HESI Med-Surg Final Exam Medical-Surgical Nursing Question
Bank (Latest 2026/2027 Edition) – 100% Correct Questions,
Answers & Detailed Rationales
Total Questions: 60
Time Allowed: 90 Minutes
Passing Score: 850+
Instructions: Select the BEST answer for each question. For SATA questions, select all
that apply based on clinical judgment and priority nursing interventions.
SECTION 1: CARDIOVASCULAR DISORDERS
Questions 1–11
Question 1
A 68-year-old patient with heart failure is receiving furosemide 40 mg IV daily. Which
assessment finding indicates the medication is achieving the desired therapeutic
effect?
A. Weight gain of 2 kg over 24 hours
B. Decreased bilateral ankle edema and auscultation of clear lung fields
,C. Serum potassium level of 3.0 mEq/L
D. Increased blood pressure from 150/92 to 168/100 mmHg
Correct Answer: B
Rationale: Furosemide is a loop diuretic that reduces fluid volume overload in heart
failure; decreased peripheral edema and clear lung fields indicate successful
mobilization of excess fluid. Option A indicates worsening fluid retention. Option C
represents hypokalemia, a common adverse effect of loop diuretics, not a therapeutic
effect. Option D suggests inadequate volume management or compensatory
vasoconstriction.
Question 2
A patient admitted with acute coronary syndrome is started on metoprolol. Which
statement by the patient indicates understanding of the medication's purpose?
A. "This medication will dissolve the clot in my coronary artery."
B. "This medication will help reduce my heart's workload and prevent recurrent chest
pain."
C. "This medication will increase my heart rate to improve cardiac output."
D. "This medication will thin my blood to prevent future strokes."
Correct Answer: B
Rationale: Metoprolol is a beta-blocker that reduces myocardial oxygen demand by
decreasing heart rate, contractility, and blood pressure, thereby reducing workload and
,preventing recurrent ischemia. Option A describes thrombolytic therapy. Option C is
incorrect because beta-blockers decrease, not increase, heart rate. Option D describes
anticoagulant or antiplatelet therapy.
Question 3
A patient with atrial fibrillation is receiving digoxin. Which finding requires immediate
nursing intervention?
A. Heart rate of 72 beats per minute
B. Serum digoxin level of 1.2 ng/mL
C. New-onset nausea, vomiting, and visual disturbances with a heart rate of 52
D. Patient reports improved exercise tolerance
Correct Answer: C
Rationale: Nausea, vomiting, visual disturbances (yellow-green halos), and bradycardia
are classic signs of digoxin toxicity, which can precipitate life-threatening dysrhythmias
and requires immediate intervention. Option A is a normal therapeutic response. Option
B is within the therapeutic range of 0.5–2.0 ng/mL. Option D indicates a positive
therapeutic outcome.
Question 4
A patient with peripheral arterial disease (PAD) complains of severe leg pain when
walking that is relieved by rest. Which nursing intervention is most appropriate to
promote arterial blood flow?
, A. Apply a heating pad to the affected extremity for 30 minutes
B. Elevate the legs above heart level to reduce edema
C. Encourage regular walking to the point of pain, followed by rest, to promote collateral
circulation
D. Massage the affected calf muscles to increase blood flow
Correct Answer: C
Rationale: Supervised exercise walking to the point of claudication followed by rest
promotes collateral circulation development and improves walking tolerance in PAD.
Option A risks thermal injury due to decreased sensation and does not address arterial
insufficiency. Option B further reduces arterial perfusion to the lower extremities. Option
D can dislodge thrombi and is contraindicated.
Question 5 (SATA)
A patient is admitted with acute decompensated heart failure. Which nursing
interventions should the nurse implement? Select all that apply.
A. Administer oxygen to maintain SpO2 > 92%
B. Place the patient in a supine position with legs elevated
C. Monitor daily weights and strict intake and output
D. Administer IV morphine as ordered for dyspnea and anxiety
E. Encourage a fluid intake of 3 liters per day
Bank (Latest 2026/2027 Edition) – 100% Correct Questions,
Answers & Detailed Rationales
Total Questions: 60
Time Allowed: 90 Minutes
Passing Score: 850+
Instructions: Select the BEST answer for each question. For SATA questions, select all
that apply based on clinical judgment and priority nursing interventions.
SECTION 1: CARDIOVASCULAR DISORDERS
Questions 1–11
Question 1
A 68-year-old patient with heart failure is receiving furosemide 40 mg IV daily. Which
assessment finding indicates the medication is achieving the desired therapeutic
effect?
A. Weight gain of 2 kg over 24 hours
B. Decreased bilateral ankle edema and auscultation of clear lung fields
,C. Serum potassium level of 3.0 mEq/L
D. Increased blood pressure from 150/92 to 168/100 mmHg
Correct Answer: B
Rationale: Furosemide is a loop diuretic that reduces fluid volume overload in heart
failure; decreased peripheral edema and clear lung fields indicate successful
mobilization of excess fluid. Option A indicates worsening fluid retention. Option C
represents hypokalemia, a common adverse effect of loop diuretics, not a therapeutic
effect. Option D suggests inadequate volume management or compensatory
vasoconstriction.
Question 2
A patient admitted with acute coronary syndrome is started on metoprolol. Which
statement by the patient indicates understanding of the medication's purpose?
A. "This medication will dissolve the clot in my coronary artery."
B. "This medication will help reduce my heart's workload and prevent recurrent chest
pain."
C. "This medication will increase my heart rate to improve cardiac output."
D. "This medication will thin my blood to prevent future strokes."
Correct Answer: B
Rationale: Metoprolol is a beta-blocker that reduces myocardial oxygen demand by
decreasing heart rate, contractility, and blood pressure, thereby reducing workload and
,preventing recurrent ischemia. Option A describes thrombolytic therapy. Option C is
incorrect because beta-blockers decrease, not increase, heart rate. Option D describes
anticoagulant or antiplatelet therapy.
Question 3
A patient with atrial fibrillation is receiving digoxin. Which finding requires immediate
nursing intervention?
A. Heart rate of 72 beats per minute
B. Serum digoxin level of 1.2 ng/mL
C. New-onset nausea, vomiting, and visual disturbances with a heart rate of 52
D. Patient reports improved exercise tolerance
Correct Answer: C
Rationale: Nausea, vomiting, visual disturbances (yellow-green halos), and bradycardia
are classic signs of digoxin toxicity, which can precipitate life-threatening dysrhythmias
and requires immediate intervention. Option A is a normal therapeutic response. Option
B is within the therapeutic range of 0.5–2.0 ng/mL. Option D indicates a positive
therapeutic outcome.
Question 4
A patient with peripheral arterial disease (PAD) complains of severe leg pain when
walking that is relieved by rest. Which nursing intervention is most appropriate to
promote arterial blood flow?
, A. Apply a heating pad to the affected extremity for 30 minutes
B. Elevate the legs above heart level to reduce edema
C. Encourage regular walking to the point of pain, followed by rest, to promote collateral
circulation
D. Massage the affected calf muscles to increase blood flow
Correct Answer: C
Rationale: Supervised exercise walking to the point of claudication followed by rest
promotes collateral circulation development and improves walking tolerance in PAD.
Option A risks thermal injury due to decreased sensation and does not address arterial
insufficiency. Option B further reduces arterial perfusion to the lower extremities. Option
D can dislodge thrombi and is contraindicated.
Question 5 (SATA)
A patient is admitted with acute decompensated heart failure. Which nursing
interventions should the nurse implement? Select all that apply.
A. Administer oxygen to maintain SpO2 > 92%
B. Place the patient in a supine position with legs elevated
C. Monitor daily weights and strict intake and output
D. Administer IV morphine as ordered for dyspnea and anxiety
E. Encourage a fluid intake of 3 liters per day
