MED SURG II HESI CONCEPT REVIEW GUIDE
2026 CRITICAL CARE AND COMPLEX PATIENT
MANAGEMENT
◉ The nurse is assessing a group of clients. Which clients are at
greater risk for hypothermia or frostbite? (select all that apply)
a. an older woman with hypertension
b. a young man with a body mass index of 42
c. a young many who has just consumed six martinis
d. an older man who smokes a pack of cigarettes a day
e. a young woman who is anorexic
f. a young woman who is diabetic.
Answer: C, D, E, F
clients with poor nutrition, fatigue, and multiple chronic illnesses
are at greater risk for hypothermia. Clients who smoke, consume
alcohol, or have impaired peripheral circulation have a higher
incidence of frostbite.
◉ Which statement made by a nurse represents the need for further
education regarding pain management in older adult clients?
,a. older adults tend to report pain less often than younger adults
b. older clients usually have more experience with pain than
younger clients
c. older adults are at greatest risk for under treated pain
d. older clients have a different pain mechanism and do not feel it as
much.
Answer: D
There is no evidence to support the idea that older adult clients
perceive pain any differently than younger clients. The other
statements are accurate regarding older clients and pain.
◉ The nurse is working at a first aid booth for a spring training
game on a hot day. A spectator comes in, reporting that he is not
feeling well. Vital signs are temp 104.1 F, pulse 132 BPM, respirs 26
breaths/min, and blood pressure 106/66 mm Hg. He trips over his
feet as the nurse leads him to a cot. What is the priory action of the
nurse?
a. admin tylenol 650 mg orally
b. encourage rest, and reassess in 15 minutes
c. sponge the victim with cool water and remove his shirt
d. encourage drinking of cool water or sports drink.
,Answer: C
The spectator shows signs of heat stroke, which is a medical
emergency. The spectator should be transported to the ED ASAP. The
nurs should take actions to lower his body temp in teh meantime by
removing his shirt and sponging his body with cool water. Lowering
body temp by drinking cool fluids or taking acetaminophen is not as
effective in an emergency situation. The client needs to be cooled
quickly and is a priority for treatment
◉ The client is receiving an IV of 60 mEq of potassium chloride ina
1000 mL solution of dextrose 5% in 0.45% saline. The client states
that the area around the IV site burns. What intervention does the
nurse perform first?
a. assess for a blood return
b. notify the physician
c. document the finding
d. stop the IV infusion.
Answer: D
Potassium is a severe tissue irritant. The safest action is to
discontinue the solution that contains the potassium and
discontinue the IV altogether, in which case the client would need
another site started. Assessing for a blood return may or may not be
, successful. The solution could be diluted (less potassium) and the
rate could be slowed once it is determined that the needle is in the
vein.
◉ A nurse is caring for an older adult client who lives alone. Which
economic situation presents the most serious problem for this
client?
a. costs of creating a living will
b. stock market fluctuations
c. increased provider benefits
d. social security as the basis of income.
Answer: D
Older adults on fixed incomes are unable to adjust their income to
meet rising costs associated with meeting basic needs
◉ Controlling pain is important to promoting wellness. Unrelieved
pain has been associated with
a. prolonged stress response and a cascade of harmful effects system
wide.
b. decreased tumor growth and longevity
c. large tidal volumes and decreased lung capacity
2026 CRITICAL CARE AND COMPLEX PATIENT
MANAGEMENT
◉ The nurse is assessing a group of clients. Which clients are at
greater risk for hypothermia or frostbite? (select all that apply)
a. an older woman with hypertension
b. a young man with a body mass index of 42
c. a young many who has just consumed six martinis
d. an older man who smokes a pack of cigarettes a day
e. a young woman who is anorexic
f. a young woman who is diabetic.
Answer: C, D, E, F
clients with poor nutrition, fatigue, and multiple chronic illnesses
are at greater risk for hypothermia. Clients who smoke, consume
alcohol, or have impaired peripheral circulation have a higher
incidence of frostbite.
◉ Which statement made by a nurse represents the need for further
education regarding pain management in older adult clients?
,a. older adults tend to report pain less often than younger adults
b. older clients usually have more experience with pain than
younger clients
c. older adults are at greatest risk for under treated pain
d. older clients have a different pain mechanism and do not feel it as
much.
Answer: D
There is no evidence to support the idea that older adult clients
perceive pain any differently than younger clients. The other
statements are accurate regarding older clients and pain.
◉ The nurse is working at a first aid booth for a spring training
game on a hot day. A spectator comes in, reporting that he is not
feeling well. Vital signs are temp 104.1 F, pulse 132 BPM, respirs 26
breaths/min, and blood pressure 106/66 mm Hg. He trips over his
feet as the nurse leads him to a cot. What is the priory action of the
nurse?
a. admin tylenol 650 mg orally
b. encourage rest, and reassess in 15 minutes
c. sponge the victim with cool water and remove his shirt
d. encourage drinking of cool water or sports drink.
,Answer: C
The spectator shows signs of heat stroke, which is a medical
emergency. The spectator should be transported to the ED ASAP. The
nurs should take actions to lower his body temp in teh meantime by
removing his shirt and sponging his body with cool water. Lowering
body temp by drinking cool fluids or taking acetaminophen is not as
effective in an emergency situation. The client needs to be cooled
quickly and is a priority for treatment
◉ The client is receiving an IV of 60 mEq of potassium chloride ina
1000 mL solution of dextrose 5% in 0.45% saline. The client states
that the area around the IV site burns. What intervention does the
nurse perform first?
a. assess for a blood return
b. notify the physician
c. document the finding
d. stop the IV infusion.
Answer: D
Potassium is a severe tissue irritant. The safest action is to
discontinue the solution that contains the potassium and
discontinue the IV altogether, in which case the client would need
another site started. Assessing for a blood return may or may not be
, successful. The solution could be diluted (less potassium) and the
rate could be slowed once it is determined that the needle is in the
vein.
◉ A nurse is caring for an older adult client who lives alone. Which
economic situation presents the most serious problem for this
client?
a. costs of creating a living will
b. stock market fluctuations
c. increased provider benefits
d. social security as the basis of income.
Answer: D
Older adults on fixed incomes are unable to adjust their income to
meet rising costs associated with meeting basic needs
◉ Controlling pain is important to promoting wellness. Unrelieved
pain has been associated with
a. prolonged stress response and a cascade of harmful effects system
wide.
b. decreased tumor growth and longevity
c. large tidal volumes and decreased lung capacity
