BSN 266 HESI
Med Surg Exam
(NGN-Style Presentation & Case Scenarios)
Actual Qs & Verified Ans to Pass the Exam
This Hesi test contains:
Next Gen-style presentation of the questions with expert rationales for a BSN-level
Med-Surg exam.
Each question includes Answer Choices, the Correct Answer, and a detailed Expert
Rationale explaining the reasoning process, suitable for the 2025 HESI Med-Surg
exam standard.
1. During an arteriogram, the client reports nausea, tingling, and dyspnea. What is the nurse’s
immediate action?
Answer Choices:
,A. Administer antiemetics
B. Inform the physician immediately
C. Reassure the client and monitor symptoms
D. Encourage deep breathing exercises
Correct Answer: B. Inform the physician immediately
Expert Rationale:
These symptoms may indicate an allergic reaction to contrast dye or anaphylaxis—an emergency requiring
immediate medical intervention.
2. . Which of the following is an expected outcome when a client is receiving an IV
administration of furosemide?
Answer Choices:
A. Decreased blood pressure
B. Increased urine output
C. Elevated serum potassium
D. Reduced respiratory rate
Correct Answer: B. Increased urine output
Expert Rationale:
Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the kidneys, promoting
diuresis. Therefore, increased urine output is an expected pharmacological effect.
3. . A client has had a pulmonary artery catheter inserted. When performing hemodynamic monitoring,
wedging the catheter provides information about:
Answer Choices:
A. Right atrial pressure
B. Pulmonary artery pressure
C. Left ventricular end-diastolic pressure
D. Systemic vascular resistance
Correct Answer: C. Left ventricular end-diastolic pressure
Expert Rationale:
Wedge pressure reflects the pressure in the left atrium and indirectly left ventricular end-diastolic pressure,
providing valuable data on left heart preload and cardiac function.
4. . After myocardial infarction, the client is taught to move the legs while resting in bed. The primary
expected outcome of this intervention is to:
Answer Choices:
A. Increase cardiac output
B. Prevent thrombophlebitis and venous thromboembolism
C. Reduce myocardial oxygen demand
D. Promote lymphatic drainage
Correct Answer: B. Prevent thrombophlebitis and venous thromboembolism
,Expert Rationale:
Leg movement in bed promotes venous return, preventing venous stasis and reducing the risk of deep vein
thrombosis (DVT) and subsequent thromboembolic complications.
5. . Which diet is most appropriate during the acute phase of myocardial infarction?
Answer Choices:
A. High-fiber large meals
B. Low-fat, bulky meals
C. Small, easily digested meals
D. High-protein supplements
Correct Answer: C. Small, easily digested meals
Expert Rationale:
Small, easily digested meals reduce metabolic demand and potential cardiac workload during acute MI,
supporting recovery and preventing gastrointestinal discomfort.
6. . A client started on clopidogrel (Plavix) after myocardial infarction should be taught which
of the following? (Select all that apply.)
Answer Choices:
1. Report unexpected or prolonged bleeding
2. Avoid all physical activity
3. Bruising and bleeding gums may occur
4. The medication prevents platelet aggregation
5. Discontinue the medication if minor bleeding occurs
Correct Answers: 1, 3, 4
Expert Rationale:
Clopidogrel inhibits platelet aggregation, increasing bleeding risk. Clients should report bleeding, expect
possible easy bruising, and understand the drug’s mechanism. Physical activity is generally encouraged;
abrupt discontinuation without provider advice is unsafe.
7. Which client is at greatest risk for coronary artery disease (CAD)?
Answer Choices:
A. 50-year-old male, BMI 22, LDL 100 mg/dL
B. 65-year-old female, obese, LDL 188 mg/dL
C. 40-year-old female, smoker, LDL 90 mg/dL
D. 55-year-old male athlete, LDL 130 mg/dL
Correct Answer: B. 65-year-old female, obese, LDL 188 mg/dL
Expert Rationale:
Advanced age, obesity, and elevated LDL cholesterol are significant CAD risk factors, placing this client at
highest risk.
8. A middle-aged adult with family history of CAD has total cholesterol 198 mg/dL, LDL 120 mg/dL,
HDL 58 mg/dL, triglycerides 148 mg/dL, blood sugar 102 mg/dL, and CRP 4.2 mg/L. The provider
prescribes statins and aspirin. The best nurse response is:
Answer Choices:
, A. "Statins and aspirin increase cholesterol levels to protect your heart."
B. "The elevated CRP shows inflammation linked to heart disease; these meds can lower it."
C. "These medications will make you feel more energetic."
D. "They will completely cure your coronary artery disease."
Correct Answer: B. "The elevated CRP shows inflammation linked to heart disease; these meds can lower
it."
Expert Rationale:
Elevated CRP is a marker of systemic inflammation associated with CAD risk. Statins and aspirin reduce
this inflammation and thrombosis risk, improving cardiovascular outcomes.
9. . The client has been treating angina with nitroglycerin. Which indicates the drug is
effective?
Answer Choices:
A. Bradycardia
B. Increased blood pressure
C. Decreased chest pain
D. Headache relief
Correct Answer: C. Decreased chest pain
Expert Rationale:
Nitroglycerin’s vasodilatory effect reduces myocardial oxygen demand and relieves ischemic chest pain —
the primary indicator of drug effectiveness.
10. . For a client with CAD risk behaviors, behavior modification can be reinforced most effectively by:
Answer Choices:
A. Punishing maladaptive behaviors
B. Ignoring client achievements
C. Rewarding acceptable behaviors immediately
D. Providing vague feedback
Correct Answer: C. Rewarding acceptable behaviors immediately
Expert Rationale:
Positive reinforcement strengthens new adaptive behaviors, increasing the likelihood of sustained lifestyle
changes necessary for CAD prevention.
11. . Alteplase (t-PA) is administered within 6 hours after myocardial infarction primarily to:
Answer Choices:
A. Dissolve plaques in coronary vessels
B. Revascularize the blocked coronary artery
C. Decrease cardiac arrhythmias
D. Lower blood pressure
Correct Answer: B. Revascularize the blocked coronary artery
Expert Rationale:
Med Surg Exam
(NGN-Style Presentation & Case Scenarios)
Actual Qs & Verified Ans to Pass the Exam
This Hesi test contains:
Next Gen-style presentation of the questions with expert rationales for a BSN-level
Med-Surg exam.
Each question includes Answer Choices, the Correct Answer, and a detailed Expert
Rationale explaining the reasoning process, suitable for the 2025 HESI Med-Surg
exam standard.
1. During an arteriogram, the client reports nausea, tingling, and dyspnea. What is the nurse’s
immediate action?
Answer Choices:
,A. Administer antiemetics
B. Inform the physician immediately
C. Reassure the client and monitor symptoms
D. Encourage deep breathing exercises
Correct Answer: B. Inform the physician immediately
Expert Rationale:
These symptoms may indicate an allergic reaction to contrast dye or anaphylaxis—an emergency requiring
immediate medical intervention.
2. . Which of the following is an expected outcome when a client is receiving an IV
administration of furosemide?
Answer Choices:
A. Decreased blood pressure
B. Increased urine output
C. Elevated serum potassium
D. Reduced respiratory rate
Correct Answer: B. Increased urine output
Expert Rationale:
Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the kidneys, promoting
diuresis. Therefore, increased urine output is an expected pharmacological effect.
3. . A client has had a pulmonary artery catheter inserted. When performing hemodynamic monitoring,
wedging the catheter provides information about:
Answer Choices:
A. Right atrial pressure
B. Pulmonary artery pressure
C. Left ventricular end-diastolic pressure
D. Systemic vascular resistance
Correct Answer: C. Left ventricular end-diastolic pressure
Expert Rationale:
Wedge pressure reflects the pressure in the left atrium and indirectly left ventricular end-diastolic pressure,
providing valuable data on left heart preload and cardiac function.
4. . After myocardial infarction, the client is taught to move the legs while resting in bed. The primary
expected outcome of this intervention is to:
Answer Choices:
A. Increase cardiac output
B. Prevent thrombophlebitis and venous thromboembolism
C. Reduce myocardial oxygen demand
D. Promote lymphatic drainage
Correct Answer: B. Prevent thrombophlebitis and venous thromboembolism
,Expert Rationale:
Leg movement in bed promotes venous return, preventing venous stasis and reducing the risk of deep vein
thrombosis (DVT) and subsequent thromboembolic complications.
5. . Which diet is most appropriate during the acute phase of myocardial infarction?
Answer Choices:
A. High-fiber large meals
B. Low-fat, bulky meals
C. Small, easily digested meals
D. High-protein supplements
Correct Answer: C. Small, easily digested meals
Expert Rationale:
Small, easily digested meals reduce metabolic demand and potential cardiac workload during acute MI,
supporting recovery and preventing gastrointestinal discomfort.
6. . A client started on clopidogrel (Plavix) after myocardial infarction should be taught which
of the following? (Select all that apply.)
Answer Choices:
1. Report unexpected or prolonged bleeding
2. Avoid all physical activity
3. Bruising and bleeding gums may occur
4. The medication prevents platelet aggregation
5. Discontinue the medication if minor bleeding occurs
Correct Answers: 1, 3, 4
Expert Rationale:
Clopidogrel inhibits platelet aggregation, increasing bleeding risk. Clients should report bleeding, expect
possible easy bruising, and understand the drug’s mechanism. Physical activity is generally encouraged;
abrupt discontinuation without provider advice is unsafe.
7. Which client is at greatest risk for coronary artery disease (CAD)?
Answer Choices:
A. 50-year-old male, BMI 22, LDL 100 mg/dL
B. 65-year-old female, obese, LDL 188 mg/dL
C. 40-year-old female, smoker, LDL 90 mg/dL
D. 55-year-old male athlete, LDL 130 mg/dL
Correct Answer: B. 65-year-old female, obese, LDL 188 mg/dL
Expert Rationale:
Advanced age, obesity, and elevated LDL cholesterol are significant CAD risk factors, placing this client at
highest risk.
8. A middle-aged adult with family history of CAD has total cholesterol 198 mg/dL, LDL 120 mg/dL,
HDL 58 mg/dL, triglycerides 148 mg/dL, blood sugar 102 mg/dL, and CRP 4.2 mg/L. The provider
prescribes statins and aspirin. The best nurse response is:
Answer Choices:
, A. "Statins and aspirin increase cholesterol levels to protect your heart."
B. "The elevated CRP shows inflammation linked to heart disease; these meds can lower it."
C. "These medications will make you feel more energetic."
D. "They will completely cure your coronary artery disease."
Correct Answer: B. "The elevated CRP shows inflammation linked to heart disease; these meds can lower
it."
Expert Rationale:
Elevated CRP is a marker of systemic inflammation associated with CAD risk. Statins and aspirin reduce
this inflammation and thrombosis risk, improving cardiovascular outcomes.
9. . The client has been treating angina with nitroglycerin. Which indicates the drug is
effective?
Answer Choices:
A. Bradycardia
B. Increased blood pressure
C. Decreased chest pain
D. Headache relief
Correct Answer: C. Decreased chest pain
Expert Rationale:
Nitroglycerin’s vasodilatory effect reduces myocardial oxygen demand and relieves ischemic chest pain —
the primary indicator of drug effectiveness.
10. . For a client with CAD risk behaviors, behavior modification can be reinforced most effectively by:
Answer Choices:
A. Punishing maladaptive behaviors
B. Ignoring client achievements
C. Rewarding acceptable behaviors immediately
D. Providing vague feedback
Correct Answer: C. Rewarding acceptable behaviors immediately
Expert Rationale:
Positive reinforcement strengthens new adaptive behaviors, increasing the likelihood of sustained lifestyle
changes necessary for CAD prevention.
11. . Alteplase (t-PA) is administered within 6 hours after myocardial infarction primarily to:
Answer Choices:
A. Dissolve plaques in coronary vessels
B. Revascularize the blocked coronary artery
C. Decrease cardiac arrhythmias
D. Lower blood pressure
Correct Answer: B. Revascularize the blocked coronary artery
Expert Rationale:
