NSG 223 MED SURG 2 HESI FINAL EXAM –
COMPREHENSIVE TEST BANK Herzing University | 2026
Updated | 200+ Questions with Correct Answers & Rationales
Section 1: Perioperative Care (Q1–Q15)
Q1. A nurse is caring for a client who is 24 hours postoperative
following abdominal surgery. The client reports incisional pain rated
6/10 and is reluctant to cough and deep breathe. Which action should
the nurse take first?
A. Document the finding and reassess in 1 hour
B. Administer prescribed analgesic and encourage splinting while coughing
C. Notify the provider immediately
D. Restrict fluids to reduce respiratory secretions
Answer: B
Rationale: Pain inhibits deep breathing and coughing, increasing risk of
atelectasis and pneumonia. Administering analgesia and teaching splinting
optimizes pain control and pulmonary hygiene. Documentation alone is
insufficient. Provider notification is not required for expected postoperative
pain. Fluid restriction is inappropriate.
Q2. A nurse is assessing a client in the PACU. Which finding requires
immediate intervention?
A. Respiratory rate 14/min
B. Oxygen saturation 89% on 2 L nasal cannula
C. Blood pressure 118/76 mm Hg
D. Pain rated 4/10
Answer: B
Rationale: SpO2 <90% indicates hypoxemia and requires immediate
,intervention (increase oxygen, assess airway, stimulate). The other findings
are within acceptable postoperative ranges.
Q3. Which client is at highest risk for malignant hyperthermia during
surgery?
A. Client with a history of asthma
B. Client with a family history of malignant hyperthermia
C. Client taking beta-blockers
D. Client with diabetes mellitus
Answer: B
Rationale: Malignant hyperthermia is an autosomal dominant genetic
disorder triggered by inhaled anesthetics and succinylcholine. Family
history is the strongest risk factor. Dantrolene is the treatment.
Q4. A nurse is preparing a client for surgery. Which instruction should
the nurse include?
A. "You may eat a light breakfast on the morning of surgery."
B. "You should stop taking all medications 1 week before surgery."
C. "You will need to sign the consent form after receiving sedation."
D. "You should practice coughing and deep breathing exercises before
surgery."
Answer: D
Rationale: Preoperative teaching includes coughing and deep breathing to
prevent postoperative pulmonary complications. NPO status is required.
Medications are managed individually by the provider. Consent must be
signed before sedation.
Q5. A nurse is monitoring a client 4 hours after surgery. The client's
blood pressure has dropped from 128/76 to 92/58 mm Hg. Which
finding is most concerning?
A. Heart rate 88/min
,B. Urine output 50 mL over 4 hours
C. Drainage saturated the dressing in 1 hour
D. Pain rated 5/10
Answer: C
Rationale: Saturating a dressing in 1 hour indicates active hemorrhage
and hypovolemia, explaining the hypotension. Urine output of 50 mL over 4
hours is minimal but not immediately life-threatening. Tachycardia may not
yet be present.
Q6. A nurse is teaching a client about the purpose of an incentive
spirometer. Which statement indicates understanding?
A. "It helps expand my lungs and prevent pneumonia."
B. "It measures my oxygen level."
C. "It delivers medication to my lungs."
D. "It helps me cough up secretions."
Answer: A
Rationale: Incentive spirometry encourages deep lung expansion to
prevent atelectasis and pneumonia. It does not measure oxygen, deliver
medication, or directly assist with coughing.
Q7. A client is scheduled for an emergency appendectomy. The nurse
should prioritize which action?
A. Obtain informed consent
B. Administer preoperative antibiotics
C. Verify NPO status
D. Insert an IV line
Answer: C
Rationale: In emergency surgery, verifying NPO status is critical to prevent
aspiration during anesthesia. Consent and IV access are important but
secondary to airway safety.
, Q8. A nurse is assessing a client with a history of obstructive sleep
apnea who is scheduled for surgery. Which action is most important?
A. Ensure the client receives sedation before surgery
B. Monitor for respiratory depression postoperatively
C. Encourage supine positioning after surgery
D. Restrict opioid pain medication
Answer: B
Rationale: Clients with OSA are at high risk for respiratory depression and
airway obstruction postoperatively. Continuous monitoring and cautious
opioid use are essential.
Q9. A nurse is caring for a client who develops a fever of 101.8°F on
postoperative day 2. Which cause should the nurse suspect first?
A. Atelectasis
B. Wound infection
C. Urinary tract infection
D. Deep vein thrombosis
Answer: A
Rationale: Atelectasis is the most common cause of early postoperative
fever (within 24–48 hours). Wound infection typically occurs later (days 3–
5). UTI and DVT may also cause fever but are less common early.
Q10. A nurse is preparing to administer preoperative medication.
Which medication is commonly given to reduce gastric acidity?
A. Metoclopramide
B. Ranitidine
C. Midazolam
D. Atropine
Answer: B
Rationale: H2 blockers (ranitidine) reduce gastric acidity and volume,
COMPREHENSIVE TEST BANK Herzing University | 2026
Updated | 200+ Questions with Correct Answers & Rationales
Section 1: Perioperative Care (Q1–Q15)
Q1. A nurse is caring for a client who is 24 hours postoperative
following abdominal surgery. The client reports incisional pain rated
6/10 and is reluctant to cough and deep breathe. Which action should
the nurse take first?
A. Document the finding and reassess in 1 hour
B. Administer prescribed analgesic and encourage splinting while coughing
C. Notify the provider immediately
D. Restrict fluids to reduce respiratory secretions
Answer: B
Rationale: Pain inhibits deep breathing and coughing, increasing risk of
atelectasis and pneumonia. Administering analgesia and teaching splinting
optimizes pain control and pulmonary hygiene. Documentation alone is
insufficient. Provider notification is not required for expected postoperative
pain. Fluid restriction is inappropriate.
Q2. A nurse is assessing a client in the PACU. Which finding requires
immediate intervention?
A. Respiratory rate 14/min
B. Oxygen saturation 89% on 2 L nasal cannula
C. Blood pressure 118/76 mm Hg
D. Pain rated 4/10
Answer: B
Rationale: SpO2 <90% indicates hypoxemia and requires immediate
,intervention (increase oxygen, assess airway, stimulate). The other findings
are within acceptable postoperative ranges.
Q3. Which client is at highest risk for malignant hyperthermia during
surgery?
A. Client with a history of asthma
B. Client with a family history of malignant hyperthermia
C. Client taking beta-blockers
D. Client with diabetes mellitus
Answer: B
Rationale: Malignant hyperthermia is an autosomal dominant genetic
disorder triggered by inhaled anesthetics and succinylcholine. Family
history is the strongest risk factor. Dantrolene is the treatment.
Q4. A nurse is preparing a client for surgery. Which instruction should
the nurse include?
A. "You may eat a light breakfast on the morning of surgery."
B. "You should stop taking all medications 1 week before surgery."
C. "You will need to sign the consent form after receiving sedation."
D. "You should practice coughing and deep breathing exercises before
surgery."
Answer: D
Rationale: Preoperative teaching includes coughing and deep breathing to
prevent postoperative pulmonary complications. NPO status is required.
Medications are managed individually by the provider. Consent must be
signed before sedation.
Q5. A nurse is monitoring a client 4 hours after surgery. The client's
blood pressure has dropped from 128/76 to 92/58 mm Hg. Which
finding is most concerning?
A. Heart rate 88/min
,B. Urine output 50 mL over 4 hours
C. Drainage saturated the dressing in 1 hour
D. Pain rated 5/10
Answer: C
Rationale: Saturating a dressing in 1 hour indicates active hemorrhage
and hypovolemia, explaining the hypotension. Urine output of 50 mL over 4
hours is minimal but not immediately life-threatening. Tachycardia may not
yet be present.
Q6. A nurse is teaching a client about the purpose of an incentive
spirometer. Which statement indicates understanding?
A. "It helps expand my lungs and prevent pneumonia."
B. "It measures my oxygen level."
C. "It delivers medication to my lungs."
D. "It helps me cough up secretions."
Answer: A
Rationale: Incentive spirometry encourages deep lung expansion to
prevent atelectasis and pneumonia. It does not measure oxygen, deliver
medication, or directly assist with coughing.
Q7. A client is scheduled for an emergency appendectomy. The nurse
should prioritize which action?
A. Obtain informed consent
B. Administer preoperative antibiotics
C. Verify NPO status
D. Insert an IV line
Answer: C
Rationale: In emergency surgery, verifying NPO status is critical to prevent
aspiration during anesthesia. Consent and IV access are important but
secondary to airway safety.
, Q8. A nurse is assessing a client with a history of obstructive sleep
apnea who is scheduled for surgery. Which action is most important?
A. Ensure the client receives sedation before surgery
B. Monitor for respiratory depression postoperatively
C. Encourage supine positioning after surgery
D. Restrict opioid pain medication
Answer: B
Rationale: Clients with OSA are at high risk for respiratory depression and
airway obstruction postoperatively. Continuous monitoring and cautious
opioid use are essential.
Q9. A nurse is caring for a client who develops a fever of 101.8°F on
postoperative day 2. Which cause should the nurse suspect first?
A. Atelectasis
B. Wound infection
C. Urinary tract infection
D. Deep vein thrombosis
Answer: A
Rationale: Atelectasis is the most common cause of early postoperative
fever (within 24–48 hours). Wound infection typically occurs later (days 3–
5). UTI and DVT may also cause fever but are less common early.
Q10. A nurse is preparing to administer preoperative medication.
Which medication is commonly given to reduce gastric acidity?
A. Metoclopramide
B. Ranitidine
C. Midazolam
D. Atropine
Answer: B
Rationale: H2 blockers (ranitidine) reduce gastric acidity and volume,
