ADVANCED MED SURG HESI FINAL EXAM
SCRIPT 2026 QUESTIONS WITH SOLUTIONS
GRADED A+
● Which type of allergic skin condition in a client is associated with
immunological irregularity, asthma, and allergic rhinitis? Answer:
Atopic dermatitis is an allergic skin condition that is a genetically
influenced, chronic, relapsing disease. It is associated with immunologic
irregularity involving inflammatory mediators associated with allergic
rhinitis and asthma. Urticaria is an allergic skin condition that results in
a local increase in permeability of capillaries, causing erythema and
edema in the upper dermis. Psoriasis is an autoimmune chronic
dermatitis but not an allergic skin condition. Acne vulgaris is an
inflammatory disorder of sebaceous glands.
● A client with a history of emphysema develops a respiratory infection
and is admitted to the hospital in acute respiratory distress. The client's
arterial blood studies indicate pH 7.30, PO2 60 mm Hg, PCO2 55 mm
Hg, and HCO3 23 mEq/L (23 mmol/L). How should the nurse interpret
these findings? Answer: The client is experiencing respiratory acidosis.
The pH is less than the norm of 7.35 to 7.45, indicating acidosis. The
PO2 is less than the norm of 80 to 100 mm Hg. The PCO2 is increased
more than the norm of 35 to 45 mm Hg. The HCO3 is within the norm
of 21 to 28 mEq/L (21 to 28 mmol/L). These results indicate a
respiratory etiology. The client's carbon dioxide level is increased
,(hypercapnia), not decreased. These values are unrelated to
hyperkalemia; a serum potassium level of more than 5 mEq/L (5
mmol/L) indicates hyperkalemia. These values are unrelated to anemia;
decreased levels of red blood cells (RBCs), hemoglobin, and hematocrit
are related to anemia.
● A client who is admitted to the hospital and requires a colon resection
states, "I want to be a do not resuscitate (DNR)." The nurse questions the
client's understanding of a DNR order. Which response by the client best
indicates to the nurse an understanding of a DNR order?
My doctor will know what to do."
2
"My family can make the decisions for me."
Correct3
"If something happens to me, I do not want CPR."
4
"If I have a heart attack, I do not want any medication Answer: The
statement, "If something happens to me, I do not want CPR,"
specifically states that if cardiac or respiratory arrest occurs, the client
would rather die peacefully and does not want cardiorespiratory
resuscitation. If a DNR order is signed by the client, cardiopulmonary
resuscitation will not be instituted. The response, "My doctor will know
what to do," reflects an advance directive (e.g., durable power of
attorney for health care), wherein a client gives power to another person
(agent, surrogate, or proxy) to make healthcare decisions on the client's
,behalf. The response, "My family can make the decisions for me,"
reflects an advance directive (e.g., durable power of attorney for health
care), wherein a client gives power to another person (agent, surrogate,
or proxy) to make healthcare decisions on the client's behalf. The
response, "If I have a heart attack, I do not want any medication,"
reflects an advance directive (e.g., living will), wherein the client directs
treatment in accordance with personal wishes.
● A client recovering from hepatitis A asks the nurse about returning to
work. Which is the best response by the nurse?
1 "As soon as you're feeling less tired, you may go back to work."
2 "Unfortunately, few people fully recover from hepatitis in less than six
months."
3 "Gradually increase your activities because relapses may occur in
those who return to full activity too soon."
4 "You cannot return to work for six months because the virus will still
be in your stools, and you still are communicable." Answer: Ans: 3
Relapses are common; they occur after too early ambulation and too
much physical activity. Fatigue is a cardinal symptom; if the client tires
at rest, a return to work must be delayed. The client does not stay
contagious for six months.
● After a subtotal gastrectomy, a client has a nasogastric (NG) tube to
continuous low suction. Three hours after the surgery, the client
, complains of nausea and abdominal pain. The client's abdomen appears
distended. What should the nurse do first?
1
Instill 30 mL of air into the NG tube
2
Administer the prescribed pain medication
3
Inform the client that abdominal pain is common with NG tubes
4
Notify the surgeon of the absence of bowel sounds Answer: Abdominal
distention, nausea, and abdominal pain can be signs of nasogastric tube
blockage. Instilling 30 mL of air may reestablish patency. Although
opioids usually are prescribed postoperatively, they tend to decrease
peristalsis and may increase abdominal distention and nausea. It is not
common for NG tubes to cause abdominal pain. There will be no stools
for several days. Bowel sounds are not expected for several days after
stomach or intestinal surgery.
Test-Taking Tip: After choosing an answer, go back and reread the
question stem along with your chosen answer. Does it fit correctly? The
choice that grammatically fits the stem and contains the correct
information is the best choice.
● A client had a cholecystectomy and asks whether there will be any
dietary restrictions after the client's discharge. The nurse evaluates that
SCRIPT 2026 QUESTIONS WITH SOLUTIONS
GRADED A+
● Which type of allergic skin condition in a client is associated with
immunological irregularity, asthma, and allergic rhinitis? Answer:
Atopic dermatitis is an allergic skin condition that is a genetically
influenced, chronic, relapsing disease. It is associated with immunologic
irregularity involving inflammatory mediators associated with allergic
rhinitis and asthma. Urticaria is an allergic skin condition that results in
a local increase in permeability of capillaries, causing erythema and
edema in the upper dermis. Psoriasis is an autoimmune chronic
dermatitis but not an allergic skin condition. Acne vulgaris is an
inflammatory disorder of sebaceous glands.
● A client with a history of emphysema develops a respiratory infection
and is admitted to the hospital in acute respiratory distress. The client's
arterial blood studies indicate pH 7.30, PO2 60 mm Hg, PCO2 55 mm
Hg, and HCO3 23 mEq/L (23 mmol/L). How should the nurse interpret
these findings? Answer: The client is experiencing respiratory acidosis.
The pH is less than the norm of 7.35 to 7.45, indicating acidosis. The
PO2 is less than the norm of 80 to 100 mm Hg. The PCO2 is increased
more than the norm of 35 to 45 mm Hg. The HCO3 is within the norm
of 21 to 28 mEq/L (21 to 28 mmol/L). These results indicate a
respiratory etiology. The client's carbon dioxide level is increased
,(hypercapnia), not decreased. These values are unrelated to
hyperkalemia; a serum potassium level of more than 5 mEq/L (5
mmol/L) indicates hyperkalemia. These values are unrelated to anemia;
decreased levels of red blood cells (RBCs), hemoglobin, and hematocrit
are related to anemia.
● A client who is admitted to the hospital and requires a colon resection
states, "I want to be a do not resuscitate (DNR)." The nurse questions the
client's understanding of a DNR order. Which response by the client best
indicates to the nurse an understanding of a DNR order?
My doctor will know what to do."
2
"My family can make the decisions for me."
Correct3
"If something happens to me, I do not want CPR."
4
"If I have a heart attack, I do not want any medication Answer: The
statement, "If something happens to me, I do not want CPR,"
specifically states that if cardiac or respiratory arrest occurs, the client
would rather die peacefully and does not want cardiorespiratory
resuscitation. If a DNR order is signed by the client, cardiopulmonary
resuscitation will not be instituted. The response, "My doctor will know
what to do," reflects an advance directive (e.g., durable power of
attorney for health care), wherein a client gives power to another person
(agent, surrogate, or proxy) to make healthcare decisions on the client's
,behalf. The response, "My family can make the decisions for me,"
reflects an advance directive (e.g., durable power of attorney for health
care), wherein a client gives power to another person (agent, surrogate,
or proxy) to make healthcare decisions on the client's behalf. The
response, "If I have a heart attack, I do not want any medication,"
reflects an advance directive (e.g., living will), wherein the client directs
treatment in accordance with personal wishes.
● A client recovering from hepatitis A asks the nurse about returning to
work. Which is the best response by the nurse?
1 "As soon as you're feeling less tired, you may go back to work."
2 "Unfortunately, few people fully recover from hepatitis in less than six
months."
3 "Gradually increase your activities because relapses may occur in
those who return to full activity too soon."
4 "You cannot return to work for six months because the virus will still
be in your stools, and you still are communicable." Answer: Ans: 3
Relapses are common; they occur after too early ambulation and too
much physical activity. Fatigue is a cardinal symptom; if the client tires
at rest, a return to work must be delayed. The client does not stay
contagious for six months.
● After a subtotal gastrectomy, a client has a nasogastric (NG) tube to
continuous low suction. Three hours after the surgery, the client
, complains of nausea and abdominal pain. The client's abdomen appears
distended. What should the nurse do first?
1
Instill 30 mL of air into the NG tube
2
Administer the prescribed pain medication
3
Inform the client that abdominal pain is common with NG tubes
4
Notify the surgeon of the absence of bowel sounds Answer: Abdominal
distention, nausea, and abdominal pain can be signs of nasogastric tube
blockage. Instilling 30 mL of air may reestablish patency. Although
opioids usually are prescribed postoperatively, they tend to decrease
peristalsis and may increase abdominal distention and nausea. It is not
common for NG tubes to cause abdominal pain. There will be no stools
for several days. Bowel sounds are not expected for several days after
stomach or intestinal surgery.
Test-Taking Tip: After choosing an answer, go back and reread the
question stem along with your chosen answer. Does it fit correctly? The
choice that grammatically fits the stem and contains the correct
information is the best choice.
● A client had a cholecystectomy and asks whether there will be any
dietary restrictions after the client's discharge. The nurse evaluates that
