Med-Surg Exit HESI Exam 2026
Questions and Answers Graded A+
Monitor ABGs - Correct answer-PO2 > 80 mm Hg; PCO2 35-45 mm Hg; HCO3
21-28 mEq/L; pH 7.35-7.45
Chronic bronchitis - Correct answer-Airway destruction
Chronic sputum with cough production on a daily basis for a minimum of 3
months in 2 consecutive years
Reduced responsiveness of respiratory center to hypoxemia stimuli
Precipitating factor: higher incidence in smokers
"Blue bloaters" - generalized cyanosis of lips, mucous membranes, face, and nail
beds
Right-sided heart failure (distended neck veins, crackles)
Lowest FiO2 possible to prevent CO2 retention
Monitor for fluid overload
Maintain PO2 between 55 and 60
©COPYRIGHT 2026, ALL RIGHTS RESERVED 1
,Administer bronchodilators and anti-inflammatory agents
Emphysema - Correct answer-Alveoli destruction
Increased air trapping (increased AP diameter)
Increased work, increased O2 consumption
Precipitating factor: cigarette smoking
"Pink puffers"
Barrel chest, pursed-lip breathing, wheezing
Lowest FiO2 possible to prevent CO2 retention
Administer bronchodilators and anti-inflammatory agents
Teach prolonged expiratory phase to clear trapped air
Asthma - Correct answer-Unlike COPD, asthma is an intermittent disease with
reversible airflow obstruction and wheezing
COPD - Correct answer-Emphysema and chronic bronchitis
Characterized by bronchospasm and dyspnea
Compensation occurs over time in clients with chronic lung disease and ABGs are
altered
©COPYRIGHT 2026, ALL RIGHTS RESERVED 2
,The amount of O2 in the blood decreased (hypoxemia) and the amount of CO2 in
the blood increases (hypercapnia) causing chronic respiratory acidosis, which
results in metabolic alkalosis as compensation
Clients at risk for pneumonia - Correct answer-Altered LOC
Depressed or absent gag and cough reflexes
Susceptible to aspirating oropharyngeal secretions (alcoholics, anesthetized
individuals)
Brain injury
Drug overdose
Stroke victims
Immunocompromised
Adrenergics and sympathomimetics - Correct answer-Epinephrine; Albuterol
(Proventil); Terbutaline (Brethine); Salmeterol (Serevent); Metaproterenol
(Alupent); Levabuterol (Xopenex)
Bronchodilation
Adverse reactions: anxiety, increased HR, N/V, urinary retention
Methylxanthine - Correct answer-Aminophylline (IV); Theophylline (PO)
©COPYRIGHT 2026, ALL RIGHTS RESERVED 3
, Bronchodilation
Adverse reactions: hyperactivity, tachycardia, sleeplessness, cardiac dysrhythmias
Monitor therapeutic range
Crosses placenta
Corticosteroids - Correct answer-Prednisone (PO); Solu-Medrol (IV); Budesonide
(Pulmicort); Fluticasone (Flovent); Triamcinolone (Azmacort)
Anti-inflammatory
Encourage oral care after use
Anticholinergics - Correct answer-Ipratropium (Atrovent); Tiotropium (Spiriva)
Bronchodilator; control of rhinorrhea
Adverse reactions: dry mouth, blurred visions, cough
O2 delivery - Correct answer-O2 must be humidified if given at >4 L/min or
delivered directly to the trachea
Tuberculosis - Correct answer-Airborne precautions*****
Symptoms: fever with night sweats, anorexia, weight loss, malaise, fatigue, cough,
hemoptysis, dyspnea, pleuritic chest pain with inspiration, positive sputum culture,
repeated upper respiratory infection
©COPYRIGHT 2026, ALL RIGHTS RESERVED 4
Questions and Answers Graded A+
Monitor ABGs - Correct answer-PO2 > 80 mm Hg; PCO2 35-45 mm Hg; HCO3
21-28 mEq/L; pH 7.35-7.45
Chronic bronchitis - Correct answer-Airway destruction
Chronic sputum with cough production on a daily basis for a minimum of 3
months in 2 consecutive years
Reduced responsiveness of respiratory center to hypoxemia stimuli
Precipitating factor: higher incidence in smokers
"Blue bloaters" - generalized cyanosis of lips, mucous membranes, face, and nail
beds
Right-sided heart failure (distended neck veins, crackles)
Lowest FiO2 possible to prevent CO2 retention
Monitor for fluid overload
Maintain PO2 between 55 and 60
©COPYRIGHT 2026, ALL RIGHTS RESERVED 1
,Administer bronchodilators and anti-inflammatory agents
Emphysema - Correct answer-Alveoli destruction
Increased air trapping (increased AP diameter)
Increased work, increased O2 consumption
Precipitating factor: cigarette smoking
"Pink puffers"
Barrel chest, pursed-lip breathing, wheezing
Lowest FiO2 possible to prevent CO2 retention
Administer bronchodilators and anti-inflammatory agents
Teach prolonged expiratory phase to clear trapped air
Asthma - Correct answer-Unlike COPD, asthma is an intermittent disease with
reversible airflow obstruction and wheezing
COPD - Correct answer-Emphysema and chronic bronchitis
Characterized by bronchospasm and dyspnea
Compensation occurs over time in clients with chronic lung disease and ABGs are
altered
©COPYRIGHT 2026, ALL RIGHTS RESERVED 2
,The amount of O2 in the blood decreased (hypoxemia) and the amount of CO2 in
the blood increases (hypercapnia) causing chronic respiratory acidosis, which
results in metabolic alkalosis as compensation
Clients at risk for pneumonia - Correct answer-Altered LOC
Depressed or absent gag and cough reflexes
Susceptible to aspirating oropharyngeal secretions (alcoholics, anesthetized
individuals)
Brain injury
Drug overdose
Stroke victims
Immunocompromised
Adrenergics and sympathomimetics - Correct answer-Epinephrine; Albuterol
(Proventil); Terbutaline (Brethine); Salmeterol (Serevent); Metaproterenol
(Alupent); Levabuterol (Xopenex)
Bronchodilation
Adverse reactions: anxiety, increased HR, N/V, urinary retention
Methylxanthine - Correct answer-Aminophylline (IV); Theophylline (PO)
©COPYRIGHT 2026, ALL RIGHTS RESERVED 3
, Bronchodilation
Adverse reactions: hyperactivity, tachycardia, sleeplessness, cardiac dysrhythmias
Monitor therapeutic range
Crosses placenta
Corticosteroids - Correct answer-Prednisone (PO); Solu-Medrol (IV); Budesonide
(Pulmicort); Fluticasone (Flovent); Triamcinolone (Azmacort)
Anti-inflammatory
Encourage oral care after use
Anticholinergics - Correct answer-Ipratropium (Atrovent); Tiotropium (Spiriva)
Bronchodilator; control of rhinorrhea
Adverse reactions: dry mouth, blurred visions, cough
O2 delivery - Correct answer-O2 must be humidified if given at >4 L/min or
delivered directly to the trachea
Tuberculosis - Correct answer-Airborne precautions*****
Symptoms: fever with night sweats, anorexia, weight loss, malaise, fatigue, cough,
hemoptysis, dyspnea, pleuritic chest pain with inspiration, positive sputum culture,
repeated upper respiratory infection
©COPYRIGHT 2026, ALL RIGHTS RESERVED 4
