[STUDY GUIDE] • HIGH-YIELD PRACTICE & REVIEW EDITION
BSN HESI 266 Med Surg Exam Questions &
Answers, Verified Updated 2026/2027
Edition
Comprehensive Examination Question Bank • In-Depth Rationales • Concept Mapping
TOTAL QUESTIONS EXAM TOPICS RATIONALES
100 Questions 11 Modules 100% Verified
DOCUMENT OVERVIEW
This document contains 100 verified questions with correct answers and detailed rationales focusing on
medical-surgical nursing. It directly aligns with critical concepts in cardiovascular and respiratory health,
making it suitable for study, review, and preparation for certification exams.
EXAM BLUEPRINT & TOPIC DISTRIBUTION
Systematic breakdown of subject domains and exam coverage.
Topic Module Scope & Core Focus Questions Share (%)
This topic covers the pathophysiology, classification, and
Heart Failure management of heart failure. 9 Qs 9.0%
This topic examines the role and interpretation of biomarkers
Cardiac Biomarkers in diagnosing acute myocardial infarction. 9 Qs 9.0%
This topic includes the identification and management of
Arrhythmias various cardiac arrhythmias. 10 Qs 10.0%
This topic focuses on the guidelines and pharmacologic
Hypertension Management treatments for managing hypertension. 10 Qs 10.0%
Chronic Obstructive Pulmonary This topic addresses the diagnosis, management, and
Disease (COPD) complications associated with COPD. 9 Qs 9.0%
Acute Coronary Syndrome This topic covers the clinical presentation, diagnosis, and
(ACS) management of ACS. 9 Qs 9.0%
This topic includes the interpretation of ECG findings related
Electrocardiography to various cardiac conditions. 9 Qs 9.0%
Confidential • Student Study Edition • Practice & Review Guide Page 1 of 52
,STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
This topic focuses on the definitions, causes, and
Respiratory Failure management of acute and chronic respiratory failure. 9 Qs 9.0%
This topic discusses the role of antiplatelet medications in the
Antiplatelet Therapy management of cardiac conditions. 9 Qs 9.0%
This topic covers principles of vascular health, including
Vascular Health pressure measurements and their implications. 9 Qs 9.0%
This topic focuses on the immediate care protocols for acute
Emergency Management cardiovascular events. 8 Qs 8.0%
Total Exam Coverage 11 Integrated Topic Modules 100 Qs 100.0%
Confidential • Student Study Edition • Practice & Review Guide Page 2 of 52
,STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
TOPIC 1: HEART FAILURE
9 Questions • 9.0% of Exam • This topic covers the pathophysiology, classification, and management of heart failure.
QUESTION 1
Heart failure can be classified as systolic or diastolic based on ventricular function. In
systolic (or reduced ejection fraction) heart failure, specific hemodynamic alterations
occur due to impaired contractility, including changes in preload, afterload, and stroke
volume. Which of the following changes most accurately describes the typical
hemodynamic profile observed in systolic heart failure?
[A] Increased left ventricular end-diastolic volume with reduced ejection fraction
[B] Decreased left ventricular end-diastolic pressure with normal ejection fraction
[C] Elevated systemic vascular resistance with preserved stroke volume
[D] Decreased left atrial pressure with increased cardiac output
Correct Answer: Increased left ventricular end-diastolic volume with reduced ejection fraction.
Rationale: Systolic failure reduces contractility, causing increased left ventricular end-diastolic volume and pressure while
ejection fraction falls. This leads to volume overload, pulmonary congestion, and reduced cardiac output.
QUESTION 2
Heart failure severity is commonly categorized using the New York Heart Association
(NYHA) functional classification system. Which NYHA class best describes a patient
who experiences fatigue and dyspnea with ordinary physical activity, such as walking
on level ground, but is comfortable at rest? The classification aids in treatment
planning and prognostic assessment.
[A] Class I
[B] Class II
[C] Class III
[D] Class IV
Correct Answer: Class II.
Rationale: NYHA Class II indicates symptoms with ordinary activity but no limitation at rest, matching the described
presentation.
Confidential • Student Study Edition • Practice & Review Guide Page 3 of 52
, STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
QUESTION 3
In patients with left ventricular failure, clinicians must distinguish between systolic and
diastolic dysfunction to guide treatment and predict outcomes. Describe the primary
alteration in ventricular performance for each type and indicate the typical ejection
fraction range that characterizes systolic versus diastolic failure. Include the expected
range of ejection fraction percentages for each condition as defined by current heart
failure guidelines.
[A] Systolic dysfunction: reduced contractility, EF <40%
[B] Diastolic dysfunction: impaired relaxation, EF >50%
[C] Systolic dysfunction: impaired relaxation, EF >55%
[D] Diastolic dysfunction: reduced contractility, EF <35%
Correct Answer: Systolic dysfunction: reduced contractility, EF <40%.
Rationale: Systolic failure shows reduced contractility with ejection fraction below 40%; diastolic failure has preserved
ejection fraction above 50% despite impaired relaxation.
QUESTION 4
Heart failure with reduced ejection fraction (HFrEF) is a clinical syndrome in which the
left ventricle cannot contract effectively, leading to diminished stroke volume and
systemic congestion. Which statement best defines the primary hemodynamic
characteristic of HFrEF according to current cardiology guidelines?
[A] Decreased myocardial contractility resulting in an ejection fraction of 40% or less
[B] Preserved ventricular compliance with an ejection fraction of 50% or greater
[C] Elevated left atrial pressure with normal ejection fraction
[D] Isolated right-sided volume overload without left-ventricular involvement
Correct Answer: Decreased myocardial contractility resulting in an ejection fraction of 40% or less.
Rationale: HFrEF is defined by reduced contractile function and an ejection fraction at or below 40%, indicating systolic
dysfunction.
Confidential • Student Study Edition • Practice & Review Guide Page 4 of 52
BSN HESI 266 Med Surg Exam Questions &
Answers, Verified Updated 2026/2027
Edition
Comprehensive Examination Question Bank • In-Depth Rationales • Concept Mapping
TOTAL QUESTIONS EXAM TOPICS RATIONALES
100 Questions 11 Modules 100% Verified
DOCUMENT OVERVIEW
This document contains 100 verified questions with correct answers and detailed rationales focusing on
medical-surgical nursing. It directly aligns with critical concepts in cardiovascular and respiratory health,
making it suitable for study, review, and preparation for certification exams.
EXAM BLUEPRINT & TOPIC DISTRIBUTION
Systematic breakdown of subject domains and exam coverage.
Topic Module Scope & Core Focus Questions Share (%)
This topic covers the pathophysiology, classification, and
Heart Failure management of heart failure. 9 Qs 9.0%
This topic examines the role and interpretation of biomarkers
Cardiac Biomarkers in diagnosing acute myocardial infarction. 9 Qs 9.0%
This topic includes the identification and management of
Arrhythmias various cardiac arrhythmias. 10 Qs 10.0%
This topic focuses on the guidelines and pharmacologic
Hypertension Management treatments for managing hypertension. 10 Qs 10.0%
Chronic Obstructive Pulmonary This topic addresses the diagnosis, management, and
Disease (COPD) complications associated with COPD. 9 Qs 9.0%
Acute Coronary Syndrome This topic covers the clinical presentation, diagnosis, and
(ACS) management of ACS. 9 Qs 9.0%
This topic includes the interpretation of ECG findings related
Electrocardiography to various cardiac conditions. 9 Qs 9.0%
Confidential • Student Study Edition • Practice & Review Guide Page 1 of 52
,STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
This topic focuses on the definitions, causes, and
Respiratory Failure management of acute and chronic respiratory failure. 9 Qs 9.0%
This topic discusses the role of antiplatelet medications in the
Antiplatelet Therapy management of cardiac conditions. 9 Qs 9.0%
This topic covers principles of vascular health, including
Vascular Health pressure measurements and their implications. 9 Qs 9.0%
This topic focuses on the immediate care protocols for acute
Emergency Management cardiovascular events. 8 Qs 8.0%
Total Exam Coverage 11 Integrated Topic Modules 100 Qs 100.0%
Confidential • Student Study Edition • Practice & Review Guide Page 2 of 52
,STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
TOPIC 1: HEART FAILURE
9 Questions • 9.0% of Exam • This topic covers the pathophysiology, classification, and management of heart failure.
QUESTION 1
Heart failure can be classified as systolic or diastolic based on ventricular function. In
systolic (or reduced ejection fraction) heart failure, specific hemodynamic alterations
occur due to impaired contractility, including changes in preload, afterload, and stroke
volume. Which of the following changes most accurately describes the typical
hemodynamic profile observed in systolic heart failure?
[A] Increased left ventricular end-diastolic volume with reduced ejection fraction
[B] Decreased left ventricular end-diastolic pressure with normal ejection fraction
[C] Elevated systemic vascular resistance with preserved stroke volume
[D] Decreased left atrial pressure with increased cardiac output
Correct Answer: Increased left ventricular end-diastolic volume with reduced ejection fraction.
Rationale: Systolic failure reduces contractility, causing increased left ventricular end-diastolic volume and pressure while
ejection fraction falls. This leads to volume overload, pulmonary congestion, and reduced cardiac output.
QUESTION 2
Heart failure severity is commonly categorized using the New York Heart Association
(NYHA) functional classification system. Which NYHA class best describes a patient
who experiences fatigue and dyspnea with ordinary physical activity, such as walking
on level ground, but is comfortable at rest? The classification aids in treatment
planning and prognostic assessment.
[A] Class I
[B] Class II
[C] Class III
[D] Class IV
Correct Answer: Class II.
Rationale: NYHA Class II indicates symptoms with ordinary activity but no limitation at rest, matching the described
presentation.
Confidential • Student Study Edition • Practice & Review Guide Page 3 of 52
, STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
QUESTION 3
In patients with left ventricular failure, clinicians must distinguish between systolic and
diastolic dysfunction to guide treatment and predict outcomes. Describe the primary
alteration in ventricular performance for each type and indicate the typical ejection
fraction range that characterizes systolic versus diastolic failure. Include the expected
range of ejection fraction percentages for each condition as defined by current heart
failure guidelines.
[A] Systolic dysfunction: reduced contractility, EF <40%
[B] Diastolic dysfunction: impaired relaxation, EF >50%
[C] Systolic dysfunction: impaired relaxation, EF >55%
[D] Diastolic dysfunction: reduced contractility, EF <35%
Correct Answer: Systolic dysfunction: reduced contractility, EF <40%.
Rationale: Systolic failure shows reduced contractility with ejection fraction below 40%; diastolic failure has preserved
ejection fraction above 50% despite impaired relaxation.
QUESTION 4
Heart failure with reduced ejection fraction (HFrEF) is a clinical syndrome in which the
left ventricle cannot contract effectively, leading to diminished stroke volume and
systemic congestion. Which statement best defines the primary hemodynamic
characteristic of HFrEF according to current cardiology guidelines?
[A] Decreased myocardial contractility resulting in an ejection fraction of 40% or less
[B] Preserved ventricular compliance with an ejection fraction of 50% or greater
[C] Elevated left atrial pressure with normal ejection fraction
[D] Isolated right-sided volume overload without left-ventricular involvement
Correct Answer: Decreased myocardial contractility resulting in an ejection fraction of 40% or less.
Rationale: HFrEF is defined by reduced contractile function and an ejection fraction at or below 40%, indicating systolic
dysfunction.
Confidential • Student Study Edition • Practice & Review Guide Page 4 of 52
