BSN 266 HESI MED SURG 2026/2027 – Comprehensive
Practice Exam
150 Questions with Detailed Rationales in Italics
SECTION A: CARDIOVASCULAR SYSTEM (Questions 1-20)
1. A nurse is caring for a client with heart failure who reports shortness of breath
and weight gain of 3 pounds in 2 days. Which intervention should the nurse
implement first?
A. Administer prescribed diuretic
B. Place the client in high Fowler's position
C. Restrict oral fluid intake
D. Auscultate lung sounds
2. A client with angina pectoris is prescribed nitroglycerin sublingual. Which
instruction should the nurse include in client teaching?
A. "Take one tablet every 15 minutes until pain subsides"
B. "Swallow the tablet with a full glass of water"
C. "Take one tablet at the first sign of chest pain and stop activity"
D. "Store the tablets in a warm, brightly lit area"
,3. A nurse is assessing a client with peripheral artery disease (PAD). Which finding
is most consistent with this condition?
A. Dependent rubor
B. Brownish discoloration of the lower legs
C. Thick, tough skin with hair loss
D. Edema around the ankles
4. A client with hypertension is prescribed lisinopril. Which adverse effect should
the nurse monitor?
A. Dry cough
B. Tachycardia
C. Hyperkalemia
D. Both A and C
,5. A nurse is caring for a client following a cardiac catheterization via the femoral
artery. Which finding requires immediate intervention?
A. Pulse rate of 88 beats/min
B. Blood pressure of 142/88 mmHg
C. Pallor and coolness of the affected extremity
D. Small amount of serous drainage at the insertion site
6. A client with coronary artery disease is prescribed clopidogrel. The nurse should
monitor for which adverse effect?
A. Thrombocytopenia
B. Bleeding
C. Bradycardia
D. Hypokalemia
7. A nurse is caring for a client with infective endocarditis. Which finding is most
indicative of this condition?
A. Murmur
B. Splinter hemorrhages
C. Osler's nodes
D. Janeway lesions
, 8. A client with atrial fibrillation is prescribed warfarin. Which laboratory value
should the nurse monitor to evaluate therapeutic effectiveness?
A. PT and INR
B. aPTT
C. Platelet count
D. Hemoglobin and hematocrit
9. A nurse is assessing a client with left-sided heart failure. Which finding is most
consistent with this condition?
A. Jugular venous distention
B. Peripheral edema
C. Crackles in the lungs
D. Ascites
Practice Exam
150 Questions with Detailed Rationales in Italics
SECTION A: CARDIOVASCULAR SYSTEM (Questions 1-20)
1. A nurse is caring for a client with heart failure who reports shortness of breath
and weight gain of 3 pounds in 2 days. Which intervention should the nurse
implement first?
A. Administer prescribed diuretic
B. Place the client in high Fowler's position
C. Restrict oral fluid intake
D. Auscultate lung sounds
2. A client with angina pectoris is prescribed nitroglycerin sublingual. Which
instruction should the nurse include in client teaching?
A. "Take one tablet every 15 minutes until pain subsides"
B. "Swallow the tablet with a full glass of water"
C. "Take one tablet at the first sign of chest pain and stop activity"
D. "Store the tablets in a warm, brightly lit area"
,3. A nurse is assessing a client with peripheral artery disease (PAD). Which finding
is most consistent with this condition?
A. Dependent rubor
B. Brownish discoloration of the lower legs
C. Thick, tough skin with hair loss
D. Edema around the ankles
4. A client with hypertension is prescribed lisinopril. Which adverse effect should
the nurse monitor?
A. Dry cough
B. Tachycardia
C. Hyperkalemia
D. Both A and C
,5. A nurse is caring for a client following a cardiac catheterization via the femoral
artery. Which finding requires immediate intervention?
A. Pulse rate of 88 beats/min
B. Blood pressure of 142/88 mmHg
C. Pallor and coolness of the affected extremity
D. Small amount of serous drainage at the insertion site
6. A client with coronary artery disease is prescribed clopidogrel. The nurse should
monitor for which adverse effect?
A. Thrombocytopenia
B. Bleeding
C. Bradycardia
D. Hypokalemia
7. A nurse is caring for a client with infective endocarditis. Which finding is most
indicative of this condition?
A. Murmur
B. Splinter hemorrhages
C. Osler's nodes
D. Janeway lesions
, 8. A client with atrial fibrillation is prescribed warfarin. Which laboratory value
should the nurse monitor to evaluate therapeutic effectiveness?
A. PT and INR
B. aPTT
C. Platelet count
D. Hemoglobin and hematocrit
9. A nurse is assessing a client with left-sided heart failure. Which finding is most
consistent with this condition?
A. Jugular venous distention
B. Peripheral edema
C. Crackles in the lungs
D. Ascites
