, BSN HESI 266 Med-Surg Exam V2:
High-Yield Questions, Answers, &
Rationales 2026/2027 Update
Question 1: Respiratory & Thoracic Surgery
A client is 6 hours postoperative following a right
pneumonectomy. When positioning the client in bed, which
action should the nurse prioritize?
A. Position the client on the operative (right) side or flat on
the back.
B. Position the client strictly on the uninfected (left) side or
back to prevent mediastinal shift.
C. Keep the head of the bed completely flat at all times to
maximize venous return.
D. Assist the client into a high Fowler's position with
bilateral knee gatch elevated.
Correct Answer: A. Position the client on the operative
(right) side or flat on the back.
Explanation: Following a pneumonectomy, positioning the
client on the operative side or on their back allows the remaining
lung on the unoperated side maximum expansion space and
prevents fluid accumulation or mediastinal shift from
compressing the remaining healthy lung tissue.
Question 2: Oncology & Chemotherapy Extravasation
A client receiving a vesicant chemotherapy infusion through a
peripheral IV line in the forearm complains of sudden burning
,and stinging at the insertion site. The nurse observes swelling
and no blood return. What is the nurse's first priority action?
A. Stop the infusion immediately and disconnect the IV
tubing.
B. Attempt to flush the IV catheter with normal saline to
clear the line.
C. Apply a warm compress directly to the site for 30
minutes.
D. Elevate the affected arm above the level of the heart.
Correct Answer: A. Stop the infusion immediately and
disconnect the IV tubing.
Explanation: The client is experiencing an extravasation of a
vesicant agent. The immediate priority is to stop the drug
infusion and disconnect the tubing. Depending on the specific
drug protocol, the nurse may then attempt to aspirate residual
drug from the catheter before removing it and applying the
appropriate thermal compress (cold or warm per protocol).
Question 3: Cardiovascular & Acute Coronary Syndrome
A client is admitted to the emergency department with
substernal chest pain radiating to the left arm and jaw. A 12-lead
electrocardiogram (ECG) reveals ST-segment elevation in leads
II, III, and aVF. The nurse recognizes that this finding indicates
ischemia in which area of the heart?
A. Anterior wall of the left ventricle.
B. Inferior wall of the left ventricle.
C. Lateral wall of the left ventricle.
D. Posterior wall of the left ventricle.
, Correct Answer: B. Inferior wall of the left ventricle.
Explanation: Leads II, III, and aVF view the inferior surface of
the heart, which is supplied primarily by the right coronary
artery (RCA). ST elevation in these leads points to an acute
inferior wall myocardial infarction.
Question 4: Gastrointestinal & Small Bowel Obstruction
The nurse is caring for a client with a nasogastric (NG) tube
connected to low intermittent suction for a mechanical small
bowel obstruction. Which finding should the nurse report to the
healthcare provider immediately?
A. Light green, watery drainage totaling 150 mL over 4
hours.
B. The client reports mild dry mouth and thirst.
C. The NG tube stops draining entirely and the client
develops sudden, severe abdominal distension and pain.
D. Serosanguineous drainage noted around the tape on the
nares.
Correct Answer: C. The NG tube stops draining entirely and
the client develops sudden, severe abdominal distension and
pain.
Explanation: A sudden cessation of NG tube output
accompanied by worsening abdominal pain, rigidity, and
distension indicates that the tube may be obstructed, displaced,
or that the bowel obstruction is worsening/perforating, requiring
urgent medical evaluation.
Question 5: Endocrine & Thyroidectomy Complications
High-Yield Questions, Answers, &
Rationales 2026/2027 Update
Question 1: Respiratory & Thoracic Surgery
A client is 6 hours postoperative following a right
pneumonectomy. When positioning the client in bed, which
action should the nurse prioritize?
A. Position the client on the operative (right) side or flat on
the back.
B. Position the client strictly on the uninfected (left) side or
back to prevent mediastinal shift.
C. Keep the head of the bed completely flat at all times to
maximize venous return.
D. Assist the client into a high Fowler's position with
bilateral knee gatch elevated.
Correct Answer: A. Position the client on the operative
(right) side or flat on the back.
Explanation: Following a pneumonectomy, positioning the
client on the operative side or on their back allows the remaining
lung on the unoperated side maximum expansion space and
prevents fluid accumulation or mediastinal shift from
compressing the remaining healthy lung tissue.
Question 2: Oncology & Chemotherapy Extravasation
A client receiving a vesicant chemotherapy infusion through a
peripheral IV line in the forearm complains of sudden burning
,and stinging at the insertion site. The nurse observes swelling
and no blood return. What is the nurse's first priority action?
A. Stop the infusion immediately and disconnect the IV
tubing.
B. Attempt to flush the IV catheter with normal saline to
clear the line.
C. Apply a warm compress directly to the site for 30
minutes.
D. Elevate the affected arm above the level of the heart.
Correct Answer: A. Stop the infusion immediately and
disconnect the IV tubing.
Explanation: The client is experiencing an extravasation of a
vesicant agent. The immediate priority is to stop the drug
infusion and disconnect the tubing. Depending on the specific
drug protocol, the nurse may then attempt to aspirate residual
drug from the catheter before removing it and applying the
appropriate thermal compress (cold or warm per protocol).
Question 3: Cardiovascular & Acute Coronary Syndrome
A client is admitted to the emergency department with
substernal chest pain radiating to the left arm and jaw. A 12-lead
electrocardiogram (ECG) reveals ST-segment elevation in leads
II, III, and aVF. The nurse recognizes that this finding indicates
ischemia in which area of the heart?
A. Anterior wall of the left ventricle.
B. Inferior wall of the left ventricle.
C. Lateral wall of the left ventricle.
D. Posterior wall of the left ventricle.
, Correct Answer: B. Inferior wall of the left ventricle.
Explanation: Leads II, III, and aVF view the inferior surface of
the heart, which is supplied primarily by the right coronary
artery (RCA). ST elevation in these leads points to an acute
inferior wall myocardial infarction.
Question 4: Gastrointestinal & Small Bowel Obstruction
The nurse is caring for a client with a nasogastric (NG) tube
connected to low intermittent suction for a mechanical small
bowel obstruction. Which finding should the nurse report to the
healthcare provider immediately?
A. Light green, watery drainage totaling 150 mL over 4
hours.
B. The client reports mild dry mouth and thirst.
C. The NG tube stops draining entirely and the client
develops sudden, severe abdominal distension and pain.
D. Serosanguineous drainage noted around the tape on the
nares.
Correct Answer: C. The NG tube stops draining entirely and
the client develops sudden, severe abdominal distension and
pain.
Explanation: A sudden cessation of NG tube output
accompanied by worsening abdominal pain, rigidity, and
distension indicates that the tube may be obstructed, displaced,
or that the bowel obstruction is worsening/perforating, requiring
urgent medical evaluation.
Question 5: Endocrine & Thyroidectomy Complications
