BSN 266 – HESI Medical-Surgical Nursing Practice Exam verified
with correct answers 2026/2027 instant pdf
1. A nurse is caring for a client with heart failure. Which assessment finding
requires immediate intervention?
A. Weight gain of 1 lb (0.45 kg) overnight
B. Bilateral ankle edema
C. Crackles throughout both lung fields and oxygen saturation of 86%
D. Fatigue after walking
Correct Answer: C
Rationale: Pulmonary edema with hypoxemia is life-threatening and requires immediate
treatment.
2. A client with COPD is receiving oxygen therapy. Which oxygen saturation is
the most appropriate goal?
A. 100%
B. 98–100%
C. 88–92%
D. Above 95%
Correct Answer: C
Rationale: COPD patients often require lower oxygen targets to reduce the risk of suppressing
respiratory drive.
3. Which laboratory value is most concerning in a client receiving furosemide?
A. Sodium 138 mEq/L
B. Potassium 2.9 mEq/L
C. Calcium 9.2 mg/dL
D. Glucose 100 mg/dL
Correct Answer: B
Rationale: Hypokalemia increases the risk of dysrhythmias.
,4. Which action should the nurse perform first when a client reports sudden
chest pain?
A. Notify the healthcare provider.
B. Administer morphine.
C. Assess pain characteristics and obtain vital signs.
D. Prepare the client for surgery.
Correct Answer: C
Rationale: Assessment always precedes intervention unless immediate life-saving action is
required.
5. A client with diabetes becomes confused and diaphoretic. What is the priority
action?
A. Administer insulin.
B. Check blood glucose.
C. Encourage exercise.
D. Restrict fluids.
Correct Answer: B
Rationale: Symptoms suggest hypoglycemia; blood glucose should be checked immediately.
6. Which electrolyte imbalance is expected with prolonged vomiting?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Correct Answer: B
Rationale: Vomiting causes potassium loss.
7. A client with bacterial meningitis should be placed under which isolation
precaution?
, A. Contact
B. Airborne
C. Droplet
D. Reverse isolation
Correct Answer: C
Rationale: Meningitis spreads through respiratory droplets.
8. Which finding indicates worsening renal failure?
A. Urine output 900 mL/day
B. Creatinine 5.8 mg/dL
C. Blood pressure 128/80 mmHg
D. Potassium 4.1 mEq/L
Correct Answer: B
Rationale: Elevated creatinine indicates declining kidney function.
9. A nurse should question which prescription for a client with potassium of 5.9
mEq/L?
A. Cardiac monitoring
B. Potassium chloride 20 mEq PO
C. IV insulin with dextrose
D. Sodium polystyrene sulfonate
Correct Answer: B
Rationale: Potassium supplements worsen hyperkalemia.
10. Which client should the nurse assess first?
A. Fever of 100.4°F (38°C) after surgery
B. Chest tube drainage of 50 mL/hr
C. New onset confusion after hip surgery
D. Pain rated 6/10
Correct Answer: C
with correct answers 2026/2027 instant pdf
1. A nurse is caring for a client with heart failure. Which assessment finding
requires immediate intervention?
A. Weight gain of 1 lb (0.45 kg) overnight
B. Bilateral ankle edema
C. Crackles throughout both lung fields and oxygen saturation of 86%
D. Fatigue after walking
Correct Answer: C
Rationale: Pulmonary edema with hypoxemia is life-threatening and requires immediate
treatment.
2. A client with COPD is receiving oxygen therapy. Which oxygen saturation is
the most appropriate goal?
A. 100%
B. 98–100%
C. 88–92%
D. Above 95%
Correct Answer: C
Rationale: COPD patients often require lower oxygen targets to reduce the risk of suppressing
respiratory drive.
3. Which laboratory value is most concerning in a client receiving furosemide?
A. Sodium 138 mEq/L
B. Potassium 2.9 mEq/L
C. Calcium 9.2 mg/dL
D. Glucose 100 mg/dL
Correct Answer: B
Rationale: Hypokalemia increases the risk of dysrhythmias.
,4. Which action should the nurse perform first when a client reports sudden
chest pain?
A. Notify the healthcare provider.
B. Administer morphine.
C. Assess pain characteristics and obtain vital signs.
D. Prepare the client for surgery.
Correct Answer: C
Rationale: Assessment always precedes intervention unless immediate life-saving action is
required.
5. A client with diabetes becomes confused and diaphoretic. What is the priority
action?
A. Administer insulin.
B. Check blood glucose.
C. Encourage exercise.
D. Restrict fluids.
Correct Answer: B
Rationale: Symptoms suggest hypoglycemia; blood glucose should be checked immediately.
6. Which electrolyte imbalance is expected with prolonged vomiting?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Correct Answer: B
Rationale: Vomiting causes potassium loss.
7. A client with bacterial meningitis should be placed under which isolation
precaution?
, A. Contact
B. Airborne
C. Droplet
D. Reverse isolation
Correct Answer: C
Rationale: Meningitis spreads through respiratory droplets.
8. Which finding indicates worsening renal failure?
A. Urine output 900 mL/day
B. Creatinine 5.8 mg/dL
C. Blood pressure 128/80 mmHg
D. Potassium 4.1 mEq/L
Correct Answer: B
Rationale: Elevated creatinine indicates declining kidney function.
9. A nurse should question which prescription for a client with potassium of 5.9
mEq/L?
A. Cardiac monitoring
B. Potassium chloride 20 mEq PO
C. IV insulin with dextrose
D. Sodium polystyrene sulfonate
Correct Answer: B
Rationale: Potassium supplements worsen hyperkalemia.
10. Which client should the nurse assess first?
A. Fever of 100.4°F (38°C) after surgery
B. Chest tube drainage of 50 mL/hr
C. New onset confusion after hip surgery
D. Pain rated 6/10
Correct Answer: C
