BSN HESI 266 Med Surg Exam V1 Questions and Answers and Explanations | Latest For
Nightingale
Question 1
A patient with Type 2 Diabetes is prescribed Metformin. Which education point is most
important for the nurse to emphasize?
A. Take the medication only when blood glucose is above 200 mg/dL.
B. Stop taking the medication 48 hours before any procedure involving IV contrast dye.
C. This medication works by stimulating the pancreas to release more insulin.
D. Monitor for weight gain as a common side effect of this drug.
Answer: B
Explanation: Metformin must be held 48 hours before and after procedures using IV contrast to
prevent lactic acidosis and acute renal failure.
Question 2
A nurse is assessing a patient with suspected left-sided heart failure. Which clinical
manifestation should the nurse expect?
A. Peripheral edema in the lower extremities.
B. Jugular venous distension (JVD).
C. Abdominal girth increase and hepatomegaly.
D. Crackles heard upon auscultation of the lungs.
Answer: D
Explanation: Left-sided heart failure results in pulmonary congestion, leading to symptoms like
crackles, dyspnea, and orthopnea.
Question 3
A patient with COPD is receiving oxygen therapy. What is the primary reason the nurse
maintains a low oxygen flow rate (1-2 L/min)?
A. Patients with COPD rely on a hypoxic drive to breathe.
B. High levels of oxygen can cause rupture of pulmonary blebs.
C. To prevent oxygen toxicity to the lung tissues.
D. High flow rates cause excessive drying of the nasal mucosa.
,BSN HESI 266 Med Surg Exam V1 Questions and Answers and Explanations | Latest For
Nightingale
Answer: A
Explanation: In chronic CO2 retainers, high oxygen levels can suppress the hypoxic drive, which
is their primary stimulus for respiration.
Question 4
An arterial blood gas (ABG) result shows: pH 7.48, PaCO2 30 mmHg, and HCO3− 24 mEq/L. How
should the nurse interpret these findings?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Metabolic Acidosis
Answer: B
Explanation: A pH > 7.45 indicates alkalosis, and a PaCO2 < 35 mmHg indicates a respiratory
cause. The normal HCO3− suggests it is uncompensated.
Question 5
Which food choice indicates that a patient with Celiac disease understands their dietary
restrictions?
A. Whole wheat toast with butter.
B. Spaghetti with meat sauce.
C. Grilled chicken with steamed white rice.
D. Cream of mushroom soup with barley.
Answer: C
Explanation: Celiac disease requires a gluten-free diet. Rice and chicken are gluten-free,
whereas wheat, barley, and rye contain gluten.
Question 6
A nurse enters the room of a patient who is having a tonic-clonic seizure. What is the nurse's
priority action?
A. Turn the patient to a side-lying position.
,BSN HESI 266 Med Surg Exam V1 Questions and Answers and Explanations | Latest For
Nightingale
B. Restrain the patient's limbs to prevent injury.
C. Insert a tongue blade into the patient's mouth.
D. Administer oral diazepam immediately.
Answer: A
Explanation: The priority is maintaining a patent airway and preventing aspiration by turning
the patient to the side. Never insert anything into the mouth.
Question 7
A patient is being treated for Deep Vein Thrombosis (DVT) with a Heparin infusion. Which
laboratory value should the nurse monitor?
A. Prothrombin Time (PT)
B. International Normalized Ratio (INR)
C. Activated Partial Thromboplastin Time (aPTT)
D. Platelet count only
Answer: C
Explanation: aPTT is used to monitor the effectiveness of Heparin therapy, whereas PT/INR is
used for Warfarin.
Question 8
What is the first sign of hypovolemic shock that a nurse should monitor for in a post-operative
patient?
A. Decreased urine output
B. Hypotension
C. Tachycardia
D. Bradypnea
Answer: C
Explanation: Tachycardia is an early compensatory mechanism for decreased blood volume as
the heart tries to maintain cardiac output.
Question 9
, BSN HESI 266 Med Surg Exam V1 Questions and Answers and Explanations | Latest For
Nightingale
A client presents to the emergency department reporting chest pain radiating to the left arm,
shortness of breath, and diaphoresis. Which pain medication should the nurse anticipate
being prescribed first for suspected acute myocardial infarction?
A. Fentanyl
B. Hydromorphone
C. Oxycodone
D. Morphine sulfate
Answer: D
Explanation: Morphine sulfate is the drug of choice for cardiac chest pain unrelieved by
nitroglycerin because it decreases cardiac workload, reduces myocardial oxygen demand, and
relieves anxiety.
Question 10
An adult client who was recently diagnosed with primary open-angle glaucoma tells the
nurse, "It feels like I am driving through a tunnel." Which nursing instruction is most
important for the nurse to provide?
A. Maintain the prescribed eye drop regimen consistently
B. Eat a diet high in carotene and lutein
C. Wear prescription glasses at all times
D. Avoid frequent intraocular pressure measurements
Answer: A
Explanation: Adherence to daily prescribed ocular hypotensive eye drops is essential in
glaucoma to lower intraocular pressure and prevent irreversible damage to the optic nerve and
further loss of peripheral vision.
Question 11
Which information should the nurse include in the discharge teaching plan for a client
diagnosed with gastroesophageal reflux disease (GERD)?
A. Adjust food intake to three large meals per day with no snacks
B. Sleep without pillows at night to maintain flat spinal alignment
Nightingale
Question 1
A patient with Type 2 Diabetes is prescribed Metformin. Which education point is most
important for the nurse to emphasize?
A. Take the medication only when blood glucose is above 200 mg/dL.
B. Stop taking the medication 48 hours before any procedure involving IV contrast dye.
C. This medication works by stimulating the pancreas to release more insulin.
D. Monitor for weight gain as a common side effect of this drug.
Answer: B
Explanation: Metformin must be held 48 hours before and after procedures using IV contrast to
prevent lactic acidosis and acute renal failure.
Question 2
A nurse is assessing a patient with suspected left-sided heart failure. Which clinical
manifestation should the nurse expect?
A. Peripheral edema in the lower extremities.
B. Jugular venous distension (JVD).
C. Abdominal girth increase and hepatomegaly.
D. Crackles heard upon auscultation of the lungs.
Answer: D
Explanation: Left-sided heart failure results in pulmonary congestion, leading to symptoms like
crackles, dyspnea, and orthopnea.
Question 3
A patient with COPD is receiving oxygen therapy. What is the primary reason the nurse
maintains a low oxygen flow rate (1-2 L/min)?
A. Patients with COPD rely on a hypoxic drive to breathe.
B. High levels of oxygen can cause rupture of pulmonary blebs.
C. To prevent oxygen toxicity to the lung tissues.
D. High flow rates cause excessive drying of the nasal mucosa.
,BSN HESI 266 Med Surg Exam V1 Questions and Answers and Explanations | Latest For
Nightingale
Answer: A
Explanation: In chronic CO2 retainers, high oxygen levels can suppress the hypoxic drive, which
is their primary stimulus for respiration.
Question 4
An arterial blood gas (ABG) result shows: pH 7.48, PaCO2 30 mmHg, and HCO3− 24 mEq/L. How
should the nurse interpret these findings?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Metabolic Acidosis
Answer: B
Explanation: A pH > 7.45 indicates alkalosis, and a PaCO2 < 35 mmHg indicates a respiratory
cause. The normal HCO3− suggests it is uncompensated.
Question 5
Which food choice indicates that a patient with Celiac disease understands their dietary
restrictions?
A. Whole wheat toast with butter.
B. Spaghetti with meat sauce.
C. Grilled chicken with steamed white rice.
D. Cream of mushroom soup with barley.
Answer: C
Explanation: Celiac disease requires a gluten-free diet. Rice and chicken are gluten-free,
whereas wheat, barley, and rye contain gluten.
Question 6
A nurse enters the room of a patient who is having a tonic-clonic seizure. What is the nurse's
priority action?
A. Turn the patient to a side-lying position.
,BSN HESI 266 Med Surg Exam V1 Questions and Answers and Explanations | Latest For
Nightingale
B. Restrain the patient's limbs to prevent injury.
C. Insert a tongue blade into the patient's mouth.
D. Administer oral diazepam immediately.
Answer: A
Explanation: The priority is maintaining a patent airway and preventing aspiration by turning
the patient to the side. Never insert anything into the mouth.
Question 7
A patient is being treated for Deep Vein Thrombosis (DVT) with a Heparin infusion. Which
laboratory value should the nurse monitor?
A. Prothrombin Time (PT)
B. International Normalized Ratio (INR)
C. Activated Partial Thromboplastin Time (aPTT)
D. Platelet count only
Answer: C
Explanation: aPTT is used to monitor the effectiveness of Heparin therapy, whereas PT/INR is
used for Warfarin.
Question 8
What is the first sign of hypovolemic shock that a nurse should monitor for in a post-operative
patient?
A. Decreased urine output
B. Hypotension
C. Tachycardia
D. Bradypnea
Answer: C
Explanation: Tachycardia is an early compensatory mechanism for decreased blood volume as
the heart tries to maintain cardiac output.
Question 9
, BSN HESI 266 Med Surg Exam V1 Questions and Answers and Explanations | Latest For
Nightingale
A client presents to the emergency department reporting chest pain radiating to the left arm,
shortness of breath, and diaphoresis. Which pain medication should the nurse anticipate
being prescribed first for suspected acute myocardial infarction?
A. Fentanyl
B. Hydromorphone
C. Oxycodone
D. Morphine sulfate
Answer: D
Explanation: Morphine sulfate is the drug of choice for cardiac chest pain unrelieved by
nitroglycerin because it decreases cardiac workload, reduces myocardial oxygen demand, and
relieves anxiety.
Question 10
An adult client who was recently diagnosed with primary open-angle glaucoma tells the
nurse, "It feels like I am driving through a tunnel." Which nursing instruction is most
important for the nurse to provide?
A. Maintain the prescribed eye drop regimen consistently
B. Eat a diet high in carotene and lutein
C. Wear prescription glasses at all times
D. Avoid frequent intraocular pressure measurements
Answer: A
Explanation: Adherence to daily prescribed ocular hypotensive eye drops is essential in
glaucoma to lower intraocular pressure and prevent irreversible damage to the optic nerve and
further loss of peripheral vision.
Question 11
Which information should the nurse include in the discharge teaching plan for a client
diagnosed with gastroesophageal reflux disease (GERD)?
A. Adjust food intake to three large meals per day with no snacks
B. Sleep without pillows at night to maintain flat spinal alignment
