BSN 266 HESI V1 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Medical-Surgical Nursing Fundamentals
Cardiovascular Systems and Disorders
Respiratory Systems and Gas Exchange
Pharmacology and Medication Management
Endocrine Systems and Metabolic Disorders
Renal and Urinary Systems
Gastrointestinal and Nutritional Systems
Neurological Systems and Care
Oncology and Cancer Care
Fluid, Electrolyte, and Acid-Base Balance
Infection Control and Safety
Professional Nursing Practice and Ethics
Purpose of the Exam
,This comprehensive assessment evaluates critical nursing knowledge and clinical decision-making skills
essential for safe, effective medical-surgical nursing practice. The exam assesses mastery of foundational theory,
applied professional knowledge, regulatory compliance, ethics, and professional standards through multiple-
choice and scenario-based questions.
Skills and knowledge assessed include pathophysiology recognition, pharmacological interventions, patient
monitoring, emergency response, and therapeutic communication. Questions emphasize real-world application
requiring critical thinking, prioritization, and evidence-based decision-making in diverse clinical scenarios.
The exam structure presents 100 multiple-choice questions with four options each, simulating actual healthcare
environments. Each question includes verified correct answers with detailed rationales explaining clinical
reasoning. This format prepares nurses for professional certification, licensure, and clinical competency
validation.*
SECTION ONE: QUESTIONS 1–100
Question 1
A client with a history of myocardial infarction presents with sudden onset of severe shortness of breath,
crackles bilaterally, and oxygen saturation of 86%. The nurse suspects which complication?
A. Pulmonary embolism
B. Acute pulmonary edema
C. Pneumothorax
D. Myocardial rupture
,🟢 Correct answer: B
🔴 RATIONALE: Acute pulmonary edema presents with sudden severe dyspnea, bilateral crackles, and
hypoxemia following MI. The crackles indicate fluid in alveoli from left ventricular failure. Pulmonary embolism
typically presents with sudden dyspnea but without bilateral crackles. Pneumothorax shows diminished breath
sounds on one side. Myocardial rupture is rare and presents with hemodynamic collapse.
Question 2
Which medication should the nurse administer first for a client experiencing acute chest pain with ST-segment
elevation?
A. Aspirin 325 mg
B. Morphine sulfate 4 mg
C. Nitroglycerin 0.4 mg
D. Beta-blocker 25 mg
🟢 Correct answer: A
🔴 RATIONALE: Aspirin is the first medication given for acute coronary syndrome to inhibit platelet
aggregation and prevent further clot formation. It should be administered immediately, even before confirming
MI. Nitroglycerin follows aspirin to reduce cardiac workload. Morphine is given if pain persists. Beta-blockers
are administered after initial stabilization.
, Question 3
A client with COPD has an oxygen saturation of 91% on 2L nasal cannula. The nurse should:
A. Increase oxygen to 4L
B. Maintain current oxygen level
C. Discontinue oxygen immediately
D. Switch to high-flow oxygen
🟢 Correct answer: B
🔴 RATIONALE: COPD clients typically maintain oxygen saturation between 88-92%. Increasing oxygen may
suppress their hypoxic drive to breathe, leading to respiratory depression. The current level is appropriate.
Discontinuing oxygen would cause hypoxemia. High-flow oxygen is dangerous for COPD clients and can cause
respiratory arrest.
Question 4
A client with type 1 diabetes presents with nausea, vomiting, abdominal pain, deep rapid breathing, and fruity-
smelling breath. Blood glucose is 450 mg/dL. What is the priority intervention?
A. Administer oral glucose
B. Give subcutaneous insulin
C. Start IV insulin and fluids
D. Encourage deep breathing
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Medical-Surgical Nursing Fundamentals
Cardiovascular Systems and Disorders
Respiratory Systems and Gas Exchange
Pharmacology and Medication Management
Endocrine Systems and Metabolic Disorders
Renal and Urinary Systems
Gastrointestinal and Nutritional Systems
Neurological Systems and Care
Oncology and Cancer Care
Fluid, Electrolyte, and Acid-Base Balance
Infection Control and Safety
Professional Nursing Practice and Ethics
Purpose of the Exam
,This comprehensive assessment evaluates critical nursing knowledge and clinical decision-making skills
essential for safe, effective medical-surgical nursing practice. The exam assesses mastery of foundational theory,
applied professional knowledge, regulatory compliance, ethics, and professional standards through multiple-
choice and scenario-based questions.
Skills and knowledge assessed include pathophysiology recognition, pharmacological interventions, patient
monitoring, emergency response, and therapeutic communication. Questions emphasize real-world application
requiring critical thinking, prioritization, and evidence-based decision-making in diverse clinical scenarios.
The exam structure presents 100 multiple-choice questions with four options each, simulating actual healthcare
environments. Each question includes verified correct answers with detailed rationales explaining clinical
reasoning. This format prepares nurses for professional certification, licensure, and clinical competency
validation.*
SECTION ONE: QUESTIONS 1–100
Question 1
A client with a history of myocardial infarction presents with sudden onset of severe shortness of breath,
crackles bilaterally, and oxygen saturation of 86%. The nurse suspects which complication?
A. Pulmonary embolism
B. Acute pulmonary edema
C. Pneumothorax
D. Myocardial rupture
,🟢 Correct answer: B
🔴 RATIONALE: Acute pulmonary edema presents with sudden severe dyspnea, bilateral crackles, and
hypoxemia following MI. The crackles indicate fluid in alveoli from left ventricular failure. Pulmonary embolism
typically presents with sudden dyspnea but without bilateral crackles. Pneumothorax shows diminished breath
sounds on one side. Myocardial rupture is rare and presents with hemodynamic collapse.
Question 2
Which medication should the nurse administer first for a client experiencing acute chest pain with ST-segment
elevation?
A. Aspirin 325 mg
B. Morphine sulfate 4 mg
C. Nitroglycerin 0.4 mg
D. Beta-blocker 25 mg
🟢 Correct answer: A
🔴 RATIONALE: Aspirin is the first medication given for acute coronary syndrome to inhibit platelet
aggregation and prevent further clot formation. It should be administered immediately, even before confirming
MI. Nitroglycerin follows aspirin to reduce cardiac workload. Morphine is given if pain persists. Beta-blockers
are administered after initial stabilization.
, Question 3
A client with COPD has an oxygen saturation of 91% on 2L nasal cannula. The nurse should:
A. Increase oxygen to 4L
B. Maintain current oxygen level
C. Discontinue oxygen immediately
D. Switch to high-flow oxygen
🟢 Correct answer: B
🔴 RATIONALE: COPD clients typically maintain oxygen saturation between 88-92%. Increasing oxygen may
suppress their hypoxic drive to breathe, leading to respiratory depression. The current level is appropriate.
Discontinuing oxygen would cause hypoxemia. High-flow oxygen is dangerous for COPD clients and can cause
respiratory arrest.
Question 4
A client with type 1 diabetes presents with nausea, vomiting, abdominal pain, deep rapid breathing, and fruity-
smelling breath. Blood glucose is 450 mg/dL. What is the priority intervention?
A. Administer oral glucose
B. Give subcutaneous insulin
C. Start IV insulin and fluids
D. Encourage deep breathing
