BSN HESI 266 Med Surg Exam (Latest )
Questions & Correct Answers With Rationales, 100%
Guaranteed Pass || Complete A+ Guide - Nightingale
Complete A+ Guide – Nightingale
This comprehensive study guide contains 150 practice questions modeled after
the BSN HESI 266 Medical-Surgical exam used at Nightingale College. All questions
are aligned with the latest 2026/2027 HESI blueprint and include verified answers
with detailed rationales to help you master critical thinking and clinical judgment
skills.
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1–25)
Question 1:
A 77-year-old female client is admitted to the hospital. She is confused, has no
appetite, is nauseated and vomiting, and is complaining of a headache. Her pulse
rate is 43 beats per minute. Which question is a priority for the nurse to ask this
client or her family on admission?
A. "Does the client have her own teeth or dentures?"
B. "Does the client take aspirin and if so, how much?"
C. "Does the client take nitroglycerin?"
D. "Does the client take digitalis?"
Correct Answer-: D. "Does the client take digitalis?"
Rationale: Symptoms such as confusion, nausea, vomiting, headache, and
bradycardia are classic signs of digitalis toxicity, especially in elderly clients.
Prompt assessment of medication history is critical to identify this potentially life-
threatening condition .
,Question 2:
A client with heart failure reports a 3-pound weight gain in 24 hours. What should
the nurse do first?
A. Administer furosemide as prescribed
B. Assess for peripheral edema
C. Restrict fluid intake
D. Notify the healthcare provider
Correct Answer-: B. Assess for peripheral edema
Rationale: Weight gain in heart failure suggests fluid retention; assessing edema
provides data to guide further action. The nurse should complete assessment
before implementing interventions or notifying the provider .
Question 3:
A client taking a thiazide diuretic for the past six months has a serum potassium
level of 3.0 mEq/L. The nurse anticipates which change in prescription for the
client?
A. The dosage of the diuretic will be decreased
B. The diuretic will be discontinued
C. A potassium supplement will be prescribed
D. The dosage of the diuretic will be increased
Correct Answer-: C. A potassium supplement will be prescribed
Rationale: This client's potassium level is too low (normal is 3.5 to 5.5 mEq/L).
Taking a thiazide diuretic often results in a loss of potassium, so a potassium
supplement needs to be prescribed to restore a normal serum potassium level .
Question 4:
A client is admitted to the medical intensive care unit with a diagnosis of
myocardial infarction. The client's history indicates the infarction occurred ten
hours ago. Which laboratory test result would the nurse expect this client to
exhibit?
,A. Elevated LDH
B. Elevated serum amylase
C. Elevated CK-MB
D. Elevated hematocrit
Correct Answer-: C. Elevated CK-MB
Rationale: The cardiac isoenzyme CK-MB is one of the cardiac markers that
indicates myocardial damage. Troponin levels elevate within 2-3 hours, followed
by CK-MB within 6-9 hours, peaking within 12 to 20 hours after myocardial
infarction .
Question 5:
A client with a history of atrial fibrillation reports dizziness. What should the nurse
assess first?
A. Blood pressure
B. Heart rate
C. Oxygen saturation
D. Blood glucose
Correct Answer-: B. Heart rate
Rationale: Dizziness in atrial fibrillation may indicate an irregular or rapid heart
rate, requiring immediate assessment. Heart rate and rhythm should be assessed
first to identify the cause of symptoms .
Question 6:
The nurse would be correct in withholding a dose of digoxin in a client with
congestive heart failure without specific instruction from the healthcare provider
if the client's:
A. Serum digoxin level is 1.5 ng/mL
B. Blood pressure is 104/68 mmHg
C. Serum potassium level is 3.0 mEq/L
D. Apical pulse is 68 beats/min
, Correct Answer-: C. Serum potassium level is 3.0 mEq/L
Rationale: Hypokalemia can precipitate digitalis toxicity in persons receiving
digoxin, which will increase the chance of dangerous dysrhythmias (normal
potassium level is 3.5 to 5.5 mEq/L) .
Question 7:
A client receiving heparin therapy is being monitored. Which laboratory test
should the nurse monitor?
A. INR
B. aPTT
C. Platelet count
D. PT
Correct Answer-: B. aPTT
Rationale: Heparin prolongs the activated partial thromboplastin time (aPTT).
Monitoring aPTT ensures therapeutic anticoagulation and prevents bleeding
complications .
Question 8:
A client with atrial fibrillation is receiving warfarin. Which laboratory value should
the nurse monitor?
A. Platelet count
B. INR
C. aPTT
D. Hemoglobin
Correct Answer-: B. INR
Rationale: Warfarin therapy is monitored by the International Normalized Ratio
(INR). The therapeutic INR for atrial fibrillation is typically 2.0–3.0 .
Questions & Correct Answers With Rationales, 100%
Guaranteed Pass || Complete A+ Guide - Nightingale
Complete A+ Guide – Nightingale
This comprehensive study guide contains 150 practice questions modeled after
the BSN HESI 266 Medical-Surgical exam used at Nightingale College. All questions
are aligned with the latest 2026/2027 HESI blueprint and include verified answers
with detailed rationales to help you master critical thinking and clinical judgment
skills.
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1–25)
Question 1:
A 77-year-old female client is admitted to the hospital. She is confused, has no
appetite, is nauseated and vomiting, and is complaining of a headache. Her pulse
rate is 43 beats per minute. Which question is a priority for the nurse to ask this
client or her family on admission?
A. "Does the client have her own teeth or dentures?"
B. "Does the client take aspirin and if so, how much?"
C. "Does the client take nitroglycerin?"
D. "Does the client take digitalis?"
Correct Answer-: D. "Does the client take digitalis?"
Rationale: Symptoms such as confusion, nausea, vomiting, headache, and
bradycardia are classic signs of digitalis toxicity, especially in elderly clients.
Prompt assessment of medication history is critical to identify this potentially life-
threatening condition .
,Question 2:
A client with heart failure reports a 3-pound weight gain in 24 hours. What should
the nurse do first?
A. Administer furosemide as prescribed
B. Assess for peripheral edema
C. Restrict fluid intake
D. Notify the healthcare provider
Correct Answer-: B. Assess for peripheral edema
Rationale: Weight gain in heart failure suggests fluid retention; assessing edema
provides data to guide further action. The nurse should complete assessment
before implementing interventions or notifying the provider .
Question 3:
A client taking a thiazide diuretic for the past six months has a serum potassium
level of 3.0 mEq/L. The nurse anticipates which change in prescription for the
client?
A. The dosage of the diuretic will be decreased
B. The diuretic will be discontinued
C. A potassium supplement will be prescribed
D. The dosage of the diuretic will be increased
Correct Answer-: C. A potassium supplement will be prescribed
Rationale: This client's potassium level is too low (normal is 3.5 to 5.5 mEq/L).
Taking a thiazide diuretic often results in a loss of potassium, so a potassium
supplement needs to be prescribed to restore a normal serum potassium level .
Question 4:
A client is admitted to the medical intensive care unit with a diagnosis of
myocardial infarction. The client's history indicates the infarction occurred ten
hours ago. Which laboratory test result would the nurse expect this client to
exhibit?
,A. Elevated LDH
B. Elevated serum amylase
C. Elevated CK-MB
D. Elevated hematocrit
Correct Answer-: C. Elevated CK-MB
Rationale: The cardiac isoenzyme CK-MB is one of the cardiac markers that
indicates myocardial damage. Troponin levels elevate within 2-3 hours, followed
by CK-MB within 6-9 hours, peaking within 12 to 20 hours after myocardial
infarction .
Question 5:
A client with a history of atrial fibrillation reports dizziness. What should the nurse
assess first?
A. Blood pressure
B. Heart rate
C. Oxygen saturation
D. Blood glucose
Correct Answer-: B. Heart rate
Rationale: Dizziness in atrial fibrillation may indicate an irregular or rapid heart
rate, requiring immediate assessment. Heart rate and rhythm should be assessed
first to identify the cause of symptoms .
Question 6:
The nurse would be correct in withholding a dose of digoxin in a client with
congestive heart failure without specific instruction from the healthcare provider
if the client's:
A. Serum digoxin level is 1.5 ng/mL
B. Blood pressure is 104/68 mmHg
C. Serum potassium level is 3.0 mEq/L
D. Apical pulse is 68 beats/min
, Correct Answer-: C. Serum potassium level is 3.0 mEq/L
Rationale: Hypokalemia can precipitate digitalis toxicity in persons receiving
digoxin, which will increase the chance of dangerous dysrhythmias (normal
potassium level is 3.5 to 5.5 mEq/L) .
Question 7:
A client receiving heparin therapy is being monitored. Which laboratory test
should the nurse monitor?
A. INR
B. aPTT
C. Platelet count
D. PT
Correct Answer-: B. aPTT
Rationale: Heparin prolongs the activated partial thromboplastin time (aPTT).
Monitoring aPTT ensures therapeutic anticoagulation and prevents bleeding
complications .
Question 8:
A client with atrial fibrillation is receiving warfarin. Which laboratory value should
the nurse monitor?
A. Platelet count
B. INR
C. aPTT
D. Hemoglobin
Correct Answer-: B. INR
Rationale: Warfarin therapy is monitored by the International Normalized Ratio
(INR). The therapeutic INR for atrial fibrillation is typically 2.0–3.0 .
