NSG 223 MERD SURG 2 HESI FINAL EXAM– QUESTIONS AND ANSWERS |
VERIFIED AND WELL DETAILED ANSWERS | EXAM TESTBANK | PLUS
RATIONALES | DOWNLOAD AND PASS | LATEST EXAM UPDATE 2026/2027
Core Domains:
• Medical-Surgical Nursing: Perioperative Care
• Fluid, Electrolyte, and Acid-Base Balance
• Cardiovascular and Respiratory Disorders
• Gastrointestinal and Renal Disorders
• Neurological and Musculoskeletal Disorders
• Endocrine and Immune System Disorders
• Pharmacology and Pain Management
• Wound Care, Infection Control, and Emergency Preparedness
Introduction:
This comprehensive examination is designed to evaluate the advanced knowledge
and critical thinking skills essential for success in medical-surgical nursing. It
encompasses a wide range of topics, from foundational pathophysiological concepts
to complex, real-world clinical scenarios. Each multiple-choice question is crafted to
assess your ability to apply theoretical knowledge, make sound clinical judgments,
and prioritize patient care effectively. The questions emphasize the integration of
evidence-based practice, legal and ethical considerations, and interprofessional
collaboration. This assessment serves as a vital tool for identifying areas of strength
and opportunities for further study, ensuring you are thoroughly prepared for the
rigors of the HESI exam and professional nursing practice. Focus on the clinical
reasoning behind each correct answer to maximize your learning and performance.
SECTION ONE: Questions 1 – 50
,1. A patient is admitted with severe dehydration. Which intravenous fluid
should the nurse anticipate administering to restore intravascular volume most
rapidly?
A. 0.45% Sodium Chloride (Half Normal Saline)
B. 0.9% Sodium Chloride (Normal Saline)
C. 5% Dextrose in Water (D5W)
D. 3% Sodium Chloride
🟢 Correct Answer: B. 0.9% Sodium Chloride (Normal Saline)
🔴 Explanation: 0.9% Normal Saline is an isotonic crystalloid solution that
expands the intravascular volume rapidly and is the first-line fluid for treating
hypovolemia and dehydration.
2. A patient is prescribed enoxaparin (Lovenox) post-operatively. Which
laboratory value should be monitored to assess for a potential adverse effect of
this medication?
A. Serum creatinine
B. Platelet count
C. International Normalized Ratio (INR)
D. White Blood Cell (WBC) count
🟢 Correct Answer: B. Platelet count
🔴 Explanation: Enoxaparin, a low-molecular-weight heparin, can cause heparin-
induced thrombocytopenia (HIT). Monitoring platelet counts is essential to detect
this serious adverse effect.
,3. A nurse is caring for a patient with a chest tube. Which finding requires
immediate intervention?
A. Constant bubbling in the suction control chamber
B. Occasional bubbling in the water seal chamber
C. Continuous bubbling in the water seal chamber
D. Tidaling in the water seal chamber
🟢 Correct Answer: C. Continuous bubbling in the water seal chamber
🔴 Explanation: Continuous bubbling in the water seal chamber indicates an air
leak in the system, which requires immediate assessment and intervention to
prevent respiratory compromise.
4. The nurse is teaching a patient with a new colostomy. Which dietary
instruction is most appropriate?
A. Increase intake of carbonated beverages to aid in passage of stool.
B. Avoid all high-fiber foods to prevent obstruction.
C. Eat regular meals and chew food thoroughly to aid digestion.
D. Take stool softeners daily to ensure easy passage of stool.
🟢 Correct Answer: C. Eat regular meals and chew food thoroughly to aid
digestion.
🔴 Explanation: Patients with a new colostomy should be advised to eat regular
meals and chew their food thoroughly. This promotes normal digestion and
reduces the risk of blockage, while also helping to regulate bowel movements.
, 5. A patient with heart failure is prescribed furosemide (Lasix). Which finding
indicates the medication is having the desired therapeutic effect?
A. Urine output of 60 mL over 2 hours
B. Weight loss of 2 kg in 24 hours
C. Blood pressure of 160/90 mmHg
D. Presence of 2+ pitting edema in lower extremities
🟢 Correct Answer: B. Weight loss of 2 kg in 24 hours
🔴 Explanation: Furosemide is a diuretic used to reduce fluid overload in heart
failure. A rapid weight loss (1-2 kg in 24 hours) indicates effective diuresis and
reduction of extracellular fluid volume.
6. A patient is being prepared for a cardiac catheterization. Which assessment
finding is most critical to report to the healthcare provider before the
procedure?
A. Allergy to shellfish
B. Serum potassium of 3.8 mEq/L
C. Blood pressure of 142/88 mmHg
D. History of occasional heart palpitations
🟢 Correct Answer: A. Allergy to shellfish
🔴 Explanation: An allergy to shellfish is a significant contraindication because
the contrast dye used in cardiac catheterization contains iodine, and cross-
reactivity is possible. This must be reported and managed prior to the procedure.
VERIFIED AND WELL DETAILED ANSWERS | EXAM TESTBANK | PLUS
RATIONALES | DOWNLOAD AND PASS | LATEST EXAM UPDATE 2026/2027
Core Domains:
• Medical-Surgical Nursing: Perioperative Care
• Fluid, Electrolyte, and Acid-Base Balance
• Cardiovascular and Respiratory Disorders
• Gastrointestinal and Renal Disorders
• Neurological and Musculoskeletal Disorders
• Endocrine and Immune System Disorders
• Pharmacology and Pain Management
• Wound Care, Infection Control, and Emergency Preparedness
Introduction:
This comprehensive examination is designed to evaluate the advanced knowledge
and critical thinking skills essential for success in medical-surgical nursing. It
encompasses a wide range of topics, from foundational pathophysiological concepts
to complex, real-world clinical scenarios. Each multiple-choice question is crafted to
assess your ability to apply theoretical knowledge, make sound clinical judgments,
and prioritize patient care effectively. The questions emphasize the integration of
evidence-based practice, legal and ethical considerations, and interprofessional
collaboration. This assessment serves as a vital tool for identifying areas of strength
and opportunities for further study, ensuring you are thoroughly prepared for the
rigors of the HESI exam and professional nursing practice. Focus on the clinical
reasoning behind each correct answer to maximize your learning and performance.
SECTION ONE: Questions 1 – 50
,1. A patient is admitted with severe dehydration. Which intravenous fluid
should the nurse anticipate administering to restore intravascular volume most
rapidly?
A. 0.45% Sodium Chloride (Half Normal Saline)
B. 0.9% Sodium Chloride (Normal Saline)
C. 5% Dextrose in Water (D5W)
D. 3% Sodium Chloride
🟢 Correct Answer: B. 0.9% Sodium Chloride (Normal Saline)
🔴 Explanation: 0.9% Normal Saline is an isotonic crystalloid solution that
expands the intravascular volume rapidly and is the first-line fluid for treating
hypovolemia and dehydration.
2. A patient is prescribed enoxaparin (Lovenox) post-operatively. Which
laboratory value should be monitored to assess for a potential adverse effect of
this medication?
A. Serum creatinine
B. Platelet count
C. International Normalized Ratio (INR)
D. White Blood Cell (WBC) count
🟢 Correct Answer: B. Platelet count
🔴 Explanation: Enoxaparin, a low-molecular-weight heparin, can cause heparin-
induced thrombocytopenia (HIT). Monitoring platelet counts is essential to detect
this serious adverse effect.
,3. A nurse is caring for a patient with a chest tube. Which finding requires
immediate intervention?
A. Constant bubbling in the suction control chamber
B. Occasional bubbling in the water seal chamber
C. Continuous bubbling in the water seal chamber
D. Tidaling in the water seal chamber
🟢 Correct Answer: C. Continuous bubbling in the water seal chamber
🔴 Explanation: Continuous bubbling in the water seal chamber indicates an air
leak in the system, which requires immediate assessment and intervention to
prevent respiratory compromise.
4. The nurse is teaching a patient with a new colostomy. Which dietary
instruction is most appropriate?
A. Increase intake of carbonated beverages to aid in passage of stool.
B. Avoid all high-fiber foods to prevent obstruction.
C. Eat regular meals and chew food thoroughly to aid digestion.
D. Take stool softeners daily to ensure easy passage of stool.
🟢 Correct Answer: C. Eat regular meals and chew food thoroughly to aid
digestion.
🔴 Explanation: Patients with a new colostomy should be advised to eat regular
meals and chew their food thoroughly. This promotes normal digestion and
reduces the risk of blockage, while also helping to regulate bowel movements.
, 5. A patient with heart failure is prescribed furosemide (Lasix). Which finding
indicates the medication is having the desired therapeutic effect?
A. Urine output of 60 mL over 2 hours
B. Weight loss of 2 kg in 24 hours
C. Blood pressure of 160/90 mmHg
D. Presence of 2+ pitting edema in lower extremities
🟢 Correct Answer: B. Weight loss of 2 kg in 24 hours
🔴 Explanation: Furosemide is a diuretic used to reduce fluid overload in heart
failure. A rapid weight loss (1-2 kg in 24 hours) indicates effective diuresis and
reduction of extracellular fluid volume.
6. A patient is being prepared for a cardiac catheterization. Which assessment
finding is most critical to report to the healthcare provider before the
procedure?
A. Allergy to shellfish
B. Serum potassium of 3.8 mEq/L
C. Blood pressure of 142/88 mmHg
D. History of occasional heart palpitations
🟢 Correct Answer: A. Allergy to shellfish
🔴 Explanation: An allergy to shellfish is a significant contraindication because
the contrast dye used in cardiac catheterization contains iodine, and cross-
reactivity is possible. This must be reported and managed prior to the procedure.
