ADVANCED MED SURG HESI PRACTICE EXAM
2026 QUESTIONS WITH FULL SOLUTIONS
GRADED A+
● The nurse should be correct in withholding a dose of digoxin in a
client with congestive heart failure without specific instruction from the
healthcare provider if the client's
A) serum digoxin level is 1.5.
B) blood pressure is 104/68.
C) serum potassium level is 3.
D) apical pulse is 68/min. Answer: C) serum potassium level is 3.
Hypokalemia (C) can precipitate digitalis toxicity in persons receiving
digoxin which will increase the chance of dangerous dysrhythmias
(normal potassium level is 3.5 to 5.5 mEq/L). The therapeutic range for
digoxin is 0.8 to 2 ng/ml (toxic levels= >2 ng/ml); (A) is within this
range. (B) would not warrant the nurse withholding the digoxin. The
nurse should withhold the digoxin if the apical pulse is less than 60/min
(D).
● In assessing a client diagnosed with primary hyperaldosteronism, the
nurse expects the laboratory test results to indicate a decreased serum
level of which substance?
,A) Sodium.
B) Antidiuretic hormone.
C) Potassium.
D) Glucose. Answer: C) Potassium.
Clients with primary aldosteronism exhibit a profound decline in the
serum levels of potassium (C) (hypokalemia)--hypertension is the most
prominent and universal sign. (A) is normal or elevated, depending on
the amount of water reabsorbed with the sodium. (B) is decreased with
diabetes insipidus. (D) is not affected by primary aldosteronism.
● Based on the analysis of the client's atrial fibrillation, the nurse should
prepare the client for which treatment protocol?
A) Diuretic therapy.
B) Pacemaker implantation.
C) Anticoagulation therapy.
D) Cardiac catheterization. Answer: C) Anticoagulation therapy.
The client is experiencing atrial fibrillation, and the nurse should prepare
the client for anticoagulation therapy (C) which should be prescribed
before rhythm control therapies to prevent cardioembolic events which
result from blood pooling in the fibrillating atria. (A, B, and D) are not
indicated.
,● Which information about mammograms is most important to provide a
post-menopausal female client?
A) Breast self-examinations are not needed if annual mammograms are
obtained.
B) Radiation exposure is minimized by shielding the abdomen with a
lead-lined apron.
C) Yearly mammograms should be done regardless of previous normal
x-rays.
D) Women at high risk should have annual routine and ultrasound
mammograms. Answer: C) Yearly mammograms should be done
regardless of previous normal x-rays.
The current breast screening recommendation is a yearly mammogram
after age 40 (C). Breast self-exam (A) continues to be a priority
recommendation for all women because a small lump (or tumor) is often
first felt by a woman before a mammogram is obtained. The radiation
exposure from a mammogram is low, so (B) is not normally provided.
The frequency of using routine and ultrasound mammograms (D) in
women with high-risk variables, such as a history of breast cancer, the
presence of BRC1 and BRC2 genes, or 2 first-degree relatives with
breast cancer, should be recommended and followed closely by the
healthcare provider.
● In assessing cancer risk, the nurse identifies which woman as being at
greatest risk of developing breast cancer?
A) A 35-year-old multipara who never breastfed.
, B) A 50-year-old whose mother had unilateral breast cancer.
C) A 55-year-old whose mother-in-law had bilateral breast cancer.
D) A 20-year-old whose menarche occurred at age 9. Answer: B) A 50-
year-old whose mother had unilateral breast cancer.
The most predictive risk factors for development of breast cancer are
over 40 years of age and a positive family history (occurrence in the
immediate family, i.e., mother or sister). Other risk factors include
nulliparity, no history of breastfeeding, early menarche and late
menopause. Although all of the women described have one of the risk
factors for developing breast cancer, (B) has the greater risk over (A, C,
and D).
● Which reaction should the nurse identify in a client who is responding
to stimulation of the sympathetic nervous system?
A) Pupil constriction.
B) Increased heart rate.
C) Bronchial constriction.
D) Decreased blood pressure. Answer: B) Increased heart rate.
Any stressor that is perceived as threatening to homeostasis acts to
stimulate the sympathetic nervous system and manifests as a flight-or-
fight response, which includes an increase in heart rate (B). (A, C, and
D) are responses of the parasympathetic nervous system.
2026 QUESTIONS WITH FULL SOLUTIONS
GRADED A+
● The nurse should be correct in withholding a dose of digoxin in a
client with congestive heart failure without specific instruction from the
healthcare provider if the client's
A) serum digoxin level is 1.5.
B) blood pressure is 104/68.
C) serum potassium level is 3.
D) apical pulse is 68/min. Answer: C) serum potassium level is 3.
Hypokalemia (C) can precipitate digitalis toxicity in persons receiving
digoxin which will increase the chance of dangerous dysrhythmias
(normal potassium level is 3.5 to 5.5 mEq/L). The therapeutic range for
digoxin is 0.8 to 2 ng/ml (toxic levels= >2 ng/ml); (A) is within this
range. (B) would not warrant the nurse withholding the digoxin. The
nurse should withhold the digoxin if the apical pulse is less than 60/min
(D).
● In assessing a client diagnosed with primary hyperaldosteronism, the
nurse expects the laboratory test results to indicate a decreased serum
level of which substance?
,A) Sodium.
B) Antidiuretic hormone.
C) Potassium.
D) Glucose. Answer: C) Potassium.
Clients with primary aldosteronism exhibit a profound decline in the
serum levels of potassium (C) (hypokalemia)--hypertension is the most
prominent and universal sign. (A) is normal or elevated, depending on
the amount of water reabsorbed with the sodium. (B) is decreased with
diabetes insipidus. (D) is not affected by primary aldosteronism.
● Based on the analysis of the client's atrial fibrillation, the nurse should
prepare the client for which treatment protocol?
A) Diuretic therapy.
B) Pacemaker implantation.
C) Anticoagulation therapy.
D) Cardiac catheterization. Answer: C) Anticoagulation therapy.
The client is experiencing atrial fibrillation, and the nurse should prepare
the client for anticoagulation therapy (C) which should be prescribed
before rhythm control therapies to prevent cardioembolic events which
result from blood pooling in the fibrillating atria. (A, B, and D) are not
indicated.
,● Which information about mammograms is most important to provide a
post-menopausal female client?
A) Breast self-examinations are not needed if annual mammograms are
obtained.
B) Radiation exposure is minimized by shielding the abdomen with a
lead-lined apron.
C) Yearly mammograms should be done regardless of previous normal
x-rays.
D) Women at high risk should have annual routine and ultrasound
mammograms. Answer: C) Yearly mammograms should be done
regardless of previous normal x-rays.
The current breast screening recommendation is a yearly mammogram
after age 40 (C). Breast self-exam (A) continues to be a priority
recommendation for all women because a small lump (or tumor) is often
first felt by a woman before a mammogram is obtained. The radiation
exposure from a mammogram is low, so (B) is not normally provided.
The frequency of using routine and ultrasound mammograms (D) in
women with high-risk variables, such as a history of breast cancer, the
presence of BRC1 and BRC2 genes, or 2 first-degree relatives with
breast cancer, should be recommended and followed closely by the
healthcare provider.
● In assessing cancer risk, the nurse identifies which woman as being at
greatest risk of developing breast cancer?
A) A 35-year-old multipara who never breastfed.
, B) A 50-year-old whose mother had unilateral breast cancer.
C) A 55-year-old whose mother-in-law had bilateral breast cancer.
D) A 20-year-old whose menarche occurred at age 9. Answer: B) A 50-
year-old whose mother had unilateral breast cancer.
The most predictive risk factors for development of breast cancer are
over 40 years of age and a positive family history (occurrence in the
immediate family, i.e., mother or sister). Other risk factors include
nulliparity, no history of breastfeeding, early menarche and late
menopause. Although all of the women described have one of the risk
factors for developing breast cancer, (B) has the greater risk over (A, C,
and D).
● Which reaction should the nurse identify in a client who is responding
to stimulation of the sympathetic nervous system?
A) Pupil constriction.
B) Increased heart rate.
C) Bronchial constriction.
D) Decreased blood pressure. Answer: B) Increased heart rate.
Any stressor that is perceived as threatening to homeostasis acts to
stimulate the sympathetic nervous system and manifests as a flight-or-
fight response, which includes an increase in heart rate (B). (A, C, and
D) are responses of the parasympathetic nervous system.
