Med Surg HESI V2 Exam Testbank - UP-TO-DATE EXAM
QUESTIONS AND 100% ACCURATE SOLUTIONS | Question And
VERIFIED ANSWERS - INSTANT PDF DOWNLOAD.
SECTION 1: CARDIOVASCULAR SYSTEM
Questions 1–40
Question 1
A client with heart failure is prescribed furosemide 40 mg IV push. Which assessment
finding requires immediate action?
A) Serum potassium 3.8 mEq/L
B) Urine output 30 mL/hour
C) Bilateral crackles in lung bases
D) Blood pressure 90/60 mm Hg
Correct Answer: D) Blood pressure 90/60 mm Hg
Rationale: Hypotension (90/60 mm Hg) indicates potential hypovolemia or excessive
vasodilation. Furosemide is a loop diuretic that reduces preload; administering it when
BP is already low can cause further hypotension, leading to decreased organ perfusion
(kidneys, brain). Crackles are expected in heart failure. Potassium 3.8 is within normal
limits. Urine output 30 mL/hour is acceptable (minimum is 30 mL/hr). The priority is to
prevent further hemodynamic compromise.
Question 2
The nurse is caring for a client post-cardiac catheterization via the femoral artery. The
client reports severe groin pain and a drop in hemoglobin. What is the priority action?
,A) Administer prescribed PRN acetaminophen
B) Assess the groin site for hematoma
C) Apply manual pressure above the insertion site
D) Document the findings
Correct Answer: C) Apply manual pressure above the insertion site
Rationale: Severe groin pain plus a drop in hemoglobin after femoral artery
catheterization suggests retroperitoneal bleeding, a life-threatening complication.
Manual pressure above the insertion site (toward the abdomen) compresses the femoral
artery to control bleeding. A visible hematoma may not be present in retroperitoneal
bleeding. Acetaminophen does not treat bleeding.
Question 3
A client with coronary artery disease has a 95% proximal left anterior descending (LAD)
artery occlusion. The client asks, "What does all of that mean for me?" What information
should the nurse provide?
A) "This is a minor blockage that can be treated with medication"
B) "This is a significant blockage in the main artery supplying the front of your heart"
C) "This blockage affects the back of your heart"
D) "This is not a serious finding"
Correct Answer: B) "This is a significant blockage in the main artery supplying the
front of your heart"
Rationale: The LAD artery supplies the anterior wall of the left ventricle and the
interventricular septum. It is often called the "widowmaker" artery because significant
occlusion can lead to extensive myocardial infarction. A 95% occlusion is critical and
requires prompt intervention (e.g., PCI or CABG). The nurse should provide honest,
understandable information without causing unnecessary panic.
Question 4
A client with peripheral vascular disease has undergone a right femoral-popliteal bypass
graft. The blood pressure has decreased from 124/80 to 94/62. What should the nurse
assess first?
,A) IV fluid solution
B) Pedal pulses
C) Nasal cannula flow rate
D) Capillary refill
Correct Answer: B) Pedal pulses
Rationale: With each set of vital signs, the nurse should assess the dorsalis pedis and
posterior tibial pulses. The nurse needs to ensure adequate perfusion to the lower
extremity with the drop in blood pressure. IV fluids, nasal cannula setting, and capillary
refill are important to assess; however, priority is to determine the cause of the drop in
blood pressure and that adequate perfusion through the new graft is maintained.
Question 5
A 68-year-old male with a history of hypertension presents with dyspnea on exertion,
orthopnea, and peripheral edema. On auscultation, you note an S3 gallop. Which of the
following is the most likely diagnosis?
A) Right-sided heart failure
B) Left-sided heart failure
C) Pericarditis
D) Myocarditis
Correct Answer: B) Left-sided heart failure
Rationale: Left-sided heart failure presents with dyspnea on exertion, orthopnea, and
an S3 gallop. The S3 heart sound is a hallmark of decreased left ventricular compliance.
Right-sided heart failure presents with peripheral edema, jugular venous distention, and
hepatomegaly. Pericarditis typically presents with chest pain that improves when leaning
forward. Myocarditis often follows a viral illness.
Question 6
A 72-year-old female is admitted with acute decompensated heart failure. Vital signs: BP
160/95, HR 102, RR 28, SpO2 88% on room air. Lung auscultation reveals crackles in the
bilateral bases. Which intervention should the nurse implement first?
, A) Administer furosemide 40 mg IV push
B) Place the patient in high Fowler's position
C) Administer oxygen via non-rebreather mask
D) Obtain a 12-lead ECG
Correct Answer: C) Administer oxygen via non-rebreather mask
Rationale: The priority is to address the patient's oxygenation. With SpO2 of 88%, the
patient is hypoxemic. Oxygen should be administered immediately. Positioning in high
Fowler's would be the next step to facilitate breathing. Furosemide is important for fluid
removal but is not the first priority. ECG is important but can be obtained after
oxygenation is addressed.
Question 7
A 65-year-old male presents with crushing substernal chest pain radiating to the left
arm. He is diaphoretic and nauseated. ECG shows ST-segment elevation in leads V1-V4.
Which coronary artery is most likely occluded?
A) Right coronary artery (RCA)
B) Left anterior descending (LAD) artery
C) Left circumflex (LCX) artery
D) Left main coronary artery
Correct Answer: B) Left anterior descending (LAD) artery
Rationale: ST-segment elevation in leads V1-V4 indicates an anterior wall
myocardial infarction, which is most commonly caused by occlusion of the LAD artery.
The LAD supplies the anterior wall of the left ventricle and the interventricular septum.
RCA occlusion causes inferior wall MI (leads II, III, aVF). LCX occlusion causes lateral wall
MI (leads I, aVL, V5-V6). Left main occlusion is often fatal.
Question 8
A 60-year-old male with a history of chronic atrial fibrillation is prescribed warfarin.
Which laboratory value should the nurse monitor to assess the effectiveness of this
medication?
QUESTIONS AND 100% ACCURATE SOLUTIONS | Question And
VERIFIED ANSWERS - INSTANT PDF DOWNLOAD.
SECTION 1: CARDIOVASCULAR SYSTEM
Questions 1–40
Question 1
A client with heart failure is prescribed furosemide 40 mg IV push. Which assessment
finding requires immediate action?
A) Serum potassium 3.8 mEq/L
B) Urine output 30 mL/hour
C) Bilateral crackles in lung bases
D) Blood pressure 90/60 mm Hg
Correct Answer: D) Blood pressure 90/60 mm Hg
Rationale: Hypotension (90/60 mm Hg) indicates potential hypovolemia or excessive
vasodilation. Furosemide is a loop diuretic that reduces preload; administering it when
BP is already low can cause further hypotension, leading to decreased organ perfusion
(kidneys, brain). Crackles are expected in heart failure. Potassium 3.8 is within normal
limits. Urine output 30 mL/hour is acceptable (minimum is 30 mL/hr). The priority is to
prevent further hemodynamic compromise.
Question 2
The nurse is caring for a client post-cardiac catheterization via the femoral artery. The
client reports severe groin pain and a drop in hemoglobin. What is the priority action?
,A) Administer prescribed PRN acetaminophen
B) Assess the groin site for hematoma
C) Apply manual pressure above the insertion site
D) Document the findings
Correct Answer: C) Apply manual pressure above the insertion site
Rationale: Severe groin pain plus a drop in hemoglobin after femoral artery
catheterization suggests retroperitoneal bleeding, a life-threatening complication.
Manual pressure above the insertion site (toward the abdomen) compresses the femoral
artery to control bleeding. A visible hematoma may not be present in retroperitoneal
bleeding. Acetaminophen does not treat bleeding.
Question 3
A client with coronary artery disease has a 95% proximal left anterior descending (LAD)
artery occlusion. The client asks, "What does all of that mean for me?" What information
should the nurse provide?
A) "This is a minor blockage that can be treated with medication"
B) "This is a significant blockage in the main artery supplying the front of your heart"
C) "This blockage affects the back of your heart"
D) "This is not a serious finding"
Correct Answer: B) "This is a significant blockage in the main artery supplying the
front of your heart"
Rationale: The LAD artery supplies the anterior wall of the left ventricle and the
interventricular septum. It is often called the "widowmaker" artery because significant
occlusion can lead to extensive myocardial infarction. A 95% occlusion is critical and
requires prompt intervention (e.g., PCI or CABG). The nurse should provide honest,
understandable information without causing unnecessary panic.
Question 4
A client with peripheral vascular disease has undergone a right femoral-popliteal bypass
graft. The blood pressure has decreased from 124/80 to 94/62. What should the nurse
assess first?
,A) IV fluid solution
B) Pedal pulses
C) Nasal cannula flow rate
D) Capillary refill
Correct Answer: B) Pedal pulses
Rationale: With each set of vital signs, the nurse should assess the dorsalis pedis and
posterior tibial pulses. The nurse needs to ensure adequate perfusion to the lower
extremity with the drop in blood pressure. IV fluids, nasal cannula setting, and capillary
refill are important to assess; however, priority is to determine the cause of the drop in
blood pressure and that adequate perfusion through the new graft is maintained.
Question 5
A 68-year-old male with a history of hypertension presents with dyspnea on exertion,
orthopnea, and peripheral edema. On auscultation, you note an S3 gallop. Which of the
following is the most likely diagnosis?
A) Right-sided heart failure
B) Left-sided heart failure
C) Pericarditis
D) Myocarditis
Correct Answer: B) Left-sided heart failure
Rationale: Left-sided heart failure presents with dyspnea on exertion, orthopnea, and
an S3 gallop. The S3 heart sound is a hallmark of decreased left ventricular compliance.
Right-sided heart failure presents with peripheral edema, jugular venous distention, and
hepatomegaly. Pericarditis typically presents with chest pain that improves when leaning
forward. Myocarditis often follows a viral illness.
Question 6
A 72-year-old female is admitted with acute decompensated heart failure. Vital signs: BP
160/95, HR 102, RR 28, SpO2 88% on room air. Lung auscultation reveals crackles in the
bilateral bases. Which intervention should the nurse implement first?
, A) Administer furosemide 40 mg IV push
B) Place the patient in high Fowler's position
C) Administer oxygen via non-rebreather mask
D) Obtain a 12-lead ECG
Correct Answer: C) Administer oxygen via non-rebreather mask
Rationale: The priority is to address the patient's oxygenation. With SpO2 of 88%, the
patient is hypoxemic. Oxygen should be administered immediately. Positioning in high
Fowler's would be the next step to facilitate breathing. Furosemide is important for fluid
removal but is not the first priority. ECG is important but can be obtained after
oxygenation is addressed.
Question 7
A 65-year-old male presents with crushing substernal chest pain radiating to the left
arm. He is diaphoretic and nauseated. ECG shows ST-segment elevation in leads V1-V4.
Which coronary artery is most likely occluded?
A) Right coronary artery (RCA)
B) Left anterior descending (LAD) artery
C) Left circumflex (LCX) artery
D) Left main coronary artery
Correct Answer: B) Left anterior descending (LAD) artery
Rationale: ST-segment elevation in leads V1-V4 indicates an anterior wall
myocardial infarction, which is most commonly caused by occlusion of the LAD artery.
The LAD supplies the anterior wall of the left ventricle and the interventricular septum.
RCA occlusion causes inferior wall MI (leads II, III, aVF). LCX occlusion causes lateral wall
MI (leads I, aVL, V5-V6). Left main occlusion is often fatal.
Question 8
A 60-year-old male with a history of chronic atrial fibrillation is prescribed warfarin.
Which laboratory value should the nurse monitor to assess the effectiveness of this
medication?
