ADULT HEALTH II EXAM II
PRACTICE TEST BANK & STUDY GUIDE
2026-2027 COMPREHENSIVE UPDATE EXAM
Subject: Advanced Medical-Surgical Nursing (Adult Health II)
Target Audience: Nursing Students & Candidates Preparing for HESI / NCLEX Exams
Exam Blueprint: Advanced Respiratory, Hepatobiliary, Pancreatic, Gastrointestinal, Rheumatology, & Immunologic Nursing Care
Core Competencies: Clinical Judgment, Pathophysiology, Pharmacotherapy, & Prioritization of Care
Gemini Notebook A+ Professional Test Bank Series
Grounded in Authentic Clinical Evidence & Healthcare Education Standards
,ADULT HEALTH II EXAM II PRACTICE TEST BANK 2026-2027 UPDATE EXAM
EXAM SPECIFICATION & STUDY GUIDE
This comprehensive practice exam and study guide has been updated for the 2026-2027 HESI and NCLEX-RN test blueprints. The
exam assesses advanced medical-surgical competencies in high-acuity patient care, focusing on pathophysiology, clinical
decision-making, nursing interventions, and pharmacotherapy. All questions are strictly grounded in professional clinical evidence and
aligned with standard curriculum guides.
Core Chapters and Blueprint Distribution
Chapter / Subject Area Major Topics Assessed Weight Target Competencies
1. Advanced Respiratory PEEP,
& ARDS,
Vent Care
pneumothorax, tracheostomy
40%care, chest
Gas Exchange,
tube troubleshooting,
Airway Management,
ET tubes, weaning
Acid-Base
protoc
Bala
2. Hepatobiliary & GILiver
Disorders
biopsy prep, viral hepatitis priority care,
35% acuteFluid
& Overload,
chronic pancreatitis,
Pain Control,cirrhosis,
Nutrition lactulose,
Support para
3. Immunologic & Rheumatology
Systemic Lupus Erythematosus (SLE), Rheumatoid
15% Self-Care,
Arthritis (RA)
Painjoint
Management,
care, methotrexate
Safety Adaptations
therapy, salic
4. HIV/AIDS & Infection
Condom
Control
education, ART adherence, opportunistic
10% infections,
Immunology, Kaposi's
Infection
sarcoma,
Prevention,
wasting
Pharmacotherapy
syndrome, skin
Clinical Learning Objectives
• Objective 1: Analyze arterial blood gas (ABG) results and implement appropriate respiratory interventions for ventilated and
non-ventilated clients.
• Objective 2: Prioritize clinical assessments and immediate post-procedure safety protocols for clients undergoing invasive
diagnostic tests (e.g., liver biopsy, upper endoscopy, thoracentesis).
• Objective 3: Distinguish between early and late manifestations of life-threatening respiratory disorders, including acute pulmonary
edema, pneumothorax, and ARDS.
• Objective 4: Formulate evidence-based nursing interventions for clients with severe metabolic, endocrine, and immunologic
disorders (e.g., pancreatitis, cirrhosis, SLE, RA).
Subject: Advanced Medical-Surgical Nursing Page 2 of 30 Gemini Notebook A+ Professional Study Guide
, ADULT HEALTH II EXAM II PRACTICE TEST BANK 2026-2027 UPDATE EXAM
KEY CLINICAL CONCEPTS & TERMINOLOGY
Essential Nursing Terminology & Definitions
<b>Asterixis</b> A classic flapping tremor of the hands when wrists are dorsiflexed, indicating worsening hepatic encephalo
<b>PEEP</b> Positive End-Expiratory Pressure; mechanical ventilation settings that keep alveoli splinted open at expira
<b>Hemoptysis</b> Coughing up blood or blood-tinged sputum, highly indicative of active pulmonary tuberculosis or advanced
<b>DMARDs</b> Disease-Modifying Antirheumatic Drugs (e.g., methotrexate); first-line medications that slow RA joint destr
Commonly Confused Clinical Concepts
1. Pneumothorax vs. Hemothorax: A pneumothorax is air in the pleural space, which is typically drained by an anteriorly placed chest
tube (high in the 2nd/3rd intercostal space). A hemothorax is blood in the pleural space and requires a lower, posteriorly placed chest
tube (usually 5th-8th intercostal space) to drain heavy fluids.
2. Cardiogenic Pulmonary Edema vs. Non-Cardiogenic ARDS: Both cause severe dyspnea, crackles, and hypoxia. To differentiate,
a Brain Natriuretic Peptide (BNP) test is used: elevated BNP (typically >100 pg/mL) indicates a cardiac origin (heart failure), while
normal BNP indicates a pulmonary origin (ARDS).
3. Hepatic Encephalopathy vs. Hepatic Shock: Encephalopathy is a neuropsychiatric decline caused by toxic systemic ammonia
accumulation. Hepatic shock is severe hemodynamic collapse due to portal hypertension, hemorrhage from ruptured esophageal
varices, or direct trauma.
Clinical Procedures Quick Reference
• Post-Liver Biopsy: Immediate right side-lying position with a towel or pillow under the puncture site to compress the bleeding-prone
liver parenchyma.
• Upper Endoscopy (EGD): Verify return of gag reflex before administering any oral fluids or medications.
• Nasogastric (NG) Tube: Verify placement with a chest or abdominal x-ray before applying continuous suction or giving fluids.
Subject: Advanced Medical-Surgical Nursing Page 3 of 30 Gemini Notebook A+ Professional Study Guide
PRACTICE TEST BANK & STUDY GUIDE
2026-2027 COMPREHENSIVE UPDATE EXAM
Subject: Advanced Medical-Surgical Nursing (Adult Health II)
Target Audience: Nursing Students & Candidates Preparing for HESI / NCLEX Exams
Exam Blueprint: Advanced Respiratory, Hepatobiliary, Pancreatic, Gastrointestinal, Rheumatology, & Immunologic Nursing Care
Core Competencies: Clinical Judgment, Pathophysiology, Pharmacotherapy, & Prioritization of Care
Gemini Notebook A+ Professional Test Bank Series
Grounded in Authentic Clinical Evidence & Healthcare Education Standards
,ADULT HEALTH II EXAM II PRACTICE TEST BANK 2026-2027 UPDATE EXAM
EXAM SPECIFICATION & STUDY GUIDE
This comprehensive practice exam and study guide has been updated for the 2026-2027 HESI and NCLEX-RN test blueprints. The
exam assesses advanced medical-surgical competencies in high-acuity patient care, focusing on pathophysiology, clinical
decision-making, nursing interventions, and pharmacotherapy. All questions are strictly grounded in professional clinical evidence and
aligned with standard curriculum guides.
Core Chapters and Blueprint Distribution
Chapter / Subject Area Major Topics Assessed Weight Target Competencies
1. Advanced Respiratory PEEP,
& ARDS,
Vent Care
pneumothorax, tracheostomy
40%care, chest
Gas Exchange,
tube troubleshooting,
Airway Management,
ET tubes, weaning
Acid-Base
protoc
Bala
2. Hepatobiliary & GILiver
Disorders
biopsy prep, viral hepatitis priority care,
35% acuteFluid
& Overload,
chronic pancreatitis,
Pain Control,cirrhosis,
Nutrition lactulose,
Support para
3. Immunologic & Rheumatology
Systemic Lupus Erythematosus (SLE), Rheumatoid
15% Self-Care,
Arthritis (RA)
Painjoint
Management,
care, methotrexate
Safety Adaptations
therapy, salic
4. HIV/AIDS & Infection
Condom
Control
education, ART adherence, opportunistic
10% infections,
Immunology, Kaposi's
Infection
sarcoma,
Prevention,
wasting
Pharmacotherapy
syndrome, skin
Clinical Learning Objectives
• Objective 1: Analyze arterial blood gas (ABG) results and implement appropriate respiratory interventions for ventilated and
non-ventilated clients.
• Objective 2: Prioritize clinical assessments and immediate post-procedure safety protocols for clients undergoing invasive
diagnostic tests (e.g., liver biopsy, upper endoscopy, thoracentesis).
• Objective 3: Distinguish between early and late manifestations of life-threatening respiratory disorders, including acute pulmonary
edema, pneumothorax, and ARDS.
• Objective 4: Formulate evidence-based nursing interventions for clients with severe metabolic, endocrine, and immunologic
disorders (e.g., pancreatitis, cirrhosis, SLE, RA).
Subject: Advanced Medical-Surgical Nursing Page 2 of 30 Gemini Notebook A+ Professional Study Guide
, ADULT HEALTH II EXAM II PRACTICE TEST BANK 2026-2027 UPDATE EXAM
KEY CLINICAL CONCEPTS & TERMINOLOGY
Essential Nursing Terminology & Definitions
<b>Asterixis</b> A classic flapping tremor of the hands when wrists are dorsiflexed, indicating worsening hepatic encephalo
<b>PEEP</b> Positive End-Expiratory Pressure; mechanical ventilation settings that keep alveoli splinted open at expira
<b>Hemoptysis</b> Coughing up blood or blood-tinged sputum, highly indicative of active pulmonary tuberculosis or advanced
<b>DMARDs</b> Disease-Modifying Antirheumatic Drugs (e.g., methotrexate); first-line medications that slow RA joint destr
Commonly Confused Clinical Concepts
1. Pneumothorax vs. Hemothorax: A pneumothorax is air in the pleural space, which is typically drained by an anteriorly placed chest
tube (high in the 2nd/3rd intercostal space). A hemothorax is blood in the pleural space and requires a lower, posteriorly placed chest
tube (usually 5th-8th intercostal space) to drain heavy fluids.
2. Cardiogenic Pulmonary Edema vs. Non-Cardiogenic ARDS: Both cause severe dyspnea, crackles, and hypoxia. To differentiate,
a Brain Natriuretic Peptide (BNP) test is used: elevated BNP (typically >100 pg/mL) indicates a cardiac origin (heart failure), while
normal BNP indicates a pulmonary origin (ARDS).
3. Hepatic Encephalopathy vs. Hepatic Shock: Encephalopathy is a neuropsychiatric decline caused by toxic systemic ammonia
accumulation. Hepatic shock is severe hemodynamic collapse due to portal hypertension, hemorrhage from ruptured esophageal
varices, or direct trauma.
Clinical Procedures Quick Reference
• Post-Liver Biopsy: Immediate right side-lying position with a towel or pillow under the puncture site to compress the bleeding-prone
liver parenchyma.
• Upper Endoscopy (EGD): Verify return of gag reflex before administering any oral fluids or medications.
• Nasogastric (NG) Tube: Verify placement with a chest or abdominal x-ray before applying continuous suction or giving fluids.
Subject: Advanced Medical-Surgical Nursing Page 3 of 30 Gemini Notebook A+ Professional Study Guide
