NSG 223 Med Surg 2 HESI Final Medical-Surgical
Nursing Actual Exam 2026/2027 | Complete Exam-
Style Questions with Detailed Rationales | Graded
A+ Verified – Pass Guaranteed
Section: Perioperative Care and Surgical Complications
Q1: A patient is returning to the surgical unit following an exploratory laparotomy. Which
assessment finding requires immediate intervention?
A. Temperature of 98.6°F
B. Respiratory rate of 16 breaths/min
C. Urine output of 20 mL/hr for the past 2 hours [CORRECT]
D. Pain rated 4 out of 10 on a numeric scale
Correct Answer: C
Rationale: The best answer is a urine output of 20 mL/hr, as oliguria indicates potential
hypovolemia, acute kidney injury, or inadequate renal perfusion, requiring prompt
evaluation.
Q2: The nurse is teaching a preoperative patient about the use of an incentive spirometer.
Which statement by the patient indicates a correct understanding of the technique?
A. I will blow into the mouthpiece as hard as I can to raise the balls.
B. I should use it only when I feel short of breath or have chest pain.
C. I will seal my lips tightly around the mouthpiece and inhale slowly and deeply. [CORRECT]
D. I need to perform this exercise quickly five times every hour.
Correct Answer: C
Rationale: This choice is correct because the goal of incentive spirometry is to promote
sustained maximal inspiration to expand the alveoli, which requires a slow, deep inhalation
with a tight seal.
Q3: A postoperative patient is prescribed enoxaparin for deep vein thrombosis prophylaxis.
Which action by the nurse is appropriate when administering this medication?
A. Expelling the air bubble from the prefilled syringe before injection
B. Massaging the injection site gently after administration
C. Administering the injection into the anterolateral abdominal wall [CORRECT]
D. Aspirating for blood return prior to pushing the plunger
Correct Answer: C
Rationale: This aligns with the principle that low-molecular-weight heparins are given
subcutaneously in the abdominal area without aspiration or post-injection massage to
prevent bruising and hematoma formation.
Q4: During a surgical procedure, the patient's end-tidal carbon dioxide level suddenly rises,
and the nurse notes tachycardia and muscle rigidity. What is the priority action?
,A. Administer a rapid-acting beta-blocker
B. Prepare to administer dantrolene sodium [CORRECT]
C. Increase the IV fluid infusion rate
D. Apply a cooling blanket to the patient's torso
Correct Answer: B
Rationale: The best answer is to prepare dantrolene sodium, as these are classic early signs
of malignant hyperthermia, a life-threatening reaction to certain anesthetics that requires
immediate administration of this specific antidote.
Q5: A patient two days post-abdominal surgery reports a sudden "popping" sensation in
their incision after coughing. The nurse assesses the wound and notes evisceration. What is
the immediate nursing action?
A. Push the protruding organs back into the abdominal cavity gently
B. Apply a sterile dressing moistened with sterile normal saline [CORRECT]
C. Leave the wound open to air and notify the surgeon immediately
D. Apply a tight abdominal binder to hold the organs in place
Correct Answer: B
Rationale: This matches the principle that eviscerated organs must be kept moist and
protected with sterile saline-soaked dressings to prevent tissue necrosis while awaiting
emergency surgical repair.
Q6: The nurse is reviewing the medication list for a patient scheduled for major surgery
tomorrow. Which medication should the nurse question the provider about holding?
A. Metoprolol
B. Lisinopril [CORRECT]
C. Levothyroxine
D. Atorvastatin
Correct Answer: B
Rationale: This choice is correct because ACE inhibitors like lisinopril are typically held the
morning of surgery to prevent severe, refractory hypotension during and after the
administration of anesthesia.
Q7: A patient is recovering from a total hip arthroplasty via a posterior approach. Which
position or movement should the nurse strictly avoid?
A. Abduction of the affected leg using a pillow
B. Flexing the hip greater than 90 degrees [CORRECT]
C. Keeping the affected leg in external rotation
D. Elevating the head of the bed to 45 degrees
Correct Answer: B
Rationale: The best answer is avoiding hip flexion greater than 90 degrees, as this position
significantly increases the risk of posterior hip dislocation following this specific surgical
approach.
Q8: A patient is four days postoperative from a bowel resection and reports increasing
abdominal pain and bloating. The nurse auscultates absent bowel sounds and notes a firm,
distended abdomen. This presentation is most consistent with:
A. Normal postoperative ileus
, B. Paralytic ileus requiring intervention [CORRECT]
C. Expected surgical site inflammation
D. Impending bowel perforation
Correct Answer: B
Rationale: This aligns with the clinical picture of a paralytic ileus, where peristalsis has
ceased beyond the expected initial postoperative period, leading to painful distension and
absent bowel sounds that require medical evaluation.
Q9: A patient arrives in the post-anesthesia care unit (PACU) following general anesthesia.
What is the nurse's primary assessment priority?
A. Checking the surgical dressing for bleeding
B. Assessing airway patency and respiratory effort [CORRECT]
C. Evaluating the return of the gag reflex
D. Monitoring the patient's pain level
Correct Answer: B
Rationale: The best answer is assessing airway patency, as the ABCs (Airway, Breathing,
Circulation) always dictate that securing a clear airway is the absolute first priority in any
post-anesthesia patient.
Q10: A patient scheduled for a diagnostic procedure reports an allergy to bananas and
avocados. The nurse should immediately alert the surgical team about the potential risk for
which type of allergy?
A. Iodine contrast allergy
B. Latex allergy [CORRECT]
C. Penicillin allergy
D. Adhesive tape allergy
Correct Answer: B
Rationale: This choice is correct because patients with allergies to certain fruits like bananas,
avocados, and kiwis have a high cross-sensitivity to latex proteins, putting them at risk for a
severe intraoperative reaction.
Q11: While assisting a postoperative patient to the chair, the nurse notices the surgical
incision has separated and a small loop of bowel is visible. After covering the area, what is
the next best action?
A. Have the patient stand up to relieve abdominal pressure
B. Instruct the patient to bend their knees and stay in a low Fowler's position [CORRECT]
C. Encourage the patient to cough to clear their airway
D. Push the emergency call bell and leave the patient to get the surgeon
Correct Answer: B
Rationale: This matches the principle that keeping the patient in a low Fowler's position with
knees bent reduces tension on the abdominal muscles and prevents further extrusion of
abdominal contents.
Q12: A nurse is obtaining informed consent for a surgical procedure. The patient asks, "Can
you explain exactly what the surgeon is going to do to my knee?" What is the most
appropriate response by the nurse?
A. I will explain the procedure to you since I have assisted in the OR.
Nursing Actual Exam 2026/2027 | Complete Exam-
Style Questions with Detailed Rationales | Graded
A+ Verified – Pass Guaranteed
Section: Perioperative Care and Surgical Complications
Q1: A patient is returning to the surgical unit following an exploratory laparotomy. Which
assessment finding requires immediate intervention?
A. Temperature of 98.6°F
B. Respiratory rate of 16 breaths/min
C. Urine output of 20 mL/hr for the past 2 hours [CORRECT]
D. Pain rated 4 out of 10 on a numeric scale
Correct Answer: C
Rationale: The best answer is a urine output of 20 mL/hr, as oliguria indicates potential
hypovolemia, acute kidney injury, or inadequate renal perfusion, requiring prompt
evaluation.
Q2: The nurse is teaching a preoperative patient about the use of an incentive spirometer.
Which statement by the patient indicates a correct understanding of the technique?
A. I will blow into the mouthpiece as hard as I can to raise the balls.
B. I should use it only when I feel short of breath or have chest pain.
C. I will seal my lips tightly around the mouthpiece and inhale slowly and deeply. [CORRECT]
D. I need to perform this exercise quickly five times every hour.
Correct Answer: C
Rationale: This choice is correct because the goal of incentive spirometry is to promote
sustained maximal inspiration to expand the alveoli, which requires a slow, deep inhalation
with a tight seal.
Q3: A postoperative patient is prescribed enoxaparin for deep vein thrombosis prophylaxis.
Which action by the nurse is appropriate when administering this medication?
A. Expelling the air bubble from the prefilled syringe before injection
B. Massaging the injection site gently after administration
C. Administering the injection into the anterolateral abdominal wall [CORRECT]
D. Aspirating for blood return prior to pushing the plunger
Correct Answer: C
Rationale: This aligns with the principle that low-molecular-weight heparins are given
subcutaneously in the abdominal area without aspiration or post-injection massage to
prevent bruising and hematoma formation.
Q4: During a surgical procedure, the patient's end-tidal carbon dioxide level suddenly rises,
and the nurse notes tachycardia and muscle rigidity. What is the priority action?
,A. Administer a rapid-acting beta-blocker
B. Prepare to administer dantrolene sodium [CORRECT]
C. Increase the IV fluid infusion rate
D. Apply a cooling blanket to the patient's torso
Correct Answer: B
Rationale: The best answer is to prepare dantrolene sodium, as these are classic early signs
of malignant hyperthermia, a life-threatening reaction to certain anesthetics that requires
immediate administration of this specific antidote.
Q5: A patient two days post-abdominal surgery reports a sudden "popping" sensation in
their incision after coughing. The nurse assesses the wound and notes evisceration. What is
the immediate nursing action?
A. Push the protruding organs back into the abdominal cavity gently
B. Apply a sterile dressing moistened with sterile normal saline [CORRECT]
C. Leave the wound open to air and notify the surgeon immediately
D. Apply a tight abdominal binder to hold the organs in place
Correct Answer: B
Rationale: This matches the principle that eviscerated organs must be kept moist and
protected with sterile saline-soaked dressings to prevent tissue necrosis while awaiting
emergency surgical repair.
Q6: The nurse is reviewing the medication list for a patient scheduled for major surgery
tomorrow. Which medication should the nurse question the provider about holding?
A. Metoprolol
B. Lisinopril [CORRECT]
C. Levothyroxine
D. Atorvastatin
Correct Answer: B
Rationale: This choice is correct because ACE inhibitors like lisinopril are typically held the
morning of surgery to prevent severe, refractory hypotension during and after the
administration of anesthesia.
Q7: A patient is recovering from a total hip arthroplasty via a posterior approach. Which
position or movement should the nurse strictly avoid?
A. Abduction of the affected leg using a pillow
B. Flexing the hip greater than 90 degrees [CORRECT]
C. Keeping the affected leg in external rotation
D. Elevating the head of the bed to 45 degrees
Correct Answer: B
Rationale: The best answer is avoiding hip flexion greater than 90 degrees, as this position
significantly increases the risk of posterior hip dislocation following this specific surgical
approach.
Q8: A patient is four days postoperative from a bowel resection and reports increasing
abdominal pain and bloating. The nurse auscultates absent bowel sounds and notes a firm,
distended abdomen. This presentation is most consistent with:
A. Normal postoperative ileus
, B. Paralytic ileus requiring intervention [CORRECT]
C. Expected surgical site inflammation
D. Impending bowel perforation
Correct Answer: B
Rationale: This aligns with the clinical picture of a paralytic ileus, where peristalsis has
ceased beyond the expected initial postoperative period, leading to painful distension and
absent bowel sounds that require medical evaluation.
Q9: A patient arrives in the post-anesthesia care unit (PACU) following general anesthesia.
What is the nurse's primary assessment priority?
A. Checking the surgical dressing for bleeding
B. Assessing airway patency and respiratory effort [CORRECT]
C. Evaluating the return of the gag reflex
D. Monitoring the patient's pain level
Correct Answer: B
Rationale: The best answer is assessing airway patency, as the ABCs (Airway, Breathing,
Circulation) always dictate that securing a clear airway is the absolute first priority in any
post-anesthesia patient.
Q10: A patient scheduled for a diagnostic procedure reports an allergy to bananas and
avocados. The nurse should immediately alert the surgical team about the potential risk for
which type of allergy?
A. Iodine contrast allergy
B. Latex allergy [CORRECT]
C. Penicillin allergy
D. Adhesive tape allergy
Correct Answer: B
Rationale: This choice is correct because patients with allergies to certain fruits like bananas,
avocados, and kiwis have a high cross-sensitivity to latex proteins, putting them at risk for a
severe intraoperative reaction.
Q11: While assisting a postoperative patient to the chair, the nurse notices the surgical
incision has separated and a small loop of bowel is visible. After covering the area, what is
the next best action?
A. Have the patient stand up to relieve abdominal pressure
B. Instruct the patient to bend their knees and stay in a low Fowler's position [CORRECT]
C. Encourage the patient to cough to clear their airway
D. Push the emergency call bell and leave the patient to get the surgeon
Correct Answer: B
Rationale: This matches the principle that keeping the patient in a low Fowler's position with
knees bent reduces tension on the abdominal muscles and prevents further extrusion of
abdominal contents.
Q12: A nurse is obtaining informed consent for a surgical procedure. The patient asks, "Can
you explain exactly what the surgeon is going to do to my knee?" What is the most
appropriate response by the nurse?
A. I will explain the procedure to you since I have assisted in the OR.
