NSG 223 MED SURG 2 HESI FINAL EXAM – COMPREHENSIVE
TEST BANK
Herzing University | 2026 Updated | 200 Questions with
Correct Answers & Rationales
TABLE OF CONTENTS
Section Topic Questions
1 Perioperative Care 1–18
2 Cardiovascular Disorders 19–42
3 Respiratory Disorders & Acid-Base 43–64
4 Neurological & Sensory Disorders 65–86
5 Renal & Urinary Disorders 87–104
6 Endocrine & Diabetes Management 105–124
7 Gastrointestinal & Hepatic Disorders 125–144
8 Musculoskeletal & Integumentary 145–162
9 Shock, Sepsis & Emergency Nursing 163–180
10 Oncology, Immune & Hematologic 181–200
,SECTION 1: PERIOPERATIVE CARE (Questions 1–18)
1. A client scheduled for surgery reports taking aspirin daily for arthritis. Which actions should
the nurse take? (Select all that apply.)
A. Document the finding and proceed with surgery
B. Notify the surgeon immediately
C. Instruct the client to continue aspirin as usual
D. Assess for signs of bleeding
E. Anticipate possible postponement of surgery
Correct Answers: B, D, E
Rationale: Aspirin irreversibly inhibits platelet aggregation and increases bleeding risk. The
nurse must notify the surgeon immediately because surgery may need to be postponed until
aspirin effects resolve (typically 5–7 days). Assessing for current bleeding signs is essential.
Instructing the client to continue aspirin (C) is incorrect and dangerous.
2. A client who had colon surgery 3 days ago experiences wound dehiscence with evisceration
while being repositioned. After placing a moist sterile dressing over the wound, which action
should the nurse take next?
A. Bring additional sterile dressing supplies to the room
B. Prepare the client to return to the operating room
C. Obtain a sample of the drainage to send to the laboratory
D. Auscultate the abdomen for bowel sounds
Correct Answer: B
Rationale: Wound dehiscence with evisceration is a surgical emergency. After covering exposed
organs with a moist sterile dressing, the priority is preparing the client for emergency surgery.
Additional supplies and laboratory samples are not the immediate priority.
3. A client is 4 hours postoperative from a total hip replacement. Which assessment findings
require immediate intervention? (Select all that apply.)
A. Pain rated 6/10 at the surgical site
B. Urine output of 40 mL over the past hour
C. Oxygen saturation of 88% on room air
D. Heart rate of 88 bpm
E. Respiratory rate of 28 breaths/min with dyspnea
Correct Answers: C, E
Rationale: SpO₂ of 88% and respiratory rate of 28 with dyspnea indicate hypoxemia and
,possible pulmonary complications (atelectasis, PE, pneumonia). These require immediate
intervention. Pain 6/10 is expected postoperatively; urine output of 40 mL/hr is adequate.
4. The nurse is caring for a client 2 hours after thyroidectomy. Which assessment findings are
most concerning? (Select all that apply.)
A. Sore throat
B. Stridor
C. Respiratory distress
D. Hoarse voice
E. Difficulty swallowing
Correct Answers: B, C
Rationale: Stridor and respiratory distress after thyroidectomy may indicate laryngeal edema,
hematoma causing airway compression, or hypocalcemia-induced laryngospasm. This is a
medical emergency. Sore throat, hoarseness, and mild dysphagia are expected postoperatively.
5. A client is preparing for surgery. Which assessment findings require further evaluation
before proceeding? (Select all that apply.)
A. Anxiety about the procedure
B. History of smoking
C. Chest pain
D. Shortness of breath
E. Temperature of 99.0°F (37.2°C)
Correct Answers: C, D
Rationale: Chest pain and shortness of breath require immediate evaluation as they may
indicate cardiac or pulmonary compromise. Anxiety and mild temperature elevation are
common and not contraindications. Smoking history is noted but does not require
postponement.
6. The nurse is providing preoperative teaching to a client scheduled for abdominal surgery.
Which instructions should be included? (Select all that apply.)
A. Splint the incision with a pillow when coughing
B. Expect to ambulate within 24 hours after surgery
C. Avoid using incentive spirometry to prevent pain
D. Report any signs of wound infection after discharge
E. Perform leg exercises to prevent DVT
Correct Answers: A, B, D, E
Rationale: Splinting the incision, early ambulation, reporting infection signs, and leg exercises
are all essential preoperative teaching points. Incentive spirometry is encouraged, not avoided,
to prevent atelectasis.
, 7. A client is scheduled for surgery and reports taking warfarin. Which actions should the
nurse take? (Select all that apply.)
A. Notify the surgeon
B. Check the INR
C. Administer vitamin K without an order
D. Assess for bruising or bleeding
E. Document the medication in the preoperative record
Correct Answers: A, B, D, E
Rationale: Warfarin increases bleeding risk. The nurse must notify the surgeon, check INR,
assess for bleeding, and document. Vitamin K is administered only with a provider's order.
8. A client who is 6 hours postoperative from abdominal surgery has not voided. Which
nursing actions are appropriate? (Select all that apply.)
A. Palpate the bladder for distention
B. Encourage the client to use the bathroom
C. Insert an indwelling catheter immediately
D. Run water to stimulate voiding
E. Assess for bladder scanner reading
Correct Answers: A, B, D, E
Rationale: Non-invasive measures should be attempted first. Bladder palpation, ambulation to
the bathroom, running water, and bladder scanning are appropriate. Catheter insertion requires
a provider's order and should be a last resort.
9. Which findings in a postoperative client indicate possible malignant hyperthermia? (Select
all that apply.)
A. Temperature of 104°F (40°C)
B. Muscle rigidity
C. Bradycardia
D. Tachycardia
E. Hypercapnia
Correct Answers: A, B, D, E
Rationale: Malignant hyperthermia presents with hyperthermia, muscle rigidity, tachycardia,
and hypercapnia. Bradycardia is not characteristic.
10. The nurse is caring for a client in the PACU. Which assessment findings require immediate
intervention? (Select all that apply.)
A. Blood pressure 90/60 mmHg
B. Oxygen saturation 89%
C. Respiratory rate 8 breaths/min
TEST BANK
Herzing University | 2026 Updated | 200 Questions with
Correct Answers & Rationales
TABLE OF CONTENTS
Section Topic Questions
1 Perioperative Care 1–18
2 Cardiovascular Disorders 19–42
3 Respiratory Disorders & Acid-Base 43–64
4 Neurological & Sensory Disorders 65–86
5 Renal & Urinary Disorders 87–104
6 Endocrine & Diabetes Management 105–124
7 Gastrointestinal & Hepatic Disorders 125–144
8 Musculoskeletal & Integumentary 145–162
9 Shock, Sepsis & Emergency Nursing 163–180
10 Oncology, Immune & Hematologic 181–200
,SECTION 1: PERIOPERATIVE CARE (Questions 1–18)
1. A client scheduled for surgery reports taking aspirin daily for arthritis. Which actions should
the nurse take? (Select all that apply.)
A. Document the finding and proceed with surgery
B. Notify the surgeon immediately
C. Instruct the client to continue aspirin as usual
D. Assess for signs of bleeding
E. Anticipate possible postponement of surgery
Correct Answers: B, D, E
Rationale: Aspirin irreversibly inhibits platelet aggregation and increases bleeding risk. The
nurse must notify the surgeon immediately because surgery may need to be postponed until
aspirin effects resolve (typically 5–7 days). Assessing for current bleeding signs is essential.
Instructing the client to continue aspirin (C) is incorrect and dangerous.
2. A client who had colon surgery 3 days ago experiences wound dehiscence with evisceration
while being repositioned. After placing a moist sterile dressing over the wound, which action
should the nurse take next?
A. Bring additional sterile dressing supplies to the room
B. Prepare the client to return to the operating room
C. Obtain a sample of the drainage to send to the laboratory
D. Auscultate the abdomen for bowel sounds
Correct Answer: B
Rationale: Wound dehiscence with evisceration is a surgical emergency. After covering exposed
organs with a moist sterile dressing, the priority is preparing the client for emergency surgery.
Additional supplies and laboratory samples are not the immediate priority.
3. A client is 4 hours postoperative from a total hip replacement. Which assessment findings
require immediate intervention? (Select all that apply.)
A. Pain rated 6/10 at the surgical site
B. Urine output of 40 mL over the past hour
C. Oxygen saturation of 88% on room air
D. Heart rate of 88 bpm
E. Respiratory rate of 28 breaths/min with dyspnea
Correct Answers: C, E
Rationale: SpO₂ of 88% and respiratory rate of 28 with dyspnea indicate hypoxemia and
,possible pulmonary complications (atelectasis, PE, pneumonia). These require immediate
intervention. Pain 6/10 is expected postoperatively; urine output of 40 mL/hr is adequate.
4. The nurse is caring for a client 2 hours after thyroidectomy. Which assessment findings are
most concerning? (Select all that apply.)
A. Sore throat
B. Stridor
C. Respiratory distress
D. Hoarse voice
E. Difficulty swallowing
Correct Answers: B, C
Rationale: Stridor and respiratory distress after thyroidectomy may indicate laryngeal edema,
hematoma causing airway compression, or hypocalcemia-induced laryngospasm. This is a
medical emergency. Sore throat, hoarseness, and mild dysphagia are expected postoperatively.
5. A client is preparing for surgery. Which assessment findings require further evaluation
before proceeding? (Select all that apply.)
A. Anxiety about the procedure
B. History of smoking
C. Chest pain
D. Shortness of breath
E. Temperature of 99.0°F (37.2°C)
Correct Answers: C, D
Rationale: Chest pain and shortness of breath require immediate evaluation as they may
indicate cardiac or pulmonary compromise. Anxiety and mild temperature elevation are
common and not contraindications. Smoking history is noted but does not require
postponement.
6. The nurse is providing preoperative teaching to a client scheduled for abdominal surgery.
Which instructions should be included? (Select all that apply.)
A. Splint the incision with a pillow when coughing
B. Expect to ambulate within 24 hours after surgery
C. Avoid using incentive spirometry to prevent pain
D. Report any signs of wound infection after discharge
E. Perform leg exercises to prevent DVT
Correct Answers: A, B, D, E
Rationale: Splinting the incision, early ambulation, reporting infection signs, and leg exercises
are all essential preoperative teaching points. Incentive spirometry is encouraged, not avoided,
to prevent atelectasis.
, 7. A client is scheduled for surgery and reports taking warfarin. Which actions should the
nurse take? (Select all that apply.)
A. Notify the surgeon
B. Check the INR
C. Administer vitamin K without an order
D. Assess for bruising or bleeding
E. Document the medication in the preoperative record
Correct Answers: A, B, D, E
Rationale: Warfarin increases bleeding risk. The nurse must notify the surgeon, check INR,
assess for bleeding, and document. Vitamin K is administered only with a provider's order.
8. A client who is 6 hours postoperative from abdominal surgery has not voided. Which
nursing actions are appropriate? (Select all that apply.)
A. Palpate the bladder for distention
B. Encourage the client to use the bathroom
C. Insert an indwelling catheter immediately
D. Run water to stimulate voiding
E. Assess for bladder scanner reading
Correct Answers: A, B, D, E
Rationale: Non-invasive measures should be attempted first. Bladder palpation, ambulation to
the bathroom, running water, and bladder scanning are appropriate. Catheter insertion requires
a provider's order and should be a last resort.
9. Which findings in a postoperative client indicate possible malignant hyperthermia? (Select
all that apply.)
A. Temperature of 104°F (40°C)
B. Muscle rigidity
C. Bradycardia
D. Tachycardia
E. Hypercapnia
Correct Answers: A, B, D, E
Rationale: Malignant hyperthermia presents with hyperthermia, muscle rigidity, tachycardia,
and hypercapnia. Bradycardia is not characteristic.
10. The nurse is caring for a client in the PACU. Which assessment findings require immediate
intervention? (Select all that apply.)
A. Blood pressure 90/60 mmHg
B. Oxygen saturation 89%
C. Respiratory rate 8 breaths/min
