Page 1 of 78
ELSEVIER HESI MED SURG EXAM LATEST
(2026) COMPLETE 130Qs&As |ALREADY
GRADED A+
1. A client with heart failure has a prescription for furosemide
(Lasix) 40 mg IV push. Which laboratory value is most
important to monitor before administration?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Answer: B – Potassium.
Rationale: Furosemide is a loop diuretic that causes potassium loss
(hypokalemia). Hypokalemia increases the risk of digoxin toxicity
and dysrhythmias.
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2. A client with hypertension is prescribed lisinopril. Which
finding requires immediate intervention?
A) Dry, nonproductive cough.
B) Blood pressure 120/80 mmHg.
C) Serum potassium 4.2 mEq/L.
D) Angioedema (swelling of lips, tongue, throat).
Answer: D – Angioedema is a life-threatening allergic reaction
to ACE inhibitors (lisinopril). Airway compromise is an emergency.
Rationale: Dry cough is a common side effect but not life-
threatening.
3. A client with myocardial infarction reports chest pain
unrelieved by nitroglycerin and morphine. The nurse notes ST-
segment elevation on the monitor. Which medication should
the nurse prepare to administer?
A) Atenolol.
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B) Tissue plasminogen activator (tPA).
C) Lidocaine.
D) Heparin infusion only.
Answer: B – tPA is a thrombolytic indicated for ST-elevation MI
(STEMI) within 12 hours of symptom onset if no contraindications.
Rationale: “Time is muscle.” Aspirin, heparin, and beta-blockers
are also given, but reperfusion is priority.
4. A nurse is assessing a client with left-sided heart failure.
Which finding is most consistent?
A) Jugular venous distention.
B) Crackles in lung bases.
C) Peripheral edema.
D) Hepatomegaly.
Answer: B – Left-sided heart failure leads to pulmonary
congestion (crackles, dyspnea, orthopnea). Right-sided failure
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causes systemic congestion (JVD, edema, hepatomegaly).
Rationale: Right-sided failure can occur secondary to left-sided
failure.
5. A client with atrial fibrillation is taking warfarin. The INR is
4.5. Which action should the nurse take first?
A) Administer vitamin K.
B) Hold the next dose of warfarin and notify the provider.
C) Continue warfarin as prescribed.
D) Draw aPTT level.
Answer: B – INR >4.0 increases bleeding risk. Warfarin should
be held, and provider notified. Vitamin K is given only if
significant bleeding or severe INR elevation (>10).
Rationale: Target INR for AF is usually 2-3.
ELSEVIER HESI MED SURG EXAM LATEST
(2026) COMPLETE 130Qs&As |ALREADY
GRADED A+
1. A client with heart failure has a prescription for furosemide
(Lasix) 40 mg IV push. Which laboratory value is most
important to monitor before administration?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Answer: B – Potassium.
Rationale: Furosemide is a loop diuretic that causes potassium loss
(hypokalemia). Hypokalemia increases the risk of digoxin toxicity
and dysrhythmias.
,Page 2 of 78
2. A client with hypertension is prescribed lisinopril. Which
finding requires immediate intervention?
A) Dry, nonproductive cough.
B) Blood pressure 120/80 mmHg.
C) Serum potassium 4.2 mEq/L.
D) Angioedema (swelling of lips, tongue, throat).
Answer: D – Angioedema is a life-threatening allergic reaction
to ACE inhibitors (lisinopril). Airway compromise is an emergency.
Rationale: Dry cough is a common side effect but not life-
threatening.
3. A client with myocardial infarction reports chest pain
unrelieved by nitroglycerin and morphine. The nurse notes ST-
segment elevation on the monitor. Which medication should
the nurse prepare to administer?
A) Atenolol.
,Page 3 of 78
B) Tissue plasminogen activator (tPA).
C) Lidocaine.
D) Heparin infusion only.
Answer: B – tPA is a thrombolytic indicated for ST-elevation MI
(STEMI) within 12 hours of symptom onset if no contraindications.
Rationale: “Time is muscle.” Aspirin, heparin, and beta-blockers
are also given, but reperfusion is priority.
4. A nurse is assessing a client with left-sided heart failure.
Which finding is most consistent?
A) Jugular venous distention.
B) Crackles in lung bases.
C) Peripheral edema.
D) Hepatomegaly.
Answer: B – Left-sided heart failure leads to pulmonary
congestion (crackles, dyspnea, orthopnea). Right-sided failure
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causes systemic congestion (JVD, edema, hepatomegaly).
Rationale: Right-sided failure can occur secondary to left-sided
failure.
5. A client with atrial fibrillation is taking warfarin. The INR is
4.5. Which action should the nurse take first?
A) Administer vitamin K.
B) Hold the next dose of warfarin and notify the provider.
C) Continue warfarin as prescribed.
D) Draw aPTT level.
Answer: B – INR >4.0 increases bleeding risk. Warfarin should
be held, and provider notified. Vitamin K is given only if
significant bleeding or severe INR elevation (>10).
Rationale: Target INR for AF is usually 2-3.
