BSN 266 – HESI Medical-Surgical Practice Exam V2
(Nightingale College, 2025/2026) – Verified Questions,
Answers, and Rationales (Grade A, 100% Correct)
1. A client with acute osteomyelitis has undergone surgical debridement of the diseased bone and
asks the nurse how long antibiotics will have to be administered. Which information should the
nurse communicate?
- A. Oral antibiotics for 2 to 4 months, then for dental procedure prophylaxis.
- B. Parenteral antibiotics for 4 to 6 weeks, then oral antibiotics for up to 1 year.
- C. Parenteral antibiotics for 4 to 8 weeks, then oral antibiotics for 4 to 8 weeks.
- D. Parenteral antibiotics for 2 to 3 weeks, then oral antibiotics for 4 weeks.
Correct Answer: C. Parenteral antibiotics for 4 to 8 weeks, then oral antibiotics for 4 to 8 weeks.
Explanation: Treatment of acute osteomyelitis requires the administration of high doses of
parenteral antibiotics for 4 to 8 weeks, followed by oral antibiotics for another 4 to 8 weeks to
ensure eradication of the infection.
2. In planning care for a client with an acute stroke resulting in right-sided hemiplegia, which
positioning should the nurse use to maintain optimal functioning?
- A. Mid-Fowler's with knees supported.
- B. Supine with trochanter rolls to the hips.
- C. Sim's position alternated with right lateral position q2 hours.
- D. Left lateral, supine, brief periods on the right side, and prone.
Correct Answer: D. Left lateral, supine, brief periods on the right side, and prone.
Explanation: After an acute stroke, a positioning schedule that minimizes lying on the affected side
(which can impair circulation and cause pain) and includes the prone position helps prevent flexion
contractures of the hips and prepares the client for optimal functioning
,3. Which preexisting diagnosis places a client at the greatest risk of developing superior vena cava
syndrome?
- A. Carotid stenosis.
- B. Steatosis hepatitis.
- C. Metastatic cancer.
- D. Clavicular fracture.
Correct Answer: C. Metastatic cancer.
Explanation: Superior vena cava syndrome occurs when the superior vena cava (SVC) is
compressed by outside structures, such as a growing tumor. It is likely to occur with metastatic
cancer, often from a primary tumor in the upper lobe of the right lung that compresses the SVC.
4. The nurse is giving discharge instructions to a client with chronic prostatitis. What instruction
should the nurse provide the client to reduce the risk of spreading the infection to other areas of
the client's urinary tract?
- A. Wear a condom when having sexual intercourse.
- B. Avoid consuming alcohol and caffeinated beverages.
- C. Empty the bladder completely with each voiding.
- D. Have intercourse or masturbate at least twice a week.
Correct Answer: D. Have intercourse or masturbate at least twice a week.
Explanation: The prostate is not easily penetrated by antibiotics and can serve as a reservoir for
microorganisms. Draining the prostate regularly through intercourse or masturbation decreases the
number of microorganisms present and reduces the risk for further infection from stored
contaminated seminal fluids.
,5. During the initial outbreak of genital herpes simplex for a female client, what should be the
nurse's primary focus in planning care?
- A. Promotion of comfort.
- B. Prevention of pregnancy.
- C. Instruction in condom use.
- D. Information about transmission.
Correct Answer: A. Promotion of comfort.
Explanation: The initial outbreak of genital herpes simplex causes severe discomfort. Promotion
of comfort is the first priority for nursing care.
6. A client who has a chronic cough with blood-tinged sputum returns to the unit after a
bronchoscopy. What nursing interventions should be implemented in the immediate post-
procedural period?
- A. Keep the client on bed rest for eight hours.
- B. Check vital signs every 15 minutes for two hours.
- C. Allow the client nothing by mouth until the gag reflex returns.
- D. Encourage fluid intake to promote elimination of the contrast media.
Correct Answer: C. Allow the client nothing by mouth until the gag reflex returns.
Explanation: The nasal and oral pharynx are anesthetized prior to bronchoscopy. Keeping the client
NPO until the gag reflex returns prevents aspiration.
7. A client is receiving a blood transfusion and develops chills, fever, and low back pain. The nurse
should first:
- A. Slow the infusion rate.
, - B. Stop the transfusion.
- C. Notify the healthcare provider.
- D. Administer an antihistamine.
Correct Answer: B. Stop the transfusion.
Explanation: These symptoms suggest a hemolytic transfusion reaction. The priority is to stop the
transfusion immediately to prevent further complications. Then, notify the provider and maintain
IV access with normal saline.
8. A nurse is caring for a client with heart failure who has gained 2 kg in 24 hours. Which action
should the nurse take first?
- A. Assess lung sounds.
- B. Restrict oral fluids.
- C. Administer furosemide.
- D. Elevate the head of the bed.
Correct Answer: A. Assess lung sounds.
Explanation: Rapid weight gain indicates fluid retention. The nurse should first assess for signs of
fluid overload, such as crackles in the lungs, before implementing interventions.
9. Which finding in a client with a permanent pacemaker requires immediate intervention?
- A. Bruising at the insertion site.
- B. Pulse rate of 72 beats per minute.
- C. Report of dizziness and palpitations.
- D. Mild incisional pain relieved by analgesics.
(Nightingale College, 2025/2026) – Verified Questions,
Answers, and Rationales (Grade A, 100% Correct)
1. A client with acute osteomyelitis has undergone surgical debridement of the diseased bone and
asks the nurse how long antibiotics will have to be administered. Which information should the
nurse communicate?
- A. Oral antibiotics for 2 to 4 months, then for dental procedure prophylaxis.
- B. Parenteral antibiotics for 4 to 6 weeks, then oral antibiotics for up to 1 year.
- C. Parenteral antibiotics for 4 to 8 weeks, then oral antibiotics for 4 to 8 weeks.
- D. Parenteral antibiotics for 2 to 3 weeks, then oral antibiotics for 4 weeks.
Correct Answer: C. Parenteral antibiotics for 4 to 8 weeks, then oral antibiotics for 4 to 8 weeks.
Explanation: Treatment of acute osteomyelitis requires the administration of high doses of
parenteral antibiotics for 4 to 8 weeks, followed by oral antibiotics for another 4 to 8 weeks to
ensure eradication of the infection.
2. In planning care for a client with an acute stroke resulting in right-sided hemiplegia, which
positioning should the nurse use to maintain optimal functioning?
- A. Mid-Fowler's with knees supported.
- B. Supine with trochanter rolls to the hips.
- C. Sim's position alternated with right lateral position q2 hours.
- D. Left lateral, supine, brief periods on the right side, and prone.
Correct Answer: D. Left lateral, supine, brief periods on the right side, and prone.
Explanation: After an acute stroke, a positioning schedule that minimizes lying on the affected side
(which can impair circulation and cause pain) and includes the prone position helps prevent flexion
contractures of the hips and prepares the client for optimal functioning
,3. Which preexisting diagnosis places a client at the greatest risk of developing superior vena cava
syndrome?
- A. Carotid stenosis.
- B. Steatosis hepatitis.
- C. Metastatic cancer.
- D. Clavicular fracture.
Correct Answer: C. Metastatic cancer.
Explanation: Superior vena cava syndrome occurs when the superior vena cava (SVC) is
compressed by outside structures, such as a growing tumor. It is likely to occur with metastatic
cancer, often from a primary tumor in the upper lobe of the right lung that compresses the SVC.
4. The nurse is giving discharge instructions to a client with chronic prostatitis. What instruction
should the nurse provide the client to reduce the risk of spreading the infection to other areas of
the client's urinary tract?
- A. Wear a condom when having sexual intercourse.
- B. Avoid consuming alcohol and caffeinated beverages.
- C. Empty the bladder completely with each voiding.
- D. Have intercourse or masturbate at least twice a week.
Correct Answer: D. Have intercourse or masturbate at least twice a week.
Explanation: The prostate is not easily penetrated by antibiotics and can serve as a reservoir for
microorganisms. Draining the prostate regularly through intercourse or masturbation decreases the
number of microorganisms present and reduces the risk for further infection from stored
contaminated seminal fluids.
,5. During the initial outbreak of genital herpes simplex for a female client, what should be the
nurse's primary focus in planning care?
- A. Promotion of comfort.
- B. Prevention of pregnancy.
- C. Instruction in condom use.
- D. Information about transmission.
Correct Answer: A. Promotion of comfort.
Explanation: The initial outbreak of genital herpes simplex causes severe discomfort. Promotion
of comfort is the first priority for nursing care.
6. A client who has a chronic cough with blood-tinged sputum returns to the unit after a
bronchoscopy. What nursing interventions should be implemented in the immediate post-
procedural period?
- A. Keep the client on bed rest for eight hours.
- B. Check vital signs every 15 minutes for two hours.
- C. Allow the client nothing by mouth until the gag reflex returns.
- D. Encourage fluid intake to promote elimination of the contrast media.
Correct Answer: C. Allow the client nothing by mouth until the gag reflex returns.
Explanation: The nasal and oral pharynx are anesthetized prior to bronchoscopy. Keeping the client
NPO until the gag reflex returns prevents aspiration.
7. A client is receiving a blood transfusion and develops chills, fever, and low back pain. The nurse
should first:
- A. Slow the infusion rate.
, - B. Stop the transfusion.
- C. Notify the healthcare provider.
- D. Administer an antihistamine.
Correct Answer: B. Stop the transfusion.
Explanation: These symptoms suggest a hemolytic transfusion reaction. The priority is to stop the
transfusion immediately to prevent further complications. Then, notify the provider and maintain
IV access with normal saline.
8. A nurse is caring for a client with heart failure who has gained 2 kg in 24 hours. Which action
should the nurse take first?
- A. Assess lung sounds.
- B. Restrict oral fluids.
- C. Administer furosemide.
- D. Elevate the head of the bed.
Correct Answer: A. Assess lung sounds.
Explanation: Rapid weight gain indicates fluid retention. The nurse should first assess for signs of
fluid overload, such as crackles in the lungs, before implementing interventions.
9. Which finding in a client with a permanent pacemaker requires immediate intervention?
- A. Bruising at the insertion site.
- B. Pulse rate of 72 beats per minute.
- C. Report of dizziness and palpitations.
- D. Mild incisional pain relieved by analgesics.
