,BSN 266 HESI Med Surg Exam 2026 – Complete Q&A
with NGN Case Scenarios & Detailed Rationales |
Nightingale College | Updated 2026/2027 Edition |
Instant Digital Download
Core Topics Covered
Section Topic Area Questions
I Cardiovascular Disorders 1–35
II Respiratory Disorders 36–60
III Gastrointestinal Disorders 61–80
IV Renal & Genitourinary Disorders 81–100
V Endocrine Disorders 101–125
VI Neurological Disorders 126–145
VII Musculoskeletal & Integumentary 146–165
VIII Infectious Diseases & Immunology 166–180
IX Oncology & Hematology 181–195
X NGN Comprehensive Case Studies 196–200
,✅ FULL 200-QUESTION PRACTICE EXAM
SECTION I: CARDIOVASCULAR DISORDERS (Questions 1–35)
Question 1 (NGN – Prioritization)
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 ECG and begin continuous cardiac monitoring
C. Give oxygen at 2 L/min via nasal cannula
D. Prepare the client for immediate cardiac catheterization
Correct 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. Obtaining an
ECG is the priority to rapidly assess for ischemic changes. While oxygen and
nitroglycerin are appropriate interventions, they should follow the ECG assessment to
guide treatment decisions.
Question 2
A patient with heart failure is prescribed furosemide (Lasix). Which electrolyte imbalance
should the nurse monitor most closely?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypermagnesemia
, Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting, leading to
hypokalemia, which increases the risk of digoxin toxicity and arrhythmias.
Question 3
A patient with heart failure with reduced ejection fraction (HFrEF) should be prescribed
which first-line medications?
A. ACE inhibitor and beta-blocker
B. Calcium channel blocker and loop diuretic
C. Digoxin and spironolactone
D. Hydralazine and isosorbide dinitrate
Correct Answer: A
Rationale: ACE inhibitors and beta-blockers are the cornerstone of HFrEF therapy,
improving mortality and morbidity.
Question 4
A patient with acute decompensated heart failure is given IV furosemide. The primary
purpose is to:
A. Increase contractility
B. Reduce preload
C. Decrease afterload
D. Increase heart rate
Correct Answer: B
Rationale: Furosemide reduces preload by promoting diuresis and decreasing blood
volume.
Question 5 (NGN – Recognizing Cues)
A 74-year-old female with a history of heart failure (ejection fraction 30%) is admitted
with worsening shortness of breath, orthopnea (needs 4 pillows to sleep), and 3+ pitting
edema in both legs. She has gained 8 lbs in the past 5 days. Vital signs: HR 112 bpm, BP
with NGN Case Scenarios & Detailed Rationales |
Nightingale College | Updated 2026/2027 Edition |
Instant Digital Download
Core Topics Covered
Section Topic Area Questions
I Cardiovascular Disorders 1–35
II Respiratory Disorders 36–60
III Gastrointestinal Disorders 61–80
IV Renal & Genitourinary Disorders 81–100
V Endocrine Disorders 101–125
VI Neurological Disorders 126–145
VII Musculoskeletal & Integumentary 146–165
VIII Infectious Diseases & Immunology 166–180
IX Oncology & Hematology 181–195
X NGN Comprehensive Case Studies 196–200
,✅ FULL 200-QUESTION PRACTICE EXAM
SECTION I: CARDIOVASCULAR DISORDERS (Questions 1–35)
Question 1 (NGN – Prioritization)
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 ECG and begin continuous cardiac monitoring
C. Give oxygen at 2 L/min via nasal cannula
D. Prepare the client for immediate cardiac catheterization
Correct 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. Obtaining an
ECG is the priority to rapidly assess for ischemic changes. While oxygen and
nitroglycerin are appropriate interventions, they should follow the ECG assessment to
guide treatment decisions.
Question 2
A patient with heart failure is prescribed furosemide (Lasix). Which electrolyte imbalance
should the nurse monitor most closely?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypermagnesemia
, Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting, leading to
hypokalemia, which increases the risk of digoxin toxicity and arrhythmias.
Question 3
A patient with heart failure with reduced ejection fraction (HFrEF) should be prescribed
which first-line medications?
A. ACE inhibitor and beta-blocker
B. Calcium channel blocker and loop diuretic
C. Digoxin and spironolactone
D. Hydralazine and isosorbide dinitrate
Correct Answer: A
Rationale: ACE inhibitors and beta-blockers are the cornerstone of HFrEF therapy,
improving mortality and morbidity.
Question 4
A patient with acute decompensated heart failure is given IV furosemide. The primary
purpose is to:
A. Increase contractility
B. Reduce preload
C. Decrease afterload
D. Increase heart rate
Correct Answer: B
Rationale: Furosemide reduces preload by promoting diuresis and decreasing blood
volume.
Question 5 (NGN – Recognizing Cues)
A 74-year-old female with a history of heart failure (ejection fraction 30%) is admitted
with worsening shortness of breath, orthopnea (needs 4 pillows to sleep), and 3+ pitting
edema in both legs. She has gained 8 lbs in the past 5 days. Vital signs: HR 112 bpm, BP
