HESI BSN 266 Med-Surg Exam 2026/2027 | 55
High-Yield Questions & Detailed Rationales |
Verified Practice Test for Medical-Surgical
Nursing Success
introduction
This comprehensive study pack is specifically designed for the HESI BSN 266 Med-Surg curriculum. It
contains 55 high-yield practice questions modeled after the actual 2025/2026 exam logic, focusing on
the complex multi-system nursing care required for BSN students.
What’s Included:
55 NCLEX-Style MCQs: Focused on prioritization, delegation, and safety.
Bold-Italicized Answers: For rapid-fire review and instant feedback.
Grey-Box Rationales: In-depth explanations for every question to help you master the "why" behind the
clinical judgment.
Multi-System Focus: Targeted sections on Cardiovascular, Respiratory, GI, Endocrine, Renal, Neuro, and
Peri-op nursing.
High-Yield Topics Covered:
Cardiovascular: EKG interpretation (V-Tach, A-Flutter), MI labs (Troponin), and Heart Failure
management.
Endocrine: DKA vs. HHS, Addisonian Crisis, and Thyroidectomy safety (Stridor/Calcium).
Critical Care: Increased ICP (Cushing’s Triad), GCS scoring, and Chest Tube maintenance.
Renal/GI: AV Fistula assessment, Cirrhosis (Lactulose), and Pancreatitis.
Safety & Peri-op: Malignant Hyperthermia (Dantrolene), fat embolism, and post-op positioning.
Part 1: Cardiovascular & Respiratory (Questions 1–20)
1. A patient with heart failure is receiving Furosemide. Which laboratory value is the
priority for the nurse to monitor?
A) Sodium 136 mEq/L
B) Potassium 3.2 mEq/L
C) Magnesium 1.9 mEq/L
D) Calcium 9.2 mg/dL
, Furosemide is a loop diuretic that causes significant potassium loss. Hypokalemia (K+
< 3.5) increases the risk of cardiac dysrhythmias and digoxin toxicity.
2. A nurse is caring for a patient 2 hours post-op from a thyroidectomy. Which
finding is the priority to report?
A) Pain at the incision site
B) Laryngeal stridor
C) Hoarse voice
D) Calcium level of 9.0 mg/dL
Stridor indicates upper airway obstruction due to edema or laryngeal nerve damage.
This is an "Airway" priority.
3. Which rhythm is characterized by a "sawtooth" P-wave pattern?
A) Atrial Fibrillation
B) Atrial Flutter
C) Ventricular Tachycardia
D) First-degree AV Block
Atrial flutter is classic for its "sawtooth" (F-wave) appearance on an ECG.
4. A patient with a PE (Pulmonary Embolism) is on a Heparin drip. The aPTT is 110
seconds. What is the nurse's first action?
A) Increase the drip rate
B) Stop the infusion
C) Administer Vitamin K
D) Notify the provider to repeat the lab in 4 hours
The therapeutic aPTT range is usually 1.5–2.5 times the normal (roughly 60–80
seconds). 110 seconds is too high, placing the patient at extreme risk for hemorrhage.
5. What is the hallmark sign of tension pneumothorax?
A) Hypertension
B) Tracheal deviation to the unaffected side
C) Productive cough
D) Inspiratory crackles
Tracheal deviation is a late, life-threatening sign indicating that pressure is shifting the
mediastinum.
6. A patient is diagnosed with Left-Sided Heart Failure. Which assessment finding
should the nurse expect?
A) Peripheral edema
High-Yield Questions & Detailed Rationales |
Verified Practice Test for Medical-Surgical
Nursing Success
introduction
This comprehensive study pack is specifically designed for the HESI BSN 266 Med-Surg curriculum. It
contains 55 high-yield practice questions modeled after the actual 2025/2026 exam logic, focusing on
the complex multi-system nursing care required for BSN students.
What’s Included:
55 NCLEX-Style MCQs: Focused on prioritization, delegation, and safety.
Bold-Italicized Answers: For rapid-fire review and instant feedback.
Grey-Box Rationales: In-depth explanations for every question to help you master the "why" behind the
clinical judgment.
Multi-System Focus: Targeted sections on Cardiovascular, Respiratory, GI, Endocrine, Renal, Neuro, and
Peri-op nursing.
High-Yield Topics Covered:
Cardiovascular: EKG interpretation (V-Tach, A-Flutter), MI labs (Troponin), and Heart Failure
management.
Endocrine: DKA vs. HHS, Addisonian Crisis, and Thyroidectomy safety (Stridor/Calcium).
Critical Care: Increased ICP (Cushing’s Triad), GCS scoring, and Chest Tube maintenance.
Renal/GI: AV Fistula assessment, Cirrhosis (Lactulose), and Pancreatitis.
Safety & Peri-op: Malignant Hyperthermia (Dantrolene), fat embolism, and post-op positioning.
Part 1: Cardiovascular & Respiratory (Questions 1–20)
1. A patient with heart failure is receiving Furosemide. Which laboratory value is the
priority for the nurse to monitor?
A) Sodium 136 mEq/L
B) Potassium 3.2 mEq/L
C) Magnesium 1.9 mEq/L
D) Calcium 9.2 mg/dL
, Furosemide is a loop diuretic that causes significant potassium loss. Hypokalemia (K+
< 3.5) increases the risk of cardiac dysrhythmias and digoxin toxicity.
2. A nurse is caring for a patient 2 hours post-op from a thyroidectomy. Which
finding is the priority to report?
A) Pain at the incision site
B) Laryngeal stridor
C) Hoarse voice
D) Calcium level of 9.0 mg/dL
Stridor indicates upper airway obstruction due to edema or laryngeal nerve damage.
This is an "Airway" priority.
3. Which rhythm is characterized by a "sawtooth" P-wave pattern?
A) Atrial Fibrillation
B) Atrial Flutter
C) Ventricular Tachycardia
D) First-degree AV Block
Atrial flutter is classic for its "sawtooth" (F-wave) appearance on an ECG.
4. A patient with a PE (Pulmonary Embolism) is on a Heparin drip. The aPTT is 110
seconds. What is the nurse's first action?
A) Increase the drip rate
B) Stop the infusion
C) Administer Vitamin K
D) Notify the provider to repeat the lab in 4 hours
The therapeutic aPTT range is usually 1.5–2.5 times the normal (roughly 60–80
seconds). 110 seconds is too high, placing the patient at extreme risk for hemorrhage.
5. What is the hallmark sign of tension pneumothorax?
A) Hypertension
B) Tracheal deviation to the unaffected side
C) Productive cough
D) Inspiratory crackles
Tracheal deviation is a late, life-threatening sign indicating that pressure is shifting the
mediastinum.
6. A patient is diagnosed with Left-Sided Heart Failure. Which assessment finding
should the nurse expect?
A) Peripheral edema
