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NSG 233 HESI Final Exam Review 2026: Medical-Surgical Nursing II – 200 High-Yield Practice Questions with Rationales/PDF.

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This comprehensive review is designed to prepare nursing students for the NSG 233 HESI Final Exam in Medical-Surgical Nursing II. It includes 200 high-quality, exam-style practice questions that reflect the structure, difficulty, and clinical focus of the actual HESI assessment. The questions cover essential medical-surgical topics, including cardiovascular, respiratory, endocrine, renal, neurological, gastrointestinal, and critical care concepts. Each question is accompanied by an italicized correct answer and a clear, concise rationale to reinforce understanding and support clinical judgment.

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HESI LPN-ADN Entrance Examination 2026–2027:
Mobility Section – Comprehensive Practice
Question Set (200 Questions with Answer
Rationales) /PDF.

Introduction
The Mobility section of the HESI LPN-ADN Entrance Exam assesses a candidate’s
foundational knowledge of musculoskeletal, neurological, cardiovascular, and
integumentary principles as they relate to patient movement, positioning,
ambulation, fall prevention, and the prevention of immobility-related
complications. Mastery of this content is essential for success on the exam and for
safe, competent clinical practice as a practical nurse.


HESI LPN-ADN Entrance Exam: Mobility Section (200 Questions)

Question 1: The LPN/LVN is preparing to ambulate a postoperative client after cardiac
surgery. The nurse plans to do which to enable the client to best tolerate the
ambulation?

1. Provide the client with a walker.
2. Remove the telemetry equipment.
3. Encourage the client to cough and deep breathe.
4. Premedicate the client with an analgesic before ambulating.

 Rationale: Pain can significantly limit a client's ability or willingness to ambulate
postoperatively. Administering an analgesic approximately 30 minutes before activity
helps manage incisional pain, reduces sympathetic stress (which decreases cardiac
workload), and allows the patient to participate more effectively in mobilization. A walker
aids stability but doesn't address pain; removing telemetry is unsafe; coughing is
important but does not directly facilitate ambulation tolerance.

Question 2: A client is wearing a continuous cardiac monitor, which begins to alarm at
the nurse's station. The nurse sees no electrocardiographic complexes on the screen.
The nurse should do which first?
a. Call a code blue.

, b. Call the health care provider.
c. Check the client status and lead placement.
d. Press the recorder button on the ECG console.

 Rationale: The absence of a waveform is often due to a technical issue, such as loose
leads, electrode detachment, or monitor malfunction, rather than true cardiac arrest. The
nurse must first assess the client visually and check lead connections to determine if the
patient is in distress or if the equipment is faulty. Calling a code without assessment
wastes critical time; checking the client is the priority.

Question 3: The LPN/LVN in a medical unit is caring for a client with heart failure. The
client suddenly develops extreme dyspnea, tachycardia, and lung crackles, and the nurse
suspects pulmonary edema. The nurse immediately notifies the registered nurse and
expects which interventions to be prescribed? Select all that apply.
a. Administering oxygen
b. Inserting a Foley catheter
c. Administering furosemide (Lasix)
d. Administering morphine sulfate intravenously
e. Transporting the client to the coronary care unit
f. Placing the client in a low-Fowler's side-lying position

 Rationale: Pulmonary edema is a medical emergency. Oxygen is given first to correct
hypoxia. Furosemide is a diuretic that rapidly reduces preload (fluid volume). Morphine
reduces preload, alleviates anxiety, and decreases the work of breathing. A Foley catheter
is inserted to monitor urine output (a key indicator of diuretic effectiveness). The patient
should be in high-Fowler's, not low-Fowler's, to ease breathing. While transfer to CCU may
occur later, it is not the immediate first-line intervention.

Question 4: The nurse is monitoring a client following cardioversion. Which
observations should be of highest priority to the nurse?
a. Blood pressure
b. Status of airway
c. Oxygen flow rate
d. Level of consciousness

 Rationale: The ABCs (Airway, Breathing, Circulation) always take priority. Following
cardioversion, the patient is often sedated and may have a depressed gag reflex or airway
obstruction. Ensuring a patent airway is the immediate, life-sustaining priority before
assessing blood pressure or level of consciousness.

, Question 5: The nurse is assisting in caring for the client immediately after insertion of a
permanent demand pacemaker via the right subclavian vein. The nurse prevents
dislodgement of the pacing catheter by implementing which intervention?
a. Limiting movement and abduction of the left arm
b. Limiting movement and abduction of the right arm
c. Assisting the client to get out of bed and ambulate with a walker
d. Having the physical therapist do active range of motion to the right arm

 Rationale: *Until the pacing lead is securely anchored in the myocardium (usually 24-48
hours), excessive movement of the arm on the insertion side can dislodge the lead.
Limiting abduction and flexion of the right arm prevents the lead from pulling out of the
vein. The left arm is not restricted. Early aggressive ROM or ambulation with a walker
increases the risk of dislodgement.*

Question 6: A client diagnosed with thrombophlebitis 1 day ago suddenly complains of
chest pain and shortness of breath, and the client is visibly anxious. The LPN/LVN
understands that a life-threatening complication of this condition is which?
a. Pneumonia
b. Pulmonary edema
c. Pulmonary embolism
d. Myocardial infarction

 Rationale: Thrombophlebitis involves a blood clot in a vein. If that clot (or a piece of it)
breaks off, it becomes an embolus. It travels through the venous system to the right side of
the heart and lodges in the pulmonary arteries, causing a pulmonary embolism (PE).
Symptoms include sudden chest pain, dyspnea, and anxiety.

Question 7: A 24-year-old man seeks medical attention for complaints of claudication
in the arch of the foot. The nurse also notes superficial thrombophlebitis of the lower
leg. The nurse should check the client for which next?
a. Smoking history
b. Recent exposure to allergens
c. History of recent insect bites
d. Familial tendency toward peripheral vascular disease

 Rationale: This combination of symptoms (claudication in a young person + migrating
thrombophlebitis) is highly suggestive of thromboangiitis obliterans (Buerger's disease).
This condition is strongly linked to tobacco use. Assessing smoking history is critical for
diagnosis and patient teaching, as cessation is the only way to halt disease progression.

, Question 8: The nurse has reinforced instructions to the client with Raynaud's disease
about self-management of the disease process. The nurse determines that the client
needs further teaching if the client states which?
a. "Smoking cessation is very important."
b. "Moving to a warmer climate should help."
c. "Sources of caffeine should be eliminated from the diet."
d. "Taking nifedipine (Procardia) as prescribed will decrease vessel spasm."

 Rationale: Raynaud's disease involves vasospasm triggered by cold or stress. While
moving to a warmer climate might reduce exposure, it is not a reliable cure (air
conditioning and stress still trigger attacks). Teaching should focus on avoiding triggers
and medications. Stating that a warmer climate "should help" suggests a
misunderstanding that climate change is a definitive cure rather than a management
strategy.

Question 9: A client with myocardial infarction suddenly becomes tachycardic, shows
signs of air hunger, and begins coughing frothy, pink-tinged sputum. The nurse listens
to breath sounds, expecting to hear which breath sounds bilaterally?
a. Rhonchi
b. Crackles
c. Wheezes
d. Diminished breath sounds

 Rationale: Frothy, pink-tinged sputum is the hallmark of pulmonary edema, usually
resulting from left-sided heart failure following an MI. As fluid accumulates in the
interstitial spaces and alveoli, it causes the alveoli to pop open during inspiration, creating
a sound called crackles (or rales). Rhonchi suggest secretions in large airways; wheezes
suggest bronchoconstriction.

Question 10: The LPN/LVN is collecting data on a client with a diagnosis of right-sided
heart failure. The nurse should expect to note which specific characteristic of this
condition?
a. Dyspnea
b. Hacking cough
c. Dependent edema
d. Crackles on lung auscultation

 Rationale: Right-sided heart failure results in systemic congestion because the right
ventricle cannot effectively pump blood to the lungs. This causes fluid to back up into the
venous system, leading to peripheral edema (especially dependent areas like

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