NURSING — MEDICAL-SURGICAL II
NSG 223 Med Surg 2 HESI Final Answers
A+
2026/2027 Official Exam
Grade A | 100% Verified | Intermediate Medical-Surgical Nursing
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
■ 1. Cardiovascular Disorders & Hemodynamic Monitoring
■ 2. Respiratory Failure, Mechanical Ventilation & Critical Care
■ 3. Neurological Emergencies & Endocrine Crises
■ 4. Renal Failure, Shock States & Fluid/Electrolyte Balance
■ 5. GI, Hematology, Oncology Prioritization & Complex Care
STUVIAACTUALEXAM
Original practice examination aligned to NSG 223 / Med-Surg II HESI-style blueprints. Not affiliated with Elsevier HESI or any nursing program.
, SECTION 1 — Cardiovascular Disorders & Hemodynamic Monitoring
Q1. A 68-year-old client with acute decompensated heart failure is receiving IV furosemide and continuous positive airway
pressure. The nurse notes a sudden drop in blood pressure from 138/82 mm Hg to 92/54 mm Hg and the client reports feeling
light-headed. The priority nursing action is to:
A. Slow or stop the diuretic infusion and notify the provider while placing the client in a supine position with legs elevated if tolerated
B. Document the finding and reassess in one hour
C. Increase the CPAP pressure immediately to improve oxygenation
D. Administer a fluid bolus of 1 L normal saline without orders
Correct Answer: A
Rationale: Rapid diuresis can cause intravascular volume depletion and hypotension. The immediate response is to protect perfusion by
adjusting the diuretic rate, positioning the client, and communicating with the provider for further orders.
Q2. A client admitted with ST-elevation myocardial infarction is scheduled for primary percutaneous coronary intervention.
While waiting for the catheterization lab, the nurse observes frequent premature ventricular contractions and a short run of
non-sustained ventricular tachycardia. The most appropriate initial action is to:
A. Administer a fluid challenge of 500 mL normal saline
B. Assess the client’s hemodynamic status, oxygenation, and electrolyte levels, particularly potassium and magnesium
C. Encourage the client to perform Valsalva maneuvers
D. Prepare for immediate synchronized cardioversion without assessment
Correct Answer: B
Rationale: Ventricular ectopy after MI is often related to ischemia, electrolyte imbalance, or hypoxia. Assessment of perfusion and correctable
factors guides safe pharmacologic or electrical intervention.
Q3. A client with cardiogenic shock is receiving a dobutamine infusion. The nurse evaluates effectiveness of therapy by
monitoring for:
A. A decrease in heart rate to less than 50 beats per minute
B. A rise in systemic vascular resistance and falling urine output
C. Complete resolution of all chest pain within five minutes
D. Improved cardiac output and urine output with decreased systemic vascular resistance signs of better end-organ perfusion
Correct Answer: D
Rationale: Dobutamine is a positive inotrope used to increase contractility and cardiac output. Clinical markers of improved perfusion include
rising urine output, improved mentation, and warmer extremities.
Q4. A client post–coronary artery bypass graft surgery has a sudden increase in chest-tube drainage to 180 mL in 30 minutes,
accompanied by tachycardia and decreasing blood pressure. The nurse should first:
A. Strip the chest tubes vigorously to clear clots
B. Increase the IV fluid rate without notifying anyone
C. Reassure the client that this amount of drainage is expected
D. Notify the surgical team immediately while preparing for possible return to the operating room and supporting hemodynamics
Correct Answer: D
Rationale: Sudden high-volume chest-tube output after cardiac surgery raises concern for surgical bleeding. Rapid communication with the
surgical team and hemodynamic support are priorities.
STUVIAACTUALEXAM | NSG 223 Med Surg 2 HESI Final 2026/2027 | Page 2
NSG 223 Med Surg 2 HESI Final Answers
A+
2026/2027 Official Exam
Grade A | 100% Verified | Intermediate Medical-Surgical Nursing
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
■ 1. Cardiovascular Disorders & Hemodynamic Monitoring
■ 2. Respiratory Failure, Mechanical Ventilation & Critical Care
■ 3. Neurological Emergencies & Endocrine Crises
■ 4. Renal Failure, Shock States & Fluid/Electrolyte Balance
■ 5. GI, Hematology, Oncology Prioritization & Complex Care
STUVIAACTUALEXAM
Original practice examination aligned to NSG 223 / Med-Surg II HESI-style blueprints. Not affiliated with Elsevier HESI or any nursing program.
, SECTION 1 — Cardiovascular Disorders & Hemodynamic Monitoring
Q1. A 68-year-old client with acute decompensated heart failure is receiving IV furosemide and continuous positive airway
pressure. The nurse notes a sudden drop in blood pressure from 138/82 mm Hg to 92/54 mm Hg and the client reports feeling
light-headed. The priority nursing action is to:
A. Slow or stop the diuretic infusion and notify the provider while placing the client in a supine position with legs elevated if tolerated
B. Document the finding and reassess in one hour
C. Increase the CPAP pressure immediately to improve oxygenation
D. Administer a fluid bolus of 1 L normal saline without orders
Correct Answer: A
Rationale: Rapid diuresis can cause intravascular volume depletion and hypotension. The immediate response is to protect perfusion by
adjusting the diuretic rate, positioning the client, and communicating with the provider for further orders.
Q2. A client admitted with ST-elevation myocardial infarction is scheduled for primary percutaneous coronary intervention.
While waiting for the catheterization lab, the nurse observes frequent premature ventricular contractions and a short run of
non-sustained ventricular tachycardia. The most appropriate initial action is to:
A. Administer a fluid challenge of 500 mL normal saline
B. Assess the client’s hemodynamic status, oxygenation, and electrolyte levels, particularly potassium and magnesium
C. Encourage the client to perform Valsalva maneuvers
D. Prepare for immediate synchronized cardioversion without assessment
Correct Answer: B
Rationale: Ventricular ectopy after MI is often related to ischemia, electrolyte imbalance, or hypoxia. Assessment of perfusion and correctable
factors guides safe pharmacologic or electrical intervention.
Q3. A client with cardiogenic shock is receiving a dobutamine infusion. The nurse evaluates effectiveness of therapy by
monitoring for:
A. A decrease in heart rate to less than 50 beats per minute
B. A rise in systemic vascular resistance and falling urine output
C. Complete resolution of all chest pain within five minutes
D. Improved cardiac output and urine output with decreased systemic vascular resistance signs of better end-organ perfusion
Correct Answer: D
Rationale: Dobutamine is a positive inotrope used to increase contractility and cardiac output. Clinical markers of improved perfusion include
rising urine output, improved mentation, and warmer extremities.
Q4. A client post–coronary artery bypass graft surgery has a sudden increase in chest-tube drainage to 180 mL in 30 minutes,
accompanied by tachycardia and decreasing blood pressure. The nurse should first:
A. Strip the chest tubes vigorously to clear clots
B. Increase the IV fluid rate without notifying anyone
C. Reassure the client that this amount of drainage is expected
D. Notify the surgical team immediately while preparing for possible return to the operating room and supporting hemodynamics
Correct Answer: D
Rationale: Sudden high-volume chest-tube output after cardiac surgery raises concern for surgical bleeding. Rapid communication with the
surgical team and hemodynamic support are priorities.
STUVIAACTUALEXAM | NSG 223 Med Surg 2 HESI Final 2026/2027 | Page 2
