MED-SURG II HESI RETAKE 2026/2027 | Remediation &
Verified Q&A | Complete Retake Prep Guide | Pass
Guaranteed - A+ Graded
[Section 1: High-Yield Missed Concepts - Cardiovascular (Q1-15)]
Q1. A 72-year-old client with heart failure reports nausea, loss of appetite, and states
that "objects look yellow." The nurse checks the morning laboratory results and notes a
serum potassium of 2.8 mEq/L. Which action is the priority?
A. Administer the scheduled dose of digoxin because the apical pulse is 68 bpm
B. Hold the digoxin and notify the provider immediately due to toxicity risk from
hypokalemia
C. Encourage the client to eat a banana and recheck the potassium in 24 hours
D. Document the findings and reassess visual changes in 2 hours
Correct Answer: B. Hold the digoxin and notify the provider immediately due to toxicity
risk from hypokalemia [CORRECT]
Rationale: Hypokalemia potentiates digoxin toxicity; yellow vision (xanthopsia) and GI
symptoms are classic toxicity signs requiring immediate provider notification and
holding the dose. A risks fatal arrhythmia, C delays critical intervention, and D ignores
the urgency.
Correct Answer: B
Q2. A client with newly diagnosed heart failure is prescribed lisinopril. Two weeks later,
the client calls the clinic reporting a persistent dry cough. The nurse's best response is:
A. "Stop the medication immediately and go to the emergency department"
B. "This is a common side effect of ACE inhibitors; I will notify the provider to discuss
alternatives"
,C. "The cough indicates you are having an allergic reaction and need epinephrine"
D. "Take an over-the-counter cough suppressant and continue the medication"
Correct Answer: B. "This is a common side effect of ACE inhibitors; I will notify the
provider to discuss alternatives" [CORRECT]
Rationale: A dry, nonproductive cough is a common ACE inhibitor side effect due to
bradykinin accumulation; it is not life-threatening but may require switching to an ARB. A
overreacts, C confuses cough with angioedema, and D dismisses a quality-of-life issue
that often necessitates medication change.
Correct Answer: B
Q3. A client with heart failure and a history of asthma is prescribed metoprolol
succinate. The nurse recognizes this prescription requires clarification because:
A. Beta-blockers are contraindicated in clients with asthma due to risk of bronchospasm
B. Metoprolol is not indicated for heart failure management
C. Succinate formulations are only used for hypertension, not heart failure
D. Beta-blockers should never be given with ACE inhibitors
Correct Answer: A. Beta-blockers are contraindicated in clients with asthma due to risk
of bronchospasm [CORRECT]
Rationale: Non-selective beta-blockers and even cardioselective agents like metoprolol
can precipitate bronchospasm in reactive airway disease; provider clarification is
essential. B is incorrect because metoprolol is standard for HF, C is false regarding
succinate, and D is incorrect as combination therapy is common.
Correct Answer: A
,Q4. A client with heart failure is admitted with 3+ pitting edema, JVD at 45 degrees, and
reports a 6-pound weight gain over 3 days. Which assessment finding indicates the
need for the most immediate intervention?
A. Bilateral crackles in the lung bases
B. Oxygen saturation of 88% on room air
C. 2+ dorsalis pedis pulses bilaterally
D. Mild fatigue with activity
Correct Answer: B. Oxygen saturation of 88% on room air [CORRECT]
Rationale: An SpO₂ of 88% indicates severe hypoxemia requiring immediate oxygen
therapy and possible escalation of care; this takes priority over other findings. A is
expected in HF but less immediately threatening, C is a normal finding, and D is a
chronic symptom.
Correct Answer: B
Q5. A client returns to the unit after a cardiac catheterization via the femoral artery. The
priority nursing action in the first 4 hours is to:
A. Encourage ambulation to prevent deep vein thrombosis
B. Maintain bed rest with the affected leg extended to prevent bleeding from the
insertion site
C. Administer aspirin and clopidogrel before the client eats lunch
D. Assess for cardiac tamponade by auscultating for muffled heart sounds
Correct Answer: B. Maintain bed rest with the affected leg extended to prevent bleeding
from the insertion site [CORRECT]
Rationale: Femoral access requires bed rest with the leg extended to allow the arterial
puncture site to seal and prevent hemorrhage or pseudoaneurysm. A increases bleeding
risk, C is important but not the first priority, and D is a later complication assessment.
, Correct Answer: B
Q6. A client with atrial fibrillation is prescribed warfarin. The nurse understands the
primary rationale for anticoagulation in this rhythm is to:
A. Convert the rhythm back to normal sinus rhythm
B. Prevent thrombus formation in the atria and reduce stroke risk
C. Slow the ventricular response rate
D. Treat the underlying cause of the atrial fibrillation
Correct Answer: B. Prevent thrombus formation in the atria and reduce stroke risk
[CORRECT]
Rationale: Stasis in the fibrillating atria promotes thrombus formation; anticoagulation
reduces embolic stroke risk. A describes antiarrhythmics or cardioversion, C describes
rate control agents, and D is not the purpose of anticoagulation.
Correct Answer: B
Q7. A client presents with a blood pressure of 220/130 mmHg, headache, and blurred
vision but no evidence of acute organ damage. The nurse anticipates the provider will
order:
A. Oral clonidine and scheduled follow-up in 24 hours
B. Immediate IV nitroprusside in the ICU regardless of organ damage status
C. Oral antihypertensives with gradual reduction over 24-48 hours
D. Sublingual nitroglycerin every 5 minutes until the pressure normalizes
Correct Answer: C. Oral antihypertensives with gradual reduction over 24-48 hours
[CORRECT]
Rationale: Hypertensive urgency (no acute organ damage) is managed with oral agents
and gradual reduction to prevent cerebral hypoperfusion; hypertensive emergency
Verified Q&A | Complete Retake Prep Guide | Pass
Guaranteed - A+ Graded
[Section 1: High-Yield Missed Concepts - Cardiovascular (Q1-15)]
Q1. A 72-year-old client with heart failure reports nausea, loss of appetite, and states
that "objects look yellow." The nurse checks the morning laboratory results and notes a
serum potassium of 2.8 mEq/L. Which action is the priority?
A. Administer the scheduled dose of digoxin because the apical pulse is 68 bpm
B. Hold the digoxin and notify the provider immediately due to toxicity risk from
hypokalemia
C. Encourage the client to eat a banana and recheck the potassium in 24 hours
D. Document the findings and reassess visual changes in 2 hours
Correct Answer: B. Hold the digoxin and notify the provider immediately due to toxicity
risk from hypokalemia [CORRECT]
Rationale: Hypokalemia potentiates digoxin toxicity; yellow vision (xanthopsia) and GI
symptoms are classic toxicity signs requiring immediate provider notification and
holding the dose. A risks fatal arrhythmia, C delays critical intervention, and D ignores
the urgency.
Correct Answer: B
Q2. A client with newly diagnosed heart failure is prescribed lisinopril. Two weeks later,
the client calls the clinic reporting a persistent dry cough. The nurse's best response is:
A. "Stop the medication immediately and go to the emergency department"
B. "This is a common side effect of ACE inhibitors; I will notify the provider to discuss
alternatives"
,C. "The cough indicates you are having an allergic reaction and need epinephrine"
D. "Take an over-the-counter cough suppressant and continue the medication"
Correct Answer: B. "This is a common side effect of ACE inhibitors; I will notify the
provider to discuss alternatives" [CORRECT]
Rationale: A dry, nonproductive cough is a common ACE inhibitor side effect due to
bradykinin accumulation; it is not life-threatening but may require switching to an ARB. A
overreacts, C confuses cough with angioedema, and D dismisses a quality-of-life issue
that often necessitates medication change.
Correct Answer: B
Q3. A client with heart failure and a history of asthma is prescribed metoprolol
succinate. The nurse recognizes this prescription requires clarification because:
A. Beta-blockers are contraindicated in clients with asthma due to risk of bronchospasm
B. Metoprolol is not indicated for heart failure management
C. Succinate formulations are only used for hypertension, not heart failure
D. Beta-blockers should never be given with ACE inhibitors
Correct Answer: A. Beta-blockers are contraindicated in clients with asthma due to risk
of bronchospasm [CORRECT]
Rationale: Non-selective beta-blockers and even cardioselective agents like metoprolol
can precipitate bronchospasm in reactive airway disease; provider clarification is
essential. B is incorrect because metoprolol is standard for HF, C is false regarding
succinate, and D is incorrect as combination therapy is common.
Correct Answer: A
,Q4. A client with heart failure is admitted with 3+ pitting edema, JVD at 45 degrees, and
reports a 6-pound weight gain over 3 days. Which assessment finding indicates the
need for the most immediate intervention?
A. Bilateral crackles in the lung bases
B. Oxygen saturation of 88% on room air
C. 2+ dorsalis pedis pulses bilaterally
D. Mild fatigue with activity
Correct Answer: B. Oxygen saturation of 88% on room air [CORRECT]
Rationale: An SpO₂ of 88% indicates severe hypoxemia requiring immediate oxygen
therapy and possible escalation of care; this takes priority over other findings. A is
expected in HF but less immediately threatening, C is a normal finding, and D is a
chronic symptom.
Correct Answer: B
Q5. A client returns to the unit after a cardiac catheterization via the femoral artery. The
priority nursing action in the first 4 hours is to:
A. Encourage ambulation to prevent deep vein thrombosis
B. Maintain bed rest with the affected leg extended to prevent bleeding from the
insertion site
C. Administer aspirin and clopidogrel before the client eats lunch
D. Assess for cardiac tamponade by auscultating for muffled heart sounds
Correct Answer: B. Maintain bed rest with the affected leg extended to prevent bleeding
from the insertion site [CORRECT]
Rationale: Femoral access requires bed rest with the leg extended to allow the arterial
puncture site to seal and prevent hemorrhage or pseudoaneurysm. A increases bleeding
risk, C is important but not the first priority, and D is a later complication assessment.
, Correct Answer: B
Q6. A client with atrial fibrillation is prescribed warfarin. The nurse understands the
primary rationale for anticoagulation in this rhythm is to:
A. Convert the rhythm back to normal sinus rhythm
B. Prevent thrombus formation in the atria and reduce stroke risk
C. Slow the ventricular response rate
D. Treat the underlying cause of the atrial fibrillation
Correct Answer: B. Prevent thrombus formation in the atria and reduce stroke risk
[CORRECT]
Rationale: Stasis in the fibrillating atria promotes thrombus formation; anticoagulation
reduces embolic stroke risk. A describes antiarrhythmics or cardioversion, C describes
rate control agents, and D is not the purpose of anticoagulation.
Correct Answer: B
Q7. A client presents with a blood pressure of 220/130 mmHg, headache, and blurred
vision but no evidence of acute organ damage. The nurse anticipates the provider will
order:
A. Oral clonidine and scheduled follow-up in 24 hours
B. Immediate IV nitroprusside in the ICU regardless of organ damage status
C. Oral antihypertensives with gradual reduction over 24-48 hours
D. Sublingual nitroglycerin every 5 minutes until the pressure normalizes
Correct Answer: C. Oral antihypertensives with gradual reduction over 24-48 hours
[CORRECT]
Rationale: Hypertensive urgency (no acute organ damage) is managed with oral agents
and gradual reduction to prevent cerebral hypoperfusion; hypertensive emergency
