MED SURG HESI EXAM SCRIPT FINAL PAPER
2026 FULL SOLUTION VIEW AHEAD
◉ HESI HINT: CLIENTS AT HIGH RISK FOR PNEUMONIA.
Answer: --ALTERED LEVEL OF CONSCIOUSNESS
--DEPRESSED OR ABSENT GAG AND COUGH REFLEXES
--SUSCEPTIBLE TO ASPIRATING OROPHARYNGEAL SECRETIONS,
INCLUDING ALCOHOLICS, ANESTHETIZED INDIVIDUAL
--BRAIN INJURY
--DRUG OVERDOSE
--STROKE VICTIMS
--IMMUNOCOMPROMISED INDIVIDUALS
◉ HESI HINT: BRONCHIAL BREATH SOUNDS.
Answer: ARE HEARD OVER AREAS OF DENSITY OR
CONSOLIDATION. SOUND WAVES ARE EASILY TRANSMITTED OVER
CONSOLIDATED TISSUE.
◉ HESI HINT: HYDRATION.
Answer: --THINS OUT THE MUCUS TRAPPED IN THE BRONCHIOLES
AND ALVEOLI, FACILITATING EXPECTORATION
,--IS ESSENTIAL FOR CLIENT EXPERIENCING FEVER
--IS IMPORTANT BECAUSE 300 TO 400mL OF FLUID IS LOST DAILY
BY THE LUNGS THROUGH EVAPORATION
◉ HESI HINT: IRRITABILITY AND RESTLESSNESS.
Answer: ARE EARLY SIGNS OF CEREBRAL HYPOXIA; THE CLIENT'S
BRAIN IS NOT RECEIVING ENOUGH 02
◉ HESI HINT: PNEUMONIA PREVENTIVES--OLDER ADULTS.
Answer: --FOR THE OLDER ADULTS; FLU SHOTS; PNEUMONIA
IMMUNIZATIONS; AVOIDING SOURCES OF INFECTION AND INDOOR
POLLUTANTS SUCH AS DUST, SMOKE, AND AEROSOLS; NO
SMOKINGING
◉ HESI HINT: PNEUMONIA PREVENTIVES--IMMUNOSUPPRESSED
AND DEBILITATED PERSONS.
Answer: --FOR THESE INDIVIDUALS; FLU SHOTS; PNEUMONIA
IMMUNIZATIONS, INFECTION AVOIDANCE, SENSIBLE NUTRITION,
ADEQUATE INTAKE, BALANCE OF REST AND ACTIVITY.
◉ HESI HINT: PNEUMONIA PREVENTIVES--COMATOSE OR
IMMOBILE INDIVIDUALS.
Answer: --FOR THESE INDIVIDUALS; ELEVATION OF THE HEAD OF
THE BED TO FEED AND FOR 1 HOUR AFTER FEEDING;
FREQUENTLY TURNING OF THESE INDIVIDUALS.
,◉ HESI HINT: PRIMARY CAUSE OF COPD.
Answer: EXPOSURE TO TOBACCO SMOKE IS THE PRIMARY CAUSE
IN THE UNITED STATES.
◉ HESI HINT: COMPENSATION OCCURS.
Answer: OVER TIME IN CLIENTS WITH CHRONIC LUNG DISEASE,
AND ABG's ARE ALTERED
◉ HESI HINT: AS COPD WORSENS.
Answer: THE AMOUNT OF 02 IN THE BLOOD DECREASES
(HYPOXIA) AND THE AMOUNT OF CARBON DIOXIDE IN THE BLOOD
INCREASES (HYPERCAPIA), CAUSING CHRONIC RESPIRATORY
ACIDOSIS (INCREASED PACO2), WHICH RESULTS IN METABOLIC
ALKALOSIS (INCREASED ARTERIAL BICARBONATE) AS
COMPENSATION.
◉ HESI HINT: NOT ALL COPD PATIENTS ARE.
Answer: C02 RETAINERS, EVEN WHEN LYPOXEMIA IS PRESENT,
BECAUSE C02 DIFFUSES MORE EASILY ACROSS LUNG MEMBRANES
THAN 02.
◉ HESI HINT: IN ADVANCED CLIENTS WITH WITH EMPHYSEMA.
, Answer: DUE TO THE ALVEOLI BEING AFFECTED, HYPERCAPIA IS A
PROBLEM, RATHER THAN IN BRONCHITIS, WHERE THE AIRWAYS
ARE AFFECTED.
--IT IS IMPERATIVE THAT BASELINE DATA BE OBTAINED FOR THE
CLIENT.
◉ HESI HINT: PRODUCTIVE COUGH AND COMFORT FOR PATIENTS
WITH COPD OR EMPHYSEMA CAN BE FACILITATED BY.
Answer: SEMI-FOWLER OR HIGH-FOWLER POSITION, WHICH
LESSENS PRESSURE ON THE DIAPHRAGM BY ABDOMINAL ORGANS.
GASTRIC DISTENTION BECOMES A PRIORITY IN THESE CLIENTS
BECAUSE IT ELEVATES THE DIAPHRAGM AND INHIBITS FULL
LUNG EXPANSION.
◉ HESI HINT: NORMAL ABG VALUES FOR THE ADULT.
Answer: PH 7.35 - 7.45
Pc02 35 - 45 mm Hg
P02 80 - 100 mm Hg
HCO3 21 - 28mEq/L
◉ HESI HINT: NORMAL ABG VALUES FOR A CHILD.
Answer: PH 7.36 - 7.44
Pc02 35 - 45 mm Hg
P02 80 - 100 mm Hg
2026 FULL SOLUTION VIEW AHEAD
◉ HESI HINT: CLIENTS AT HIGH RISK FOR PNEUMONIA.
Answer: --ALTERED LEVEL OF CONSCIOUSNESS
--DEPRESSED OR ABSENT GAG AND COUGH REFLEXES
--SUSCEPTIBLE TO ASPIRATING OROPHARYNGEAL SECRETIONS,
INCLUDING ALCOHOLICS, ANESTHETIZED INDIVIDUAL
--BRAIN INJURY
--DRUG OVERDOSE
--STROKE VICTIMS
--IMMUNOCOMPROMISED INDIVIDUALS
◉ HESI HINT: BRONCHIAL BREATH SOUNDS.
Answer: ARE HEARD OVER AREAS OF DENSITY OR
CONSOLIDATION. SOUND WAVES ARE EASILY TRANSMITTED OVER
CONSOLIDATED TISSUE.
◉ HESI HINT: HYDRATION.
Answer: --THINS OUT THE MUCUS TRAPPED IN THE BRONCHIOLES
AND ALVEOLI, FACILITATING EXPECTORATION
,--IS ESSENTIAL FOR CLIENT EXPERIENCING FEVER
--IS IMPORTANT BECAUSE 300 TO 400mL OF FLUID IS LOST DAILY
BY THE LUNGS THROUGH EVAPORATION
◉ HESI HINT: IRRITABILITY AND RESTLESSNESS.
Answer: ARE EARLY SIGNS OF CEREBRAL HYPOXIA; THE CLIENT'S
BRAIN IS NOT RECEIVING ENOUGH 02
◉ HESI HINT: PNEUMONIA PREVENTIVES--OLDER ADULTS.
Answer: --FOR THE OLDER ADULTS; FLU SHOTS; PNEUMONIA
IMMUNIZATIONS; AVOIDING SOURCES OF INFECTION AND INDOOR
POLLUTANTS SUCH AS DUST, SMOKE, AND AEROSOLS; NO
SMOKINGING
◉ HESI HINT: PNEUMONIA PREVENTIVES--IMMUNOSUPPRESSED
AND DEBILITATED PERSONS.
Answer: --FOR THESE INDIVIDUALS; FLU SHOTS; PNEUMONIA
IMMUNIZATIONS, INFECTION AVOIDANCE, SENSIBLE NUTRITION,
ADEQUATE INTAKE, BALANCE OF REST AND ACTIVITY.
◉ HESI HINT: PNEUMONIA PREVENTIVES--COMATOSE OR
IMMOBILE INDIVIDUALS.
Answer: --FOR THESE INDIVIDUALS; ELEVATION OF THE HEAD OF
THE BED TO FEED AND FOR 1 HOUR AFTER FEEDING;
FREQUENTLY TURNING OF THESE INDIVIDUALS.
,◉ HESI HINT: PRIMARY CAUSE OF COPD.
Answer: EXPOSURE TO TOBACCO SMOKE IS THE PRIMARY CAUSE
IN THE UNITED STATES.
◉ HESI HINT: COMPENSATION OCCURS.
Answer: OVER TIME IN CLIENTS WITH CHRONIC LUNG DISEASE,
AND ABG's ARE ALTERED
◉ HESI HINT: AS COPD WORSENS.
Answer: THE AMOUNT OF 02 IN THE BLOOD DECREASES
(HYPOXIA) AND THE AMOUNT OF CARBON DIOXIDE IN THE BLOOD
INCREASES (HYPERCAPIA), CAUSING CHRONIC RESPIRATORY
ACIDOSIS (INCREASED PACO2), WHICH RESULTS IN METABOLIC
ALKALOSIS (INCREASED ARTERIAL BICARBONATE) AS
COMPENSATION.
◉ HESI HINT: NOT ALL COPD PATIENTS ARE.
Answer: C02 RETAINERS, EVEN WHEN LYPOXEMIA IS PRESENT,
BECAUSE C02 DIFFUSES MORE EASILY ACROSS LUNG MEMBRANES
THAN 02.
◉ HESI HINT: IN ADVANCED CLIENTS WITH WITH EMPHYSEMA.
, Answer: DUE TO THE ALVEOLI BEING AFFECTED, HYPERCAPIA IS A
PROBLEM, RATHER THAN IN BRONCHITIS, WHERE THE AIRWAYS
ARE AFFECTED.
--IT IS IMPERATIVE THAT BASELINE DATA BE OBTAINED FOR THE
CLIENT.
◉ HESI HINT: PRODUCTIVE COUGH AND COMFORT FOR PATIENTS
WITH COPD OR EMPHYSEMA CAN BE FACILITATED BY.
Answer: SEMI-FOWLER OR HIGH-FOWLER POSITION, WHICH
LESSENS PRESSURE ON THE DIAPHRAGM BY ABDOMINAL ORGANS.
GASTRIC DISTENTION BECOMES A PRIORITY IN THESE CLIENTS
BECAUSE IT ELEVATES THE DIAPHRAGM AND INHIBITS FULL
LUNG EXPANSION.
◉ HESI HINT: NORMAL ABG VALUES FOR THE ADULT.
Answer: PH 7.35 - 7.45
Pc02 35 - 45 mm Hg
P02 80 - 100 mm Hg
HCO3 21 - 28mEq/L
◉ HESI HINT: NORMAL ABG VALUES FOR A CHILD.
Answer: PH 7.36 - 7.44
Pc02 35 - 45 mm Hg
P02 80 - 100 mm Hg
