BSN HESI 266 Med Surg Exam – 100 Practice Questions (Multi
Choice with Answers & Rationales)
Question 1
A client with a completed ischemic stroke has a blood pressure of 180/90 mm Hg. Which action should
the nurse implement?
A) Position the head of the bed (HOB) flat.
B) Withhold intravenous fluids.
C) Administer a bolus of IV fluids.
D) Give an antihypertensive medication.
Answer: D
Rationale: Most ischemic strokes occur during sleep when baseline blood pressure declines or blood
viscosity increases due to minimal fluid intake. Completed strokes usually produce neurologic deficits
within an hour, and the client's current elevated blood pressure requires antihypertensive medication.
Question 2
A client who is receiving chemotherapy asks the nurse, "Why is so much of my hair falling out each day?"
Which response by the nurse best explains the reason for alopecia?
A) "Chemotherapy affects the cells of the body that grow rapidly, both normal and malignant."
B) "Alopecia is a common side effect you will experience during long-term steroid therapy."
C) "Your hair will grow back completely after your course of chemotherapy is completed."
D) "The chemotherapy causes permanent alterations in your hair follicles that lead to hair loss."
Answer: A
Rationale: Chemotherapy affects rapidly dividing cells, including hair follicle cells, which leads to
alopecia. This is a temporary effect, and hair typically grows back after treatment.
,Question 3
Which intervention should the nurse plan to implement when caring for a client who has just undergone
a right above-the-knee amputation?
A) Maintain the residual limb on three pillows at all times.
B) Place a large tourniquet at the client's bedside.
C) Apply constant, direct pressure to the residual limb.
D) Do not allow the client to lie in the prone position.
Answer: B
Rationale: A large tourniquet should be placed in plain sight at the client's bedside in case severe
bleeding occurs. The residual limb should not be placed on a pillow because a flexion contracture of the
hip may result, and the client should be encouraged to lie in the prone position to prevent flexion
contracture of the hip.
Question 4
Two days postoperative, a male client reports aching pain in his left leg. The nurse assesses redness and
warmth on the lower left calf. What intervention would be most helpful to this client?
A) Apply sequential compression devices (SCDs) bilaterally.
B) Assess for a positive Homan's sign in each leg.
C) Pad all bony prominences on the affected leg.
D) Elevate the affected leg and apply warm compresses.
Answer: D
Rationale: The findings suggest possible deep vein thrombosis (DVT). Elevation and warm compresses
help reduce edema and pain, but the healthcare provider should be notified immediately. Homan's sign
is no longer a reliable assessment for DVT.
,Question 5
A client with acute osteomyelitis has undergone surgical debridement of diseased bone and asks the
nurse how long antibiotics will have to be administered. Which information should the nurse
communicate?
A) Oral antibiotics for 2 to 4 months, then for dental procedure prophylaxis.
B) Parenteral antibiotics for 4 to 6 weeks, then oral antibiotics for up to 1 year.
C) Parenteral antibiotics for 4 to 8 weeks, then oral antibiotics for another 4 to 8 weeks.
D) Parenteral antibiotics for 2 to 3 weeks, then oral antibiotics for 4 weeks.
Answer: C
Rationale: Treatment of acute osteomyelitis requires the administration of high doses of parenteral
antibiotics for 4 to 8 weeks, followed by oral antibiotics for another 4 to 8 weeks.
Question 6
In planning care for a client with an acute stroke resulting in right-sided hemiplegia, which positioning
should the nurse use to maintain optimal functioning?
A) Mid-Fowler's with knees supported.
B) Supine with trochanter rolls to the hips.
C) Sim's position alternated with right lateral position q2 hours.
D) Left lateral, supine, brief periods on the right side, and prone.
Answer: D
Rationale: A positioning schedule that minimizes lying on the affected side (which can impair circulation
and cause pain) and includes the prone position helps prevent flexion contractures of the hips, preparing
the client for optimal functioning and ambulation.
, Question 7
Which preexisting diagnosis places a client at the greatest risk of developing superior vena cava
syndrome?
A) Carotid stenosis.
B) Steatosis hepatitis.
C) Metastatic cancer.
D) Clavicular fracture.
Answer: C
Rationale: Superior vena cava syndrome occurs when the superior vena cava (SVC) is compressed by
outside structures, such as a growing tumor, that impede return blood flow to the heart. It is likely to
occur with metastatic cancer from a primary tumor in the upper lobe of the right lung.
Question 8
The nurse is giving discharge instructions to a client with chronic prostatitis. What instruction should the
nurse provide to reduce the risk of spreading the infection to other areas of the client's urinary tract?
A) Wear a condom when having sexual intercourse.
B) Avoid consuming alcohol and caffeinated beverages.
C) Empty the bladder completely with each voiding.
D) Have intercourse or masturbate at least twice a week.
Answer: D
Rationale: The prostate is not easily penetrated by antibiotics and can serve as a reservoir for
microorganisms. Draining the prostate regularly through intercourse or masturbation decreases the
number of microorganisms present and reduces the risk for further infection from stored contaminated
seminal fluids.
Choice with Answers & Rationales)
Question 1
A client with a completed ischemic stroke has a blood pressure of 180/90 mm Hg. Which action should
the nurse implement?
A) Position the head of the bed (HOB) flat.
B) Withhold intravenous fluids.
C) Administer a bolus of IV fluids.
D) Give an antihypertensive medication.
Answer: D
Rationale: Most ischemic strokes occur during sleep when baseline blood pressure declines or blood
viscosity increases due to minimal fluid intake. Completed strokes usually produce neurologic deficits
within an hour, and the client's current elevated blood pressure requires antihypertensive medication.
Question 2
A client who is receiving chemotherapy asks the nurse, "Why is so much of my hair falling out each day?"
Which response by the nurse best explains the reason for alopecia?
A) "Chemotherapy affects the cells of the body that grow rapidly, both normal and malignant."
B) "Alopecia is a common side effect you will experience during long-term steroid therapy."
C) "Your hair will grow back completely after your course of chemotherapy is completed."
D) "The chemotherapy causes permanent alterations in your hair follicles that lead to hair loss."
Answer: A
Rationale: Chemotherapy affects rapidly dividing cells, including hair follicle cells, which leads to
alopecia. This is a temporary effect, and hair typically grows back after treatment.
,Question 3
Which intervention should the nurse plan to implement when caring for a client who has just undergone
a right above-the-knee amputation?
A) Maintain the residual limb on three pillows at all times.
B) Place a large tourniquet at the client's bedside.
C) Apply constant, direct pressure to the residual limb.
D) Do not allow the client to lie in the prone position.
Answer: B
Rationale: A large tourniquet should be placed in plain sight at the client's bedside in case severe
bleeding occurs. The residual limb should not be placed on a pillow because a flexion contracture of the
hip may result, and the client should be encouraged to lie in the prone position to prevent flexion
contracture of the hip.
Question 4
Two days postoperative, a male client reports aching pain in his left leg. The nurse assesses redness and
warmth on the lower left calf. What intervention would be most helpful to this client?
A) Apply sequential compression devices (SCDs) bilaterally.
B) Assess for a positive Homan's sign in each leg.
C) Pad all bony prominences on the affected leg.
D) Elevate the affected leg and apply warm compresses.
Answer: D
Rationale: The findings suggest possible deep vein thrombosis (DVT). Elevation and warm compresses
help reduce edema and pain, but the healthcare provider should be notified immediately. Homan's sign
is no longer a reliable assessment for DVT.
,Question 5
A client with acute osteomyelitis has undergone surgical debridement of diseased bone and asks the
nurse how long antibiotics will have to be administered. Which information should the nurse
communicate?
A) Oral antibiotics for 2 to 4 months, then for dental procedure prophylaxis.
B) Parenteral antibiotics for 4 to 6 weeks, then oral antibiotics for up to 1 year.
C) Parenteral antibiotics for 4 to 8 weeks, then oral antibiotics for another 4 to 8 weeks.
D) Parenteral antibiotics for 2 to 3 weeks, then oral antibiotics for 4 weeks.
Answer: C
Rationale: Treatment of acute osteomyelitis requires the administration of high doses of parenteral
antibiotics for 4 to 8 weeks, followed by oral antibiotics for another 4 to 8 weeks.
Question 6
In planning care for a client with an acute stroke resulting in right-sided hemiplegia, which positioning
should the nurse use to maintain optimal functioning?
A) Mid-Fowler's with knees supported.
B) Supine with trochanter rolls to the hips.
C) Sim's position alternated with right lateral position q2 hours.
D) Left lateral, supine, brief periods on the right side, and prone.
Answer: D
Rationale: A positioning schedule that minimizes lying on the affected side (which can impair circulation
and cause pain) and includes the prone position helps prevent flexion contractures of the hips, preparing
the client for optimal functioning and ambulation.
, Question 7
Which preexisting diagnosis places a client at the greatest risk of developing superior vena cava
syndrome?
A) Carotid stenosis.
B) Steatosis hepatitis.
C) Metastatic cancer.
D) Clavicular fracture.
Answer: C
Rationale: Superior vena cava syndrome occurs when the superior vena cava (SVC) is compressed by
outside structures, such as a growing tumor, that impede return blood flow to the heart. It is likely to
occur with metastatic cancer from a primary tumor in the upper lobe of the right lung.
Question 8
The nurse is giving discharge instructions to a client with chronic prostatitis. What instruction should the
nurse provide to reduce the risk of spreading the infection to other areas of the client's urinary tract?
A) Wear a condom when having sexual intercourse.
B) Avoid consuming alcohol and caffeinated beverages.
C) Empty the bladder completely with each voiding.
D) Have intercourse or masturbate at least twice a week.
Answer: D
Rationale: The prostate is not easily penetrated by antibiotics and can serve as a reservoir for
microorganisms. Draining the prostate regularly through intercourse or masturbation decreases the
number of microorganisms present and reduces the risk for further infection from stored contaminated
seminal fluids.
