Page 1 of 77
125 BSN HESI MED SURG PRACTICE QUESTIONS &
RATIONALES | HESI 266 EXAM PREP 2026
Adult Health Nursing & Physiological / Pathophysiology / Clinical Pharmacology
Exam coverage :-
✓ Section A (Q1–Q20): Management of care, delegation,
prioritization, legal/ethical issues, and informed consent.
✓ Section B (Q21–Q40): Safety and infection control,
standard precautions, isolation, fall prevention, and error
prevention.
✓ Section C (Q41–Q55): Basic care and comfort, ADLs, pain
management, nutrition, and mobility.
✓ Section D (Q56–Q75): Pharmacological and parenteral
therapies, medication administration, side effects, and IV
therapy.
✓ Section E (Q76–Q95): Reduction of risk potential,
diagnostic tests, complication prevention, and pre/post-op
care.
✓ Section F (Q96–Q125): Physiological adaptation,
acute/chronic conditions, fluid/electrolytes, and multi-
system disorders.
SECTION A: MANAGEMENT OF CARE (Q1–Q20)
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1. The charge nurse is making client assignments for the night
shift. Which client should be assigned to the licensed practical
nurse (LPN) under the supervision of the registered nurse (RN)?
A) A client who is 12 hours postoperative following a subtotal
thyroidectomy and requires assessment for signs of
hypocalcemia
B) A client admitted with heart failure exacerbation who has
crackles bilaterally and needs a furosemide IV push
C) A client with a stage III pressure injury requiring wound
irrigation, debridement, and evaluation of healing progress
D) A client who is 2 days post-appendectomy with an abdominal
incision that needs vital signs monitoring and ambulation
CORRECT ANSWER: D) A client who is 2 days post-
appendectomy with an abdominal incision that needs vital
signs monitoring and ambulation
RATIONALE: Option D is correct because vital signs monitoring
and ambulation are routine, stable tasks appropriate for an LPN
under RN supervision. Option A is incorrect because
assessment for hypocalcemia requires RN-level clinical
judgment. Option B is incorrect because IV push furosemide in
an unstable heart failure client requires RN assessment. Option
C is incorrect because wound debridement and evaluation of
healing progress require RN assessment.
2. The nurse receives report on four patients. Which patient
should the nurse assess FIRST?
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A) Heart failure patient with 2+ pitting edema in lower
extremities
B) Post-op hip replacement patient reporting pain 6/10
C) COPD patient on 2L NC with SpO2 92%
D) Diabetic patient with a new red, warm area on the plantar
surface of the foot
CORRECT ANSWER: D) Diabetic patient with a new red,
warm area on the plantar surface of the foot
RATIONALE: Option D is correct because a new red, warm area
on the foot of a diabetic patient is a potential diabetic foot
ulcer/infection, which is a medical emergency due to the risk of
sepsis and amputation. Option A is incorrect because edema is
chronic and expected. Option B is incorrect because
postoperative pain is expected. Option C is incorrect because
SpO2 92% may be baseline for a COPD patient.
3. The nurse is delegating tasks to an experienced UAP for a
stable heart failure patient. Which tasks are appropriate to
delegate? (Select all that apply)
A) Assist patient with ambulation to the bathroom
B) Measure and record daily weight
C) Auscultate lung sounds after incentive spirometry
D) Reinforce teaching about a 2-gram sodium diet
E) Take vital signs and report abnormal findings
F) Assess for peripheral edema
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CORRECT ANSWER: A, B, E
RATIONALE: Options A, B, and E are correct because UAPs may
perform non-invasive, routine tasks such as assisting with
ambulation, measuring weights, and taking vital signs. Option C
is incorrect because auscultation requires nursing judgment.
Option D is incorrect because reinforcing teaching requires
evaluation of understanding, which is the RN's responsibility.
Option F is incorrect because assessment for edema requires
nursing judgment.
4. A post-operative cholecystectomy patient's PCA pump is
locked out after delivering 4 doses in 1 hour. The patient reports
pain 8/10. What is the nurse's FIRST action?
A) Call the provider for a higher basal rate
B) Administer PRN morphine 4 mg IV from the narcotic drawer
C) Assess pain location, quality, and implement non-
pharmacologic interventions
D) Discontinue PCA and switch to oral analgesics
CORRECT ANSWER: C) Assess pain location, quality, and
implement non-pharmacologic interventions
RATIONALE: Option C is correct because comprehensive pain
assessment rules out complications (retained stone, bile leak)
and guides the next intervention. Option A is incorrect because
calling the provider without assessment is premature. Option B
is incorrect because administering additional opioids without
125 BSN HESI MED SURG PRACTICE QUESTIONS &
RATIONALES | HESI 266 EXAM PREP 2026
Adult Health Nursing & Physiological / Pathophysiology / Clinical Pharmacology
Exam coverage :-
✓ Section A (Q1–Q20): Management of care, delegation,
prioritization, legal/ethical issues, and informed consent.
✓ Section B (Q21–Q40): Safety and infection control,
standard precautions, isolation, fall prevention, and error
prevention.
✓ Section C (Q41–Q55): Basic care and comfort, ADLs, pain
management, nutrition, and mobility.
✓ Section D (Q56–Q75): Pharmacological and parenteral
therapies, medication administration, side effects, and IV
therapy.
✓ Section E (Q76–Q95): Reduction of risk potential,
diagnostic tests, complication prevention, and pre/post-op
care.
✓ Section F (Q96–Q125): Physiological adaptation,
acute/chronic conditions, fluid/electrolytes, and multi-
system disorders.
SECTION A: MANAGEMENT OF CARE (Q1–Q20)
, Page 2 of 77
1. The charge nurse is making client assignments for the night
shift. Which client should be assigned to the licensed practical
nurse (LPN) under the supervision of the registered nurse (RN)?
A) A client who is 12 hours postoperative following a subtotal
thyroidectomy and requires assessment for signs of
hypocalcemia
B) A client admitted with heart failure exacerbation who has
crackles bilaterally and needs a furosemide IV push
C) A client with a stage III pressure injury requiring wound
irrigation, debridement, and evaluation of healing progress
D) A client who is 2 days post-appendectomy with an abdominal
incision that needs vital signs monitoring and ambulation
CORRECT ANSWER: D) A client who is 2 days post-
appendectomy with an abdominal incision that needs vital
signs monitoring and ambulation
RATIONALE: Option D is correct because vital signs monitoring
and ambulation are routine, stable tasks appropriate for an LPN
under RN supervision. Option A is incorrect because
assessment for hypocalcemia requires RN-level clinical
judgment. Option B is incorrect because IV push furosemide in
an unstable heart failure client requires RN assessment. Option
C is incorrect because wound debridement and evaluation of
healing progress require RN assessment.
2. The nurse receives report on four patients. Which patient
should the nurse assess FIRST?
, Page 3 of 77
A) Heart failure patient with 2+ pitting edema in lower
extremities
B) Post-op hip replacement patient reporting pain 6/10
C) COPD patient on 2L NC with SpO2 92%
D) Diabetic patient with a new red, warm area on the plantar
surface of the foot
CORRECT ANSWER: D) Diabetic patient with a new red,
warm area on the plantar surface of the foot
RATIONALE: Option D is correct because a new red, warm area
on the foot of a diabetic patient is a potential diabetic foot
ulcer/infection, which is a medical emergency due to the risk of
sepsis and amputation. Option A is incorrect because edema is
chronic and expected. Option B is incorrect because
postoperative pain is expected. Option C is incorrect because
SpO2 92% may be baseline for a COPD patient.
3. The nurse is delegating tasks to an experienced UAP for a
stable heart failure patient. Which tasks are appropriate to
delegate? (Select all that apply)
A) Assist patient with ambulation to the bathroom
B) Measure and record daily weight
C) Auscultate lung sounds after incentive spirometry
D) Reinforce teaching about a 2-gram sodium diet
E) Take vital signs and report abnormal findings
F) Assess for peripheral edema
, Page 4 of 77
CORRECT ANSWER: A, B, E
RATIONALE: Options A, B, and E are correct because UAPs may
perform non-invasive, routine tasks such as assisting with
ambulation, measuring weights, and taking vital signs. Option C
is incorrect because auscultation requires nursing judgment.
Option D is incorrect because reinforcing teaching requires
evaluation of understanding, which is the RN's responsibility.
Option F is incorrect because assessment for edema requires
nursing judgment.
4. A post-operative cholecystectomy patient's PCA pump is
locked out after delivering 4 doses in 1 hour. The patient reports
pain 8/10. What is the nurse's FIRST action?
A) Call the provider for a higher basal rate
B) Administer PRN morphine 4 mg IV from the narcotic drawer
C) Assess pain location, quality, and implement non-
pharmacologic interventions
D) Discontinue PCA and switch to oral analgesics
CORRECT ANSWER: C) Assess pain location, quality, and
implement non-pharmacologic interventions
RATIONALE: Option C is correct because comprehensive pain
assessment rules out complications (retained stone, bile leak)
and guides the next intervention. Option A is incorrect because
calling the provider without assessment is premature. Option B
is incorrect because administering additional opioids without
