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BSN 266 – HESI MEDICAL-SURGICAL PRACTICE EXAM V2
NIGHTINGALE COLLEGE 2026/2027 COMPLETE (150)
CURRENT TESTING QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES.
MEDICAL-SURGICAL
Prepare effectively for the BSN 266 HESI Medical-Surgical Practice Exam V2 at
Nightingale College with this focused study resource. It supports review of adult
health conditions, patient assessment, pathophysiology, pharmacology, nursing
interventions, clinical judgment, and patient safety. Use the material to reinforce your
medical-surgical nursing knowledge, practice high-yield concepts, and identify areas
that may require additional study. This resource is suited for Nightingale College BSN
students, medical-surgical nursing learners, and candidates preparing for the HESI
Medical-Surgical assessment.
MULTIPLE CHOICE.
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1–25)
Question 1:
A patient with heart failure is prescribed furosemide (Lasix). Which electrolyte
imbalance should the nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hypermagnesemia
Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss in the
urine, leading to hypokalemia. Potassium levels should be monitored closely,
and the patient should be encouraged to eat potassium-rich foods.
Question 2:
A patient with atrial fibrillation is prescribed warfarin. Which laboratory value
should the nurse monitor to evaluate the effectiveness of this medication?
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A) aPTT
B) INR
C) Platelet count
D) Anti-factor Xa
Answer: B
Rationale: Warfarin therapy is monitored with the INR (international
normalized ratio), with a therapeutic target of 2.0–3.0 for atrial fibrillation.
aPTT is used for heparin monitoring.
Question 3:
A patient with angina is prescribed sublingual nitroglycerin. Which instruction
should the nurse include in patient teaching?
A) "Take the medication with food."
B) "Replace tablets every 6 months."
C) "Swallow the tablet with water."
D) "Take the medication only when pain is severe."
Answer: B
Rationale: Nitroglycerin sublingual tablets lose potency over time and should
be replaced every 6 months. They should be taken at the first sign of angina,
placed under the tongue, and not swallowed.
Question 4:
A patient with hypertension is prescribed lisinopril. Which adverse effect
should the nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hyponatremia
D) Hypercalcemia
Answer: A
Rationale: ACE inhibitors (lisinopril) can cause hyperkalemia by reducing
aldosterone secretion. Serum potassium should be monitored periodically.
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Question 5:
A patient with heart failure reports a 5-pound weight gain in 3 days and
increasing shortness of breath. What is the nurse's priority action?
A) Restrict all fluids
B) Notify the healthcare provider
C) Administer a PRN diuretic
D) Encourage the patient to ambulate
Answer: B
Rationale: Weight gain and increasing shortness of breath are signs of fluid
overload in heart failure. The nurse should notify the healthcare provider
immediately for further evaluation and potential adjustment of diuretic
therapy.
Question 6:
A patient is diagnosed with infective endocarditis. Which assessment finding
is most consistent with this diagnosis?
A) Petechiae
B) Janeway lesions
C) Osler's nodes
D) All of the above
Answer: D
Rationale: Infective endocarditis can present with petechiae, Janeway lesions
(painless hemorrhagic lesions on palms and soles), and Osler's nodes
(painful nodules on fingertips). All are classic findings.
Question 7:
A patient with peripheral artery disease (PAD) reports pain in the calves when
walking that resolves with rest. This is known as:
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A) Rest pain
B) Intermittent claudication
C) Venous insufficiency
D) Neuropathic pain
Answer: B
Rationale: Intermittent claudication is pain in the calves (or other muscles)
that occurs with exercise and resolves with rest. It is caused by arterial
narrowing leading to ischemia during activity.
Question 8:
Which position should the nurse place a patient with left-sided heart failure to
reduce venous return and improve breathing?
A) Supine
B) High Fowler's
C) Trendelenburg
D) Left lateral
Answer: B
Rationale: High Fowler's position reduces venous return to the heart,
decreases preload, and improves breathing in patients with left-sided heart
failure. It also reduces pulmonary congestion.
Question 9:
A patient with an abdominal aortic aneurysm (AAA) is at risk for which life-
threatening complication?
A) Rupture with hemorrhage
B) Myocardial infarction
C) Stroke
D) Pulmonary embolism
Answer: A
Rationale: An abdominal aortic aneurysm (AAA) is at risk for rupture, leading
BSN 266 – HESI MEDICAL-SURGICAL PRACTICE EXAM V2
NIGHTINGALE COLLEGE 2026/2027 COMPLETE (150)
CURRENT TESTING QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES.
MEDICAL-SURGICAL
Prepare effectively for the BSN 266 HESI Medical-Surgical Practice Exam V2 at
Nightingale College with this focused study resource. It supports review of adult
health conditions, patient assessment, pathophysiology, pharmacology, nursing
interventions, clinical judgment, and patient safety. Use the material to reinforce your
medical-surgical nursing knowledge, practice high-yield concepts, and identify areas
that may require additional study. This resource is suited for Nightingale College BSN
students, medical-surgical nursing learners, and candidates preparing for the HESI
Medical-Surgical assessment.
MULTIPLE CHOICE.
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1–25)
Question 1:
A patient with heart failure is prescribed furosemide (Lasix). Which electrolyte
imbalance should the nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hypermagnesemia
Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss in the
urine, leading to hypokalemia. Potassium levels should be monitored closely,
and the patient should be encouraged to eat potassium-rich foods.
Question 2:
A patient with atrial fibrillation is prescribed warfarin. Which laboratory value
should the nurse monitor to evaluate the effectiveness of this medication?
, Page 2 of 60
A) aPTT
B) INR
C) Platelet count
D) Anti-factor Xa
Answer: B
Rationale: Warfarin therapy is monitored with the INR (international
normalized ratio), with a therapeutic target of 2.0–3.0 for atrial fibrillation.
aPTT is used for heparin monitoring.
Question 3:
A patient with angina is prescribed sublingual nitroglycerin. Which instruction
should the nurse include in patient teaching?
A) "Take the medication with food."
B) "Replace tablets every 6 months."
C) "Swallow the tablet with water."
D) "Take the medication only when pain is severe."
Answer: B
Rationale: Nitroglycerin sublingual tablets lose potency over time and should
be replaced every 6 months. They should be taken at the first sign of angina,
placed under the tongue, and not swallowed.
Question 4:
A patient with hypertension is prescribed lisinopril. Which adverse effect
should the nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hyponatremia
D) Hypercalcemia
Answer: A
Rationale: ACE inhibitors (lisinopril) can cause hyperkalemia by reducing
aldosterone secretion. Serum potassium should be monitored periodically.
, Page 3 of 60
Question 5:
A patient with heart failure reports a 5-pound weight gain in 3 days and
increasing shortness of breath. What is the nurse's priority action?
A) Restrict all fluids
B) Notify the healthcare provider
C) Administer a PRN diuretic
D) Encourage the patient to ambulate
Answer: B
Rationale: Weight gain and increasing shortness of breath are signs of fluid
overload in heart failure. The nurse should notify the healthcare provider
immediately for further evaluation and potential adjustment of diuretic
therapy.
Question 6:
A patient is diagnosed with infective endocarditis. Which assessment finding
is most consistent with this diagnosis?
A) Petechiae
B) Janeway lesions
C) Osler's nodes
D) All of the above
Answer: D
Rationale: Infective endocarditis can present with petechiae, Janeway lesions
(painless hemorrhagic lesions on palms and soles), and Osler's nodes
(painful nodules on fingertips). All are classic findings.
Question 7:
A patient with peripheral artery disease (PAD) reports pain in the calves when
walking that resolves with rest. This is known as:
, Page 4 of 60
A) Rest pain
B) Intermittent claudication
C) Venous insufficiency
D) Neuropathic pain
Answer: B
Rationale: Intermittent claudication is pain in the calves (or other muscles)
that occurs with exercise and resolves with rest. It is caused by arterial
narrowing leading to ischemia during activity.
Question 8:
Which position should the nurse place a patient with left-sided heart failure to
reduce venous return and improve breathing?
A) Supine
B) High Fowler's
C) Trendelenburg
D) Left lateral
Answer: B
Rationale: High Fowler's position reduces venous return to the heart,
decreases preload, and improves breathing in patients with left-sided heart
failure. It also reduces pulmonary congestion.
Question 9:
A patient with an abdominal aortic aneurysm (AAA) is at risk for which life-
threatening complication?
A) Rupture with hemorrhage
B) Myocardial infarction
C) Stroke
D) Pulmonary embolism
Answer: A
Rationale: An abdominal aortic aneurysm (AAA) is at risk for rupture, leading
