BSN 266 HESI Med Surg Practice Exam V1 – Newest
Questions with Answers & Detailed Explanations for
Nightingale College (2026/2027)
Introduction / Description
🏥 Ace the BSN 266 HESI Med Surg Exam V1 – Guaranteed!
Are you preparing for the BSN 266 HESI Medical-Surgical Exam V1 at Nightingale College? Feeling the
pressure of needing to pass this critical nursing exam—especially with the emphasis on clinical judgment,
prioritization, and evidence-based care?
This comprehensive question practice exam is your ultimate study tool. Designed to mirror the actual
BSN 266 HESI Med Surg V1 exam in format, difficulty, and content distribution, this document will give you
the confidence you need to pass on your very first attempt.
📌 What's Inside:
✅ realistic multiple-choice and NGN-style questions covering every core domain of the BSN 266
HESI Med Surg V1 exam blueprint:
o Cardiovascular Disorders – heart failure (HFrEF, beta-blocker therapy), hypertension, myocardial
infarction, dysrhythmias, cardiac stent complications, cardiac catheterization, pericarditis, peripheral
vascular disease, and angina vs. MI differentiation
o Respiratory Disorders – COPD (upright positioning, low-flow oxygen), pneumonia, asthma, pulmonary
embolism, chest tube insertion, pleuritic chest pain, and post-surgical respiratory complications
o Gastrointestinal Disorders – GI bleed, pancreatitis, diverticulitis, liver cirrhosis (hypoalbuminemia,
edema, ascites), Crohn's disease (elimination diet), surgical wound infection, and paracentesis
complications
o Renal & Urinary Disorders – acute glomerulonephritis (AGN, sodium restriction), chronic kidney disease,
acute kidney injury, nephrolithiasis, TURP discharge teaching (drink 3L water daily), and urolithiasis post-
lithotripsy teaching
o Endocrine Disorders – diabetes mellitus (Type 1, Type 2, DKA, HHNS, hypokalemia in DKA, nocturnal
hypoglycemia), Graves disease, thyroid disorders, and pheochromocytoma
o Neurological Disorders – stroke (Broca's aphasia, picture charts for communication), multiple sclerosis
(MS, fall prevention, patch one eye while walking), Parkinson's disease (mask-like face, dysphagia
assessment), and seizure disorders
,o Musculoskeletal Disorders – fractures, amputation (BKA postoperative care, risk for infection,
contractures, neuroma), osteoarthritis, rheumatoid arthritis, and Raynaud's disease
o Hematological & Immunological Disorders – anemia, DIC, sickle cell disease, HIV/AIDS, anaphylaxis,
and lupus
o Oncology Nursing – chemotherapy side effects, radiation therapy skin care (avoid antibacterial soap),
neutropenic precautions, and cancer pain management
o Fluid & Electrolyte Imbalances – acid-base disorders, hyperkalemia, hypokalemia, dehydration, and IV
fluid resuscitation
o Perioperative Care – preoperative assessment, postoperative complications, wound dehiscence (visualize
incision first), surgical wound infection, and pain management
o Pharmacology & Medication Administration – medication calculations, drug classifications, side effects,
and patient education
✅ Every correct answer in bold italics – no second-guessing
✅ Detailed explanations for every question – learn the why behind the answer, not just the letter,
reinforcing clinical reasoning and NCLEX-style critical thinking
✅ Verified answers with rationales – based on actual BSN 266 HESI Med Surg V1 exam content
Table of Contents:
Section 1: Cardiovascular Disorders (Questions 1–30)
Section 2: Respiratory Disorders (Questions 31–50)
Section 3: Gastrointestinal Disorders (Questions 51–70)
Section 4: Renal & Urinary Disorders (Questions 71–85)
Section 5: Endocrine Disorders (Questions 86–100)
Section 6: Neurological Disorders (Questions 101–115)
Section 7: Musculoskeletal & Integumentary Disorders (Questions 116–130)
Section 8: Oncology Nursing (Questions 131–140)
Section 9: Pharmacology, Fluid & Electrolytes (Questions 141–150)
Section 10: NGN-Style Clinical Judgment & Mixed Practice (Questions 151–159)
Includes: Answer Key with Detailed Explanations for Every Question
Covers: BSN 266 HESI Med Surg V1, Medical-Surgical Nursing, Cardiovascular,
Respiratory, GI, Renal, Endocrine, Neurological, Pharmacology, Prioritization, and NGN
Clinical Judgment
,Section 1: Cardiovascular Disorders (Questions 1-30)
1. An older adult client with a long history of COPD is admitted with progressive
shortness of breath and a persistent cough. She is anxious and complaining of a dry
mouth. Which intervention should the nurse implement?
A. Administer a prescribed sedative
B. Assist client to an upright position
C. Encourage client to drink water
D. Apply a high flow venturi mask
Answer: B. Assist client to an upright position
Explanation: Assisting the client to an upright position promotes lung expansion and
facilitates breathing. Sedatives may depress the respiratory drive in COPD patients; oxygen
should be administered cautiously; hydration can help but position change is the priority
intervention in acute dyspnea .
2. A client with chronic heart failure (HFrEF) is prescribed metoprolol succinate. The
client reports dizziness and fatigue. Vital signs: BP 92/58, HR 54. What is the priority
nursing action?
A. Administer the metoprolol as prescribed
B. Hold the metoprolol and notify the provider
, C. Administer IV fluids
D. Increase the metoprolol dose
Answer: B. Hold the metoprolol and notify the provider
Explanation: In acute decompensated heart failure with hemodynamic instability (SBP < 90-
100, bradycardia), beta-blockers should be temporarily withheld. Continuing may worsen
hypotension; increasing the dose is dangerous .
3. A client is 4 hours post-cardiac catheterization via the femoral artery. Which
finding requires immediate intervention?
A. Small amount of serous drainage at the insertion site
B. Bruising around the insertion site
C. Pain in the affected leg
D. Loss of pulse distal to the insertion site
Answer: D. Loss of pulse distal to the insertion site
Explanation: Loss of distal pulse indicates arterial occlusion and requires immediate
intervention. Bruising and serous drainage are expected; pain may be normal but should be
monitored .
4. A client prescribed clopidogrel for a recent MI asks the nurse about this
medication. Which statement indicates understanding?
A. "I will take this medication on an empty stomach."
B. "I will notify my dentist that I take this medication."
Questions with Answers & Detailed Explanations for
Nightingale College (2026/2027)
Introduction / Description
🏥 Ace the BSN 266 HESI Med Surg Exam V1 – Guaranteed!
Are you preparing for the BSN 266 HESI Medical-Surgical Exam V1 at Nightingale College? Feeling the
pressure of needing to pass this critical nursing exam—especially with the emphasis on clinical judgment,
prioritization, and evidence-based care?
This comprehensive question practice exam is your ultimate study tool. Designed to mirror the actual
BSN 266 HESI Med Surg V1 exam in format, difficulty, and content distribution, this document will give you
the confidence you need to pass on your very first attempt.
📌 What's Inside:
✅ realistic multiple-choice and NGN-style questions covering every core domain of the BSN 266
HESI Med Surg V1 exam blueprint:
o Cardiovascular Disorders – heart failure (HFrEF, beta-blocker therapy), hypertension, myocardial
infarction, dysrhythmias, cardiac stent complications, cardiac catheterization, pericarditis, peripheral
vascular disease, and angina vs. MI differentiation
o Respiratory Disorders – COPD (upright positioning, low-flow oxygen), pneumonia, asthma, pulmonary
embolism, chest tube insertion, pleuritic chest pain, and post-surgical respiratory complications
o Gastrointestinal Disorders – GI bleed, pancreatitis, diverticulitis, liver cirrhosis (hypoalbuminemia,
edema, ascites), Crohn's disease (elimination diet), surgical wound infection, and paracentesis
complications
o Renal & Urinary Disorders – acute glomerulonephritis (AGN, sodium restriction), chronic kidney disease,
acute kidney injury, nephrolithiasis, TURP discharge teaching (drink 3L water daily), and urolithiasis post-
lithotripsy teaching
o Endocrine Disorders – diabetes mellitus (Type 1, Type 2, DKA, HHNS, hypokalemia in DKA, nocturnal
hypoglycemia), Graves disease, thyroid disorders, and pheochromocytoma
o Neurological Disorders – stroke (Broca's aphasia, picture charts for communication), multiple sclerosis
(MS, fall prevention, patch one eye while walking), Parkinson's disease (mask-like face, dysphagia
assessment), and seizure disorders
,o Musculoskeletal Disorders – fractures, amputation (BKA postoperative care, risk for infection,
contractures, neuroma), osteoarthritis, rheumatoid arthritis, and Raynaud's disease
o Hematological & Immunological Disorders – anemia, DIC, sickle cell disease, HIV/AIDS, anaphylaxis,
and lupus
o Oncology Nursing – chemotherapy side effects, radiation therapy skin care (avoid antibacterial soap),
neutropenic precautions, and cancer pain management
o Fluid & Electrolyte Imbalances – acid-base disorders, hyperkalemia, hypokalemia, dehydration, and IV
fluid resuscitation
o Perioperative Care – preoperative assessment, postoperative complications, wound dehiscence (visualize
incision first), surgical wound infection, and pain management
o Pharmacology & Medication Administration – medication calculations, drug classifications, side effects,
and patient education
✅ Every correct answer in bold italics – no second-guessing
✅ Detailed explanations for every question – learn the why behind the answer, not just the letter,
reinforcing clinical reasoning and NCLEX-style critical thinking
✅ Verified answers with rationales – based on actual BSN 266 HESI Med Surg V1 exam content
Table of Contents:
Section 1: Cardiovascular Disorders (Questions 1–30)
Section 2: Respiratory Disorders (Questions 31–50)
Section 3: Gastrointestinal Disorders (Questions 51–70)
Section 4: Renal & Urinary Disorders (Questions 71–85)
Section 5: Endocrine Disorders (Questions 86–100)
Section 6: Neurological Disorders (Questions 101–115)
Section 7: Musculoskeletal & Integumentary Disorders (Questions 116–130)
Section 8: Oncology Nursing (Questions 131–140)
Section 9: Pharmacology, Fluid & Electrolytes (Questions 141–150)
Section 10: NGN-Style Clinical Judgment & Mixed Practice (Questions 151–159)
Includes: Answer Key with Detailed Explanations for Every Question
Covers: BSN 266 HESI Med Surg V1, Medical-Surgical Nursing, Cardiovascular,
Respiratory, GI, Renal, Endocrine, Neurological, Pharmacology, Prioritization, and NGN
Clinical Judgment
,Section 1: Cardiovascular Disorders (Questions 1-30)
1. An older adult client with a long history of COPD is admitted with progressive
shortness of breath and a persistent cough. She is anxious and complaining of a dry
mouth. Which intervention should the nurse implement?
A. Administer a prescribed sedative
B. Assist client to an upright position
C. Encourage client to drink water
D. Apply a high flow venturi mask
Answer: B. Assist client to an upright position
Explanation: Assisting the client to an upright position promotes lung expansion and
facilitates breathing. Sedatives may depress the respiratory drive in COPD patients; oxygen
should be administered cautiously; hydration can help but position change is the priority
intervention in acute dyspnea .
2. A client with chronic heart failure (HFrEF) is prescribed metoprolol succinate. The
client reports dizziness and fatigue. Vital signs: BP 92/58, HR 54. What is the priority
nursing action?
A. Administer the metoprolol as prescribed
B. Hold the metoprolol and notify the provider
, C. Administer IV fluids
D. Increase the metoprolol dose
Answer: B. Hold the metoprolol and notify the provider
Explanation: In acute decompensated heart failure with hemodynamic instability (SBP < 90-
100, bradycardia), beta-blockers should be temporarily withheld. Continuing may worsen
hypotension; increasing the dose is dangerous .
3. A client is 4 hours post-cardiac catheterization via the femoral artery. Which
finding requires immediate intervention?
A. Small amount of serous drainage at the insertion site
B. Bruising around the insertion site
C. Pain in the affected leg
D. Loss of pulse distal to the insertion site
Answer: D. Loss of pulse distal to the insertion site
Explanation: Loss of distal pulse indicates arterial occlusion and requires immediate
intervention. Bruising and serous drainage are expected; pain may be normal but should be
monitored .
4. A client prescribed clopidogrel for a recent MI asks the nurse about this
medication. Which statement indicates understanding?
A. "I will take this medication on an empty stomach."
B. "I will notify my dentist that I take this medication."
