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2026 BSN 266 HESI Med Surg Study Guide | 400+ Questions & Answers | NGN Nursing Case Scenarios

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This comprehensive BSN 266 HESI Med Surg Study Guide is designed to help nursing students prepare effectively for their exam. It includes over 400 carefully selected questions and answers, covering key medical-surgical nursing concepts frequently tested. The material features NGN-style questions and realistic case scenarios that enhance clinical judgment, critical thinking, and decision-making skills—essential for both HESI and Next Gen NCLEX success. Updated for 2026, this study guide is ideal for structured learning, self-assessment, and last-minute revision. It helps identify weak areas, reinforce core concepts, and build confidence for exam day.

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BSN 266 HESI
MED SURG STUDY GUIDE
(NGN-Style & Case Scenarios)

400+ Qs & Ans to Pass the Exam


This Hesi Test Contains:
➢ 400+ Qs & Ans
➢ Format Set of Multiple-choice
➢ Questions with incorporating Next Generation
NCLEX (NGN) and Case Scenarios
➢ Expert-Verified Explanations & Solutions

,### 1.
A client who underwent cardiac stent placement 4 days ago arrives to
the emergency department reporting sudden onset chest pressure
and shortness of breath.
Which action should the nurse take next?


Answer Choices:
a. Administer prescribed nitroglycerin sublingually.
b. Obtain a 12-lead electrocardiogram (ECG) and begin continuous cardiac
monitoring.
c. Give oxygen at 2 liters per minute via nasal cannula.
d. Prepare the client for immediate cardiac catheterization.


Correct Answer:
b. Obtain a 12-lead electrocardiogram (ECG) and begin continuous cardiac
monitoring.


Expert Rationale:
A client with sudden chest pressure and shortness of breath after recent
stenting is at high risk for acute stent thrombosis or myocardial infarction
(MI). Immediate acquisition of a 12-lead ECG is critical to assess for
ischemic changes and to prioritize timely reperfusion therapy if needed.
Continuous cardiac monitoring is essential to detect arrhythmias. Although
oxygen and nitroglycerin may be administered per protocol, assessment
data guides further interventions. Immediate preparation for catheterization
is premature before diagnostic confirmation.

,---


### 2.
While completing a health assessment for a client with migraine
headaches, the nurse identifies bilateral weakness in the client’s hand
grips. The client reports joint pain and difficulty twisting a door knob
due to weakness.
Which action should the nurse take next?


Answer Choices:
a. Teach the client relaxation techniques to manage migraine pain.
b. Document the findings and continue with the neurological assessment.
c. Gather additional assessment data about the pain and weakness.
d. Refer the client immediately to a neurologist.


Correct Answer:
c. Gather additional assessment data about the pain and weakness.


Expert Rationale:
Bilateral hand weakness and joint pain suggest possible systemic or
neurological disease beyond migraines (e.g., rheumatoid arthritis,
neuropathy). Further assessment to clarify onset, duration, associated
symptoms, and functional impact is needed before specialist referral.
Immediate referral without data may delay appropriate care; documenting
without further inquiry risks missing early diagnostic clues.


---

, ### 3.
The nurse is caring for a client diagnosed with psoriasis vulgaris
receiving psoralen and ultraviolet A light (PUVA) treatment.
Which assessment finding indicates overexposure to treatment?


Answer Choices:
a. Increased thickening and scaling of plaques.
b. Tenderness upon palpation and generalized erythema.
c. Development of vesicular lesions on treated skin.
d. Mild tanning of treated areas.


Correct Answer:
b. Tenderness upon palpation and generalized erythema.


Expert Rationale:
PUVA therapy carries a risk of phototoxic reactions causing erythema,
tenderness, and burning which signal overexposure. Tenderness with
generalized erythema suggests a burn-like reaction requiring treatment
modification. Vesicular lesions are rare but possible. Mild tanning is
expected, while increased plaque scaling indicates disease progression,
not treatment toxicity.


---


### 4.

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