply.)
A. "Take your pulse before each dose."
B. "Notify your provider if your pulse is below 60."
C. "Take the medication with an antacid if it upsets your stomach."
D. "Report visual disturbances such as yellow halos."
E. "Increase your potassium intake unless told otherwise."
Correct Answers: A, B, D
Rationale: Digoxin requires pulse assessment and holding for bradycardia <60. Visual
changes (yellow-green halos) indicate toxicity. Antacids decrease absorption. Potassium should
be maintained, not indiscriminately increased without provider orders.
6. A client with an abdominal aortic aneurysm (AAA) reports sudden severe back pain. What
is the nurse's priority action?
,A. Administer PRN morphine
B. Assess vital signs and notify the provider immediately
C. Apply a warm compress to the back
D. Encourage ambulation
Correct Answer: B
Rationale: Sudden severe back pain in AAA may indicate rupture, a life-threatening
emergency. Vital signs (hypotension, tachycardia) and immediate provider notification are
priority. Analgesia, heat, and ambulation are not appropriate until rupture is ruled out.
7. The nurse is caring for a client after coronary artery bypass graft (CABG). Which finding is
most concerning?
A. Chest tube drainage of 50 mL/hr for the first 2 hours
B. Temperature 37.8°C (100°F)
C. Sudden cessation of chest tube drainage with tachycardia and hypotension
D. Incisional pain rated 5/10
Correct Answer: C
Rationale: Sudden cessation of chest tube drainage with tachycardia and hypotension
suggests cardiac tamponade from clot obstruction. This is an emergency. Moderate drainage,
low-grade fever, and incisional pain are expected.
8. A client with hypertension is prescribed lisinopril. Which side effect should the nurse
monitor for?
A. Hyperkalemia
B. Hypokalemia
C. Bradycardia
D. Hypernatremia
Correct Answer: A
Rationale: ACE inhibitors such as lisinopril reduce aldosterone secretion, causing potassium
retention (hyperkalemia). They do not typically cause hypokalemia, bradycardia, or
hypernatremia.
9. The nurse is assessing a client with left-sided heart failure. Which finding is expected?
, A. Peripheral 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,
dyspnea, and orthopnea. Peripheral edema, JVD, and hepatomegaly are right-sided signs.
10. A client is prescribed enoxaparin. Which laboratory value should the nurse monitor?
A. INR
B. aPTT
C. Platelet count
D. Bleeding time
Correct Answer: C
Rationale: Enoxaparin (low-molecular-weight heparin) can cause heparin-induced
thrombocytopenia (HIT). Platelet counts should be monitored. INR monitors warfarin; aPTT
monitors unfractionated heparin.
11. SATA: Which clients are at increased risk for venous thromboembolism (VTE)? (Select all
that apply.)
A. A client on prolonged bed rest
B. A client with atrial fibrillation
C. A client who recently had orthopedic surgery
D. A client with active cancer
E. A client taking warfarin
Correct Answers: A, C, D
Rationale: Immobility, orthopedic surgery, and malignancy (Virchow's triad) increase VTE
risk. Atrial fibrillation increases risk of arterial thrombi/stroke, not typically DVT. Warfarin is
anticoagulant therapy, not a risk factor.
12. The nurse is caring for a client with a temporary pacemaker. Which finding indicates
failure to capture?
