NSG 233 HESI FINAL EXAM 300 ACTUAL
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST UPDATE ALREADY
GRADED A+
This comprehensive resource provides 300 unique, sectioned multiple-choice
questions tailored for the NSG 233 HESI Final Exam, covering core medical-
surgical nursing content. It includes essential topics such as emergency nursing,
shock and hemodynamic monitoring, cardiovascular and respiratory disorders,
endocrine and renal conditions, fluid and electrolyte balance, hematology,
oncology, critical care, pharmacology, pain management, and ethical issues. Each
question includes the correct answer and a detailed rationale designed to reinforce
clinical reasoning and evidence-based practice. The content emphasizes high-yield
concepts frequently tested on HESI exams, making it an ideal tool for intensive
review and mastery of medical-surgical nursing competencies required for
successful exam completion and clinical practice.
Section 1: Emergency Nursing and Triage
Question 1: A nurse is working in an occupational health clinic when an employee
walks in and states that he was struck by lightning while working in a truck bed.
The client is alert but reports feeling faint. Which assessment will the nurse
perform first?
A) Pulse characteristics
B) Open airway
C) Entrance and exit wounds
D) Cervical spine injury
Answer: A
Rationale: Lightning is a jolt of electrical current and can produce a "natural"
defibrillation, so assessment of the pulse rate and regularity is a priority. Because
the client is talking, he has an open airway, so that assessment is not necessary.
Assessing for entrance/exit wounds and cervical spine injury should occur after
assessing for adequate circulation .
,Question 2: In the emergency department, which patient should the triage nurse
prioritize first?
A) Patient with chest pain radiating to the left arm
B) Patient with a minor laceration to the hand
C) Patient requesting medication for headache
D) Patient with a sprained ankle
Answer: A
Rationale: Chest pain radiating to the left arm is a classic sign of myocardial
infarction and requires immediate attention. This patient should be prioritized over
those with less urgent conditions such as minor lacerations, headaches, or sprains.
Question 3: A client presents to the emergency department with a fever of 104°F,
hot dry skin, confusion, and no sweating after working outside on a hot day. The
nurse should suspect which condition?
A) Heat exhaustion
B) Heat stroke
C) Malignant hyperthermia
D) Sun poisoning
Answer: B
Rationale: Heat stroke is a medical emergency characterized by a core temperature
>104°F, hot dry skin (anhidrosis), confusion, and central nervous system
dysfunction. The absence of sweating distinguishes heat stroke from heat
exhaustion. Priority interventions include rapid cooling with cool towels (no ice
bath), IV fluids, and oxygen .
Question 4: The nurse is caring for a client with a drug overdose. What is the
priority action?
A) Determine what substance the patient overdosed on
B) Administer activated charcoal
C) Prepare for gastric lavage
D) Call social services
Answer: A
Rationale: The priority is to find out what the patient overdosed on so that the
appropriate antidote can be given if available. Treatment goals include supporting
respiratory and cardiovascular functions, enhancing clearance of the agent, and
ensuring patient and staff safety .
Question 5: A client is admitted with urosepsis. Which vital sign changes indicate
that the client is in the initial stages of septic shock?
A) Bradycardia and hypotension
,B) Tachycardia and tachypnea
C) Bradycardia and hypertension
D) Tachycardia and hypotension
Answer: B
Rationale: Sepsis triggers a systemic inflammatory response. Initial stages (warm
sepsis) are characterized by increased cardiac output and systemic vasodilation.
Clinical manifestations include fever, tachycardia, tachypnea, and warm, flushed
skin. Hypotension is a later sign of decompensated shock .
Question 6: A nurse is performing triage in a mass casualty situation. Which
patient should receive a red tag?
A) Patient with a minor laceration
B) Patient with a life-threatening airway obstruction
C) Patient with a fractured femur
D) Patient with no respirations and no pulse
Answer: B
Rationale: In mass casualty triage, red tags are assigned to patients with life-
threatening conditions that require immediate intervention. Airway obstruction is a
critical priority. Minor injuries receive green tags, delayed care receives yellow,
and deceased patients receive black tags.
Question 7: The nurse is providing care to a client with anaphylaxis. What is the
priority medication to administer?
A) Antihistamine
B) Corticosteroid
C) Epinephrine
D) Oxygen
Answer: C
Rationale: Epinephrine is the first-line, lifesaving medication for anaphylaxis. It
works by causing vasoconstriction, bronchodilation, and reducing vascular
permeability. Antihistamines and corticosteroids are adjunctive therapies, and
oxygen should be administered but epinephrine is the priority .
Question 8: A client with a traumatic brain injury has a Glasgow Coma Scale
(GCS) score of 9. The nurse interprets this as:
A) Mild brain injury
B) Moderate brain injury
C) Severe brain injury
D) Normal neurological function
Answer: B
, Rationale: GCS scores range from 3-15. A score of 9-12 indicates moderate brain
injury. Scores of 13-15 indicate mild injury, and scores of 3-8 indicate severe
injury. This score requires close monitoring for deterioration.
Question 9: A patient with a head injury opens eyes to pain, makes
incomprehensible sounds, and localizes pain. What is the GCS score?
A) 9
B) 10
C) 12
D) 15
Answer: A
Rationale: Eye opening to pain = 2, verbal response of incomprehensible sounds =
2, and motor response of localizing to pain = 5. Total = 2 + 2 + 5 = 9. This
indicates a moderate brain injury requiring close monitoring .
Question 10: The nurse is caring for a victim of interpersonal violence. Which
action should the nurse prioritize?
A) Ask assessment questions in private
B) Call the police immediately
C) Contact the abuser for information
D) Document findings in the medical record
Answer: A
Rationale: The priority is to ask assessment questions in private, separate from the
person who may be abusive. Adults are free to accept or refuse help, but safety
plans should be explored. Mandatory reporting applies to children and elderly
abuse, requiring only a suspicion of abuse, not proof .
---
Section 2: Shock and Hemodynamic Monitoring
Question 11: A client with hypovolemic shock has a reduction of intravascular
volume by 15-30%. The nurse should anticipate which treatment?
A) Fluid and blood replacement
B) Vasopressor therapy
C) Diuretic therapy
D) Cardiac monitoring only
Answer: A
Rationale: Hypovolemic shock treatment focuses on the underlying cause and
replacement of fluid and blood volume. Lactated Ringer's (LR) or normal saline
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST UPDATE ALREADY
GRADED A+
This comprehensive resource provides 300 unique, sectioned multiple-choice
questions tailored for the NSG 233 HESI Final Exam, covering core medical-
surgical nursing content. It includes essential topics such as emergency nursing,
shock and hemodynamic monitoring, cardiovascular and respiratory disorders,
endocrine and renal conditions, fluid and electrolyte balance, hematology,
oncology, critical care, pharmacology, pain management, and ethical issues. Each
question includes the correct answer and a detailed rationale designed to reinforce
clinical reasoning and evidence-based practice. The content emphasizes high-yield
concepts frequently tested on HESI exams, making it an ideal tool for intensive
review and mastery of medical-surgical nursing competencies required for
successful exam completion and clinical practice.
Section 1: Emergency Nursing and Triage
Question 1: A nurse is working in an occupational health clinic when an employee
walks in and states that he was struck by lightning while working in a truck bed.
The client is alert but reports feeling faint. Which assessment will the nurse
perform first?
A) Pulse characteristics
B) Open airway
C) Entrance and exit wounds
D) Cervical spine injury
Answer: A
Rationale: Lightning is a jolt of electrical current and can produce a "natural"
defibrillation, so assessment of the pulse rate and regularity is a priority. Because
the client is talking, he has an open airway, so that assessment is not necessary.
Assessing for entrance/exit wounds and cervical spine injury should occur after
assessing for adequate circulation .
,Question 2: In the emergency department, which patient should the triage nurse
prioritize first?
A) Patient with chest pain radiating to the left arm
B) Patient with a minor laceration to the hand
C) Patient requesting medication for headache
D) Patient with a sprained ankle
Answer: A
Rationale: Chest pain radiating to the left arm is a classic sign of myocardial
infarction and requires immediate attention. This patient should be prioritized over
those with less urgent conditions such as minor lacerations, headaches, or sprains.
Question 3: A client presents to the emergency department with a fever of 104°F,
hot dry skin, confusion, and no sweating after working outside on a hot day. The
nurse should suspect which condition?
A) Heat exhaustion
B) Heat stroke
C) Malignant hyperthermia
D) Sun poisoning
Answer: B
Rationale: Heat stroke is a medical emergency characterized by a core temperature
>104°F, hot dry skin (anhidrosis), confusion, and central nervous system
dysfunction. The absence of sweating distinguishes heat stroke from heat
exhaustion. Priority interventions include rapid cooling with cool towels (no ice
bath), IV fluids, and oxygen .
Question 4: The nurse is caring for a client with a drug overdose. What is the
priority action?
A) Determine what substance the patient overdosed on
B) Administer activated charcoal
C) Prepare for gastric lavage
D) Call social services
Answer: A
Rationale: The priority is to find out what the patient overdosed on so that the
appropriate antidote can be given if available. Treatment goals include supporting
respiratory and cardiovascular functions, enhancing clearance of the agent, and
ensuring patient and staff safety .
Question 5: A client is admitted with urosepsis. Which vital sign changes indicate
that the client is in the initial stages of septic shock?
A) Bradycardia and hypotension
,B) Tachycardia and tachypnea
C) Bradycardia and hypertension
D) Tachycardia and hypotension
Answer: B
Rationale: Sepsis triggers a systemic inflammatory response. Initial stages (warm
sepsis) are characterized by increased cardiac output and systemic vasodilation.
Clinical manifestations include fever, tachycardia, tachypnea, and warm, flushed
skin. Hypotension is a later sign of decompensated shock .
Question 6: A nurse is performing triage in a mass casualty situation. Which
patient should receive a red tag?
A) Patient with a minor laceration
B) Patient with a life-threatening airway obstruction
C) Patient with a fractured femur
D) Patient with no respirations and no pulse
Answer: B
Rationale: In mass casualty triage, red tags are assigned to patients with life-
threatening conditions that require immediate intervention. Airway obstruction is a
critical priority. Minor injuries receive green tags, delayed care receives yellow,
and deceased patients receive black tags.
Question 7: The nurse is providing care to a client with anaphylaxis. What is the
priority medication to administer?
A) Antihistamine
B) Corticosteroid
C) Epinephrine
D) Oxygen
Answer: C
Rationale: Epinephrine is the first-line, lifesaving medication for anaphylaxis. It
works by causing vasoconstriction, bronchodilation, and reducing vascular
permeability. Antihistamines and corticosteroids are adjunctive therapies, and
oxygen should be administered but epinephrine is the priority .
Question 8: A client with a traumatic brain injury has a Glasgow Coma Scale
(GCS) score of 9. The nurse interprets this as:
A) Mild brain injury
B) Moderate brain injury
C) Severe brain injury
D) Normal neurological function
Answer: B
, Rationale: GCS scores range from 3-15. A score of 9-12 indicates moderate brain
injury. Scores of 13-15 indicate mild injury, and scores of 3-8 indicate severe
injury. This score requires close monitoring for deterioration.
Question 9: A patient with a head injury opens eyes to pain, makes
incomprehensible sounds, and localizes pain. What is the GCS score?
A) 9
B) 10
C) 12
D) 15
Answer: A
Rationale: Eye opening to pain = 2, verbal response of incomprehensible sounds =
2, and motor response of localizing to pain = 5. Total = 2 + 2 + 5 = 9. This
indicates a moderate brain injury requiring close monitoring .
Question 10: The nurse is caring for a victim of interpersonal violence. Which
action should the nurse prioritize?
A) Ask assessment questions in private
B) Call the police immediately
C) Contact the abuser for information
D) Document findings in the medical record
Answer: A
Rationale: The priority is to ask assessment questions in private, separate from the
person who may be abusive. Adults are free to accept or refuse help, but safety
plans should be explored. Mandatory reporting applies to children and elderly
abuse, requiring only a suspicion of abuse, not proof .
---
Section 2: Shock and Hemodynamic Monitoring
Question 11: A client with hypovolemic shock has a reduction of intravascular
volume by 15-30%. The nurse should anticipate which treatment?
A) Fluid and blood replacement
B) Vasopressor therapy
C) Diuretic therapy
D) Cardiac monitoring only
Answer: A
Rationale: Hypovolemic shock treatment focuses on the underlying cause and
replacement of fluid and blood volume. Lactated Ringer's (LR) or normal saline
