,BSN 266 HESI Med Surg Study Guide (2026) – 400+ NGN
Practice Questions & Answers with Detailed Rationales
| Nightingale College | Instant PDF Download
TABLE OF CONTENTS
Unit Topic Questions
1 Cardiovascular System 1-70
2 Respiratory System 71-130
3 Gastrointestinal System 131-190
4 Endocrine & Metabolic Disorders 191-240
5 Renal & Urinary System 241-280
6 Neurological System 281-330
7 Hematologic & Immune System 331-370
8 Musculoskeletal System 371-400
9 Oncology & Infectious Diseases 401-430
10 NGN Case Scenarios 431-450
,UNIT 1: CARDIOVASCULAR SYSTEM (Questions 1-70)
Heart Failure & Fluid Management
Question 1
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 2
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 3
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 4
A patient taking digoxin has a potassium level of 3.0 mEq/L.
Which ECG change should the nurse anticipate?
A. Tall, peaked T waves
B. Flat T waves and U waves
C. Prolonged PR interval
D. Widened QRS complex
Correct Answer: B
Rationale: Hypokalemia (potassium <3.5 mEq/L) potentiates
Practice Questions & Answers with Detailed Rationales
| Nightingale College | Instant PDF Download
TABLE OF CONTENTS
Unit Topic Questions
1 Cardiovascular System 1-70
2 Respiratory System 71-130
3 Gastrointestinal System 131-190
4 Endocrine & Metabolic Disorders 191-240
5 Renal & Urinary System 241-280
6 Neurological System 281-330
7 Hematologic & Immune System 331-370
8 Musculoskeletal System 371-400
9 Oncology & Infectious Diseases 401-430
10 NGN Case Scenarios 431-450
,UNIT 1: CARDIOVASCULAR SYSTEM (Questions 1-70)
Heart Failure & Fluid Management
Question 1
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 2
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 3
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 4
A patient taking digoxin has a potassium level of 3.0 mEq/L.
Which ECG change should the nurse anticipate?
A. Tall, peaked T waves
B. Flat T waves and U waves
C. Prolonged PR interval
D. Widened QRS complex
Correct Answer: B
Rationale: Hypokalemia (potassium <3.5 mEq/L) potentiates
