BSN 266 HESI Med Surg V1 Practice Exam: 200 Questions
on Cardiovascular, Respiratory, GI, Renal, Endocrine, &
Neurological Disorders latest update this year Download
now and pass first try!
Exam Information
Course: BSN 266 – Medical-Surgical HESI
Target Audience: Nursing students preparing for the HESI Med-Surg specialty
exam and/or NCLEX-RN
Core Domains Covered: Cardiovascular, respiratory, gastrointestinal, renal/urinary,
endocrine, neurological, musculoskeletal, hematological/immunological, infectious
diseases, oncology, perioperative care, fluid/electrolyte balance, and pharmacology
Question Format: Multiple-choice, with answers and detailed rationales
Key Topics to Study
Category Specific Focus Areas
Cardiovascular Heart failure, hypertension, myocardial infarction,
dysrhythmias, peripheral artery disease,
warfarin/digoxin therapy
Respiratory COPD, pneumonia, asthma, pulmonary embolism,
TB, ARDS, oxygen therapy
, Gastrointestinal GI bleeding, pancreatitis, diverticulitis, liver
cirrhosis, peptic ulcer disease, ostomy care
Renal/Urinary Acute kidney injury, chronic kidney disease, UTI,
nephrolithiasis, TURP
Endocrine Diabetes mellitus (Type 1 & 2), DKA, HHNS,
thyroid disorders, adrenal disorders
Neurological Stroke, seizures, head injury, meningitis, multiple
sclerosis
Musculoskeletal Fractures, osteoarthritis, rheumatoid arthritis, gout,
traction/cast care
Hematological/Immunological Anemia, DIC, sickle cell disease, HIV/AIDS,
anaphylaxis
Oncology Chemotherapy side effects, radiation safety,
neutropenic precautions
Fluid & Electrolytes Imbalances, acid-base disorders, IV therapy
Perioperative Preoperative assessment, postoperative
complications, wound care, pain management
SECTION 1: CARDIOVASCULAR SYSTEM (Questions 1-30)
1. A client with heart failure is prescribed furosemide (Lasix) and digoxin (Lanoxin).
Which laboratory value is most critical for the nurse to monitor before administering
these medications?
A) Serum sodium
, B) Serum potassium
C) Serum calcium
D) Serum magnesium
Answer: B. Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia
increases the risk of digoxin toxicity (which can cause fatal dysrhythmias). The nurse must
check potassium and hold the digoxin if the potassium is low (< 3.5 mEq/L).
2. A client with heart failure reports a 3-pound weight gain in 24 hours. What should
the nurse do first?
A) Administer furosemide as prescribed
B) Assess for peripheral edema
C) Restrict fluid intake
D) Notify the healthcare provider
Answer: B. Rapid weight gain suggests fluid retention. Assessing for peripheral edema
provides baseline data to determine the severity of fluid overload before implementing
further interventions.
3. A client with chest pain has an ECG showing ST-segment elevation in leads II, III,
and aVF. Which coronary artery is most likely occluded?
A) Left anterior descending artery
B) Left circumflex artery
C) Right coronary artery
D) Posterior descending artery
, Answer: C. Leads II, III, and aVF represent the inferior wall of the heart, which is supplied
by the right coronary artery (RCA).
4. A client is 2 days post-myocardial infarction (MI). The nurse notes new-onset
jugular venous distention, muffled heart sounds, and a 15 mmHg drop in systolic
blood pressure during inspiration. What is the nurse's priority action?
A) Administer IV nitroglycerin
B) Prepare for pericardiocentesis
C) Administer a fluid bolus
D) Prepare for endotracheal intubation
Answer: B. The classic triad of muffled heart sounds, JVD, and hypotension (Beck's triad)
indicates cardiac tamponade. The priority is to prepare for pericardiocentesis to relieve the
pressure.
5. A client is prescribed sublingual nitroglycerin for angina. Which instruction is most
important for the nurse to include in the teaching?
A) "Take one tablet every 15 minutes for up to 3 doses."
B) "Swallow the tablet whole with a full glass of water."
C) "Call 911 if chest pain is not relieved after 1 tablet and 5 minutes."
D) "Take the tablet every 5 minutes for up to 3 doses."
Answer: D. Nitroglycerin should be taken every 5 minutes up to 3 doses. If chest pain
persists after 3 doses, the client should call 911 immediately.
6. A client with peripheral artery disease (PAD) reports leg pain that starts after
walking for 10 minutes and stops with rest. The nurse documents this finding as:
on Cardiovascular, Respiratory, GI, Renal, Endocrine, &
Neurological Disorders latest update this year Download
now and pass first try!
Exam Information
Course: BSN 266 – Medical-Surgical HESI
Target Audience: Nursing students preparing for the HESI Med-Surg specialty
exam and/or NCLEX-RN
Core Domains Covered: Cardiovascular, respiratory, gastrointestinal, renal/urinary,
endocrine, neurological, musculoskeletal, hematological/immunological, infectious
diseases, oncology, perioperative care, fluid/electrolyte balance, and pharmacology
Question Format: Multiple-choice, with answers and detailed rationales
Key Topics to Study
Category Specific Focus Areas
Cardiovascular Heart failure, hypertension, myocardial infarction,
dysrhythmias, peripheral artery disease,
warfarin/digoxin therapy
Respiratory COPD, pneumonia, asthma, pulmonary embolism,
TB, ARDS, oxygen therapy
, Gastrointestinal GI bleeding, pancreatitis, diverticulitis, liver
cirrhosis, peptic ulcer disease, ostomy care
Renal/Urinary Acute kidney injury, chronic kidney disease, UTI,
nephrolithiasis, TURP
Endocrine Diabetes mellitus (Type 1 & 2), DKA, HHNS,
thyroid disorders, adrenal disorders
Neurological Stroke, seizures, head injury, meningitis, multiple
sclerosis
Musculoskeletal Fractures, osteoarthritis, rheumatoid arthritis, gout,
traction/cast care
Hematological/Immunological Anemia, DIC, sickle cell disease, HIV/AIDS,
anaphylaxis
Oncology Chemotherapy side effects, radiation safety,
neutropenic precautions
Fluid & Electrolytes Imbalances, acid-base disorders, IV therapy
Perioperative Preoperative assessment, postoperative
complications, wound care, pain management
SECTION 1: CARDIOVASCULAR SYSTEM (Questions 1-30)
1. A client with heart failure is prescribed furosemide (Lasix) and digoxin (Lanoxin).
Which laboratory value is most critical for the nurse to monitor before administering
these medications?
A) Serum sodium
, B) Serum potassium
C) Serum calcium
D) Serum magnesium
Answer: B. Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia
increases the risk of digoxin toxicity (which can cause fatal dysrhythmias). The nurse must
check potassium and hold the digoxin if the potassium is low (< 3.5 mEq/L).
2. A client with heart failure reports a 3-pound weight gain in 24 hours. What should
the nurse do first?
A) Administer furosemide as prescribed
B) Assess for peripheral edema
C) Restrict fluid intake
D) Notify the healthcare provider
Answer: B. Rapid weight gain suggests fluid retention. Assessing for peripheral edema
provides baseline data to determine the severity of fluid overload before implementing
further interventions.
3. A client with chest pain has an ECG showing ST-segment elevation in leads II, III,
and aVF. Which coronary artery is most likely occluded?
A) Left anterior descending artery
B) Left circumflex artery
C) Right coronary artery
D) Posterior descending artery
, Answer: C. Leads II, III, and aVF represent the inferior wall of the heart, which is supplied
by the right coronary artery (RCA).
4. A client is 2 days post-myocardial infarction (MI). The nurse notes new-onset
jugular venous distention, muffled heart sounds, and a 15 mmHg drop in systolic
blood pressure during inspiration. What is the nurse's priority action?
A) Administer IV nitroglycerin
B) Prepare for pericardiocentesis
C) Administer a fluid bolus
D) Prepare for endotracheal intubation
Answer: B. The classic triad of muffled heart sounds, JVD, and hypotension (Beck's triad)
indicates cardiac tamponade. The priority is to prepare for pericardiocentesis to relieve the
pressure.
5. A client is prescribed sublingual nitroglycerin for angina. Which instruction is most
important for the nurse to include in the teaching?
A) "Take one tablet every 15 minutes for up to 3 doses."
B) "Swallow the tablet whole with a full glass of water."
C) "Call 911 if chest pain is not relieved after 1 tablet and 5 minutes."
D) "Take the tablet every 5 minutes for up to 3 doses."
Answer: D. Nitroglycerin should be taken every 5 minutes up to 3 doses. If chest pain
persists after 3 doses, the client should call 911 immediately.
6. A client with peripheral artery disease (PAD) reports leg pain that starts after
walking for 10 minutes and stops with rest. The nurse documents this finding as:
