BSN HESI 266 MED SURG EXAM PREP
QUESTIONS AND ANSWERS
1. A patient with a potassium level of 2.8 mEq/L is most likely to show which EKG change?
A. Tall peaked T waves
B. Widened QRS complex
C. Shortened QT interval
D. Prominent U waves
Answer: D
Conceptual Explanation: Hypokalemia (K+ < 3.5) causes prominent U waves, ST-segment
depression, and flattened T waves, whereas hyperkalemia causes tall peaked T waves.
2. An ABG result shows pH 7.31, PaCO2 50, and HCO3 24. How should the nurse interpret
this?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
,D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: The pH is low (<7.35) indicating acidosis, and the PaCO2 is high
(>45) indicating a respiratory cause without compensation.
3. Which clinical manifestation is a hallmark sign of Digoxin toxicity?
A. Visual disturbances such as yellow halos
B. Hyperactive bowel sounds
C. Increased appetite
D. Rapid weight gain
Answer: A
Conceptual Explanation: Digoxin toxicity often presents with visual changes
(yellow/green halos), nausea, vomiting, and bradycardia.
4. A patient with Cushing’s Syndrome is most likely to exhibit which of the following?
A. Hypotension and weight loss
B. Central obesity and thin extremities
C. Hyperpigmentation of the skin
D. Hyperkalemia and hyponatremia
Answer: B
, Conceptual Explanation: Cushing’s Syndrome results from excess cortisol, leading to
moon face, buffalo hump, central obesity, and muscle wasting in limbs.
5. What is the first action a nurse should take when a patient receiving a blood transfusion
reports back pain and chills?
A. Slow the rate of infusion
B. Stop the transfusion immediately
C. Administer diphenhydramine
D. Check the patient’s temperature
Answer: B
Conceptual Explanation: Back pain and chills suggest a hemolytic reaction; the priority is
to stop the transfusion to prevent further exposure to the antigen.
6. A patient on Total Parenteral Nutrition (TPN) has their bag run out before the next one
arrives. What should the nurse hang?
A. 0.9% Normal Saline
B. 5% Dextrose in Normal Saline
C. Lactated Ringer’s
D. 10% Dextrose in Water
Answer: D
QUESTIONS AND ANSWERS
1. A patient with a potassium level of 2.8 mEq/L is most likely to show which EKG change?
A. Tall peaked T waves
B. Widened QRS complex
C. Shortened QT interval
D. Prominent U waves
Answer: D
Conceptual Explanation: Hypokalemia (K+ < 3.5) causes prominent U waves, ST-segment
depression, and flattened T waves, whereas hyperkalemia causes tall peaked T waves.
2. An ABG result shows pH 7.31, PaCO2 50, and HCO3 24. How should the nurse interpret
this?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
,D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: The pH is low (<7.35) indicating acidosis, and the PaCO2 is high
(>45) indicating a respiratory cause without compensation.
3. Which clinical manifestation is a hallmark sign of Digoxin toxicity?
A. Visual disturbances such as yellow halos
B. Hyperactive bowel sounds
C. Increased appetite
D. Rapid weight gain
Answer: A
Conceptual Explanation: Digoxin toxicity often presents with visual changes
(yellow/green halos), nausea, vomiting, and bradycardia.
4. A patient with Cushing’s Syndrome is most likely to exhibit which of the following?
A. Hypotension and weight loss
B. Central obesity and thin extremities
C. Hyperpigmentation of the skin
D. Hyperkalemia and hyponatremia
Answer: B
, Conceptual Explanation: Cushing’s Syndrome results from excess cortisol, leading to
moon face, buffalo hump, central obesity, and muscle wasting in limbs.
5. What is the first action a nurse should take when a patient receiving a blood transfusion
reports back pain and chills?
A. Slow the rate of infusion
B. Stop the transfusion immediately
C. Administer diphenhydramine
D. Check the patient’s temperature
Answer: B
Conceptual Explanation: Back pain and chills suggest a hemolytic reaction; the priority is
to stop the transfusion to prevent further exposure to the antigen.
6. A patient on Total Parenteral Nutrition (TPN) has their bag run out before the next one
arrives. What should the nurse hang?
A. 0.9% Normal Saline
B. 5% Dextrose in Normal Saline
C. Lactated Ringer’s
D. 10% Dextrose in Water
Answer: D
