Medical Surgical HESI

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Sample questions from Medical Surgical HESI

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

1. 1.A 68-year-old client with a history of heart failure reports sudden shortness of breath and is coughing pink, frothy sputum. The oxygen saturation is 82% on room air. Which action should the nurse take first?

   • A.Administer the scheduled oral diuretic with food
   • B.Place the client in high-Fowler position and apply prescribed oxygen
   • C.Obtain a daily weight and compare it with yesterday's weight
   • D.Encourage the client to drink water to thin secretions

   Rationale: High-Fowler positioning and oxygen support address the immediate threat of hypoxemia from acute pulmonary edema. A daily weight helps evaluate fluid status but does not stabilize breathing. Oral fluids may worsen congestion, and a scheduled oral medication is not the first response to severe respiratory distress.

2. 2.A client with heart failure is being discharged with a prescription for furosemide. Which instructions should the nurse include? Select all that apply.

   • A.Keep follow-up appointments for electrolyte and kidney-function monitoring
   • B.Report new muscle weakness or palpitations
   • C.Take the medication in the morning when possible
   • D.Change positions slowly, especially when first standing
   • E.Stop the medication whenever the ankles look less swollen

   Rationale: Morning dosing can reduce nighttime urination, and slow position changes help prevent dizziness from orthostatic hypotension. Muscle weakness or palpitations may signal an electrolyte disturbance, so they should be reported. The medication should not be stopped without the prescriber's direction, and monitoring electrolytes and kidney function is important during diuretic therapy.

3. 3.A client with angina reports chest pressure that has not improved 5 minutes after taking one prescribed nitroglycerin tablet. Which instruction should the nurse give?

   • A.Drive to the clinic after taking two more tablets
   • B.Take an antacid because the pain may be indigestion
   • C.Call emergency medical services now and follow the prescribed nitroglycerin directions
   • D.Lie down and wait 30 minutes before seeking help

   Rationale: Persistent chest discomfort may indicate acute coronary syndrome, so emergency medical services should be activated promptly. The client should follow the prescribed nitroglycerin instructions while awaiting help, not drive independently. Waiting or assuming the pain is indigestion can delay treatment of a potentially life-threatening event.

4. 4.A client taking warfarin for atrial fibrillation asks why regular blood tests are needed. Which response is best?

   • A.They confirm that the medication is dissolving any existing clot
   • B.They show whether the heart rhythm has returned to normal
   • C.They determine whether the medication is causing low blood glucose
   • D.They measure the INR so the dose can be adjusted to balance clotting and bleeding risk

   Answer and rationale are in the full material.

5. 5.A client with a recent myocardial infarction is prescribed a beta blocker. Which finding should the nurse report before administering the dose?

   • A.Heart rate of 48 beats/min
   • B.Blood pressure of 138/82 mm Hg
   • C.Temperature of 37.0 C
   • D.Respiratory rate of 18/min

   Answer and rationale are in the full material.