MED SURG 3 NSG233 FINAL EXAM-
HESI QUESTIONS AND ANSWERS | 2026
UPDATE | 100% CORRECT.
Diffusing anger in the ED - ANS Self safety is PRIORITY
gunfire- protect self
separate feuding individuals explains activities, eliminate triggers.
Heat Stroke ** - ANS Priority action: *Lower body temperature; O2, fluids, cool towel, cool
bath (NO ICE BATH) elevate feet
+HR, +temp, confusion, headache, anxiety, cramps, gooseflesh, HOT,DRY skin, NO sweating
Alcoholic- first assessment - ANS CAGE: Cut, Annoyed, Guilty, Eye-opener.
Assess: psych, w/drawal.
Mgt: blood glucose, benzo, barbiturate, seizure precautions.
Let them sleep if calm-
not calm- benzo's-
check on patient regularly for - LOC
Blood glucose range: 70-110
Non-fatal drowning ** - ANS Priority: manage hypoxia, acidosis and hypothermia > airway,
oxygen
Management: CPR, core temp (rectal) rewarming procedures during CPR, trach/PEEP, O2
Risks: ARDS> hypoxia, hypercarbia and respiratory acidosis can occur
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,Hypothermia> metabolic acidosis
NGT> decompress stomach and prevent aspirating gastric contents.
Monitor: ECG, ICP, I/O
Labs: serum electrolytes
Highest risk: <5 yo, >85 yo
Freshwater: loss of surfactant- inability to expand lungs
Saltwater: pulmonary edema
Observe pt for 23 + hours
Serum Electrolytes - ANS * Mg+ 1.5-2.5
* Phos 2.5-4.5
* K+ 3.5-5
* Ca 8.5-10.9
* Chl 95-105
Bite Priority - ANS Human bite: know what to do first with a human bite!
Animal: rabies prophylaxis
Snakebite: lie down, removing constrictive items, providing warmth, cleansing the wound,
covering the wound with a light sterile dressing, and immobilizing the injured body part below
the level of the heart.
CABs (Circulation, Airway Breathing)
NO: Ice, incision and suction, or a tourniquet
Tetanus and analgesia should be given as necessary.
Meds: FabAV or CroFAb: no limit on how much to give
S&S: necrosis, edema, ecchymosis
Tick: remove with tweezers, straight up pull, (try to get close to skin as possible)
S&S: bulls eye rash
Poisoning in the house - ANS Carbon Monoxide: 100% O2 Atmospheric/hyperbaric chamber
@COPYRIGHT ALL RIGHTS RESERVED PAGE 2 OF 20
, Ingested Poison: ABC, Call poison control, try to describe what was ingested
Charcoal: most effective, Do not use if heavy metals were ingested. Corrosives: give water/milk
Cathartics: sorbitol: give w/ 1st dose of charcoal
syrup ipecac: Induces vomiting, only give to alert patients-and NO patients who ingested a
corrosive agent
Gastric emptying: intubate before lavage ( if -LOC/-gag reflex) with in 1 hour of ingestion.
Overdose- multiply organ dysfunction syndrome - ANS Find out what Patient OD'd on. Give
antidote if there is one
Treatment goals for a patient with a drug overdose are to support the respiratory and
cardiovascular functions, to enhance clearance of the agent, and to provide for safety of the
patient and staff.
Abuse- interpersonal violence - ANS Priority: ask questions IN PRIVATE, separate from person
who is abusive/neglectful
referral to shelter
adults are free to accept or refuse help
safety plans should be explored
Mandatory report: children and elderly abuse - only need to suspect abuse, do not need to
prove it
PTSD- rape and stabbing - ANS Keep patient comfortable
Offer therapeutic communication -listen
Avoid triggers
**ask if patient plans to harm self-
Chest-Blunt trauma complications ** - ANS Flail chest: paradoxical chest movement,
hypoxemia, resp acidosis
Pulmonary contusion: abnormal accumulation of fluid,
- lung sounds, cough, frank blood, mucus, chest pain, atelectasis, -BP, resp acidosis
Monitor: fluid intake, fluid replacement and pain
@COPYRIGHT ALL RIGHTS RESERVED PAGE 3 OF 20
HESI QUESTIONS AND ANSWERS | 2026
UPDATE | 100% CORRECT.
Diffusing anger in the ED - ANS Self safety is PRIORITY
gunfire- protect self
separate feuding individuals explains activities, eliminate triggers.
Heat Stroke ** - ANS Priority action: *Lower body temperature; O2, fluids, cool towel, cool
bath (NO ICE BATH) elevate feet
+HR, +temp, confusion, headache, anxiety, cramps, gooseflesh, HOT,DRY skin, NO sweating
Alcoholic- first assessment - ANS CAGE: Cut, Annoyed, Guilty, Eye-opener.
Assess: psych, w/drawal.
Mgt: blood glucose, benzo, barbiturate, seizure precautions.
Let them sleep if calm-
not calm- benzo's-
check on patient regularly for - LOC
Blood glucose range: 70-110
Non-fatal drowning ** - ANS Priority: manage hypoxia, acidosis and hypothermia > airway,
oxygen
Management: CPR, core temp (rectal) rewarming procedures during CPR, trach/PEEP, O2
Risks: ARDS> hypoxia, hypercarbia and respiratory acidosis can occur
@COPYRIGHT ALL RIGHTS RESERVED PAGE 1 OF 20
,Hypothermia> metabolic acidosis
NGT> decompress stomach and prevent aspirating gastric contents.
Monitor: ECG, ICP, I/O
Labs: serum electrolytes
Highest risk: <5 yo, >85 yo
Freshwater: loss of surfactant- inability to expand lungs
Saltwater: pulmonary edema
Observe pt for 23 + hours
Serum Electrolytes - ANS * Mg+ 1.5-2.5
* Phos 2.5-4.5
* K+ 3.5-5
* Ca 8.5-10.9
* Chl 95-105
Bite Priority - ANS Human bite: know what to do first with a human bite!
Animal: rabies prophylaxis
Snakebite: lie down, removing constrictive items, providing warmth, cleansing the wound,
covering the wound with a light sterile dressing, and immobilizing the injured body part below
the level of the heart.
CABs (Circulation, Airway Breathing)
NO: Ice, incision and suction, or a tourniquet
Tetanus and analgesia should be given as necessary.
Meds: FabAV or CroFAb: no limit on how much to give
S&S: necrosis, edema, ecchymosis
Tick: remove with tweezers, straight up pull, (try to get close to skin as possible)
S&S: bulls eye rash
Poisoning in the house - ANS Carbon Monoxide: 100% O2 Atmospheric/hyperbaric chamber
@COPYRIGHT ALL RIGHTS RESERVED PAGE 2 OF 20
, Ingested Poison: ABC, Call poison control, try to describe what was ingested
Charcoal: most effective, Do not use if heavy metals were ingested. Corrosives: give water/milk
Cathartics: sorbitol: give w/ 1st dose of charcoal
syrup ipecac: Induces vomiting, only give to alert patients-and NO patients who ingested a
corrosive agent
Gastric emptying: intubate before lavage ( if -LOC/-gag reflex) with in 1 hour of ingestion.
Overdose- multiply organ dysfunction syndrome - ANS Find out what Patient OD'd on. Give
antidote if there is one
Treatment goals for a patient with a drug overdose are to support the respiratory and
cardiovascular functions, to enhance clearance of the agent, and to provide for safety of the
patient and staff.
Abuse- interpersonal violence - ANS Priority: ask questions IN PRIVATE, separate from person
who is abusive/neglectful
referral to shelter
adults are free to accept or refuse help
safety plans should be explored
Mandatory report: children and elderly abuse - only need to suspect abuse, do not need to
prove it
PTSD- rape and stabbing - ANS Keep patient comfortable
Offer therapeutic communication -listen
Avoid triggers
**ask if patient plans to harm self-
Chest-Blunt trauma complications ** - ANS Flail chest: paradoxical chest movement,
hypoxemia, resp acidosis
Pulmonary contusion: abnormal accumulation of fluid,
- lung sounds, cough, frank blood, mucus, chest pain, atelectasis, -BP, resp acidosis
Monitor: fluid intake, fluid replacement and pain
@COPYRIGHT ALL RIGHTS RESERVED PAGE 3 OF 20
