BSN HESI 266 MED SURG EXAM 200 ACTUAL QUESTIONS
AND CORRECT ANSWER WITH RATIONALE LATEST 2026
ALREADY GRADED A+ ASSURED PASS
This comprehensive 200-question BSN HESI 266 Med Surg exam bank
provides a rigorous review of essential medical-surgical nursing concepts for
baccalaureate nursing students. Each question is uniquely crafted with
realistic clinical scenarios, multiple-choice options, a definitive correct answer,
and a detailed rationale explaining the underlying pathophysiology,
pharmacology, and nursing interventions. Content spans cardiovascular
disorders (heart failure, MI, dysrhythmias, PAD, valve disorders), respiratory
conditions (COPD, asthma, pneumonia, ARDS, TB), renal and urinary
disorders (AKI, CKD, dialysis, UTI, stones), gastrointestinal conditions,
oncology, and perioperative care. Questions emphasize priority nursing
actions, clinical judgment, medication administration safety, patient
education, and complication identification. Designed to align with HESI Med
Surg exam blueprints, this resource promotes critical thinking, identifies
knowledge gaps, and enhances test-taking strategies for successful
examination performance and clinical application. Each rationale reinforces
evidence-based practice and prepares students for comprehensive nursing
care of adults with complex health alterations.
1. A client with a completed ischemic stroke has a blood pressure of 180/90 mm
Hg. Which action should the nurse implement?
A) Position the head of the bed (HOB) flat.
B) Withhold intravenous fluids.
C) Administer a bolus of IV fluids.
D) Give an antihypertensive medication.
Correct Answer: D) Give an antihypertensive medication.
Rationale: Completed strokes usually produce neurologic deficits within an hour,
and the client's current elevated blood pressure requires antihypertensive
medication to prevent further damage .
,2. A client who is receiving chemotherapy asks the nurse, "Why is so much of my
hair falling out each day?" Which response by the nurse best explains the reason
for alopecia?
A) "Chemotherapy affects the cells of the body that grow rapidly, both normal and
malignant."
B) "Alopecia is a common side effect you will experience during long-term steroid
therapy."
C) "Your hair will grow back completely after your course of chemotherapy is
completed."
D) "The chemotherapy causes permanent alterations in your hair follicles that lead
to hair loss."
Correct Answer: A) "Chemotherapy affects the cells of the body that grow rapidly,
both normal and malignant."
Rationale: The common adverse effects of chemotherapy (nausea, vomiting,
alopecia, bone marrow depression) are due to chemotherapy's effect on the rapidly
reproducing cells, both normal and malignant .
3. After checking the urinary drainage system for kinks in the tubing, the nurse
determines that a client who has returned from the post-anesthesia care has a dark,
concentrated urinary output of 54 ml for the last 2 hours. What priority nursing
action should be implemented?
A) Report the findings to the surgeon.
B) Irrigate the indwelling urinary catheter.
C) Apply manual pressure to the bladder.
D) Increase the IV flow rate for 15 minutes.
Correct Answer: A) Report the findings to the surgeon.
Rationale: An adult who weighs 132 pounds (60 kg) should produce about 60 ml
of urine hourly (1 ml/kg/hour). Dark, concentrated, and low volume of urine output
should be reported to the surgeon .
4. A male client who smokes two packs of cigarettes a day states he understands
that smoking cigarettes is contributing to the difficulty that he and his wife are
having in getting pregnant and wants to know if other factors could be contributing
to their difficulty. What information is best for the nurse to provide? (Select all that
apply.)
A) Marijuana cigarettes do not affect sperm count.
B) Alcohol consumption can cause erectile dysfunction.
C) Low testosterone levels affect sperm production.
D) Cessation of smoking improves general health and fertility.
E) Obesity has no effect on sperm production.
,Correct Answer: B, C and D
Rationale: Use of tobacco, alcohol, and marijuana may affect sperm counts. Sperm
count is also negatively affected by low testosterone levels and obesity. Cessation
of smoking improves general health and fertility .
5. A client with gastroesophageal reflux disease (GERD) has been experiencing
severe reflux during sleep. Which recommendation by the nurse is most effective
to assist the client?
A) Losing weight.
B) Decreasing caffeine intake.
C) Avoiding large meals.
D) Raising the head of the bed on blocks.
Correct Answer: D) Raising the head of the bed on blocks.
Rationale: Raising the head of the bed on blocks (reverse Trendelenburg position)
to reduce reflux and subsequent aspiration is the most non-pharmacological
effective recommendation for a client experiencing severe gastroesophageal reflux
during sleep .
6. A 51-year-old truck driver who smokes two packs of cigarettes a day and is 30
pounds overweight is diagnosed with having a gastric ulcer. What content is most
important for the nurse to include in the discharge teaching for this client?
A) Information about smoking cessation.
B) Diet instructions for a low-residue diet.
C) Instructions on a weight-loss program.
D) The importance of increasing milk in the diet.
Correct Answer: A) Information about smoking cessation.
Rationale: Smoking has been associated with ulcer formation, and stopping or
decreasing the number of cigarettes smoked per day is an important aspect of ulcer
management .
7. What types of medications should the nurse expect to administer to a client
during an acute respiratory distress episode?
A) Vasodilators and hormones.
B) Analgesics and sedatives.
C) Anticoagulants and expectorants.
D) Bronchodilators and steroids.
Correct Answer: D) Bronchodilators and steroids.
Rationale: Besides supplemental oxygen, this client with ARDS needs medications
to widen air passages, increase air space, and reduce alveolar membrane
inflammation, such as bronchodilators and steroids .
, 8. A female client is brought to the clinic by her daughter for a flu shot. She has
lost significant weight since the last visit. She has poor personal hygiene and
inadequate clothing for the weather. The client states that she lives alone and
denies problems or concerns. What action should the nurse implement?
A) Notify social services immediately of suspected elderly abuse.
B) Discuss the need for mental health counseling with the daughter.
C) Explain to the client that she needs to take better care of herself.
D) Collect further data to determine whether self-neglect is occurring.
Correct Answer: D) Collect further data to determine whether self-neglect is
occurring.
Rationale: Changes in weight and hygiene may be indicators of self-neglect or
neglect by family members. Further assessment is needed before notifying social
services or discussing a need for counseling .
9. The nurse is assisting a client out of bed for the first time after surgery. What
action should the nurse do first?
A) Place a chair at a right angle to the bedside.
B) Encourage deep breathing prior to standing.
C) Help the client to sit and dangle legs on the side of the bed.
D) Allow the client to sit with the bed in a high Fowler's position.
Correct Answer: D) Allow the client to sit with the bed in a high Fowler's position.
Rationale: The first step is to raise the head of the bed to a high Fowler's position,
which allow venous return to compensate from lying flat and the vasodilation
effects of perioperative drugs. This helps prevent the client from becoming light-
headed and decreases the chance of a client fall .
10. A 32-year-old female client complains of severe abdominal pain each month
before her menstrual period, painful intercourse, and painful defecation. Which
additional history should the nurse obtain that is consistent with the client's
complaints?
A) Frequent urinary tract infections.
B) Inability to get pregnant.
C) Premenstrual syndrome.
D) Chronic use of laxatives.
Correct Answer: B) Inability to get pregnant.
Rationale: Dysmenorrhea, dyspareunia, and difficulty or painful defecation are
common symptoms of endometriosis, which is the abnormal displacement of
endometrial tissue in the dependent areas of the pelvic peritoneum. A history of
infertility is another common finding associated with endometriosis .
AND CORRECT ANSWER WITH RATIONALE LATEST 2026
ALREADY GRADED A+ ASSURED PASS
This comprehensive 200-question BSN HESI 266 Med Surg exam bank
provides a rigorous review of essential medical-surgical nursing concepts for
baccalaureate nursing students. Each question is uniquely crafted with
realistic clinical scenarios, multiple-choice options, a definitive correct answer,
and a detailed rationale explaining the underlying pathophysiology,
pharmacology, and nursing interventions. Content spans cardiovascular
disorders (heart failure, MI, dysrhythmias, PAD, valve disorders), respiratory
conditions (COPD, asthma, pneumonia, ARDS, TB), renal and urinary
disorders (AKI, CKD, dialysis, UTI, stones), gastrointestinal conditions,
oncology, and perioperative care. Questions emphasize priority nursing
actions, clinical judgment, medication administration safety, patient
education, and complication identification. Designed to align with HESI Med
Surg exam blueprints, this resource promotes critical thinking, identifies
knowledge gaps, and enhances test-taking strategies for successful
examination performance and clinical application. Each rationale reinforces
evidence-based practice and prepares students for comprehensive nursing
care of adults with complex health alterations.
1. A client with a completed ischemic stroke has a blood pressure of 180/90 mm
Hg. Which action should the nurse implement?
A) Position the head of the bed (HOB) flat.
B) Withhold intravenous fluids.
C) Administer a bolus of IV fluids.
D) Give an antihypertensive medication.
Correct Answer: D) Give an antihypertensive medication.
Rationale: Completed strokes usually produce neurologic deficits within an hour,
and the client's current elevated blood pressure requires antihypertensive
medication to prevent further damage .
,2. A client who is receiving chemotherapy asks the nurse, "Why is so much of my
hair falling out each day?" Which response by the nurse best explains the reason
for alopecia?
A) "Chemotherapy affects the cells of the body that grow rapidly, both normal and
malignant."
B) "Alopecia is a common side effect you will experience during long-term steroid
therapy."
C) "Your hair will grow back completely after your course of chemotherapy is
completed."
D) "The chemotherapy causes permanent alterations in your hair follicles that lead
to hair loss."
Correct Answer: A) "Chemotherapy affects the cells of the body that grow rapidly,
both normal and malignant."
Rationale: The common adverse effects of chemotherapy (nausea, vomiting,
alopecia, bone marrow depression) are due to chemotherapy's effect on the rapidly
reproducing cells, both normal and malignant .
3. After checking the urinary drainage system for kinks in the tubing, the nurse
determines that a client who has returned from the post-anesthesia care has a dark,
concentrated urinary output of 54 ml for the last 2 hours. What priority nursing
action should be implemented?
A) Report the findings to the surgeon.
B) Irrigate the indwelling urinary catheter.
C) Apply manual pressure to the bladder.
D) Increase the IV flow rate for 15 minutes.
Correct Answer: A) Report the findings to the surgeon.
Rationale: An adult who weighs 132 pounds (60 kg) should produce about 60 ml
of urine hourly (1 ml/kg/hour). Dark, concentrated, and low volume of urine output
should be reported to the surgeon .
4. A male client who smokes two packs of cigarettes a day states he understands
that smoking cigarettes is contributing to the difficulty that he and his wife are
having in getting pregnant and wants to know if other factors could be contributing
to their difficulty. What information is best for the nurse to provide? (Select all that
apply.)
A) Marijuana cigarettes do not affect sperm count.
B) Alcohol consumption can cause erectile dysfunction.
C) Low testosterone levels affect sperm production.
D) Cessation of smoking improves general health and fertility.
E) Obesity has no effect on sperm production.
,Correct Answer: B, C and D
Rationale: Use of tobacco, alcohol, and marijuana may affect sperm counts. Sperm
count is also negatively affected by low testosterone levels and obesity. Cessation
of smoking improves general health and fertility .
5. A client with gastroesophageal reflux disease (GERD) has been experiencing
severe reflux during sleep. Which recommendation by the nurse is most effective
to assist the client?
A) Losing weight.
B) Decreasing caffeine intake.
C) Avoiding large meals.
D) Raising the head of the bed on blocks.
Correct Answer: D) Raising the head of the bed on blocks.
Rationale: Raising the head of the bed on blocks (reverse Trendelenburg position)
to reduce reflux and subsequent aspiration is the most non-pharmacological
effective recommendation for a client experiencing severe gastroesophageal reflux
during sleep .
6. A 51-year-old truck driver who smokes two packs of cigarettes a day and is 30
pounds overweight is diagnosed with having a gastric ulcer. What content is most
important for the nurse to include in the discharge teaching for this client?
A) Information about smoking cessation.
B) Diet instructions for a low-residue diet.
C) Instructions on a weight-loss program.
D) The importance of increasing milk in the diet.
Correct Answer: A) Information about smoking cessation.
Rationale: Smoking has been associated with ulcer formation, and stopping or
decreasing the number of cigarettes smoked per day is an important aspect of ulcer
management .
7. What types of medications should the nurse expect to administer to a client
during an acute respiratory distress episode?
A) Vasodilators and hormones.
B) Analgesics and sedatives.
C) Anticoagulants and expectorants.
D) Bronchodilators and steroids.
Correct Answer: D) Bronchodilators and steroids.
Rationale: Besides supplemental oxygen, this client with ARDS needs medications
to widen air passages, increase air space, and reduce alveolar membrane
inflammation, such as bronchodilators and steroids .
, 8. A female client is brought to the clinic by her daughter for a flu shot. She has
lost significant weight since the last visit. She has poor personal hygiene and
inadequate clothing for the weather. The client states that she lives alone and
denies problems or concerns. What action should the nurse implement?
A) Notify social services immediately of suspected elderly abuse.
B) Discuss the need for mental health counseling with the daughter.
C) Explain to the client that she needs to take better care of herself.
D) Collect further data to determine whether self-neglect is occurring.
Correct Answer: D) Collect further data to determine whether self-neglect is
occurring.
Rationale: Changes in weight and hygiene may be indicators of self-neglect or
neglect by family members. Further assessment is needed before notifying social
services or discussing a need for counseling .
9. The nurse is assisting a client out of bed for the first time after surgery. What
action should the nurse do first?
A) Place a chair at a right angle to the bedside.
B) Encourage deep breathing prior to standing.
C) Help the client to sit and dangle legs on the side of the bed.
D) Allow the client to sit with the bed in a high Fowler's position.
Correct Answer: D) Allow the client to sit with the bed in a high Fowler's position.
Rationale: The first step is to raise the head of the bed to a high Fowler's position,
which allow venous return to compensate from lying flat and the vasodilation
effects of perioperative drugs. This helps prevent the client from becoming light-
headed and decreases the chance of a client fall .
10. A 32-year-old female client complains of severe abdominal pain each month
before her menstrual period, painful intercourse, and painful defecation. Which
additional history should the nurse obtain that is consistent with the client's
complaints?
A) Frequent urinary tract infections.
B) Inability to get pregnant.
C) Premenstrual syndrome.
D) Chronic use of laxatives.
Correct Answer: B) Inability to get pregnant.
Rationale: Dysmenorrhea, dyspareunia, and difficulty or painful defecation are
common symptoms of endometriosis, which is the abnormal displacement of
endometrial tissue in the dependent areas of the pelvic peritoneum. A history of
infertility is another common finding associated with endometriosis .
