BSN HESI 266 Med Surg Exam Questions and Answers and Explanations Latest
For Nightingale V4..
BSN 266 HESI Med-Surg Exam Practice Questions
Version 4 - 180 Practice Questions with Answers and Rationales
Section 1: Cardiovascular Disorders (Questions 1-25)
Question 1
The nurse is caring for a client three weeks post-myocardial infarction who
reports that his wife has moved to a separate bedroom and states, "I guess we
will never have sex again." What is the nurse's best response?
A. "Sexual activity has similar cardiac workload as climbing two flights of stairs
and can be resumed like other activities."
B. "You should avoid sexual activity for at least six months."
C. "This is a common fear; I will notify the physician."
D. "Your wife should attend cardiac rehab for education."
Answer: A
Rationale: Sexual activity in stable patients post-MI generally exerts a moderate
cardiac workload comparable to mild exercise and can be safely resumed after
,risk stratification and recovery. This provides accurate, reassuring information
that addresses the client's concern without minimizing it.
Question 2
A client presents with acute chest pain. The nurse obtains a 12-lead ECG. Which
assessment finding is most crucial?
A. Irregular pulse rate
B. Bile-colored emesis
C. ST elevation in three leads
D. Complaint of radiating jaw pain
Answer: C
Rationale: ST elevation in three leads indicates a STEMI (ST-segment elevation
myocardial infarction), which requires immediate intervention. This is a priority
finding that suggests acute cardiac injury requiring urgent reperfusion therapy.
Question 3
,An older client is admitted agitated, dyspneic, orthopneic, and using accessory
muscles to breathe. Initial assessment includes heart rate 128 beats/minute and
irregular, respirations 38 breaths/minute, blood pressure 168/100 mm Hg,
wheezes and crackles in all lung fields. An hour after administration of furosemide
60 mg IV, which assessments should the nurse obtain to determine the client's
response to treatment? (Select all that apply.)
A. Urinary output
B. Oxygen saturation
C. Pain scale
D. Lung sounds
E. Skin elasticity
Answer: A, B, D
Rationale: Urinary output indicates diuretic effectiveness, oxygen saturation
shows respiratory status improvement, and lung sounds reveal resolution of
pulmonary congestion. Pain scale and skin elasticity are less directly related to
assessing furosemide response.
Question 4
, A client who is receiving zidovudine reports the appearance of pinpoint, red,
round spots on the skin. Which result should the nurse report to the healthcare
provider?
A. Electromyography
B. Allergy test
C. Complete blood count
D. Skin biopsy
Answer: C
Rationale: Pinpoint red spots (petechiae) in a client taking zidovudine may
indicate bone marrow suppression or thrombocytopenia. A complete blood count
would reveal decreased platelet counts, which is a critical finding requiring
immediate intervention.
Question 5
A client is obtaining a medication history prior to starting nitroglycerin for chest
discomfort with activity. Which medication should the nurse instruct the client to
avoid taking within 24 hours of using nitroglycerin?
For Nightingale V4..
BSN 266 HESI Med-Surg Exam Practice Questions
Version 4 - 180 Practice Questions with Answers and Rationales
Section 1: Cardiovascular Disorders (Questions 1-25)
Question 1
The nurse is caring for a client three weeks post-myocardial infarction who
reports that his wife has moved to a separate bedroom and states, "I guess we
will never have sex again." What is the nurse's best response?
A. "Sexual activity has similar cardiac workload as climbing two flights of stairs
and can be resumed like other activities."
B. "You should avoid sexual activity for at least six months."
C. "This is a common fear; I will notify the physician."
D. "Your wife should attend cardiac rehab for education."
Answer: A
Rationale: Sexual activity in stable patients post-MI generally exerts a moderate
cardiac workload comparable to mild exercise and can be safely resumed after
,risk stratification and recovery. This provides accurate, reassuring information
that addresses the client's concern without minimizing it.
Question 2
A client presents with acute chest pain. The nurse obtains a 12-lead ECG. Which
assessment finding is most crucial?
A. Irregular pulse rate
B. Bile-colored emesis
C. ST elevation in three leads
D. Complaint of radiating jaw pain
Answer: C
Rationale: ST elevation in three leads indicates a STEMI (ST-segment elevation
myocardial infarction), which requires immediate intervention. This is a priority
finding that suggests acute cardiac injury requiring urgent reperfusion therapy.
Question 3
,An older client is admitted agitated, dyspneic, orthopneic, and using accessory
muscles to breathe. Initial assessment includes heart rate 128 beats/minute and
irregular, respirations 38 breaths/minute, blood pressure 168/100 mm Hg,
wheezes and crackles in all lung fields. An hour after administration of furosemide
60 mg IV, which assessments should the nurse obtain to determine the client's
response to treatment? (Select all that apply.)
A. Urinary output
B. Oxygen saturation
C. Pain scale
D. Lung sounds
E. Skin elasticity
Answer: A, B, D
Rationale: Urinary output indicates diuretic effectiveness, oxygen saturation
shows respiratory status improvement, and lung sounds reveal resolution of
pulmonary congestion. Pain scale and skin elasticity are less directly related to
assessing furosemide response.
Question 4
, A client who is receiving zidovudine reports the appearance of pinpoint, red,
round spots on the skin. Which result should the nurse report to the healthcare
provider?
A. Electromyography
B. Allergy test
C. Complete blood count
D. Skin biopsy
Answer: C
Rationale: Pinpoint red spots (petechiae) in a client taking zidovudine may
indicate bone marrow suppression or thrombocytopenia. A complete blood count
would reveal decreased platelet counts, which is a critical finding requiring
immediate intervention.
Question 5
A client is obtaining a medication history prior to starting nitroglycerin for chest
discomfort with activity. Which medication should the nurse instruct the client to
avoid taking within 24 hours of using nitroglycerin?
