BSN HESI 266 Medical-Surgical Exam Practice Test
Actual 2025/2026 with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Section 1: Cardiovascular Disorders (12 Questions)
Q1: A client with heart failure is prescribed furosemide 40 mg IV daily. Which
laboratory value should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B
Rationale: Correct because furosemide is a loop diuretic that causes potassium
wasting; hypokalemia increases the risk of cardiac dysrhythmias in clients with heart
failure.
Q2: A client with acute myocardial infarction develops chest pain unrelieved by
nitroglycerin. The nurse notes ST-segment elevation in leads II, III, and aVF. Which
area of the heart is affected?
A. Anterior wall
B. Lateral wall
C. Inferior wall
D. Septal wall
Correct Answer: C
Rationale: Correct because ST-segment elevation in leads II, III, and aVF indicates an
inferior wall myocardial infarction caused by occlusion of the right coronary artery.
Q3: A client with hypertension is prescribed lisinopril. The nurse should monitor for
which potential adverse effect?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hyponatremia
Correct Answer: A
,Rationale: Correct because ACE inhibitors such as lisinopril can cause hyperkalemia
by reducing aldosterone secretion, which decreases potassium excretion.
Q4: A client with atrial fibrillation is prescribed warfarin. Which laboratory test is used
to monitor therapeutic effectiveness?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT) and international normalized ratio (INR)
C. Platelet count
D. Bleeding time
Correct Answer: B
Rationale: Correct because warfarin affects vitamin K-dependent clotting factors; PT
and INR are the standard laboratory tests to monitor warfarin therapy and maintain
therapeutic anticoagulation.
Q5: A client with peripheral arterial disease reports pain in the legs when walking that
is relieved by rest. This is most consistent with:
A. Deep vein thrombosis
B. Intermittent claudication
C. Compartment syndrome
D. Cellulitis
Correct Answer: B
Rationale: Correct because intermittent claudication is reproducible ischemic leg
pain caused by inadequate blood flow during activity that resolves with rest,
characteristic of peripheral arterial disease.
Q6: A client with aortic stenosis is being prepared for valve replacement surgery.
Which assessment finding is most concerning preoperatively?
A. Systolic murmur at the right sternal border
B. Syncope with exertion
C. Diastolic murmur at the apex
D. Bounding peripheral pulses
Correct Answer: B
Rationale: Correct because syncope with exertion in aortic stenosis indicates severe
obstruction and reduced cardiac output, which significantly increases perioperative
mortality risk.
Q7: A client with heart failure has a daily weight gain of 3 lb in 24 hours. Which
nursing intervention is the priority?
, A. Increase oral fluid intake to prevent dehydration
B. Notify the provider and assess for fluid overload
C. Restrict dietary sodium to 4 g per day
D. Administer a potassium supplement
Correct Answer: B
Rationale: Correct because a weight gain of 2 to 3 lb in 24 hours indicates fluid
retention and worsening heart failure, requiring prompt provider notification and
potential diuretic adjustment.
Q8: A client with coronary artery disease is prescribed atorvastatin. Which
instruction should the nurse include?
A. Take the medication in the morning with breakfast
B. Report muscle pain or weakness immediately
C. Avoid all dietary fat to enhance effectiveness
D. Stop the medication if nausea occurs
Correct Answer: B
Rationale: Correct because statins can cause rhabdomyolysis, a serious adverse
effect characterized by muscle pain, weakness, and dark urine; clients must report
these symptoms promptly.
Q9: A client with acute pulmonary edema is receiving morphine sulfate IV. What is
the primary therapeutic effect of morphine in this situation?
A. Increase myocardial contractility
B. Reduce preload and afterload while decreasing anxiety
C. Dilate coronary arteries exclusively
D. Increase urine output
Correct Answer: B
Rationale: Correct because morphine reduces venous return (preload) and systemic
vascular resistance (afterload), decreases anxiety, and reduces the work of breathing
in acute pulmonary edema.
Q10: A client with a permanent pacemaker asks when it is safe to use a microwave
oven. What is the nurse's best response?
A. "You should never use a microwave oven again."
B. "You can use a microwave, but stand at least 2 feet away from it while operating."
C. "Microwaves are safe to use with modern pacemakers at normal distances."
D. "Only use the microwave if someone else is in the room."
Correct Answer: C
Actual 2025/2026 with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Section 1: Cardiovascular Disorders (12 Questions)
Q1: A client with heart failure is prescribed furosemide 40 mg IV daily. Which
laboratory value should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B
Rationale: Correct because furosemide is a loop diuretic that causes potassium
wasting; hypokalemia increases the risk of cardiac dysrhythmias in clients with heart
failure.
Q2: A client with acute myocardial infarction develops chest pain unrelieved by
nitroglycerin. The nurse notes ST-segment elevation in leads II, III, and aVF. Which
area of the heart is affected?
A. Anterior wall
B. Lateral wall
C. Inferior wall
D. Septal wall
Correct Answer: C
Rationale: Correct because ST-segment elevation in leads II, III, and aVF indicates an
inferior wall myocardial infarction caused by occlusion of the right coronary artery.
Q3: A client with hypertension is prescribed lisinopril. The nurse should monitor for
which potential adverse effect?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hyponatremia
Correct Answer: A
,Rationale: Correct because ACE inhibitors such as lisinopril can cause hyperkalemia
by reducing aldosterone secretion, which decreases potassium excretion.
Q4: A client with atrial fibrillation is prescribed warfarin. Which laboratory test is used
to monitor therapeutic effectiveness?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT) and international normalized ratio (INR)
C. Platelet count
D. Bleeding time
Correct Answer: B
Rationale: Correct because warfarin affects vitamin K-dependent clotting factors; PT
and INR are the standard laboratory tests to monitor warfarin therapy and maintain
therapeutic anticoagulation.
Q5: A client with peripheral arterial disease reports pain in the legs when walking that
is relieved by rest. This is most consistent with:
A. Deep vein thrombosis
B. Intermittent claudication
C. Compartment syndrome
D. Cellulitis
Correct Answer: B
Rationale: Correct because intermittent claudication is reproducible ischemic leg
pain caused by inadequate blood flow during activity that resolves with rest,
characteristic of peripheral arterial disease.
Q6: A client with aortic stenosis is being prepared for valve replacement surgery.
Which assessment finding is most concerning preoperatively?
A. Systolic murmur at the right sternal border
B. Syncope with exertion
C. Diastolic murmur at the apex
D. Bounding peripheral pulses
Correct Answer: B
Rationale: Correct because syncope with exertion in aortic stenosis indicates severe
obstruction and reduced cardiac output, which significantly increases perioperative
mortality risk.
Q7: A client with heart failure has a daily weight gain of 3 lb in 24 hours. Which
nursing intervention is the priority?
, A. Increase oral fluid intake to prevent dehydration
B. Notify the provider and assess for fluid overload
C. Restrict dietary sodium to 4 g per day
D. Administer a potassium supplement
Correct Answer: B
Rationale: Correct because a weight gain of 2 to 3 lb in 24 hours indicates fluid
retention and worsening heart failure, requiring prompt provider notification and
potential diuretic adjustment.
Q8: A client with coronary artery disease is prescribed atorvastatin. Which
instruction should the nurse include?
A. Take the medication in the morning with breakfast
B. Report muscle pain or weakness immediately
C. Avoid all dietary fat to enhance effectiveness
D. Stop the medication if nausea occurs
Correct Answer: B
Rationale: Correct because statins can cause rhabdomyolysis, a serious adverse
effect characterized by muscle pain, weakness, and dark urine; clients must report
these symptoms promptly.
Q9: A client with acute pulmonary edema is receiving morphine sulfate IV. What is
the primary therapeutic effect of morphine in this situation?
A. Increase myocardial contractility
B. Reduce preload and afterload while decreasing anxiety
C. Dilate coronary arteries exclusively
D. Increase urine output
Correct Answer: B
Rationale: Correct because morphine reduces venous return (preload) and systemic
vascular resistance (afterload), decreases anxiety, and reduces the work of breathing
in acute pulmonary edema.
Q10: A client with a permanent pacemaker asks when it is safe to use a microwave
oven. What is the nurse's best response?
A. "You should never use a microwave oven again."
B. "You can use a microwave, but stand at least 2 feet away from it while operating."
C. "Microwaves are safe to use with modern pacemakers at normal distances."
D. "Only use the microwave if someone else is in the room."
Correct Answer: C
