NSG 223 MED SURG 2 HESI FINAL EXAM – COMPREHENSIVE TEST BANK HERZING
UNIVERSITY | QUESTIONS AND ANSWERS ALREADY GRADED A+| 100% VERIFIED
SOLUTIONS………...
CORE DOMAINS
Cardiovascular System
Respiratory System
Endocrine System
Renal and Urinary System
Neurological System
Gastrointestinal System
Musculoskeletal System
Oncological and Hematological Disorders
Perioperative and Emergency Nursing
Pharmacology and IV Therapy
INTRODUCTION
This comprehensive assessment is designed to evaluate the critical thinking and applied knowledge
of nursing students in the medical-surgical setting. It assesses proficiency in managing complex
patient conditions across various body systems. The exam structure utilizes multiple-choice and
scenario-based questions to simulate real-world clinical decision-making. Emphasis is placed on
safety, prioritization, and evidence-based practice to prepare the candidate for professional nursing
responsibilities.
SECTION ONE: QUESTIONS 1–100
,1. A nurse is caring for a client who has a new prescription for enalapril. The nurse should
monitor the client for which of the following adverse effects?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hyponatremia
🟢 A. Hyperkalemia
🔴 RATIONALE: Enalapril is an ACE inhibitor. ACE inhibitors block the conversion of
angiotensin I to angiotensin II, which leads to decreased aldosterone secretion. This results in
potassium retention, placing the client at risk for hyperkalemia.
2. A client with chronic obstructive pulmonary disease (COPD) is experiencing dyspnea. Which of
the following positions should the nurse place the client in to promote maximum lung
expansion?
A. Supine
B. Prone
C. High-Fowler's
D. Trendelenburg
🟢 C. High-Fowler's
🔴 RATIONALE: High-Fowler's position allows the diaphragm to descend, which maximizes
lung expansion and improves ventilation for clients with COPD who are experiencing dyspnea.
3. A nurse is assessing a client who has a diagnosis of diabetic ketoacidosis (DKA). Which of the
following findings should the nurse expect?
A. Blood glucose 120 mg/dL
B. Respiratory rate 12/min
, C. Deep, rapid respirations
D. Hypertension
🟢 C. Deep, rapid respirations
🔴 RATIONALE: Kussmaul respirations (deep and rapid) are a compensatory mechanism to
blow off carbon dioxide and correct metabolic acidosis, which is a hallmark of diabetic
ketoacidosis.
4. A nurse is reviewing the laboratory results of a client who has acute kidney injury (AKI). Which
of the following findings is a priority for the nurse to report?
A. Potassium 6.5 mEq/L
B. Sodium 138 mEq/L
C. Calcium 9.0 mg/dL
D. Hemoglobin 12 g/dL
🟢 A. Potassium 6.5 mEq/L
🔴 RATIONALE: Hyperkalemia is a life-threatening complication of acute kidney injury due to
the kidneys' inability to excrete potassium. A level of 6.5 mEq/L can lead to cardiac
dysrhythmias and requires immediate intervention.
5. A nurse is teaching a client who is scheduled for a colonoscopy. Which of the following
instructions should the nurse include?
A. "You can have a light breakfast on the day of the procedure."
B. "You will need to drink a clear liquid diet the day before."
C. "Stop taking your antihypertensive medication 1 week prior."
D. "You will receive a general anesthetic for the procedure."
🟢 B. "You will need to drink a clear liquid diet the day before."
, 🔴 RATIONALE: A clear liquid diet is required the day before a colonoscopy to ensure the
bowel is clean and free of residue, allowing for adequate visualization of the colon.
6. A client is admitted with an acute exacerbation of heart failure. Which of the following findings
indicates to the nurse that the client's condition is worsening?
A. Weight loss of 1 kg (2.2 lb)
B. Urine output of 40 mL/hr
C. Crackles in the lung bases
D. Heart rate of 88/min
🟢 C. Crackles in the lung bases
🔴 RATIONALE: Crackles in the lung bases indicate fluid accumulation in the alveoli, a sign of
worsening pulmonary edema and heart failure exacerbation.
7. A nurse is caring for a client who is post-operative following a total hip arthroplasty. Which of
the following actions should the nurse take to prevent dislocation of the new hip?
A. Place a pillow between the client's legs when turning.
B. Keep the client's hips flexed at a 90-degree angle.
C. Encourage the client to cross their legs when sitting.
D. Position the client on the operative side immediately.
🟢 A. Place a pillow between the client's legs when turning.
🔴 RATIONALE: An abduction pillow is used to keep the legs apart and prevent adduction,
which is a primary mechanism for hip dislocation following a total hip arthroplasty.
8. A nurse is preparing to administer packed red blood cells (PRBCs) to a client. Which of the
following actions is the priority?
A. Ensure the client has a patent IV access.
B. Verify the client's identification with a second nurse.
UNIVERSITY | QUESTIONS AND ANSWERS ALREADY GRADED A+| 100% VERIFIED
SOLUTIONS………...
CORE DOMAINS
Cardiovascular System
Respiratory System
Endocrine System
Renal and Urinary System
Neurological System
Gastrointestinal System
Musculoskeletal System
Oncological and Hematological Disorders
Perioperative and Emergency Nursing
Pharmacology and IV Therapy
INTRODUCTION
This comprehensive assessment is designed to evaluate the critical thinking and applied knowledge
of nursing students in the medical-surgical setting. It assesses proficiency in managing complex
patient conditions across various body systems. The exam structure utilizes multiple-choice and
scenario-based questions to simulate real-world clinical decision-making. Emphasis is placed on
safety, prioritization, and evidence-based practice to prepare the candidate for professional nursing
responsibilities.
SECTION ONE: QUESTIONS 1–100
,1. A nurse is caring for a client who has a new prescription for enalapril. The nurse should
monitor the client for which of the following adverse effects?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hyponatremia
🟢 A. Hyperkalemia
🔴 RATIONALE: Enalapril is an ACE inhibitor. ACE inhibitors block the conversion of
angiotensin I to angiotensin II, which leads to decreased aldosterone secretion. This results in
potassium retention, placing the client at risk for hyperkalemia.
2. A client with chronic obstructive pulmonary disease (COPD) is experiencing dyspnea. Which of
the following positions should the nurse place the client in to promote maximum lung
expansion?
A. Supine
B. Prone
C. High-Fowler's
D. Trendelenburg
🟢 C. High-Fowler's
🔴 RATIONALE: High-Fowler's position allows the diaphragm to descend, which maximizes
lung expansion and improves ventilation for clients with COPD who are experiencing dyspnea.
3. A nurse is assessing a client who has a diagnosis of diabetic ketoacidosis (DKA). Which of the
following findings should the nurse expect?
A. Blood glucose 120 mg/dL
B. Respiratory rate 12/min
, C. Deep, rapid respirations
D. Hypertension
🟢 C. Deep, rapid respirations
🔴 RATIONALE: Kussmaul respirations (deep and rapid) are a compensatory mechanism to
blow off carbon dioxide and correct metabolic acidosis, which is a hallmark of diabetic
ketoacidosis.
4. A nurse is reviewing the laboratory results of a client who has acute kidney injury (AKI). Which
of the following findings is a priority for the nurse to report?
A. Potassium 6.5 mEq/L
B. Sodium 138 mEq/L
C. Calcium 9.0 mg/dL
D. Hemoglobin 12 g/dL
🟢 A. Potassium 6.5 mEq/L
🔴 RATIONALE: Hyperkalemia is a life-threatening complication of acute kidney injury due to
the kidneys' inability to excrete potassium. A level of 6.5 mEq/L can lead to cardiac
dysrhythmias and requires immediate intervention.
5. A nurse is teaching a client who is scheduled for a colonoscopy. Which of the following
instructions should the nurse include?
A. "You can have a light breakfast on the day of the procedure."
B. "You will need to drink a clear liquid diet the day before."
C. "Stop taking your antihypertensive medication 1 week prior."
D. "You will receive a general anesthetic for the procedure."
🟢 B. "You will need to drink a clear liquid diet the day before."
, 🔴 RATIONALE: A clear liquid diet is required the day before a colonoscopy to ensure the
bowel is clean and free of residue, allowing for adequate visualization of the colon.
6. A client is admitted with an acute exacerbation of heart failure. Which of the following findings
indicates to the nurse that the client's condition is worsening?
A. Weight loss of 1 kg (2.2 lb)
B. Urine output of 40 mL/hr
C. Crackles in the lung bases
D. Heart rate of 88/min
🟢 C. Crackles in the lung bases
🔴 RATIONALE: Crackles in the lung bases indicate fluid accumulation in the alveoli, a sign of
worsening pulmonary edema and heart failure exacerbation.
7. A nurse is caring for a client who is post-operative following a total hip arthroplasty. Which of
the following actions should the nurse take to prevent dislocation of the new hip?
A. Place a pillow between the client's legs when turning.
B. Keep the client's hips flexed at a 90-degree angle.
C. Encourage the client to cross their legs when sitting.
D. Position the client on the operative side immediately.
🟢 A. Place a pillow between the client's legs when turning.
🔴 RATIONALE: An abduction pillow is used to keep the legs apart and prevent adduction,
which is a primary mechanism for hip dislocation following a total hip arthroplasty.
8. A nurse is preparing to administer packed red blood cells (PRBCs) to a client. Which of the
following actions is the priority?
A. Ensure the client has a patent IV access.
B. Verify the client's identification with a second nurse.
