Med-Surg Subject HESI

Free preview · Original latest version

Sample questions from Med-Surg Subject HESI

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

1. 1.In the emergency department, an adult with chest pressure has a 12-lead ECG showing ST-segment elevation in leads II, III, and aVF. Which action should the nurse take first?

   • A.Obtain a prescription for fibrinolytic therapy before assessing contraindications
   • B.Establish IV access and prepare for rapid reperfusion therapy
   • C.Administer sublingual nitroglycerin and reassess in 30 minutes
   • D.Encourage the client to walk to reduce anxiety

   Rationale: ST elevation in the inferior leads indicates an acute myocardial infarction requiring rapid reperfusion, and IV access supports urgent treatment. Fibrinolytic therapy requires assessment for contraindications and is not initiated independently. Nitroglycerin may be prescribed, but delaying reperfusion to reassess later is unsafe; ambulation increases myocardial oxygen demand.

2. 2.A client with heart failure taking digoxin reports nausea and seeing yellow halos. The apical pulse is 54/min. Which action should the nurse take?

   • A.Give the dose and recheck the pulse in 1 hour
   • B.Encourage the client to increase dietary potassium
   • C.Administer the scheduled dose with food
   • D.Hold the dose and notify the provider

   Rationale: Bradycardia, nausea, and visual halos are concerning for digoxin toxicity, so the dose should be withheld and the provider notified. Giving the medication could worsen bradycardia and toxicity. Food does not make an unsafe dose appropriate, and potassium should not be increased without evaluating the client's level and treatment plan.

3. 3.Which statement by a client prescribed warfarin for atrial fibrillation indicates understanding of discharge teaching?

   • A.I do not need blood tests once my dose is established.
   • B.I will take aspirin for a headache without checking first.
   • C.I will keep my intake of leafy green vegetables consistent from week to week.
   • D.I can stop the medication when I no longer feel palpitations.

   Rationale: Consistent vitamin K intake helps maintain a stable warfarin effect; clients do not need to avoid vitamin K foods entirely. Warfarin is taken to reduce embolic risk even when symptoms are absent. Aspirin can increase bleeding risk, and regular INR monitoring is needed to guide dosing and assess safety.

4. 4.Refer to the client's chart. Which findings support worsening left-sided heart failure and require prompt follow-up? Select all that apply.

   • A.Increasing crackles and new orthopnea
   • B.Oxygen saturation decreasing from 95% to 89% on room air
   • C.Warm, dry skin with capillary refill under 2 seconds
   • D.A 1.8-kg weight gain in 48 hours
   • E.Urine output of 45 mL/hr

   Answer and rationale are in the full material.

5. 5.A client taking lisinopril for hypertension calls the clinic to report swelling of the lips and tongue that began this morning. Which instruction is the priority?

   • A.Seek emergency care immediately
   • B.Take the next dose with food to reduce irritation
   • C.Schedule a routine appointment within 1 week
   • D.Take an over-the-counter antihistamine and continue the medication

   Answer and rationale are in the full material.