BSN_266_HESI_MedSurg_Exam_Bank_325
QUESTIONS Multiple Choice, Select-All-That-Apply
(SATA), Next Generation NCLEX (NGN) Case
Scenarios with Detailed Rationales: BSN 266 HESI
Medical-Surgical Nursing Exam Original Content –
High-Yield Exam Prep
TABLE OF CONTENTS
========================================
Section 1: Cardiovascular Disorders (Q1-Q40)
Section 2: Respiratory Disorders (Q41-Q75)
Section 3: Gastrointestinal Disorders (Q76-Q115)
Section 4: Renal & Urinary Disorders (Q116-Q145)
Section 5: Endocrine Disorders (Q146-Q175)
Section 6: Neurological Disorders (Q176-Q205)
Section 7: Musculoskeletal Disorders (Q206-Q230)
Section 8: Integumentary Disorders (Q231-Q255)
Section 9: Hematologic & Immunologic Disorders (Q256-Q280)
Section 10: Infectious Diseases & Infection Control (Q281-Q305)
Section 11: NGN Case Scenarios (Q306-Q325)
========================================
SECTION 1: CARDIOVASCULAR DISORDERS (40 questions)
========================================
Q1. A client who underwent cardiac stent placement 4 days ago arrives to
the emergency department reporting sudden onset chest pressure and
,shortness of breath. Which action should the nurse take next?
A) Administer prescribed nitroglycerin sublingually
B) Obtain a 12-lead electrocardiogram (ECG) and begin continuous
cardiac monitoring
C) Give oxygen at 2 liters per minute via nasal cannula
D) Prepare the client for immediate cardiac catheterization
Answer: B
Rationale: A client with sudden chest pressure and shortness of breath
after recent stenting is at high risk for acute stent thrombosis or
myocardial infarction (MI). Immediate acquisition of a 12-lead ECG is
critical to assess for ischemic changes and to prioritize timely reperfusion
therapy if needed [citation:2].
Q2. A client with heart failure reports a 3-pound weight gain in 24 hours.
What should the nurse do first?
A) Administer furosemide as prescribed
B) Assess for peripheral edema
C) Restrict fluid intake
D) Notify the healthcare provider
Answer: B
Rationale: Weight gain in heart failure suggests fluid retention; assessing
edema provides data to guide further action before implementing
interventions [citation:3].
Q3. A male client with heart failure (HF) calls the clinic and reports that
he cannot put his shoes on because they are too tight. Which additional
information should the nurse obtain?
A) What time did he take his last medications?
B) Has his weight changed in the last several days?
C) Is he still able to tighten his belt buckle?
D) How many hours did he sleep last night?
,Answer: B
Rationale: Tight shoes indicate possible peripheral edema from fluid
retention. Daily weight monitoring is the most reliable indicator of fluid
status in heart failure patients [citation:6].
Q4. A client with a history of atrial fibrillation reports dizziness. What
should the nurse assess first?
A) Blood pressure
B) Heart rate
C) Oxygen saturation
D) Blood glucose
Answer: B
Rationale: Dizziness in atrial fibrillation may indicate an irregular or
rapid heart rate, requiring immediate assessment to determine if the client
is experiencing decreased cardiac output [citation:3].
Q5. A client with a history of atrial fibrillation is receiving warfarin.
Which laboratory value should the nurse monitor?
A) Platelet count
B) INR
C) aPTT
D) Hemoglobin
Answer: B
Rationale: INR (International Normalized Ratio) is the standard
monitoring test for warfarin therapy. The therapeutic range for atrial
fibrillation is typically 2.0-3.0 [citation:3].
Q6. A client with a history of myocardial infarction reports chest pain.
What should the nurse do first?
A) Administer nitroglycerin sublingually
B) Obtain a 12-lead ECG
C) Administer oxygen at 2 L/min
, D) Notify the healthcare provider
Answer: C
Rationale: Administering oxygen improves myocardial oxygenation,
addressing potential ischemia as the first step before further assessment
and interventions [citation:3].
Q7. A client presents to the emergency department reporting chest pain
radiating to the left arm, shortness of breath, and diaphoresis. Which
medication should the nurse anticipate being prescribed by the healthcare
provider?
A) Fentanyl
B) Hydromorphone
C) Oxycodone
D) Morphine
Answer: D
Rationale: Morphine is used for chest pain unrelieved by initial
treatment; it also reduces anxiety and decreases myocardial oxygen
demand. It is part of the standard MONA (Morphine, Oxygen,
Nitroglycerin, Aspirin) protocol for MI [citation:5].
Q8. A cardiac catheterization of a client with heart disease indicates the
following blockages: 95% proximal left anterior descending (LAD), 99%
proximal circumflex, and proximal right coronary artery (RCA). The
client asks the nurse, "What does all this mean for me?" What
information should the nurse provide?
A) Blood supply to the heart is diminished by atherosclerotic lesions,
which necessitate lifestyle changes
B) Blood vessels supplying the pumping chamber have blockages
indicating a past heart attack
C) Three main arteries have major blockages, with only 1 to 5% of blood
flow getting through to the heart muscle
D) The heart is not receiving enough blood, so there is a risk of heart
QUESTIONS Multiple Choice, Select-All-That-Apply
(SATA), Next Generation NCLEX (NGN) Case
Scenarios with Detailed Rationales: BSN 266 HESI
Medical-Surgical Nursing Exam Original Content –
High-Yield Exam Prep
TABLE OF CONTENTS
========================================
Section 1: Cardiovascular Disorders (Q1-Q40)
Section 2: Respiratory Disorders (Q41-Q75)
Section 3: Gastrointestinal Disorders (Q76-Q115)
Section 4: Renal & Urinary Disorders (Q116-Q145)
Section 5: Endocrine Disorders (Q146-Q175)
Section 6: Neurological Disorders (Q176-Q205)
Section 7: Musculoskeletal Disorders (Q206-Q230)
Section 8: Integumentary Disorders (Q231-Q255)
Section 9: Hematologic & Immunologic Disorders (Q256-Q280)
Section 10: Infectious Diseases & Infection Control (Q281-Q305)
Section 11: NGN Case Scenarios (Q306-Q325)
========================================
SECTION 1: CARDIOVASCULAR DISORDERS (40 questions)
========================================
Q1. A client who underwent cardiac stent placement 4 days ago arrives to
the emergency department reporting sudden onset chest pressure and
,shortness of breath. Which action should the nurse take next?
A) Administer prescribed nitroglycerin sublingually
B) Obtain a 12-lead electrocardiogram (ECG) and begin continuous
cardiac monitoring
C) Give oxygen at 2 liters per minute via nasal cannula
D) Prepare the client for immediate cardiac catheterization
Answer: B
Rationale: A client with sudden chest pressure and shortness of breath
after recent stenting is at high risk for acute stent thrombosis or
myocardial infarction (MI). Immediate acquisition of a 12-lead ECG is
critical to assess for ischemic changes and to prioritize timely reperfusion
therapy if needed [citation:2].
Q2. A client with heart failure reports a 3-pound weight gain in 24 hours.
What should the nurse do first?
A) Administer furosemide as prescribed
B) Assess for peripheral edema
C) Restrict fluid intake
D) Notify the healthcare provider
Answer: B
Rationale: Weight gain in heart failure suggests fluid retention; assessing
edema provides data to guide further action before implementing
interventions [citation:3].
Q3. A male client with heart failure (HF) calls the clinic and reports that
he cannot put his shoes on because they are too tight. Which additional
information should the nurse obtain?
A) What time did he take his last medications?
B) Has his weight changed in the last several days?
C) Is he still able to tighten his belt buckle?
D) How many hours did he sleep last night?
,Answer: B
Rationale: Tight shoes indicate possible peripheral edema from fluid
retention. Daily weight monitoring is the most reliable indicator of fluid
status in heart failure patients [citation:6].
Q4. A client with a history of atrial fibrillation reports dizziness. What
should the nurse assess first?
A) Blood pressure
B) Heart rate
C) Oxygen saturation
D) Blood glucose
Answer: B
Rationale: Dizziness in atrial fibrillation may indicate an irregular or
rapid heart rate, requiring immediate assessment to determine if the client
is experiencing decreased cardiac output [citation:3].
Q5. A client with a history of atrial fibrillation is receiving warfarin.
Which laboratory value should the nurse monitor?
A) Platelet count
B) INR
C) aPTT
D) Hemoglobin
Answer: B
Rationale: INR (International Normalized Ratio) is the standard
monitoring test for warfarin therapy. The therapeutic range for atrial
fibrillation is typically 2.0-3.0 [citation:3].
Q6. A client with a history of myocardial infarction reports chest pain.
What should the nurse do first?
A) Administer nitroglycerin sublingually
B) Obtain a 12-lead ECG
C) Administer oxygen at 2 L/min
, D) Notify the healthcare provider
Answer: C
Rationale: Administering oxygen improves myocardial oxygenation,
addressing potential ischemia as the first step before further assessment
and interventions [citation:3].
Q7. A client presents to the emergency department reporting chest pain
radiating to the left arm, shortness of breath, and diaphoresis. Which
medication should the nurse anticipate being prescribed by the healthcare
provider?
A) Fentanyl
B) Hydromorphone
C) Oxycodone
D) Morphine
Answer: D
Rationale: Morphine is used for chest pain unrelieved by initial
treatment; it also reduces anxiety and decreases myocardial oxygen
demand. It is part of the standard MONA (Morphine, Oxygen,
Nitroglycerin, Aspirin) protocol for MI [citation:5].
Q8. A cardiac catheterization of a client with heart disease indicates the
following blockages: 95% proximal left anterior descending (LAD), 99%
proximal circumflex, and proximal right coronary artery (RCA). The
client asks the nurse, "What does all this mean for me?" What
information should the nurse provide?
A) Blood supply to the heart is diminished by atherosclerotic lesions,
which necessitate lifestyle changes
B) Blood vessels supplying the pumping chamber have blockages
indicating a past heart attack
C) Three main arteries have major blockages, with only 1 to 5% of blood
flow getting through to the heart muscle
D) The heart is not receiving enough blood, so there is a risk of heart
