NSG 233 HESI Final Exam Review 2026: Medical-
Surgical Nursing II – 200 High-Yield Practice
Questions with Rationales/PDF.
INTRODUCTION
This comprehensive review is designed to prepare nursing students for the NSG 233 HESI
Final Exam in Medical-Surgical Nursing II. It includes 200 high-quality, exam-style
practice questions that reflect the structure, difficulty, and clinical focus of the actual HESI
assessment.
The questions cover essential medical-surgical topics, including cardiovascular,
respiratory, endocrine, renal, neurological, gastrointestinal, and critical care concepts.
Each question is accompanied by an italicized correct answer and a clear, concise rationale
to reinforce understanding and support clinical judgment.
NSG 233 HESI FINAL
1.
A client with acute myocardial infarction reports chest pain unrelieved by nitroglycerin. What is
the priority action?
A. Administer morphine
B. Obtain ECG
C. Start IV fluids
D. Provide oxygen
Answer: D. Provide oxygen
Rationale: Airway and oxygenation are priority to limit myocardial damage.
2.
A potassium level of 2.9 mEq/L places the patient at risk for:
A. Hyperactivity
B. Cardiac dysrhythmias
C. Hypertension
D. Seizures
,Answer: B. Cardiac dysrhythmias
Rationale: Hypokalemia disrupts cardiac conduction.
3.
Which assessment finding suggests left-sided heart failure?
A. Peripheral edema
B. Jugular vein distention
C. Crackles in lungs
D. Ascites
Answer: C. Crackles in lungs
Rationale: Left-sided failure causes pulmonary congestion.
4.
A client with COPD has increasing CO₂ levels. What condition is developing?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Answer: C. Respiratory acidosis
Rationale: CO₂ retention leads to acidosis.
5.
Which food should a patient on warfarin avoid in excess?
A. Apples
B. Spinach
C. Chicken
D. Rice
Answer: B. Spinach
Rationale: Vitamin K reduces warfarin effectiveness.
6.
A client with diabetic ketoacidosis (DKA) has which finding?
A. Hypoglycemia
B. Kussmaul respirations
, C. Bradycardia
D. Low urine output
Answer: B. Kussmaul respirations
Rationale: Deep, rapid breathing compensates for metabolic acidosis.
7.
Which is the priority intervention for a tension pneumothorax?
A. Chest tube insertion
B. Oxygen therapy
C. Needle decompression
D. Positioning
Answer: C. Needle decompression
Rationale: Immediate pressure relief is life-saving.
8.
A burn patient is at highest risk for which electrolyte imbalance?
A. Hypercalcemia
B. Hypokalemia
C. Hyperkalemia
D. Hyponatremia
Answer: C. Hyperkalemia
Rationale: Cell destruction releases potassium.
9.
Which sign indicates increased intracranial pressure (ICP)?
A. Hypotension
B. Bradycardia
C. Tachypnea
D. Warm skin
Answer: B. Bradycardia
Rationale: Part of Cushing’s triad.
10.
A client with Addison’s disease is at risk for:
Surgical Nursing II – 200 High-Yield Practice
Questions with Rationales/PDF.
INTRODUCTION
This comprehensive review is designed to prepare nursing students for the NSG 233 HESI
Final Exam in Medical-Surgical Nursing II. It includes 200 high-quality, exam-style
practice questions that reflect the structure, difficulty, and clinical focus of the actual HESI
assessment.
The questions cover essential medical-surgical topics, including cardiovascular,
respiratory, endocrine, renal, neurological, gastrointestinal, and critical care concepts.
Each question is accompanied by an italicized correct answer and a clear, concise rationale
to reinforce understanding and support clinical judgment.
NSG 233 HESI FINAL
1.
A client with acute myocardial infarction reports chest pain unrelieved by nitroglycerin. What is
the priority action?
A. Administer morphine
B. Obtain ECG
C. Start IV fluids
D. Provide oxygen
Answer: D. Provide oxygen
Rationale: Airway and oxygenation are priority to limit myocardial damage.
2.
A potassium level of 2.9 mEq/L places the patient at risk for:
A. Hyperactivity
B. Cardiac dysrhythmias
C. Hypertension
D. Seizures
,Answer: B. Cardiac dysrhythmias
Rationale: Hypokalemia disrupts cardiac conduction.
3.
Which assessment finding suggests left-sided heart failure?
A. Peripheral edema
B. Jugular vein distention
C. Crackles in lungs
D. Ascites
Answer: C. Crackles in lungs
Rationale: Left-sided failure causes pulmonary congestion.
4.
A client with COPD has increasing CO₂ levels. What condition is developing?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Answer: C. Respiratory acidosis
Rationale: CO₂ retention leads to acidosis.
5.
Which food should a patient on warfarin avoid in excess?
A. Apples
B. Spinach
C. Chicken
D. Rice
Answer: B. Spinach
Rationale: Vitamin K reduces warfarin effectiveness.
6.
A client with diabetic ketoacidosis (DKA) has which finding?
A. Hypoglycemia
B. Kussmaul respirations
, C. Bradycardia
D. Low urine output
Answer: B. Kussmaul respirations
Rationale: Deep, rapid breathing compensates for metabolic acidosis.
7.
Which is the priority intervention for a tension pneumothorax?
A. Chest tube insertion
B. Oxygen therapy
C. Needle decompression
D. Positioning
Answer: C. Needle decompression
Rationale: Immediate pressure relief is life-saving.
8.
A burn patient is at highest risk for which electrolyte imbalance?
A. Hypercalcemia
B. Hypokalemia
C. Hyperkalemia
D. Hyponatremia
Answer: C. Hyperkalemia
Rationale: Cell destruction releases potassium.
9.
Which sign indicates increased intracranial pressure (ICP)?
A. Hypotension
B. Bradycardia
C. Tachypnea
D. Warm skin
Answer: B. Bradycardia
Rationale: Part of Cushing’s triad.
10.
A client with Addison’s disease is at risk for:
