Bsn hesi 266 med-surg exam bank (2026–2027) – 200 verified questions,
answers & rationales updated & graded a+..
Cardiovascular Disorders
Q1. A client who underwent cardiac stent placement 4 days ago arrives at the
emergency department reporting sudden onset chest pressure and shortness of
breath. Which action should the nurse take FIRST?
A) Administer prescribed nitroglycerin sublingually
B) Obtain a 12-lead electrocardiogram (ECG) and begin continuous cardiac
monitoring
C) Give oxygen at 2 L/min via nasal cannula
D) Prepare the client for immediate cardiac catheterization
Answer: B
Rationale: A client with sudden chest pressure and shortness of breath after
recent stenting is at high risk for acute stent thrombosis or myocardial infarction.
Immediate acquisition of a 12-lead ECG is critical to assess for ischemic changes
and prioritize timely reperfusion therapy. Continuous cardiac monitoring is
essential to detect arrhythmias .
,Q2. A client with heart failure is classified as having systolic dysfunction. Which
hemodynamic alteration is characteristic of this condition?
A) Increased left ventricular end-diastolic volume with reduced ejection fraction
B) Decreased left ventricular end-diastolic pressure with normal ejection fraction
C) Elevated systemic vascular resistance with preserved stroke volume
D) Decreased left atrial pressure with increased cardiac output
Answer: A
Rationale: Systolic failure reduces contractility, causing increased left ventricular
end-diastolic volume and pressure while ejection fraction falls. This leads to
volume overload, pulmonary congestion, and reduced cardiac output .
Q3. A client with heart failure has a prescription for furosemide 40 mg IV. Which
laboratory value should the nurse monitor most closely?
A) Serum potassium
B) Serum sodium
C) Serum calcium
D) Serum glucose
,Answer: A
Rationale: Furosemide is a loop diuretic that causes potassium loss, leading to
hypokalemia. Hypokalemia increases the risk of digoxin toxicity and cardiac
arrhythmias. Potassium levels should be monitored closely .
Q4. A client with peripheral artery disease (PAD) complains of leg pain when
walking that resolves with rest. The nurse documents this as:
A) Rest pain
B) Intermittent claudication
C) Venous stasis
D) Deep vein thrombosis
Answer: B
Rationale: Intermittent claudication is muscle pain or cramping in the legs that
occurs with exercise and is relieved by rest. It is caused by inadequate blood flow
due to atherosclerosis and is a classic symptom of PAD .
Q5. A client with deep vein thrombosis (DVT) is receiving a heparin infusion. The
nurse should monitor which laboratory value to evaluate therapeutic effect?
, A) PT/INR
B) aPTT
C) Platelet count
D) Fibrinogen
Answer: B
Rationale: Activated partial thromboplastin time (aPTT) is monitored for heparin
therapy. The therapeutic range is typically 1.5–2.5 times the baseline control
value. PT/INR is monitored for warfarin therapy .
Q6. A client with hypertension is prescribed lisinopril. The nurse should teach the
client to report which adverse effect immediately?
A) Dry cough
B) Angioedema (swelling of lips, tongue, throat)
C) Headache
D) Fatigue
Answer: B
answers & rationales updated & graded a+..
Cardiovascular Disorders
Q1. A client who underwent cardiac stent placement 4 days ago arrives at the
emergency department reporting sudden onset chest pressure and shortness of
breath. Which action should the nurse take FIRST?
A) Administer prescribed nitroglycerin sublingually
B) Obtain a 12-lead electrocardiogram (ECG) and begin continuous cardiac
monitoring
C) Give oxygen at 2 L/min via nasal cannula
D) Prepare the client for immediate cardiac catheterization
Answer: B
Rationale: A client with sudden chest pressure and shortness of breath after
recent stenting is at high risk for acute stent thrombosis or myocardial infarction.
Immediate acquisition of a 12-lead ECG is critical to assess for ischemic changes
and prioritize timely reperfusion therapy. Continuous cardiac monitoring is
essential to detect arrhythmias .
,Q2. A client with heart failure is classified as having systolic dysfunction. Which
hemodynamic alteration is characteristic of this condition?
A) Increased left ventricular end-diastolic volume with reduced ejection fraction
B) Decreased left ventricular end-diastolic pressure with normal ejection fraction
C) Elevated systemic vascular resistance with preserved stroke volume
D) Decreased left atrial pressure with increased cardiac output
Answer: A
Rationale: Systolic failure reduces contractility, causing increased left ventricular
end-diastolic volume and pressure while ejection fraction falls. This leads to
volume overload, pulmonary congestion, and reduced cardiac output .
Q3. A client with heart failure has a prescription for furosemide 40 mg IV. Which
laboratory value should the nurse monitor most closely?
A) Serum potassium
B) Serum sodium
C) Serum calcium
D) Serum glucose
,Answer: A
Rationale: Furosemide is a loop diuretic that causes potassium loss, leading to
hypokalemia. Hypokalemia increases the risk of digoxin toxicity and cardiac
arrhythmias. Potassium levels should be monitored closely .
Q4. A client with peripheral artery disease (PAD) complains of leg pain when
walking that resolves with rest. The nurse documents this as:
A) Rest pain
B) Intermittent claudication
C) Venous stasis
D) Deep vein thrombosis
Answer: B
Rationale: Intermittent claudication is muscle pain or cramping in the legs that
occurs with exercise and is relieved by rest. It is caused by inadequate blood flow
due to atherosclerosis and is a classic symptom of PAD .
Q5. A client with deep vein thrombosis (DVT) is receiving a heparin infusion. The
nurse should monitor which laboratory value to evaluate therapeutic effect?
, A) PT/INR
B) aPTT
C) Platelet count
D) Fibrinogen
Answer: B
Rationale: Activated partial thromboplastin time (aPTT) is monitored for heparin
therapy. The therapeutic range is typically 1.5–2.5 times the baseline control
value. PT/INR is monitored for warfarin therapy .
Q6. A client with hypertension is prescribed lisinopril. The nurse should teach the
client to report which adverse effect immediately?
A) Dry cough
B) Angioedema (swelling of lips, tongue, throat)
C) Headache
D) Fatigue
Answer: B
