NSG 223 MEDICAL-SURGICAL NURSING
1 HESI FINAL EXAMINATION
QUESTIONS AND ANSWERS
1. A client with a history of Chronic Obstructive Pulmonary Disease (COPD) is admitted with
acute exacerbation. The nurse notes an oxygen saturation of 89% on room air. Which oxygen
delivery method is most appropriate to ensure precise oxygen concentration for this client?
A. Simple face mask
B. Nasal cannula at 6 L/min
C. Non-rebreather mask
D. Venturi mask
Answer: D
Conceptual Explanation: The Venturi mask is the most accurate method for delivering a
precise oxygen concentration (FiO2), which is critical for COPD patients to avoid
suppressing their hypoxic drive.
2. A patient is 12 hours post-operative following an abdominal hysterectomy. The nurse notes
the patient has not voided since the indwelling catheter was removed 6 hours ago. What is
the priority nursing action?
A. Encourage increased fluid intake
,B. Insert a straight catheter
C. Notify the surgeon immediately
D. Perform a bladder scan
Answer: D
Conceptual Explanation: The first step in assessing suspected urinary retention is non-
invasive. A bladder scan provides objective data regarding the volume of urine in the
bladder before proceeding to more invasive interventions.
3. The nurse is caring for a client with a serum potassium level of 2.8 mEq/L. Which ECG
change should the nurse expect to observe?
A. Presence of U waves
B. Shortened QT interval
C. Peaked T waves
D. Widened QRS complex
Answer: A
Conceptual Explanation: Hypokalemia (potassium < 3.5 mEq/L) typically manifests on an
ECG as flat or inverted T waves and the appearance of U waves. Peaked T waves are
associated with hyperkalemia.
, 4. Which laboratory result is most indicative of a client’s long-term compliance with a diabetic
treatment regimen?
A. Glycosylated hemoglobin (HbA1c) of 6.5%
B. Postprandial glucose of 140 mg/dL
C. Fasting blood glucose of 110 mg/dL
D. Urine ketones: negative
Answer: A
Conceptual Explanation: HbA1c reflects the average blood glucose levels over the
previous 2 to 3 months, making it the gold standard for assessing long-term glycemic
control.
5. A client is diagnosed with Deep Vein Thrombosis (DVT) and is started on a continuous
Heparin infusion. Which laboratory value must the nurse monitor to adjust the dosage?
A. Activated Partial Thromboplastin Time (aPTT)
B. International Normalized Ratio (INR)
C. Prothrombin Time (PT)
D. Platelet count
Answer: A
Conceptual Explanation: aPTT is used to monitor the therapeutic effect of unfractionated
Heparin. PT and INR are used to monitor Warfarin therapy.
1 HESI FINAL EXAMINATION
QUESTIONS AND ANSWERS
1. A client with a history of Chronic Obstructive Pulmonary Disease (COPD) is admitted with
acute exacerbation. The nurse notes an oxygen saturation of 89% on room air. Which oxygen
delivery method is most appropriate to ensure precise oxygen concentration for this client?
A. Simple face mask
B. Nasal cannula at 6 L/min
C. Non-rebreather mask
D. Venturi mask
Answer: D
Conceptual Explanation: The Venturi mask is the most accurate method for delivering a
precise oxygen concentration (FiO2), which is critical for COPD patients to avoid
suppressing their hypoxic drive.
2. A patient is 12 hours post-operative following an abdominal hysterectomy. The nurse notes
the patient has not voided since the indwelling catheter was removed 6 hours ago. What is
the priority nursing action?
A. Encourage increased fluid intake
,B. Insert a straight catheter
C. Notify the surgeon immediately
D. Perform a bladder scan
Answer: D
Conceptual Explanation: The first step in assessing suspected urinary retention is non-
invasive. A bladder scan provides objective data regarding the volume of urine in the
bladder before proceeding to more invasive interventions.
3. The nurse is caring for a client with a serum potassium level of 2.8 mEq/L. Which ECG
change should the nurse expect to observe?
A. Presence of U waves
B. Shortened QT interval
C. Peaked T waves
D. Widened QRS complex
Answer: A
Conceptual Explanation: Hypokalemia (potassium < 3.5 mEq/L) typically manifests on an
ECG as flat or inverted T waves and the appearance of U waves. Peaked T waves are
associated with hyperkalemia.
, 4. Which laboratory result is most indicative of a client’s long-term compliance with a diabetic
treatment regimen?
A. Glycosylated hemoglobin (HbA1c) of 6.5%
B. Postprandial glucose of 140 mg/dL
C. Fasting blood glucose of 110 mg/dL
D. Urine ketones: negative
Answer: A
Conceptual Explanation: HbA1c reflects the average blood glucose levels over the
previous 2 to 3 months, making it the gold standard for assessing long-term glycemic
control.
5. A client is diagnosed with Deep Vein Thrombosis (DVT) and is started on a continuous
Heparin infusion. Which laboratory value must the nurse monitor to adjust the dosage?
A. Activated Partial Thromboplastin Time (aPTT)
B. International Normalized Ratio (INR)
C. Prothrombin Time (PT)
D. Platelet count
Answer: A
Conceptual Explanation: aPTT is used to monitor the therapeutic effect of unfractionated
Heparin. PT and INR are used to monitor Warfarin therapy.
