Med-Surg HESI Exam

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Sample questions from Med-Surg HESI Exam

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 68-year-old client with chest pressure has ST-segment elevation on the ECG and a blood pressure of 84/50 mm Hg. Which prescription should the nurse question?

   • A.Establish intravenous access
   • B.Administer sublingual nitroglycerin
   • C.Obtain a 12-lead ECG
   • D.Prepare for reperfusion therapy

   Rationale: Nitroglycerin can further lower blood pressure and worsen poor coronary perfusion in a client who is hypotensive. A 12-lead ECG, intravenous access, and preparation for reperfusion are appropriate priorities in suspected acute myocardial infarction. Assess blood pressure and contraindications before giving nitrates.

2. 2.A nurse is teaching a client with heart failure about when to report changes at home. Which findings should the client report promptly? Select all that apply.

   • A.A dry mouth after waking
   • B.Heart rate of 64 beats/min while resting without symptoms
   • C.Swelling that is increasing in both ankles
   • D.New shortness of breath when lying flat
   • E.Weight gain of 2 lb (0.9 kg) in 24 hours

   Rationale: A rapid weight gain can signal fluid retention and should be reported according to the client's heart-failure plan. New orthopnea and increasing ankle edema also suggest worsening congestion. An asymptomatic resting heart rate of 64 beats/min and isolated morning dry mouth are not typical signs of worsening heart failure.

3. 3.A client taking digoxin reports nausea and seeing yellow halos. The apical pulse is 54 beats/min. What should the nurse do?

   • A.Encourage the client to increase potassium intake without further assessment
   • B.Give the dose with food
   • C.Withhold the dose and notify the prescriber
   • D.Administer the dose and recheck the pulse in 1 hour

   Rationale: Bradycardia, nausea, and visual changes are concerning for digoxin toxicity, so the dose should be withheld and the prescriber notified. Food does not resolve suspected toxicity, and giving the medication may worsen bradycardia. Potassium status should be assessed because hypokalemia increases toxicity risk, but unsupervised dietary changes are not a substitute for evaluation.

4. 4.A nurse is teaching a client with hypertension about lifestyle changes that can lower cardiovascular risk. Which instructions are appropriate? Select all that apply.

   • A.Stop prescribed antihypertensive medication when blood pressure readings improve
   • B.Use tobacco to reduce stress instead of eating salty snacks
   • C.Engage in regular physical activity if medically appropriate
   • D.Choose a diet rich in fruits, vegetables, and low-fat dairy foods
   • E.Limit sodium intake as recommended by the health care team

   Answer and rationale are in the full material.

5. 5.A client with atrial fibrillation who takes warfarin reports black, tarry stools. Which action should the nurse take?

   • A.Notify the provider promptly and assess for bleeding
   • B.Recommend increasing dietary vitamin K immediately
   • C.Advise the client to take an extra dose to prevent clot formation
   • D.Reassure the client that this is an expected effect of warfarin

   Answer and rationale are in the full material.