, BSN HESI 266 Med-Surg Exam V3:
High-Yield Questions, Answers, &
Rationales 2026/2027 Update
Question 1: Respiratory & Thoracic Surgery
A client is 4 hours postoperative following a left
pneumonectomy. When positioning the client in bed, which
action should the nurse prioritize?
• A. Position the client on the operative (left) side or flat on
the back.
• B. Position the client strictly on the uninfected (right) side
or back to prevent mediastinal shift.
• C. Keep the head of the bed completely flat at all times to
maximize venous return.
• D. Assist the client into a high Fowler's position with
bilateral knee gatch elevated.
Correct Answer: A. Position the client on the operative (left)
side or flat on the back.
Explanation: Following a pneumonectomy, positioning the
client on the operative side or flat on their back allows the
remaining unoperated lung maximum expansion space and
prevents fluid accumulation or mediastinal shift from
compressing healthy lung tissue.
Question 2: Oncology & Chemotherapy Extravasation
A client receiving a vesicant chemotherapy infusion through a
peripheral IV line in the forearm reports sudden burning and
,stinging at the insertion site. The nurse observes swelling and no
blood return. What is the nurse's first priority action?
• A. Stop the infusion immediately and disconnect the IV
tubing.
• B. Attempt to flush the IV catheter with normal saline to
clear the line.
• C. Apply a warm compress directly to the site for 30
minutes.
• D. Elevate the affected arm above the level of the heart.
Correct Answer: A. Stop the infusion immediately and
disconnect the IV tubing.
Explanation: The client is experiencing an extravasation of a
vesicant agent. The immediate priority is to stop the drug
infusion and disconnect the tubing. Depending on the drug
protocol, the nurse may then attempt to aspirate residual drug
before removing the catheter and applying thermal compresses.
Question 3: Cardiovascular & Acute Coronary Syndrome
A client is admitted to the emergency department with
substernal chest pain radiating to the left arm and jaw. A 12-lead
electrocardiogram (ECG) reveals ST-segment elevation in leads
I, aVL, and V4 through V6. The nurse recognizes that this
finding indicates ischemia in which area of the heart?
• A. Anterior-lateral wall of the left ventricle.
• B. Inferior wall of the left ventricle.
• C. Right ventricular wall.
• D. Posterior wall of the left ventricle.
, Correct Answer: A. Anterior-lateral wall of the left
ventricle.
Explanation: Leads I, aVL, and V4 through V6 view the
anterior-lateral surface of the left ventricle, which is supplied
primarily by the left anterior descending (LAD) and left
circumflex arteries.
Question 4: Gastrointestinal & Small Bowel Obstruction
The nurse is caring for a client with a nasogastric (NG) tube
connected to low intermittent suction for a mechanical small
bowel obstruction. Which finding should the nurse report to the
healthcare provider immediately?
• A. Light green, watery drainage totaling 150 mL over 4
hours.
• B. The client reports mild dry mouth and thirst.
• C. The NG tube stops draining entirely and the client
develops sudden, severe abdominal distension and pain.
• D. Serosanguineous drainage noted around the tape on the
nares.
Correct Answer: C. The NG tube stops draining entirely and
the client develops sudden, severe abdominal distension and
pain.
Explanation: A sudden cessation of NG tube output
accompanied by worsening abdominal pain and rigidity
indicates that the tube may be obstructed or displaced, or that the
bowel obstruction is worsening, requiring urgent medical
evaluation.
High-Yield Questions, Answers, &
Rationales 2026/2027 Update
Question 1: Respiratory & Thoracic Surgery
A client is 4 hours postoperative following a left
pneumonectomy. When positioning the client in bed, which
action should the nurse prioritize?
• A. Position the client on the operative (left) side or flat on
the back.
• B. Position the client strictly on the uninfected (right) side
or back to prevent mediastinal shift.
• C. Keep the head of the bed completely flat at all times to
maximize venous return.
• D. Assist the client into a high Fowler's position with
bilateral knee gatch elevated.
Correct Answer: A. Position the client on the operative (left)
side or flat on the back.
Explanation: Following a pneumonectomy, positioning the
client on the operative side or flat on their back allows the
remaining unoperated lung maximum expansion space and
prevents fluid accumulation or mediastinal shift from
compressing healthy lung tissue.
Question 2: Oncology & Chemotherapy Extravasation
A client receiving a vesicant chemotherapy infusion through a
peripheral IV line in the forearm reports sudden burning and
,stinging at the insertion site. The nurse observes swelling and no
blood return. What is the nurse's first priority action?
• A. Stop the infusion immediately and disconnect the IV
tubing.
• B. Attempt to flush the IV catheter with normal saline to
clear the line.
• C. Apply a warm compress directly to the site for 30
minutes.
• D. Elevate the affected arm above the level of the heart.
Correct Answer: A. Stop the infusion immediately and
disconnect the IV tubing.
Explanation: The client is experiencing an extravasation of a
vesicant agent. The immediate priority is to stop the drug
infusion and disconnect the tubing. Depending on the drug
protocol, the nurse may then attempt to aspirate residual drug
before removing the catheter and applying thermal compresses.
Question 3: Cardiovascular & Acute Coronary Syndrome
A client is admitted to the emergency department with
substernal chest pain radiating to the left arm and jaw. A 12-lead
electrocardiogram (ECG) reveals ST-segment elevation in leads
I, aVL, and V4 through V6. The nurse recognizes that this
finding indicates ischemia in which area of the heart?
• A. Anterior-lateral wall of the left ventricle.
• B. Inferior wall of the left ventricle.
• C. Right ventricular wall.
• D. Posterior wall of the left ventricle.
, Correct Answer: A. Anterior-lateral wall of the left
ventricle.
Explanation: Leads I, aVL, and V4 through V6 view the
anterior-lateral surface of the left ventricle, which is supplied
primarily by the left anterior descending (LAD) and left
circumflex arteries.
Question 4: Gastrointestinal & Small Bowel Obstruction
The nurse is caring for a client with a nasogastric (NG) tube
connected to low intermittent suction for a mechanical small
bowel obstruction. Which finding should the nurse report to the
healthcare provider immediately?
• A. Light green, watery drainage totaling 150 mL over 4
hours.
• B. The client reports mild dry mouth and thirst.
• C. The NG tube stops draining entirely and the client
develops sudden, severe abdominal distension and pain.
• D. Serosanguineous drainage noted around the tape on the
nares.
Correct Answer: C. The NG tube stops draining entirely and
the client develops sudden, severe abdominal distension and
pain.
Explanation: A sudden cessation of NG tube output
accompanied by worsening abdominal pain and rigidity
indicates that the tube may be obstructed or displaced, or that the
bowel obstruction is worsening, requiring urgent medical
evaluation.
