NUR 208 HESI FINAL Exam: (Latest 2026/2027 Update) Medical-Surgical
Nursing | Q&A | Grade A | 100% Correct (Verified Answers) – Nursing
Program
Subject: NUR 208 – HESI Final Exam / Medical-Surgical Nursing
Source: HESI Comprehensive Review – Fundamentals, Med-Surg, Ethics, and End-of-Life Care
Format: Q&A Guide with Rationale | All Questions Exhausted
Total questions: 35 (every question and concept from raw data)
1: Three days following surgery, a male client observes his colostomy for the first time. He
becomes upset and tells the nurse that it is much bigger than he expected. What is the
best response by the RN?
Correct Answer: Instruct the client that the stoma will become smaller when the swelling diminishes.
1. Post-operative swelling causes the stoma to appear larger initially; as edema subsides over the first 6-8
weeks, the stoma naturally shrinks to its permanent size.
2. This response provides factual reassurance without minimizing the client's feelings. It addresses the
underlying concern (size) with accurate physiological information.
3. Acknowledging the client's distress while offering education supports both emotional and informational
needs. Avoid false reassurance ("it looks fine") or dismissive responses.
2: Which snack food is best for a client with myasthenia gravis who is at risk for altered
nutritional status?
Correct Answer: Chocolate pudding
1. Myasthenia gravis causes muscle weakness including the muscles of mastication (chewing) and
swallowing. Soft, easy-to-swallow foods reduce aspiration risk and fatigue during meals.
2. Chocolate pudding is soft, requires no chewing, and provides calories and protein. It is also palatable,
encouraging intake in clients with fatigue.
3. Avoid hard, crunchy, or sticky foods that require significant chewing effort or may cause choking in
clients with bulbar weakness.
3: After completing an assessment and determining that a client has a problem, which
action should the RN perform next?
Correct Answer: Determine the etiology of the problem.
1. The nursing process sequence: Assessment → Diagnosis (identify problem) → Determine etiology/cause
→ Plan interventions → Implement → Evaluate.
2. Identifying the cause (etiology) of the problem guides appropriate intervention selection. Without
understanding the cause, interventions may be ineffective.
3. For example, identifying that impaired skin integrity is caused by pressure vs. moisture vs. friction
changes the nursing interventions chosen.
, 4: On admission, a patient signs a living will that includes a DNR order. When the client
stops breathing, the RN performs CPR and revives the client. What legal issue could be
brought against the RN?
Correct Answer: Malpractice
1. A valid DNR order is legally binding; performing CPR against the patient's documented wishes
constitutes battery and potentially malpractice (failure to follow advance directives).
2. Malpractice requires duty, breach of duty (violating DNR), causation, and damages (unwanted
resuscitation). The RN violated the patient's right to self-determination.
3. Exceptions: if DNR order was not readily accessible, ordered after arrest, or family requested
resuscitation are defenses, but generally honoring DNR is mandatory.
5: An RN notices Hispanic parents of a toddler offering only broth on the clear liquid tray.
Gelatin, popsicles, and juices remain untouched. What explanation is most appropriate for
this behavior?
Correct Answer: Hot remedies restore balance after surgery.
1. Many Hispanic cultures subscribe to the "hot-cold" theory of health, where illness or surgery creates an
imbalance requiring "hot" remedies (broth, tea, warm foods) rather than "cold" items (gelatin, popsicles,
juices).
2. This is a culturally congruent health belief; the nurse should respect this preference when not medically
contraindicated.
3. Broth provides hydration and nutrition; the nurse can work within cultural preferences while ensuring
the toddler receives adequate fluids.
6: A client has a nursing diagnosis of spiritual distress. Which finding indicates to the nurse
that a desired outcome measure has been met?
Correct Answer: Accepts that punishment from God is not related to illness.
1. Spiritual distress often involves guilt, anger at God, or belief that illness is punishment for wrongdoing.
Resolution includes reconciling these beliefs.
2. The client moving from a punitive view of God ("this is punishment") to a non-punitive view indicates
spiritual healing and acceptance.
3. Desired outcomes for spiritual distress include expression of hope, resumption of spiritual practices, and
decreased anxiety about meaning/suffering.
7: Which food selection shows that a client understands a low-sodium restriction?
Correct Answer: Skim milk, turkey salad, roll, and vanilla ice cream.
1. Low-sodium diet limits processed foods, canned goods, salty snacks, and high-sodium condiments.
Fresh turkey (not processed deli meat), skim milk, plain roll, and ice cream are appropriate low-sodium
choices.
2. Avoid items like canned soup, pickles, cheese, bacon, ham, salted nuts, and added table salt.
3. Turkey salad should be checked for added salt; if prepared with fresh turkey and low-sodium
ingredients, it is acceptable.
Nursing | Q&A | Grade A | 100% Correct (Verified Answers) – Nursing
Program
Subject: NUR 208 – HESI Final Exam / Medical-Surgical Nursing
Source: HESI Comprehensive Review – Fundamentals, Med-Surg, Ethics, and End-of-Life Care
Format: Q&A Guide with Rationale | All Questions Exhausted
Total questions: 35 (every question and concept from raw data)
1: Three days following surgery, a male client observes his colostomy for the first time. He
becomes upset and tells the nurse that it is much bigger than he expected. What is the
best response by the RN?
Correct Answer: Instruct the client that the stoma will become smaller when the swelling diminishes.
1. Post-operative swelling causes the stoma to appear larger initially; as edema subsides over the first 6-8
weeks, the stoma naturally shrinks to its permanent size.
2. This response provides factual reassurance without minimizing the client's feelings. It addresses the
underlying concern (size) with accurate physiological information.
3. Acknowledging the client's distress while offering education supports both emotional and informational
needs. Avoid false reassurance ("it looks fine") or dismissive responses.
2: Which snack food is best for a client with myasthenia gravis who is at risk for altered
nutritional status?
Correct Answer: Chocolate pudding
1. Myasthenia gravis causes muscle weakness including the muscles of mastication (chewing) and
swallowing. Soft, easy-to-swallow foods reduce aspiration risk and fatigue during meals.
2. Chocolate pudding is soft, requires no chewing, and provides calories and protein. It is also palatable,
encouraging intake in clients with fatigue.
3. Avoid hard, crunchy, or sticky foods that require significant chewing effort or may cause choking in
clients with bulbar weakness.
3: After completing an assessment and determining that a client has a problem, which
action should the RN perform next?
Correct Answer: Determine the etiology of the problem.
1. The nursing process sequence: Assessment → Diagnosis (identify problem) → Determine etiology/cause
→ Plan interventions → Implement → Evaluate.
2. Identifying the cause (etiology) of the problem guides appropriate intervention selection. Without
understanding the cause, interventions may be ineffective.
3. For example, identifying that impaired skin integrity is caused by pressure vs. moisture vs. friction
changes the nursing interventions chosen.
, 4: On admission, a patient signs a living will that includes a DNR order. When the client
stops breathing, the RN performs CPR and revives the client. What legal issue could be
brought against the RN?
Correct Answer: Malpractice
1. A valid DNR order is legally binding; performing CPR against the patient's documented wishes
constitutes battery and potentially malpractice (failure to follow advance directives).
2. Malpractice requires duty, breach of duty (violating DNR), causation, and damages (unwanted
resuscitation). The RN violated the patient's right to self-determination.
3. Exceptions: if DNR order was not readily accessible, ordered after arrest, or family requested
resuscitation are defenses, but generally honoring DNR is mandatory.
5: An RN notices Hispanic parents of a toddler offering only broth on the clear liquid tray.
Gelatin, popsicles, and juices remain untouched. What explanation is most appropriate for
this behavior?
Correct Answer: Hot remedies restore balance after surgery.
1. Many Hispanic cultures subscribe to the "hot-cold" theory of health, where illness or surgery creates an
imbalance requiring "hot" remedies (broth, tea, warm foods) rather than "cold" items (gelatin, popsicles,
juices).
2. This is a culturally congruent health belief; the nurse should respect this preference when not medically
contraindicated.
3. Broth provides hydration and nutrition; the nurse can work within cultural preferences while ensuring
the toddler receives adequate fluids.
6: A client has a nursing diagnosis of spiritual distress. Which finding indicates to the nurse
that a desired outcome measure has been met?
Correct Answer: Accepts that punishment from God is not related to illness.
1. Spiritual distress often involves guilt, anger at God, or belief that illness is punishment for wrongdoing.
Resolution includes reconciling these beliefs.
2. The client moving from a punitive view of God ("this is punishment") to a non-punitive view indicates
spiritual healing and acceptance.
3. Desired outcomes for spiritual distress include expression of hope, resumption of spiritual practices, and
decreased anxiety about meaning/suffering.
7: Which food selection shows that a client understands a low-sodium restriction?
Correct Answer: Skim milk, turkey salad, roll, and vanilla ice cream.
1. Low-sodium diet limits processed foods, canned goods, salty snacks, and high-sodium condiments.
Fresh turkey (not processed deli meat), skim milk, plain roll, and ice cream are appropriate low-sodium
choices.
2. Avoid items like canned soup, pickles, cheese, bacon, ham, salted nuts, and added table salt.
3. Turkey salad should be checked for added salt; if prepared with fresh turkey and low-sodium
ingredients, it is acceptable.
