, BSN HESI 266 Med-Surg Exam V1:
High-Yield Questions, Answers, &
Rationales 2026/2027 Update
Question 1: Respiratory & Oncology
The nurse explains to a client with lung cancer that a pleurodesis
is performed to achieve which expected outcome?
• A. Reduce the overall size of the malignant tumor mass.
• B. Prevent the formation of pleural effusion fluid.
• C. Clear obstruction from the primary mainstem bronchus.
• D. Enhance the diffusion capacity of alveolar gases.
Correct Answer: B. Prevent the formation of pleural
effusion fluid.
Explanation: Pleurodesis involves instilling a sclerosing agent
(such as talc or bleomycin) into the pleural space. This chemical
irritation causes the visceral and parietal pleura to adhere to one
another, obliterating the space and effectively preventing the
recurrent accumulation of malignant pleural effusion fluid.
Question 2: Oncology & Late Complications
The nurse obtains a client's health history that includes a right
mastectomy and radiation therapy for breast cancer 10 years
ago. Which current health problem should the nurse consider as
a delayed consequence of the past radiation therapy?
• A. Chronic lymphedema of the left lower extremity.
• B. Pathologic fracture of two ribs on the right chest.
, • C. Bilateral sensorineural hearing loss.
• D. Degenerative osteoarthritis of the lumbar spine.
Correct Answer: B. Pathologic fracture of two ribs on the
right chest.
Explanation: Therapeutic radiation causes localized tissue
changes, including microvascular sclerosis and reduction in
bone density over time. Radiation directed at the right chest wall
decades prior puts the client at risk for bone fragility and
pathologic rib fractures.
Question 3: Cardiovascular & Patient Education
Three weeks after discharge for an acute myocardial infarction
(MI), a client returns for a follow-up visit. When discussing
sleep and lifestyle patterns, the client mentions sleeping fine, but
notes that his wife moved into the spare bedroom because, "I
guess we will never have sex again after this." Which response
is best for the nurse to provide?
• A. "You should completely abstain from sexual activity for
at least six months to let your heart fully heal."
• B. "Sexual activity is similar in cardiac workload and
energy expenditure to climbing two flights of stairs and
may be resumed like other activities."
• C. "If you can walk on a flat treadmill for 30 minutes
without chest pain, you are safe to have intercourse."
• D. "Most couples find alternative ways of showing
affection since sexual intercourse is permanently restricted
post-MI."
, Correct Answer: B. Sexual activity is similar in cardiac
workload and energy expenditure to climbing two flights of
stairs and may be resumed like other activities.
Explanation: A common metric used in cardiac rehabilitation is
that sexual intercourse roughly equates to the physical exertion
of climbing two flights of stairs briskly (about 3 to 5 METs). If a
patient can perform this level of activity without symptoms like
dyspnea, chest pain, or severe fatigue, they can safely resume
sexual activity under healthcare provider guidance.
Question 4: Gastrointestinal & Clinical Procedures
The nurse is caring for a client scheduled to undergo the
insertion of a percutaneous endoscopic gastrostomy (PEG) tube.
The client asks the nurse how a PEG tube differs from a
traditional surgical gastrostomy tube (GT). Which explanation
best describes their primary difference?
• A. The type of liquid feeding formula infused through
them.
• B. The permanent versus temporary nature of the device.
• C. The method of insertion.
• D. The risk profile for developing local wound infections.
Correct Answer: C. The method of insertion.
Explanation: Both a PEG and a standard surgical GT enter the
stomach for enteral nutrition. However, a PEG tube is placed
percutaneously with the assistance of an endoscope (usually
under local anesthesia/sedation) without requiring an open
surgical laparotomy incision, whereas a traditional GT is placed
surgically via an open or laparoscopic abdominal approach.
High-Yield Questions, Answers, &
Rationales 2026/2027 Update
Question 1: Respiratory & Oncology
The nurse explains to a client with lung cancer that a pleurodesis
is performed to achieve which expected outcome?
• A. Reduce the overall size of the malignant tumor mass.
• B. Prevent the formation of pleural effusion fluid.
• C. Clear obstruction from the primary mainstem bronchus.
• D. Enhance the diffusion capacity of alveolar gases.
Correct Answer: B. Prevent the formation of pleural
effusion fluid.
Explanation: Pleurodesis involves instilling a sclerosing agent
(such as talc or bleomycin) into the pleural space. This chemical
irritation causes the visceral and parietal pleura to adhere to one
another, obliterating the space and effectively preventing the
recurrent accumulation of malignant pleural effusion fluid.
Question 2: Oncology & Late Complications
The nurse obtains a client's health history that includes a right
mastectomy and radiation therapy for breast cancer 10 years
ago. Which current health problem should the nurse consider as
a delayed consequence of the past radiation therapy?
• A. Chronic lymphedema of the left lower extremity.
• B. Pathologic fracture of two ribs on the right chest.
, • C. Bilateral sensorineural hearing loss.
• D. Degenerative osteoarthritis of the lumbar spine.
Correct Answer: B. Pathologic fracture of two ribs on the
right chest.
Explanation: Therapeutic radiation causes localized tissue
changes, including microvascular sclerosis and reduction in
bone density over time. Radiation directed at the right chest wall
decades prior puts the client at risk for bone fragility and
pathologic rib fractures.
Question 3: Cardiovascular & Patient Education
Three weeks after discharge for an acute myocardial infarction
(MI), a client returns for a follow-up visit. When discussing
sleep and lifestyle patterns, the client mentions sleeping fine, but
notes that his wife moved into the spare bedroom because, "I
guess we will never have sex again after this." Which response
is best for the nurse to provide?
• A. "You should completely abstain from sexual activity for
at least six months to let your heart fully heal."
• B. "Sexual activity is similar in cardiac workload and
energy expenditure to climbing two flights of stairs and
may be resumed like other activities."
• C. "If you can walk on a flat treadmill for 30 minutes
without chest pain, you are safe to have intercourse."
• D. "Most couples find alternative ways of showing
affection since sexual intercourse is permanently restricted
post-MI."
, Correct Answer: B. Sexual activity is similar in cardiac
workload and energy expenditure to climbing two flights of
stairs and may be resumed like other activities.
Explanation: A common metric used in cardiac rehabilitation is
that sexual intercourse roughly equates to the physical exertion
of climbing two flights of stairs briskly (about 3 to 5 METs). If a
patient can perform this level of activity without symptoms like
dyspnea, chest pain, or severe fatigue, they can safely resume
sexual activity under healthcare provider guidance.
Question 4: Gastrointestinal & Clinical Procedures
The nurse is caring for a client scheduled to undergo the
insertion of a percutaneous endoscopic gastrostomy (PEG) tube.
The client asks the nurse how a PEG tube differs from a
traditional surgical gastrostomy tube (GT). Which explanation
best describes their primary difference?
• A. The type of liquid feeding formula infused through
them.
• B. The permanent versus temporary nature of the device.
• C. The method of insertion.
• D. The risk profile for developing local wound infections.
Correct Answer: C. The method of insertion.
Explanation: Both a PEG and a standard surgical GT enter the
stomach for enteral nutrition. However, a PEG tube is placed
percutaneously with the assistance of an endoscope (usually
under local anesthesia/sedation) without requiring an open
surgical laparotomy incision, whereas a traditional GT is placed
surgically via an open or laparoscopic abdominal approach.
