HESI Med-Surg RN Custom Exam (Med Surg II) – 150 NGN Questions & Answers | 2025/2026 Study Resource

Mastering High-Acuity Clinical JudgmentThe Med-Surg II Custom HESI is designed to test your knowledge of complex system failures, multisystem organ dysfunction, and critical care interventions. This 150-question NGN bank moves beyond basic medical-surgical concepts into advanced clinical reasoning.Unlike standard exams, this custom version emphasizes the NCLEX Clinical Judgment Measurement Model (NCJMM). You will encounter evolving case studies, trend analysis, and complex prioritization scenarios involving hemodynamically unstable patients, ventilator management, and advanced electrolyte imbalances.Why This 2025/2026 Resource is Graded A+NGN Format Mastery: Includes Matrix/Grid, Bowtie, and Drop-down Cloze questions specifically designed for Med-Surg II content.Acute Care Focus: Deep dives into ACLS protocols, Shock (Hypovolemic, Septic, Cardiogenic), and ARDS management.Prioritization Logic: Features "Who do you see first?" scenarios for the high-acuity floor.Verified Rationales: Every answer is supported by the latest Lewis or Ignatavicius Medical-Surgical Nursing standards.Detailed Content Blueprint (Advanced Med-Surg II)1. Critical Care & Hemodynamics (25%)Shock States: Recognizing the early signs of Septic Shock (warm phase) vs. late signs (cold phase).Hemodynamic Monitoring: Interpreting CVP, PAWP, and Cardiac Output values to guide fluid resuscitation.2. Advanced Cardiovascular & EKG (20%)Dysrhythmias: Identifying and treating life-threatening rhythms: V-Tach, V-Fib, SVT, and 3rd Degree Heart Block.Acute Coronary Syndrome (ACS): Management of STEMI vs. NSTEMI and post-CABG nursing care.3. Complex Respiratory & Ventilator Care (20%)Mechanical Ventilation: Troubleshooting high-pressure vs. low-pressure alarms and preventing Ventilator-Associated Pneumonia (VAP).ARDS & PE: Identifying the "Ground Glass" appearance on imaging and managing refractory hypoxemia.4. Neurological & Renal Emergencies (20%)Increased ICP: Monitoring for Cushing’s Triad and managing osmotic diuretics (Mannitol).AKI & ESRD: Differentiating between Prerenal, Intrarenal, and Postrenal failure and managing hemodialysis complications.5. Multisystem Failure & Trauma (15%)DIC & MODS: Recognizing the systemic inflammatory response syndrome (SIRS) criteria.Burns: Utilizing the Parkland Formula for fluid resuscitation and the "Rule of Nines" for assessment.Strategic Preparation: The HESI Med-Surg II RoadmapThe "Trend" is Your Friend: In NGN case studies, look at the labs over a 24-hour period. A Potassium that moves from $3.2$ to $2.8$ is more urgent than a stable low value.The "Next Best Action" Filter: Always ask, "What is the priority safety intervention?" If a patient is in V-Tach with a pulse, the answer is cardioversion; without a pulse, it is defibrillation.Lab Thresholds for Med-Surg II:Troponin: Any elevation is critical.BNP: $100$ suggests Heart Failure.Lactate: $2$ suggests anaerobic metabolism/Sepsis.Creatinine: $1.3$ suggests acute kidney injury.Conclusion: Conquer the High-Acuity HESIThe HESI Med-Surg II RN Custom Exam is a rigorous test of your transition from student to professional nurse. This 150-question NGN bank provides the depth, clinical logic, and specialized content needed to score over 900 and move toward graduation with confidence.