Nightingale College
ISEH · 662 NSB
★ ★
N School of Nursing
EST. 2010
CONFIDENCE · COMPETENCE · COMPASSION
BSN 266 HESI V2 — Comprehensive Nursing Review
M E D I C A L-S U R G I C A L N U RS I N G & P H A R M ACO LO G Y | A L R E A DY G RA D E D A +
INSTITUTION Nightingale College COURSE CODE BSN 266
PROGRAM Bachelor of Science in Nursing ACADEMIC YEAR
(BSN)
EXAM TITLE BSN 266 HESI V2 — TOTAL QUESTIONS 48 Questions
Comprehensive Nursing Review
COURSE TITLE Medical-Surgical Nursing & FORMAT Multiple Choice — Select the
Pharmacology Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise instructed.
▸ Nursing interventions, pharmacology, pathophysiology, and prioritization are all testable content.
▸ Select all that apply (SATA) questions require careful evaluation of each option.
▸ Correct answers and detailed rationales appear below each question for NCLEX/HESI review purposes.
▸ All content reflects evidence-based nursing practice and current clinical guidelines.
, SECTION I — MEDICAL-SURGICAL NURSING &
Questions 1 – 48
PHARMACOLOGY
1. While caring for a client with full thickness burns covering 40% of the body, the nurse
observes purulent drainage from the wounds. Before reporting the finding, what is the
best lab value to evaluate?
A. Neutrophil count
B. Serum albumin
C. Hemoglobin
D. Potassium level
CORRECT ANSWER A — Neutrophil count
RATIONALE Purulent drainage from wounds indicates infection. The neutrophil count is the
most important lab value to evaluate before reporting the finding, as neutrophils
are the primary white blood cells that respond to bacterial infection. An elevated
neutrophil count would support the suspicion of infection and guide treatment
decisions.
2. An older woman who experienced a cerebrovascular accident (CVA) has difficulty with
visual perception and she only eats half of the food on her meal tray. Her family expresses
concern about her nutritional status. How should the nurse respond to the family's
concern?
A. Demonstrate the use of visual scanning during meals to the client and family
B. Inform the family that poor appetite is expected after a CVA
C. Request a dietary consult for nutritional supplements
D. Reassure the family that the client will eat when hungry
CORRECT ANSWER A — Demonstrate the use of visual scanning during meals to the client and
family
RATIONALE Visual perception difficulties after CVA can cause clients to only eat food on one
side of the plate. Teaching visual scanning techniques helps the client
systematically scan the entire tray and improves nutritional intake. This directly
addresses the family's concern and empowers them to assist the client.
, 3. Which position is best for a patient in respiratory distress?
A. Supine position
B. High Fowler's position
C. Trendelenburg position
D. Side-lying position
CORRECT ANSWER B — High Fowler's position
RATIONALE High Fowler's position helps to decrease venous return, which decreases fluid
volume in the heart that results in decreased cardiac workload. It also improves
lung expansion and diaphragmatic excursion, making it the best position for
patients in respiratory distress.
4. A patient with peripheral artery disease has marked peripheral neuropathy. An
appropriate nursing diagnosis for the patient is:
A. High risk for injury
B. Impaired skin integrity
C. Acute pain
D. Ineffective tissue perfusion
CORRECT ANSWER A — High risk for injury
RATIONALE Peripheral neuropathy causes decreased sensation in the extremities, putting the
patient at high risk for injury (cuts, burns, pressure ulcers) without being aware of
the injury. This is the most appropriate nursing diagnosis because the decreased
sensation makes the patient vulnerable to unrecognized trauma.
ISEH · 662 NSB
★ ★
N School of Nursing
EST. 2010
CONFIDENCE · COMPETENCE · COMPASSION
BSN 266 HESI V2 — Comprehensive Nursing Review
M E D I C A L-S U R G I C A L N U RS I N G & P H A R M ACO LO G Y | A L R E A DY G RA D E D A +
INSTITUTION Nightingale College COURSE CODE BSN 266
PROGRAM Bachelor of Science in Nursing ACADEMIC YEAR
(BSN)
EXAM TITLE BSN 266 HESI V2 — TOTAL QUESTIONS 48 Questions
Comprehensive Nursing Review
COURSE TITLE Medical-Surgical Nursing & FORMAT Multiple Choice — Select the
Pharmacology Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise instructed.
▸ Nursing interventions, pharmacology, pathophysiology, and prioritization are all testable content.
▸ Select all that apply (SATA) questions require careful evaluation of each option.
▸ Correct answers and detailed rationales appear below each question for NCLEX/HESI review purposes.
▸ All content reflects evidence-based nursing practice and current clinical guidelines.
, SECTION I — MEDICAL-SURGICAL NURSING &
Questions 1 – 48
PHARMACOLOGY
1. While caring for a client with full thickness burns covering 40% of the body, the nurse
observes purulent drainage from the wounds. Before reporting the finding, what is the
best lab value to evaluate?
A. Neutrophil count
B. Serum albumin
C. Hemoglobin
D. Potassium level
CORRECT ANSWER A — Neutrophil count
RATIONALE Purulent drainage from wounds indicates infection. The neutrophil count is the
most important lab value to evaluate before reporting the finding, as neutrophils
are the primary white blood cells that respond to bacterial infection. An elevated
neutrophil count would support the suspicion of infection and guide treatment
decisions.
2. An older woman who experienced a cerebrovascular accident (CVA) has difficulty with
visual perception and she only eats half of the food on her meal tray. Her family expresses
concern about her nutritional status. How should the nurse respond to the family's
concern?
A. Demonstrate the use of visual scanning during meals to the client and family
B. Inform the family that poor appetite is expected after a CVA
C. Request a dietary consult for nutritional supplements
D. Reassure the family that the client will eat when hungry
CORRECT ANSWER A — Demonstrate the use of visual scanning during meals to the client and
family
RATIONALE Visual perception difficulties after CVA can cause clients to only eat food on one
side of the plate. Teaching visual scanning techniques helps the client
systematically scan the entire tray and improves nutritional intake. This directly
addresses the family's concern and empowers them to assist the client.
, 3. Which position is best for a patient in respiratory distress?
A. Supine position
B. High Fowler's position
C. Trendelenburg position
D. Side-lying position
CORRECT ANSWER B — High Fowler's position
RATIONALE High Fowler's position helps to decrease venous return, which decreases fluid
volume in the heart that results in decreased cardiac workload. It also improves
lung expansion and diaphragmatic excursion, making it the best position for
patients in respiratory distress.
4. A patient with peripheral artery disease has marked peripheral neuropathy. An
appropriate nursing diagnosis for the patient is:
A. High risk for injury
B. Impaired skin integrity
C. Acute pain
D. Ineffective tissue perfusion
CORRECT ANSWER A — High risk for injury
RATIONALE Peripheral neuropathy causes decreased sensation in the extremities, putting the
patient at high risk for injury (cuts, burns, pressure ulcers) without being aware of
the injury. This is the most appropriate nursing diagnosis because the decreased
sensation makes the patient vulnerable to unrecognized trauma.
