BSN 266 HESI MED SURG PRACTICE EXAM VERSION 2
2026/2027 | Questions & Verified Answers with Rationales |
100% Correct | Grade A | Nightingale | Pass Guaranteed - A+
Graded
Section 1: Cardiovascular Disorders (12 Questions)
Q1: A nurse is caring for four patients on a medical-surgical unit. Which patient should
the nurse see first?
A. Patient with chronic heart failure requesting assistance to ambulate to the bathroom
B. Patient with new-onset atrial fibrillation with heart rate 110, asymptomatic
C. Patient with ST-elevation myocardial infarction 2 hours post-thrombolysis with chest
pain rated 8/10 [CORRECT]
D. Patient with hypertension requesting PRN antihypertensive medication
Correct Answer: C
Rationale: For HESI practice Version 2, remember the priority is the patient with
life-threatening complications. Post-MI chest pain rated 8/10 after thrombolysis
suggests possible reocclusion or extension—this requires immediate ECG and provider
notification. The new A-fib patient (B) is stable and can wait; the CHF patient (A) has
chronic condition with non-urgent request; the hypertension patient (D) is stable.
,Q2: A patient with heart failure is prescribed furosemide 40 mg IV push. Which
assessment finding requires immediate intervention by the nurse?
A. Blood pressure 138/88 mmHg
B. Serum potassium 3.2 mEq/L [CORRECT]
C. Weight gain of 2 pounds in 24 hours
D. Respiratory rate 18 breaths per minute
Correct Answer: B
Rationale: The priority action is addressing the hypokalemia. For HESI practice,
remember that furosemide causes potassium wasting, and a level of 3.2 is dangerously
low, risking cardiac dysrhythmias. While weight gain (C) is concerning in heart failure,
hypokalemia is immediately life-threatening and requires potassium replacement and
cardiac monitoring.
Q3: A patient with deep vein thrombosis is started on enoxaparin. Which instruction is
essential?
A. Report any signs of bleeding immediately [CORRECT]
B. Take aspirin for any headache
C. Discontinue when pain subsides
D. Massage injection site to prevent bruising
Correct Answer: A
,Rationale: That's correct because enoxaparin is a low molecular weight heparin with
bleeding risk. The priority patient education is recognizing and reporting bleeding signs
(hematuria, melena, unusual bruising) immediately. Aspirin (B) is contraindicated due to
additive bleeding risk. Injection technique involves not massaging (D) to prevent
hematoma.
Q4: A patient with hypertension asks about lifestyle modifications. Which
recommendation has the strongest evidence for blood pressure reduction?
A. Reduce sodium intake to less than 2 grams per day
B. Follow the DASH diet and reduce sodium to 1500mg daily [CORRECT]
C. Take potassium supplements
D. Eliminate all caffeine
Correct Answer: B
Rationale: For HESI practice Version 2, the DASH diet with sodium restriction to 1500mg
daily has the strongest evidence for hypertension management, per JNC-8 guidelines.
While sodium reduction helps (A), the complete DASH dietary pattern (fruits, vegetables,
low-fat dairy) provides optimal results.
Q5: A patient post-cardiac catheterization reports numbness and tingling in the affected
extremity. Which action is priority?
A. Elevate the extremity above heart level
B. Assess distal pulses and notify provider immediately [CORRECT]
C. Apply warm compresses
, D. Document and continue monitoring
Correct Answer: B
Rationale: The priority action is assessing circulation and notifying the provider because
this could indicate arterial occlusion—a serious complication. While elevation (A) helps
edema, neurovascular changes require immediate assessment and intervention to
prevent permanent damage.
Q6: A patient with peripheral arterial disease has a foot ulcer with pale, cool skin and
absent pedal pulses. Which intervention is priority?
A. Apply moisturizing lotion to prevent dryness
B. Position with legs dependent to improve perfusion
C. Immediate vascular surgery consultation [CORRECT]
D. Encourage ambulation to promote circulation
Correct Answer: C
Rationale: For HESI practice, absent pulses with pale, cool skin indicates critical limb
ischemia requiring immediate vascular intervention to save the limb. Dependent
positioning (B) is contraindicated in PAD. Moisturizing (A) and ambulation (D) are
inappropriate with absent pulses and risk further injury.
Q7: A nurse is caring for a patient 24 hours post-abdominal aortic aneurysm repair.
Which finding requires immediate reporting?
A. Blood pressure 142/88 mmHg
2026/2027 | Questions & Verified Answers with Rationales |
100% Correct | Grade A | Nightingale | Pass Guaranteed - A+
Graded
Section 1: Cardiovascular Disorders (12 Questions)
Q1: A nurse is caring for four patients on a medical-surgical unit. Which patient should
the nurse see first?
A. Patient with chronic heart failure requesting assistance to ambulate to the bathroom
B. Patient with new-onset atrial fibrillation with heart rate 110, asymptomatic
C. Patient with ST-elevation myocardial infarction 2 hours post-thrombolysis with chest
pain rated 8/10 [CORRECT]
D. Patient with hypertension requesting PRN antihypertensive medication
Correct Answer: C
Rationale: For HESI practice Version 2, remember the priority is the patient with
life-threatening complications. Post-MI chest pain rated 8/10 after thrombolysis
suggests possible reocclusion or extension—this requires immediate ECG and provider
notification. The new A-fib patient (B) is stable and can wait; the CHF patient (A) has
chronic condition with non-urgent request; the hypertension patient (D) is stable.
,Q2: A patient with heart failure is prescribed furosemide 40 mg IV push. Which
assessment finding requires immediate intervention by the nurse?
A. Blood pressure 138/88 mmHg
B. Serum potassium 3.2 mEq/L [CORRECT]
C. Weight gain of 2 pounds in 24 hours
D. Respiratory rate 18 breaths per minute
Correct Answer: B
Rationale: The priority action is addressing the hypokalemia. For HESI practice,
remember that furosemide causes potassium wasting, and a level of 3.2 is dangerously
low, risking cardiac dysrhythmias. While weight gain (C) is concerning in heart failure,
hypokalemia is immediately life-threatening and requires potassium replacement and
cardiac monitoring.
Q3: A patient with deep vein thrombosis is started on enoxaparin. Which instruction is
essential?
A. Report any signs of bleeding immediately [CORRECT]
B. Take aspirin for any headache
C. Discontinue when pain subsides
D. Massage injection site to prevent bruising
Correct Answer: A
,Rationale: That's correct because enoxaparin is a low molecular weight heparin with
bleeding risk. The priority patient education is recognizing and reporting bleeding signs
(hematuria, melena, unusual bruising) immediately. Aspirin (B) is contraindicated due to
additive bleeding risk. Injection technique involves not massaging (D) to prevent
hematoma.
Q4: A patient with hypertension asks about lifestyle modifications. Which
recommendation has the strongest evidence for blood pressure reduction?
A. Reduce sodium intake to less than 2 grams per day
B. Follow the DASH diet and reduce sodium to 1500mg daily [CORRECT]
C. Take potassium supplements
D. Eliminate all caffeine
Correct Answer: B
Rationale: For HESI practice Version 2, the DASH diet with sodium restriction to 1500mg
daily has the strongest evidence for hypertension management, per JNC-8 guidelines.
While sodium reduction helps (A), the complete DASH dietary pattern (fruits, vegetables,
low-fat dairy) provides optimal results.
Q5: A patient post-cardiac catheterization reports numbness and tingling in the affected
extremity. Which action is priority?
A. Elevate the extremity above heart level
B. Assess distal pulses and notify provider immediately [CORRECT]
C. Apply warm compresses
, D. Document and continue monitoring
Correct Answer: B
Rationale: The priority action is assessing circulation and notifying the provider because
this could indicate arterial occlusion—a serious complication. While elevation (A) helps
edema, neurovascular changes require immediate assessment and intervention to
prevent permanent damage.
Q6: A patient with peripheral arterial disease has a foot ulcer with pale, cool skin and
absent pedal pulses. Which intervention is priority?
A. Apply moisturizing lotion to prevent dryness
B. Position with legs dependent to improve perfusion
C. Immediate vascular surgery consultation [CORRECT]
D. Encourage ambulation to promote circulation
Correct Answer: C
Rationale: For HESI practice, absent pulses with pale, cool skin indicates critical limb
ischemia requiring immediate vascular intervention to save the limb. Dependent
positioning (B) is contraindicated in PAD. Moisturizing (A) and ambulation (D) are
inappropriate with absent pulses and risk further injury.
Q7: A nurse is caring for a patient 24 hours post-abdominal aortic aneurysm repair.
Which finding requires immediate reporting?
A. Blood pressure 142/88 mmHg
