NSG 223 MEDICAL-SURGICAL NURSING
1 HESI FINAL REVIEW
1. A patient with a history of heart failure is prescribed Furosemide and Digoxin. Which
laboratory result should the nurse prioritize checking before administration?
A. Serum Sodium 136 mEq/L
B. Hemoglobin 14 g/dL
C. Serum Creatinine 1.0 mg/dL
D. Serum Potassium 3.2 mEq/L
Answer: D
Conceptual Explanation: Hypokalemia (low potassium) significantly increases the risk of
Digoxin toxicity. Furosemide is a loop diuretic that causes potassium wasting.
2. A client presents to the emergency department with Kussmaul respirations, fruity breath
odor, and a blood glucose of 520 mg/dL. Which acid-base imbalance does the nurse expect?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Metabolic Acidosis
,Answer: D
Conceptual Explanation: These are classic signs of Diabetic Ketoacidosis (DKA), which
results in metabolic acidosis due to the accumulation of ketones.
3. Which clinical manifestation would the nurse expect to find in a client diagnosed with
Cushing’s Syndrome?
A. Weight loss and hypotension
B. Hyperpigmentation of the skin
C. Truncal obesity and moon face
D. Persistent tachycardia and tremors
Answer: C
Conceptual Explanation: Cushing’s Syndrome involves excessive cortisol, leading to fat
redistribution (moon face, buffalo hump, truncal obesity) and skin thinning.
4. Following a total hip arthroplasty, a patient suddenly develops chest pain, dyspnea, and a
feeling of impending doom. What is the nurse’s priority action?
A. Apply supplemental oxygen and notify the Rapid Response Team
B. Administer an oral analgesic as prescribed
C. Perform an incentive spirometry check
D. Reposition the patient on their side
Answer: A
, Conceptual Explanation: Sudden chest pain and dyspnea post-surgery suggest a
Pulmonary Embolism (PE), which is a medical emergency requiring immediate oxygen and
intervention.
5. A nurse is reviewing the arterial blood gas (ABG) results for a client with COPD: pH 7.31,
PaCO2 55, HCO3 25. How should the nurse interpret these results?
A. Partially Compensated Metabolic Alkalosis
B. Compensated Metabolic Acidosis
C. Uncompensated Respiratory Alkalosis
D. Uncompensated Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is acidic (< 7.35) and the PaCO2 is high (> 45), while the
HCO3 is normal, indicating respiratory acidosis without compensation.
6. A client is scheduled for an intravenous pyelogram (IVP). Which allergy is most critical for
the nurse to assess prior to the procedure?
A. Penicillin
B. Latex
C. Peanuts
D. Shellfish or Iodine
Answer: D
1 HESI FINAL REVIEW
1. A patient with a history of heart failure is prescribed Furosemide and Digoxin. Which
laboratory result should the nurse prioritize checking before administration?
A. Serum Sodium 136 mEq/L
B. Hemoglobin 14 g/dL
C. Serum Creatinine 1.0 mg/dL
D. Serum Potassium 3.2 mEq/L
Answer: D
Conceptual Explanation: Hypokalemia (low potassium) significantly increases the risk of
Digoxin toxicity. Furosemide is a loop diuretic that causes potassium wasting.
2. A client presents to the emergency department with Kussmaul respirations, fruity breath
odor, and a blood glucose of 520 mg/dL. Which acid-base imbalance does the nurse expect?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Metabolic Acidosis
,Answer: D
Conceptual Explanation: These are classic signs of Diabetic Ketoacidosis (DKA), which
results in metabolic acidosis due to the accumulation of ketones.
3. Which clinical manifestation would the nurse expect to find in a client diagnosed with
Cushing’s Syndrome?
A. Weight loss and hypotension
B. Hyperpigmentation of the skin
C. Truncal obesity and moon face
D. Persistent tachycardia and tremors
Answer: C
Conceptual Explanation: Cushing’s Syndrome involves excessive cortisol, leading to fat
redistribution (moon face, buffalo hump, truncal obesity) and skin thinning.
4. Following a total hip arthroplasty, a patient suddenly develops chest pain, dyspnea, and a
feeling of impending doom. What is the nurse’s priority action?
A. Apply supplemental oxygen and notify the Rapid Response Team
B. Administer an oral analgesic as prescribed
C. Perform an incentive spirometry check
D. Reposition the patient on their side
Answer: A
, Conceptual Explanation: Sudden chest pain and dyspnea post-surgery suggest a
Pulmonary Embolism (PE), which is a medical emergency requiring immediate oxygen and
intervention.
5. A nurse is reviewing the arterial blood gas (ABG) results for a client with COPD: pH 7.31,
PaCO2 55, HCO3 25. How should the nurse interpret these results?
A. Partially Compensated Metabolic Alkalosis
B. Compensated Metabolic Acidosis
C. Uncompensated Respiratory Alkalosis
D. Uncompensated Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is acidic (< 7.35) and the PaCO2 is high (> 45), while the
HCO3 is normal, indicating respiratory acidosis without compensation.
6. A client is scheduled for an intravenous pyelogram (IVP). Which allergy is most critical for
the nurse to assess prior to the procedure?
A. Penicillin
B. Latex
C. Peanuts
D. Shellfish or Iodine
Answer: D
