BSN HESI 266 MED SURG PRACTICE
EXAM QUESTIONS WITH CORRECT
ANSWERS (LATEST ), (A+
GUARANTEE).
1. A client with chronic heart failure is prescribed digoxin and furosemide. The nurse notes
the client’s potassium level is 3.2 mEq/L. Which action should the nurse take first?
A. Administer the scheduled dose of digoxin.
B. Monitor the client’s heart rate for one full minute.
C. Encourage the client to eat a banana.
D. Hold the digoxin and notify the healthcare provider.
Answer: D
Conceptual Explanation: Hypokalemia (potassium < 3.5 mEq/L) significantly increases
the risk of digoxin toxicity. The nurse must hold the medication and notify the provider to
address the electrolyte imbalance before administration.
2. A nurse is caring for a client with a T6 spinal cord injury who reports a pounding headache
and nasal congestion. The client’s blood pressure is 190/100 mmHg. What is the priority
nursing intervention?
A. Administer an antihypertensive medication.
,B. Check the client for bladder distention.
C. Document the findings in the electronic health record.
D. Elevate the head of the bed to 90 degrees.
Answer: D
Conceptual Explanation: These symptoms indicate autonomic dysreflexia, a medical
emergency. The first action is to sit the patient upright to help lower blood pressure via
orthostatic effect before identifying the noxious stimulus (like a full bladder).
3. Which arterial blood gas (ABG) result is most consistent with a client experiencing an acute
exacerbation of COPD?
A. pH 7.50, PaCO2 45, HCO3 32
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.35, PaCO2 40, HCO3 24
D. pH 7.30, PaCO2 55, HCO3 26
Answer: D
Conceptual Explanation: COPD exacerbations typically result in respiratory acidosis due
to CO2 retention (hypercapnia). pH < 7.35 and PaCO2 > 45 mmHg reflect this state.
4. A client is admitted with Diabetic Ketoacidosis (DKA). Which intravenous fluid should the
nurse anticipate administering initially?
A. 0.9% Normal Saline
, B. 0.45% Normal Saline
C. Dextrose 5% in 0.45% Normal Saline
D. Dextrose 5% in Water
Answer: A
Conceptual Explanation: The initial goal in DKA treatment is volume resuscitation.
Isotonic saline (0.9% NS) is used to restore circulatory volume and tissue perfusion.
5. Following a thyroidectomy, a client develops tremors and a positive Chvostek’s sign. Which
medication should the nurse have readily available?
A. Potassium chloride
B. Calcium gluconate
C. Magnesium sulfate
D. Sodium bicarbonate
Answer: B
Conceptual Explanation: A positive Chvostek’s sign indicates hypocalcemia, which can
occur if the parathyroid glands are accidentally removed or damaged during a
thyroidectomy. IV calcium gluconate is the treatment.
6. A client with a chest tube has continuous bubbling in the water-seal chamber. What does
this finding suggest?
A. The system is functioning normally.
EXAM QUESTIONS WITH CORRECT
ANSWERS (LATEST ), (A+
GUARANTEE).
1. A client with chronic heart failure is prescribed digoxin and furosemide. The nurse notes
the client’s potassium level is 3.2 mEq/L. Which action should the nurse take first?
A. Administer the scheduled dose of digoxin.
B. Monitor the client’s heart rate for one full minute.
C. Encourage the client to eat a banana.
D. Hold the digoxin and notify the healthcare provider.
Answer: D
Conceptual Explanation: Hypokalemia (potassium < 3.5 mEq/L) significantly increases
the risk of digoxin toxicity. The nurse must hold the medication and notify the provider to
address the electrolyte imbalance before administration.
2. A nurse is caring for a client with a T6 spinal cord injury who reports a pounding headache
and nasal congestion. The client’s blood pressure is 190/100 mmHg. What is the priority
nursing intervention?
A. Administer an antihypertensive medication.
,B. Check the client for bladder distention.
C. Document the findings in the electronic health record.
D. Elevate the head of the bed to 90 degrees.
Answer: D
Conceptual Explanation: These symptoms indicate autonomic dysreflexia, a medical
emergency. The first action is to sit the patient upright to help lower blood pressure via
orthostatic effect before identifying the noxious stimulus (like a full bladder).
3. Which arterial blood gas (ABG) result is most consistent with a client experiencing an acute
exacerbation of COPD?
A. pH 7.50, PaCO2 45, HCO3 32
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.35, PaCO2 40, HCO3 24
D. pH 7.30, PaCO2 55, HCO3 26
Answer: D
Conceptual Explanation: COPD exacerbations typically result in respiratory acidosis due
to CO2 retention (hypercapnia). pH < 7.35 and PaCO2 > 45 mmHg reflect this state.
4. A client is admitted with Diabetic Ketoacidosis (DKA). Which intravenous fluid should the
nurse anticipate administering initially?
A. 0.9% Normal Saline
, B. 0.45% Normal Saline
C. Dextrose 5% in 0.45% Normal Saline
D. Dextrose 5% in Water
Answer: A
Conceptual Explanation: The initial goal in DKA treatment is volume resuscitation.
Isotonic saline (0.9% NS) is used to restore circulatory volume and tissue perfusion.
5. Following a thyroidectomy, a client develops tremors and a positive Chvostek’s sign. Which
medication should the nurse have readily available?
A. Potassium chloride
B. Calcium gluconate
C. Magnesium sulfate
D. Sodium bicarbonate
Answer: B
Conceptual Explanation: A positive Chvostek’s sign indicates hypocalcemia, which can
occur if the parathyroid glands are accidentally removed or damaged during a
thyroidectomy. IV calcium gluconate is the treatment.
6. A client with a chest tube has continuous bubbling in the water-seal chamber. What does
this finding suggest?
A. The system is functioning normally.
