HESI ADULT HEALTH NURSING
PRACTICE TEST 2026 QUESTIONS
AND ANSWERS WITH
RATIONALES/GRADED A+/2026
UPDATE/100% CORRECT /INSTANT
DOWNLOAD
Section 1: Cardiovascular Disorders (Questions 1-12)
1. A nurse is assessing a client with left-sided heart failure. Which finding would
the nurse expect to observe?
• A) Jugular vein distention
• B) Peripheral edema
• C) Crackles in lung bases
• D) Hepatomegaly
Rationale: Left-sided heart failure leads to pulmonary congestion due to blood
backing up into the lungs, causing crackles (rales) in lung bases. JVD, peripheral
edema, and hepatomegaly are signs of right-sided heart failure.
2. A client with atrial fibrillation is prescribed warfarin (Coumadin). Which
laboratory value indicates therapeutic anticoagulation?
• A) PT of 12 seconds
• B) INR of 2.5
• C) aPTT of 35 seconds
• D) Platelet count of 250,000/mm³
,Rationale: For atrial fibrillation, therapeutic INR range is 2.0-3.0. PT of 12 seconds is
normal (11-13.5). aPTT monitors heparin therapy. Platelet count checks bleeding risk,
not warfarin efficacy.
3. A client reports chest pain radiating to the jaw with nausea and diaphoresis.
The nurse administers nitroglycerin sublingually. After 5 minutes, the pain is
unchanged. What should the nurse do next?
• A) Administer second nitroglycerin dose
• B) Administer morphine sulfate as prescribed
• C) Apply oxygen at 2 L/min via nasal cannula
• D) Obtain a 12-lead ECG
Rationale: Standard protocol for ongoing chest pain is to administer up to three
nitroglycerin doses 5 minutes apart. If pain persists after first dose, second dose is
indicated. Morphine is given if pain unresponsive to nitroglycerin. Oxygen for SpO2
<90%.
4. A client with hypertension is prescribed lisinopril. Which adverse effect
requires immediate discontinuation and provider notification?
• A) Dry cough
• B) Dizziness
• C) Angioedema
• D) Hyperkalemia
Rationale: Angioedema (swelling of lips, tongue, throat, face) is a life-threatening
adverse effect of ACE inhibitors requiring immediate discontinuation. Dry cough is
common but not emergent. Dizziness and hyperkalemia require monitoring but not
immediate discontinuation.
5. A nurse is caring for a client 2 hours after cardiac catheterization via femoral
artery. Which assessment finding requires immediate action?
• A) Pulse rate of 88 bpm
, • B) Blood pressure 118/76 mm Hg
• C) Absent dorsalis pedis pulse on affected leg
• D) Small amount of serous drainage at insertion site
Rationale: Absent distal pulse indicates arterial occlusion or thrombus formation, a
critical complication requiring immediate intervention. Vital signs are stable. Small
serous drainage is expected.
6. A client with heart failure has crackles in all lung fields, SpO2 88% on room
air, and respiratory rate 28/min. Which intervention should the nurse
implement first?
• A) Administer furosemide IV push
• B) Apply oxygen via non-rebreather mask
• C) Place client in high Fowler's position
• D) Prepare for endotracheal intubation
Rationale: Airway and breathing take priority. Hypoxia (SpO2 88%) requires
immediate oxygen administration. High Fowler's position and furosemide are
important but after oxygenation. Intubation is for impending respiratory failure.
7. A client with peripheral artery disease (PAD) reports leg pain when walking
that resolves with rest. The nurse documents this finding as:
• A) Rest pain
• B) Intermittent claudication
• C) Venous stasis pain
• D) Neuropathic pain
Rationale: Intermittent claudication is ischemic muscle pain that occurs with exercise
and resolves with rest, characteristic of PAD. Rest pain indicates severe PAD. Venous
stasis pain improves with elevation.
8. Which discharge instruction is most important for a client with an
implantable cardioverter-defibrillator (ICD)?
, • A) "Avoid driving for 6 months"
• B) "Report any episode of receiving a shock"
• C) "You cannot use a microwave oven"
• D) "Avoid lifting more than 10 pounds"
Rationale: Reporting ICD shocks is critical as a single shock indicates dysrhythmia;
multiple shocks (storm) is medical emergency. Driving restrictions vary (often 6
months post-implant but individual). Microwaves are safe. Lifting restrictions are
temporary.
9. A client with infective endocarditis develops left-sided weakness and slurred
speech. The nurse suspects:
• A) Septic shock
• B) Cerebral embolism
• C) Intracranial hemorrhage
• D) Hypoglycemia
Rationale: Endocarditis involves vegetations on heart valves that can embolize to
cerebral circulation, causing stroke symptoms. Septic shock presents with
hypotension. Hemorrhage requires trauma or anticoagulation. Hypoglycemia causes
confusion, not focal deficits.
10. A client's telemetry shows ventricular tachycardia. The client is alert with
blood pressure 110/70 mm Hg. What is the priority action?
• A) Administer amiodarone IV
• B) Synchronized cardioversion
• C) Defibrillation at 200 J
• D) Prepare for transcutaneous pacing
Rationale: Stable ventricular tachycardia (with pulse and adequate BP) is treated with
antiarrhythmics like amiodarone. Synchronized cardioversion is for unstable VT with
symptoms. Defibrillation is for pulseless VT. Pacing is for bradyarrhythmias.
PRACTICE TEST 2026 QUESTIONS
AND ANSWERS WITH
RATIONALES/GRADED A+/2026
UPDATE/100% CORRECT /INSTANT
DOWNLOAD
Section 1: Cardiovascular Disorders (Questions 1-12)
1. A nurse is assessing a client with left-sided heart failure. Which finding would
the nurse expect to observe?
• A) Jugular vein distention
• B) Peripheral edema
• C) Crackles in lung bases
• D) Hepatomegaly
Rationale: Left-sided heart failure leads to pulmonary congestion due to blood
backing up into the lungs, causing crackles (rales) in lung bases. JVD, peripheral
edema, and hepatomegaly are signs of right-sided heart failure.
2. A client with atrial fibrillation is prescribed warfarin (Coumadin). Which
laboratory value indicates therapeutic anticoagulation?
• A) PT of 12 seconds
• B) INR of 2.5
• C) aPTT of 35 seconds
• D) Platelet count of 250,000/mm³
,Rationale: For atrial fibrillation, therapeutic INR range is 2.0-3.0. PT of 12 seconds is
normal (11-13.5). aPTT monitors heparin therapy. Platelet count checks bleeding risk,
not warfarin efficacy.
3. A client reports chest pain radiating to the jaw with nausea and diaphoresis.
The nurse administers nitroglycerin sublingually. After 5 minutes, the pain is
unchanged. What should the nurse do next?
• A) Administer second nitroglycerin dose
• B) Administer morphine sulfate as prescribed
• C) Apply oxygen at 2 L/min via nasal cannula
• D) Obtain a 12-lead ECG
Rationale: Standard protocol for ongoing chest pain is to administer up to three
nitroglycerin doses 5 minutes apart. If pain persists after first dose, second dose is
indicated. Morphine is given if pain unresponsive to nitroglycerin. Oxygen for SpO2
<90%.
4. A client with hypertension is prescribed lisinopril. Which adverse effect
requires immediate discontinuation and provider notification?
• A) Dry cough
• B) Dizziness
• C) Angioedema
• D) Hyperkalemia
Rationale: Angioedema (swelling of lips, tongue, throat, face) is a life-threatening
adverse effect of ACE inhibitors requiring immediate discontinuation. Dry cough is
common but not emergent. Dizziness and hyperkalemia require monitoring but not
immediate discontinuation.
5. A nurse is caring for a client 2 hours after cardiac catheterization via femoral
artery. Which assessment finding requires immediate action?
• A) Pulse rate of 88 bpm
, • B) Blood pressure 118/76 mm Hg
• C) Absent dorsalis pedis pulse on affected leg
• D) Small amount of serous drainage at insertion site
Rationale: Absent distal pulse indicates arterial occlusion or thrombus formation, a
critical complication requiring immediate intervention. Vital signs are stable. Small
serous drainage is expected.
6. A client with heart failure has crackles in all lung fields, SpO2 88% on room
air, and respiratory rate 28/min. Which intervention should the nurse
implement first?
• A) Administer furosemide IV push
• B) Apply oxygen via non-rebreather mask
• C) Place client in high Fowler's position
• D) Prepare for endotracheal intubation
Rationale: Airway and breathing take priority. Hypoxia (SpO2 88%) requires
immediate oxygen administration. High Fowler's position and furosemide are
important but after oxygenation. Intubation is for impending respiratory failure.
7. A client with peripheral artery disease (PAD) reports leg pain when walking
that resolves with rest. The nurse documents this finding as:
• A) Rest pain
• B) Intermittent claudication
• C) Venous stasis pain
• D) Neuropathic pain
Rationale: Intermittent claudication is ischemic muscle pain that occurs with exercise
and resolves with rest, characteristic of PAD. Rest pain indicates severe PAD. Venous
stasis pain improves with elevation.
8. Which discharge instruction is most important for a client with an
implantable cardioverter-defibrillator (ICD)?
, • A) "Avoid driving for 6 months"
• B) "Report any episode of receiving a shock"
• C) "You cannot use a microwave oven"
• D) "Avoid lifting more than 10 pounds"
Rationale: Reporting ICD shocks is critical as a single shock indicates dysrhythmia;
multiple shocks (storm) is medical emergency. Driving restrictions vary (often 6
months post-implant but individual). Microwaves are safe. Lifting restrictions are
temporary.
9. A client with infective endocarditis develops left-sided weakness and slurred
speech. The nurse suspects:
• A) Septic shock
• B) Cerebral embolism
• C) Intracranial hemorrhage
• D) Hypoglycemia
Rationale: Endocarditis involves vegetations on heart valves that can embolize to
cerebral circulation, causing stroke symptoms. Septic shock presents with
hypotension. Hemorrhage requires trauma or anticoagulation. Hypoglycemia causes
confusion, not focal deficits.
10. A client's telemetry shows ventricular tachycardia. The client is alert with
blood pressure 110/70 mm Hg. What is the priority action?
• A) Administer amiodarone IV
• B) Synchronized cardioversion
• C) Defibrillation at 200 J
• D) Prepare for transcutaneous pacing
Rationale: Stable ventricular tachycardia (with pulse and adequate BP) is treated with
antiarrhythmics like amiodarone. Synchronized cardioversion is for unstable VT with
symptoms. Defibrillation is for pulseless VT. Pacing is for bradyarrhythmias.
