BSN HESI 266 MED SURG EXAM STUDY
GUIDE 2026/2027 QUESTIONS AND
ANSWERS
1. A patient with chronic kidney disease (CKD) presents with a potassium level of 6.2 mEq/L.
Which EKG finding should the nurse prioritize?
A. Prominent U waves
B. Tall, peaked T waves
C. Shortened PR interval
D. ST-segment elevation
Answer: B
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on
an EKG as tall, peaked T waves. Prominent U waves are associated with hypokalemia.
2. Which assessment finding in a patient receiving peritoneal dialysis should be reported to
the healthcare provider immediately?
A. Clear, straw-colored effluent
B. Cloudy or opaque effluent
,C. Slow drainage of the dialysate
D. Abdominal discomfort during inflow
Answer: B
Conceptual Explanation: Cloudy effluent is the earliest sign of peritonitis, a serious
complication of peritoneal dialysis. Clear drainage is normal, and slow drainage can often
be fixed by repositioning.
3. A patient is admitted with a suspected Myocardial Infarction (MI). Which cardiac
biomarker is most specific for myocardial injury?
A. Myoglobin
B. Creatine Kinase (CK-MB)
C. C-reactive protein
D. Troponin I
Answer: D
Conceptual Explanation: Troponin I is highly specific to cardiac muscle and remains
elevated longer than CK-MB, making it the gold standard for diagnosing MI.
4. When caring for a patient with Cushing’s Syndrome, which clinical manifestation should
the nurse expect?
A. Central obesity and thin extremities
B. Hyperpigmentation of the skin
, C. Hypotension and weight loss
D. Hyperkalemia and hypoglycemia
Answer: A
Conceptual Explanation: Cushing’s Syndrome involves excess cortisol, leading to truncal
obesity, moon face, buffalo hump, and thin skin/extremities. Hypotension and
hyperpigmentation are seen in Addison’s disease.
5. A nurse is caring for a patient post-thyroidectomy. Which assessment finding indicates a
potential complication regarding calcium levels?
A. Negative Babinski sign
B. Positive Chvostek’s sign
C. Bradycardia
D. Hyporeflexia
Answer: B
Conceptual Explanation: A positive Chvostek’s sign (facial twitching) indicates
hypocalcemia, which can occur if the parathyroid glands are accidentally damaged or
removed during a thyroidectomy.
6. Which nursing intervention is a priority for a patient experiencing an Addisonian Crisis?
A. Administering insulin and glucose
B. Restricting sodium intake
GUIDE 2026/2027 QUESTIONS AND
ANSWERS
1. A patient with chronic kidney disease (CKD) presents with a potassium level of 6.2 mEq/L.
Which EKG finding should the nurse prioritize?
A. Prominent U waves
B. Tall, peaked T waves
C. Shortened PR interval
D. ST-segment elevation
Answer: B
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on
an EKG as tall, peaked T waves. Prominent U waves are associated with hypokalemia.
2. Which assessment finding in a patient receiving peritoneal dialysis should be reported to
the healthcare provider immediately?
A. Clear, straw-colored effluent
B. Cloudy or opaque effluent
,C. Slow drainage of the dialysate
D. Abdominal discomfort during inflow
Answer: B
Conceptual Explanation: Cloudy effluent is the earliest sign of peritonitis, a serious
complication of peritoneal dialysis. Clear drainage is normal, and slow drainage can often
be fixed by repositioning.
3. A patient is admitted with a suspected Myocardial Infarction (MI). Which cardiac
biomarker is most specific for myocardial injury?
A. Myoglobin
B. Creatine Kinase (CK-MB)
C. C-reactive protein
D. Troponin I
Answer: D
Conceptual Explanation: Troponin I is highly specific to cardiac muscle and remains
elevated longer than CK-MB, making it the gold standard for diagnosing MI.
4. When caring for a patient with Cushing’s Syndrome, which clinical manifestation should
the nurse expect?
A. Central obesity and thin extremities
B. Hyperpigmentation of the skin
, C. Hypotension and weight loss
D. Hyperkalemia and hypoglycemia
Answer: A
Conceptual Explanation: Cushing’s Syndrome involves excess cortisol, leading to truncal
obesity, moon face, buffalo hump, and thin skin/extremities. Hypotension and
hyperpigmentation are seen in Addison’s disease.
5. A nurse is caring for a patient post-thyroidectomy. Which assessment finding indicates a
potential complication regarding calcium levels?
A. Negative Babinski sign
B. Positive Chvostek’s sign
C. Bradycardia
D. Hyporeflexia
Answer: B
Conceptual Explanation: A positive Chvostek’s sign (facial twitching) indicates
hypocalcemia, which can occur if the parathyroid glands are accidentally damaged or
removed during a thyroidectomy.
6. Which nursing intervention is a priority for a patient experiencing an Addisonian Crisis?
A. Administering insulin and glucose
B. Restricting sodium intake
