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BSN 266 HESI MED-SURG EXAM - ACTUAL EXAM
2026/2027 | EXPERT VERIFIED | NGN-STYLE | MULTIPLE-
CHOICE | 100 VERIFIED Q&A | COMPLETE RATIONALES |
PASS GUARANTEED - A+ GRADED
EXAM OVERVIEW
This BSN 266 HESI Med-Surg Exam is a course-specific comprehensive assessment for BSN-level medical-
surgical nursing students. It includes high-difficulty clinical judgment questions, pharmacology prioritization,
and comprehensive coverage across all Med-Surg II systems with detailed rationales.
QUESTION 1
A client with heart failure is prescribed digoxin. Which finding indicates the client is experiencing digoxin
toxicity?
A) Serum potassium of 3.8 mEq/L
B) Heart rate of 68 bpm
C) Nausea, vomiting, and visual disturbances
D) Blood pressure of 138/86 mmHg
Correct Answer: C
Rationale: Signs of digoxin toxicity include nausea, vomiting, visual disturbances (yellow-green halos), and
bradycardia. A heart rate of 68 bpm (B) is normal. Potassium of 3.8 (A) is normal. Blood pressure of 138/86
(D) is acceptable.
QUESTION 2
A client with COPD is receiving oxygen at 2 L/min via nasal cannula. Which assessment finding indicates the
client is developing carbon dioxide retention?
A) Respiratory rate of 22 breaths/min
B) SpO2 of 92%
C) Confusion and headache
D) Heart rate of 88 bpm
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Correct Answer: C
Rationale: Carbon dioxide retention in COPD clients can cause confusion, headache, and drowsiness.
Confusion and headache indicate CO2 retention and require intervention.
QUESTION 3
A client with acute pancreatitis is receiving IV fluids. Which finding indicates the client is developing a
complication?
A) Blood glucose of 150 mg/dL
B) Serum calcium of 8.5 mg/dL
C) Abdominal pain radiating to the back
D) Cullen's sign
Correct Answer: D
Rationale: Cullen's sign (ecchymosis around the umbilicus) indicates retroperitoneal bleeding, a severe
complication of acute pancreatitis.
QUESTION 4
A client with cirrhosis is experiencing ascites. Which dietary modification is most appropriate?
A) High-protein diet
B) Low-sodium diet
C) High-carbohydrate diet
D) Low-fat diet
Correct Answer: B
Rationale: Ascites is managed with sodium restriction (typically <2 g/day) to reduce fluid retention.
QUESTION 5
A client with hypothyroidism is prescribed levothyroxine. Which statement indicates the client understands
the medication?
A) "I should take this medication with food."
B) "I should take this medication on an empty stomach, 30-60 minutes before breakfast."
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C) "I should stop taking this medication if I feel better."
D) "I can take this medication with calcium supplements."
Correct Answer: B
Rationale: Levothyroxine should be taken on an empty stomach, 30-60 minutes before breakfast, to optimize
absorption.
QUESTION 6
A client with hyperthyroidism is prescribed methimazole. Which side effect should the nurse monitor for?
A) Agranulocytosis
B) Liver toxicity
C) Rash
D) All of the above
Correct Answer: D
Rationale: Methimazole can cause agranulocytosis, liver toxicity, and rash. Clients should be monitored for
fever, sore throat (signs of agranulocytosis), jaundice, and rash.
QUESTION 7
A client with a fractured tibia is in skeletal traction. Which nursing action is most appropriate?
A) Check the traction weights daily
B) Ensure the weights are off the floor
C) Remove the traction pins for cleaning
D) Encourage the client to bear weight on the affected leg
Correct Answer: B
Rationale: The weights must hang freely off the floor to provide constant traction force.
QUESTION 8
A client with a total knee replacement is 1 day postoperative. Which nursing action is most appropriate?
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A) Maintain the knee in flexion
B) Perform continuous passive motion (CPM)
C) Avoid ambulation
D) Apply heat to the knee
Correct Answer: B
Rationale: Continuous passive motion (CPM) is often used after total knee replacement to promote range of
motion and prevent stiffness.
QUESTION 9
A client with a cast on the forearm develops pallor, coolness, and tingling in the fingers. Which condition is
the priority concern?
A) Compartment syndrome
B) Skin breakdown
C) Infection
D) Muscle atrophy
Correct Answer: A
Rationale: Pallor, coolness, tingling, and pain are signs of compartment syndrome, a medical emergency
requiring immediate intervention.
QUESTION 10
A client is receiving a blood transfusion and develops a fever, chills, and hypotension. Which action should
the nurse take first?
A) Slow the transfusion rate
B) Stop the transfusion
C) Administer antihistamines
D) Notify the healthcare provider
Correct Answer: B
Rationale: These symptoms indicate a possible transfusion reaction. The first action is to stop the transfusion
immediately.
BSN 266 HESI MED-SURG EXAM - ACTUAL EXAM
2026/2027 | EXPERT VERIFIED | NGN-STYLE | MULTIPLE-
CHOICE | 100 VERIFIED Q&A | COMPLETE RATIONALES |
PASS GUARANTEED - A+ GRADED
EXAM OVERVIEW
This BSN 266 HESI Med-Surg Exam is a course-specific comprehensive assessment for BSN-level medical-
surgical nursing students. It includes high-difficulty clinical judgment questions, pharmacology prioritization,
and comprehensive coverage across all Med-Surg II systems with detailed rationales.
QUESTION 1
A client with heart failure is prescribed digoxin. Which finding indicates the client is experiencing digoxin
toxicity?
A) Serum potassium of 3.8 mEq/L
B) Heart rate of 68 bpm
C) Nausea, vomiting, and visual disturbances
D) Blood pressure of 138/86 mmHg
Correct Answer: C
Rationale: Signs of digoxin toxicity include nausea, vomiting, visual disturbances (yellow-green halos), and
bradycardia. A heart rate of 68 bpm (B) is normal. Potassium of 3.8 (A) is normal. Blood pressure of 138/86
(D) is acceptable.
QUESTION 2
A client with COPD is receiving oxygen at 2 L/min via nasal cannula. Which assessment finding indicates the
client is developing carbon dioxide retention?
A) Respiratory rate of 22 breaths/min
B) SpO2 of 92%
C) Confusion and headache
D) Heart rate of 88 bpm
,2
Correct Answer: C
Rationale: Carbon dioxide retention in COPD clients can cause confusion, headache, and drowsiness.
Confusion and headache indicate CO2 retention and require intervention.
QUESTION 3
A client with acute pancreatitis is receiving IV fluids. Which finding indicates the client is developing a
complication?
A) Blood glucose of 150 mg/dL
B) Serum calcium of 8.5 mg/dL
C) Abdominal pain radiating to the back
D) Cullen's sign
Correct Answer: D
Rationale: Cullen's sign (ecchymosis around the umbilicus) indicates retroperitoneal bleeding, a severe
complication of acute pancreatitis.
QUESTION 4
A client with cirrhosis is experiencing ascites. Which dietary modification is most appropriate?
A) High-protein diet
B) Low-sodium diet
C) High-carbohydrate diet
D) Low-fat diet
Correct Answer: B
Rationale: Ascites is managed with sodium restriction (typically <2 g/day) to reduce fluid retention.
QUESTION 5
A client with hypothyroidism is prescribed levothyroxine. Which statement indicates the client understands
the medication?
A) "I should take this medication with food."
B) "I should take this medication on an empty stomach, 30-60 minutes before breakfast."
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C) "I should stop taking this medication if I feel better."
D) "I can take this medication with calcium supplements."
Correct Answer: B
Rationale: Levothyroxine should be taken on an empty stomach, 30-60 minutes before breakfast, to optimize
absorption.
QUESTION 6
A client with hyperthyroidism is prescribed methimazole. Which side effect should the nurse monitor for?
A) Agranulocytosis
B) Liver toxicity
C) Rash
D) All of the above
Correct Answer: D
Rationale: Methimazole can cause agranulocytosis, liver toxicity, and rash. Clients should be monitored for
fever, sore throat (signs of agranulocytosis), jaundice, and rash.
QUESTION 7
A client with a fractured tibia is in skeletal traction. Which nursing action is most appropriate?
A) Check the traction weights daily
B) Ensure the weights are off the floor
C) Remove the traction pins for cleaning
D) Encourage the client to bear weight on the affected leg
Correct Answer: B
Rationale: The weights must hang freely off the floor to provide constant traction force.
QUESTION 8
A client with a total knee replacement is 1 day postoperative. Which nursing action is most appropriate?
, 4
A) Maintain the knee in flexion
B) Perform continuous passive motion (CPM)
C) Avoid ambulation
D) Apply heat to the knee
Correct Answer: B
Rationale: Continuous passive motion (CPM) is often used after total knee replacement to promote range of
motion and prevent stiffness.
QUESTION 9
A client with a cast on the forearm develops pallor, coolness, and tingling in the fingers. Which condition is
the priority concern?
A) Compartment syndrome
B) Skin breakdown
C) Infection
D) Muscle atrophy
Correct Answer: A
Rationale: Pallor, coolness, tingling, and pain are signs of compartment syndrome, a medical emergency
requiring immediate intervention.
QUESTION 10
A client is receiving a blood transfusion and develops a fever, chills, and hypotension. Which action should
the nurse take first?
A) Slow the transfusion rate
B) Stop the transfusion
C) Administer antihistamines
D) Notify the healthcare provider
Correct Answer: B
Rationale: These symptoms indicate a possible transfusion reaction. The first action is to stop the transfusion
immediately.
