MEDICAL-SURGICAL NURSING HESI
COMPREHENSIVE FINAL QUESTIONS
AND ANSWERS
1. A client with chronic heart failure is prescribed digoxin and furosemide. The nurse notes
the client’s potassium level is 3.2 mEq/L. Which assessment finding should the nurse
prioritize?
A. Muscle weakness and leg cramps
B. Increased urinary output
C. Visual disturbances and nausea
D. Hypotension and dizziness
Answer: C
Conceptual Explanation: Hypokalemia (potassium 3.2) increases the risk of digoxin
toxicity. Visual disturbances (yellow-green halos) and nausea are classic signs of digoxin
toxicity that require immediate attention in this context.
2. An arterial blood gas (ABG) report shows pH 7.28, PaCO2 50 mmHg, and HCO3 24 mEq/L.
The nurse interprets this as:
A. Respiratory Acidosis
,B. Metabolic Alkalosis
C. Metabolic Acidosis
D. Respiratory Alkalosis
Answer: A
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is normal, it is uncompensated respiratory
acidosis.
3. Which clinical manifestation should the nurse expect in a client diagnosed with left-sided
heart failure?
A. Jugular venous distention
B. Crackles in the lungs
C. Peripheral edema
D. Hepatomegaly
Answer: B
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion, resulting
in crackles, dyspnea, and orthopnea. The other options are signs of right-sided heart
failure.
, 4. A client with type 1 diabetes presents with deep, rapid respirations, fruity breath odor, and
a blood glucose of 450 mg/dL. What is the nurse’s priority action?
A. Administer 15g of simple carbohydrates
B. Initiate IV fluid resuscitation with normal saline
C. Administer subcutaneous glargine insulin
D. Encourage the client to drink orange juice
Answer: B
Conceptual Explanation: The client is showing signs of Diabetic Ketoacidosis (DKA). The
priority is fluid resuscitation to restore circulatory volume and stabilize perfusion before
or during insulin administration.
5. A client is 24 hours post-thyroidectomy. The nurse notes the client is experiencing muscle
twitching and a positive Chvostek’s sign. Which medication should the nurse prepare?
A. Potassium chloride
B. Calcium gluconate
C. Sodium bicarbonate
D. Magnesium sulfate
Answer: B
COMPREHENSIVE FINAL QUESTIONS
AND ANSWERS
1. A client with chronic heart failure is prescribed digoxin and furosemide. The nurse notes
the client’s potassium level is 3.2 mEq/L. Which assessment finding should the nurse
prioritize?
A. Muscle weakness and leg cramps
B. Increased urinary output
C. Visual disturbances and nausea
D. Hypotension and dizziness
Answer: C
Conceptual Explanation: Hypokalemia (potassium 3.2) increases the risk of digoxin
toxicity. Visual disturbances (yellow-green halos) and nausea are classic signs of digoxin
toxicity that require immediate attention in this context.
2. An arterial blood gas (ABG) report shows pH 7.28, PaCO2 50 mmHg, and HCO3 24 mEq/L.
The nurse interprets this as:
A. Respiratory Acidosis
,B. Metabolic Alkalosis
C. Metabolic Acidosis
D. Respiratory Alkalosis
Answer: A
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is normal, it is uncompensated respiratory
acidosis.
3. Which clinical manifestation should the nurse expect in a client diagnosed with left-sided
heart failure?
A. Jugular venous distention
B. Crackles in the lungs
C. Peripheral edema
D. Hepatomegaly
Answer: B
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion, resulting
in crackles, dyspnea, and orthopnea. The other options are signs of right-sided heart
failure.
, 4. A client with type 1 diabetes presents with deep, rapid respirations, fruity breath odor, and
a blood glucose of 450 mg/dL. What is the nurse’s priority action?
A. Administer 15g of simple carbohydrates
B. Initiate IV fluid resuscitation with normal saline
C. Administer subcutaneous glargine insulin
D. Encourage the client to drink orange juice
Answer: B
Conceptual Explanation: The client is showing signs of Diabetic Ketoacidosis (DKA). The
priority is fluid resuscitation to restore circulatory volume and stabilize perfusion before
or during insulin administration.
5. A client is 24 hours post-thyroidectomy. The nurse notes the client is experiencing muscle
twitching and a positive Chvostek’s sign. Which medication should the nurse prepare?
A. Potassium chloride
B. Calcium gluconate
C. Sodium bicarbonate
D. Magnesium sulfate
Answer: B
