NSG 233 HESI Final Exam – (2024|2025) comprehensive
questions and verified answers (detailed & elaborated)
ACTUAL EXAM 2025 TEST!!
1. A nurse is caring for a client with a C6 spinal cord injury. What is the priority
assessment?
A. Bowel sounds
B. Peripheral pulses
C. Respiratory effort
D. Deep tendon reflexes
Rationale: Cervical spine injuries may compromise diaphragmatic innervation,
especially at or above C5–C6. Respiratory status is the top priority.
2. A patient is admitted with hypovolemic shock. Which clinical finding should
the nurse expect?
A. Bradycardia
B. Hypotension
C. Bounding pulse
D. Warm, flushed skin
Rationale: Hypovolemic shock typically presents with hypotension due to reduced
circulating blood volume.
3. A client with HIV develops a productive cough and fever. Which intervention
is most appropriate?
A. Administer antivirals
,B. Obtain a sputum culture
C. Initiate airborne precautions
D. Encourage fluid restriction
Rationale: A sputum culture helps identify potential opportunistic respiratory
infections like PCP or TB.
4. Which sign indicates peritonitis in a client with a perforated duodenal ulcer?
A. Bradycardia
B. Soft, non-tender abdomen
C. Board-like abdominal rigidity
D. Increased bowel sounds
Rationale: Peritonitis typically results in a rigid, board-like abdomen due to
inflammation of the peritoneum.
5. Which ECG finding is most concerning in a client with chest pain?
A. ST segment elevation
B. Sinus bradycardia
C. Premature atrial contractions
D. Inverted P waves
Rationale: ST elevation may indicate myocardial infarction and requires
immediate action.
6. A nurse is teaching a patient about nitroglycerin. What statement indicates
correct understanding?
A. "I will take it with food to prevent ulcers."
B. "If I feel dizzy, I should lie flat and take another dose."
C. "If chest pain continues after three doses, I will call 911."
D. "I will store it in the bathroom for easy access."
Rationale: Chest pain unrelieved after three sublingual doses requires emergency
attention.
,7. What is a priority intervention for a patient receiving TPN (total parenteral
nutrition)?
A. Monitor stool output
B. Monitor blood glucose levels
C. Assess bowel sounds
D. Encourage oral fluids
Rationale: TPN is high in glucose and can lead to hyperglycemia, requiring regular
glucose checks.
8. A nurse is caring for a patient with left-sided heart failure. Which finding is
expected?
A. Jugular vein distention
B. Crackles in lung bases
C. Peripheral edema
D. Ascites
Rationale: Left-sided heart failure causes pulmonary congestion, resulting in
crackles.
9. What lab value should be monitored closely in a patient receiving
furosemide?
A. Hemoglobin
B. Sodium
C. Potassium
D. Calcium
Rationale: Furosemide is a loop diuretic that promotes potassium loss, increasing
the risk of hypokalemia.
10. A patient with COPD is on 2 L/min of oxygen via nasal cannula. Which
finding warrants immediate intervention?
, A. Oxygen saturation of 91%
B. Drowsiness and confusion
C. Use of accessory muscles
D. Clubbing of fingers
Rationale: Drowsiness may indicate CO2 retention due to hypoventilation caused
by excessive O2 in COPD patients.
11. What dietary instruction is appropriate for a patient with chronic kidney
disease (CKD)?
A. Limit protein intake
B. Increase potassium-rich foods
C. Encourage dairy for calcium
D. Liberalize sodium intake
Rationale: Excess protein can burden kidneys; protein should be limited
depending on disease stage.
12. In a patient with liver cirrhosis, which lab value is most concerning?
A. AST 38
B. Platelets 160,000
C. Ammonia 120 mcg/dL
D. Albumin 3.6 g/dL
Rationale: Elevated ammonia levels may lead to hepatic encephalopathy,
requiring immediate management.
13. A patient presents with a sodium level of 120 mEq/L. What symptom would
the nurse expect?
A. Constipation
B. Decreased reflexes
C. Confusion and seizures
D. Hypertension
questions and verified answers (detailed & elaborated)
ACTUAL EXAM 2025 TEST!!
1. A nurse is caring for a client with a C6 spinal cord injury. What is the priority
assessment?
A. Bowel sounds
B. Peripheral pulses
C. Respiratory effort
D. Deep tendon reflexes
Rationale: Cervical spine injuries may compromise diaphragmatic innervation,
especially at or above C5–C6. Respiratory status is the top priority.
2. A patient is admitted with hypovolemic shock. Which clinical finding should
the nurse expect?
A. Bradycardia
B. Hypotension
C. Bounding pulse
D. Warm, flushed skin
Rationale: Hypovolemic shock typically presents with hypotension due to reduced
circulating blood volume.
3. A client with HIV develops a productive cough and fever. Which intervention
is most appropriate?
A. Administer antivirals
,B. Obtain a sputum culture
C. Initiate airborne precautions
D. Encourage fluid restriction
Rationale: A sputum culture helps identify potential opportunistic respiratory
infections like PCP or TB.
4. Which sign indicates peritonitis in a client with a perforated duodenal ulcer?
A. Bradycardia
B. Soft, non-tender abdomen
C. Board-like abdominal rigidity
D. Increased bowel sounds
Rationale: Peritonitis typically results in a rigid, board-like abdomen due to
inflammation of the peritoneum.
5. Which ECG finding is most concerning in a client with chest pain?
A. ST segment elevation
B. Sinus bradycardia
C. Premature atrial contractions
D. Inverted P waves
Rationale: ST elevation may indicate myocardial infarction and requires
immediate action.
6. A nurse is teaching a patient about nitroglycerin. What statement indicates
correct understanding?
A. "I will take it with food to prevent ulcers."
B. "If I feel dizzy, I should lie flat and take another dose."
C. "If chest pain continues after three doses, I will call 911."
D. "I will store it in the bathroom for easy access."
Rationale: Chest pain unrelieved after three sublingual doses requires emergency
attention.
,7. What is a priority intervention for a patient receiving TPN (total parenteral
nutrition)?
A. Monitor stool output
B. Monitor blood glucose levels
C. Assess bowel sounds
D. Encourage oral fluids
Rationale: TPN is high in glucose and can lead to hyperglycemia, requiring regular
glucose checks.
8. A nurse is caring for a patient with left-sided heart failure. Which finding is
expected?
A. Jugular vein distention
B. Crackles in lung bases
C. Peripheral edema
D. Ascites
Rationale: Left-sided heart failure causes pulmonary congestion, resulting in
crackles.
9. What lab value should be monitored closely in a patient receiving
furosemide?
A. Hemoglobin
B. Sodium
C. Potassium
D. Calcium
Rationale: Furosemide is a loop diuretic that promotes potassium loss, increasing
the risk of hypokalemia.
10. A patient with COPD is on 2 L/min of oxygen via nasal cannula. Which
finding warrants immediate intervention?
, A. Oxygen saturation of 91%
B. Drowsiness and confusion
C. Use of accessory muscles
D. Clubbing of fingers
Rationale: Drowsiness may indicate CO2 retention due to hypoventilation caused
by excessive O2 in COPD patients.
11. What dietary instruction is appropriate for a patient with chronic kidney
disease (CKD)?
A. Limit protein intake
B. Increase potassium-rich foods
C. Encourage dairy for calcium
D. Liberalize sodium intake
Rationale: Excess protein can burden kidneys; protein should be limited
depending on disease stage.
12. In a patient with liver cirrhosis, which lab value is most concerning?
A. AST 38
B. Platelets 160,000
C. Ammonia 120 mcg/dL
D. Albumin 3.6 g/dL
Rationale: Elevated ammonia levels may lead to hepatic encephalopathy,
requiring immediate management.
13. A patient presents with a sodium level of 120 mEq/L. What symptom would
the nurse expect?
A. Constipation
B. Decreased reflexes
C. Confusion and seizures
D. Hypertension
