MED-SURG II HESI ADVANCED
PREPARATION QUESTIONS AND
VERIFIED ANSWERS |GRADE A+| JUST
RELEASED
1. A patient with acute respiratory distress syndrome (ARDS) is receiving mechanical
ventilation with high levels of positive end-expiratory pressure (PEEP). Which assessment
finding most likely indicates a complication of this therapy?
A. Respiratory alkalosis on ABG
B. Increased arterial oxygen saturation
C. Decreased plateau pressure
D. Reduced cardiac output and hypotension
Answer: D
Conceptual Explanation: High levels of PEEP increase intrathoracic pressure, which can
decrease venous return to the heart, leading to reduced preload, decreased cardiac output,
and hypotension.
,2. A client with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which cardiac rhythm change should the nurse expect to see on the ECG monitor?
A. Presence of U waves
B. Prominent P waves
C. Prolonged ST segment
D. Tall, peaked T waves
Answer: D
Conceptual Explanation: Hyperkalemia (K+ > 5.0 mEq/L) causes peaked T waves,
widened QRS complexes, and potentially cardiac arrest. U waves are seen in hypokalemia.
3. The nurse is caring for a patient in the ICU with a head injury. The patient’s intracranial
pressure (ICP) is 22 mmHg. Which intervention should the nurse prioritize?
A. Encourage the patient to cough and deep breathe
B. Cluster nursing care to allow for rest periods
C. Perform frequent endotracheal suctioning
D. Maintain the head of the bed at 30 to 45 degrees
Answer: D
Conceptual Explanation: Elevating the head of the bed promotes venous drainage from
the brain and helps lower ICP. Coughing and suctioning increase ICP and should be
minimized.
, 4. A patient is admitted with Diabetic Ketoacidosis (DKA). The nurse initiates an IV infusion of
0.9% Normal Saline. What is the primary purpose of this initial intervention?
A. To lower blood glucose levels rapidly
B. To replace intracellular potassium levels
C. To restore extracellular fluid volume and perfusion
D. To correct the metabolic acidosis
Answer: C
Conceptual Explanation: The priority in DKA is volume repletion to treat dehydration and
shock. Insulin is used to lower glucose and correct acidosis after fluid resuscitation has
begun.
5. A patient with liver cirrhosis is prescribed lactulose. The nurse determines the medication
is effective based on which finding?
A. Increased urine output
B. Reduced abdominal girth
C. Decreased serum ammonia levels
D. Increased serum albumin levels
Answer: C
PREPARATION QUESTIONS AND
VERIFIED ANSWERS |GRADE A+| JUST
RELEASED
1. A patient with acute respiratory distress syndrome (ARDS) is receiving mechanical
ventilation with high levels of positive end-expiratory pressure (PEEP). Which assessment
finding most likely indicates a complication of this therapy?
A. Respiratory alkalosis on ABG
B. Increased arterial oxygen saturation
C. Decreased plateau pressure
D. Reduced cardiac output and hypotension
Answer: D
Conceptual Explanation: High levels of PEEP increase intrathoracic pressure, which can
decrease venous return to the heart, leading to reduced preload, decreased cardiac output,
and hypotension.
,2. A client with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which cardiac rhythm change should the nurse expect to see on the ECG monitor?
A. Presence of U waves
B. Prominent P waves
C. Prolonged ST segment
D. Tall, peaked T waves
Answer: D
Conceptual Explanation: Hyperkalemia (K+ > 5.0 mEq/L) causes peaked T waves,
widened QRS complexes, and potentially cardiac arrest. U waves are seen in hypokalemia.
3. The nurse is caring for a patient in the ICU with a head injury. The patient’s intracranial
pressure (ICP) is 22 mmHg. Which intervention should the nurse prioritize?
A. Encourage the patient to cough and deep breathe
B. Cluster nursing care to allow for rest periods
C. Perform frequent endotracheal suctioning
D. Maintain the head of the bed at 30 to 45 degrees
Answer: D
Conceptual Explanation: Elevating the head of the bed promotes venous drainage from
the brain and helps lower ICP. Coughing and suctioning increase ICP and should be
minimized.
, 4. A patient is admitted with Diabetic Ketoacidosis (DKA). The nurse initiates an IV infusion of
0.9% Normal Saline. What is the primary purpose of this initial intervention?
A. To lower blood glucose levels rapidly
B. To replace intracellular potassium levels
C. To restore extracellular fluid volume and perfusion
D. To correct the metabolic acidosis
Answer: C
Conceptual Explanation: The priority in DKA is volume repletion to treat dehydration and
shock. Insulin is used to lower glucose and correct acidosis after fluid resuscitation has
begun.
5. A patient with liver cirrhosis is prescribed lactulose. The nurse determines the medication
is effective based on which finding?
A. Increased urine output
B. Reduced abdominal girth
C. Decreased serum ammonia levels
D. Increased serum albumin levels
Answer: C
