BSN HESI 266 MED SURG EXAM MEDICAL SURGICAL NURSING
2026/2027 - QUESTIONS AND ANSWERS 100% VERIFIED
DETAILED RATIONALES - PASS GUARANTEED - A+ GRADED
143 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
BSN HESI 266 MED SURG EXAM MEDICAL SURGICAL NURSING 2026/2027 - QUESTIONS AND ANSWERS
100% VERIFIED DETAILED RATIONALES - PASS GUARANTEED - A+ GRADED. It contains 143 carefully
selected questions that reflect the most current exam content and testing strategies. Each question is
accompanied by a correct answer and a detailed rationale that explains the underlying pathophysiology,
pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 143 Questions
Foundations - Application - BSN HESI 266 MED SURG Medical Surgical Nursing 2026/2027 AND 100
Detailed Rationales PASS Guaranteed A Medical-surgical Nursing Undergraduate YEAR 3 - BSN
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
BSN HESI 266 MED SURG 1-24 Receiving, Finding, Acute, Indicates, Intervention
Medical Surgical Nursing
2026/2027 AND 100 Detailed
Rationales PASS Guaranteed
A Medical-surgical Nursing
Undergraduate YEAR 3 - BSN
Acute 25-48 Finding, Indicates, Intervention, First, Pressure
Receiving 49-72 Finding, Indicates, Acute, Intervention, Continuous
Indicates 73-96 Acute, Finding, Intervention, First, Receiving
Intervention 97-120 Acute, Indicates, Finding, Receiving, Failure
Injury 121-143 Finding, Intervention, Acute, Appropriate, Receiving
TOTAL 143 All questions include answers and detailed rationales
,Section A - BSN HESI 266 MED SURG Medical Surgical
Nursing 2026/2027 AND 100 Detailed Rationales PASS
Guaranteed A Medical-surgical Nursing Undergraduate
YEAR 3 - BSN
Q1.
A patient with acute decompensated heart failure is receiving intravenous furosemide.
Which assessment finding most urgently indicates a need to hold the dose and notify the
provider?
A. Serum potassium 3.1 mEq/L with B. Urine output 50 mL/hr for the past 2
new-onset U waves on ECG hours
C. Blood pressure 102/68 mm Hg D. Serum sodium 134 mEq/L
Correct: A - Serum potassium 3.1 mEq/L with new-onset U waves on ECG
Rationale:Hypokalemia (K+ <3.5) with U waves increases risk for lethal dysrhythmias;
furosemide should be held and potassium replaced. The other findings are expected or not
immediately life-threatening.
Q2.
Which arterial blood gas value in a patient with COPD exacerbation indicates impending
respiratory failure requiring immediate intervention?
A. pH 7.28, PaCO2 68 mm Hg, HCO3- 30 B. pH 7.36, PaCO2 55 mm Hg, HCO3- 32
mEq/L mEq/L
C. pH 7.44, PaCO2 48 mm Hg, HCO3- 28 D. pH 7.32, PaCO2 50 mm Hg, HCO3- 24
mEq/L mEq/L
Correct: D - pH 7.32, PaCO2 50 mm Hg, HCO3- 24 mEq/L
Rationale:A pH of 7.32 with elevated PaCO2 and normal HCO3- indicates acute respiratory
acidosis without metabolic compensation, signaling acute ventilatory failure. The other options
show either compensated or less severe states.
Q3.
A patient with chronic kidney disease (CKD) stage 4 has a hemoglobin of 8.9 g/dL. Which
laboratory value must be assessed before administering epoetin alfa?
A. Serum ferritin and transferrin saturation B. Serum potassium and creatinine
C. Serum calcium and phosphorus D. White blood cell count and platelets
Page 3
, Section A - BSN HESI 266 MED SURG Medical Surgical Nursing 2026/2027 AND 100 Detailed Rationales PASS Guaranteed A Medical-surgical
Nursing Undergraduate YEAR 3 - BSN
Correct: A - Serum ferritin and transferrin saturation
Rationale:Epoetin alfa requires adequate iron stores for effective erythropoiesis; ferritin and
transferrin saturation must be evaluated and corrected if low. The other labs are important for
CKD but not directly required before epoetin administration.
Q4.
Which finding in a patient receiving levothyroxine for hypothyroidism most strongly
suggests excessive replacement?
A. Heart rate 112 bpm and weight loss B. Heart rate 58 bpm and fatigue
C. Blood pressure 150/90 mm Hg and D. Constipation and dry skin
headache
Correct: A - Heart rate 112 bpm and weight loss
Rationale:Tachycardia and weight loss indicate iatrogenic hyperthyroidism from
over-replacement. Bradycardia, fatigue, constipation, and dry skin suggest
under-replacement; hypertension alone is nonspecific.
Q5.
A patient with acute ischemic stroke is being evaluated for intravenous thrombolytic
therapy. Which condition is an absolute contraindication?
A. Blood pressure 185/110 mm Hg B. Platelet count 90,000/mm³
C. International normalized ratio (INR) 2.5 D. Serum glucose 180 mg/dL
Correct: B - Platelet count 90,000/mm³
Rationale:Platelet count <100,000/mm³ is an absolute contraindication due to high bleeding
risk. Blood pressure >185/110 is a relative contraindication that can be lowered; INR >1.7 is a
contraindication but 2.5 is absolute; glucose >180 is not a contraindication.
Q6.
Which assessment finding in a patient with a new ileostomy requires immediate nursing
intervention?
A. Stoma is dark blue and dry B. Output is 500 mL in 24 hours
C. Stoma is pink and moist D. Peristomal skin is intact
Correct: A - Stoma is dark blue and dry
Rationale:A dark blue, dry stoma indicates ischemia and requires immediate notification of
the surgeon. The other findings are normal or expected for a new ileostomy.
Page 4
2026/2027 - QUESTIONS AND ANSWERS 100% VERIFIED
DETAILED RATIONALES - PASS GUARANTEED - A+ GRADED
143 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
BSN HESI 266 MED SURG EXAM MEDICAL SURGICAL NURSING 2026/2027 - QUESTIONS AND ANSWERS
100% VERIFIED DETAILED RATIONALES - PASS GUARANTEED - A+ GRADED. It contains 143 carefully
selected questions that reflect the most current exam content and testing strategies. Each question is
accompanied by a correct answer and a detailed rationale that explains the underlying pathophysiology,
pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 143 Questions
Foundations - Application - BSN HESI 266 MED SURG Medical Surgical Nursing 2026/2027 AND 100
Detailed Rationales PASS Guaranteed A Medical-surgical Nursing Undergraduate YEAR 3 - BSN
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
BSN HESI 266 MED SURG 1-24 Receiving, Finding, Acute, Indicates, Intervention
Medical Surgical Nursing
2026/2027 AND 100 Detailed
Rationales PASS Guaranteed
A Medical-surgical Nursing
Undergraduate YEAR 3 - BSN
Acute 25-48 Finding, Indicates, Intervention, First, Pressure
Receiving 49-72 Finding, Indicates, Acute, Intervention, Continuous
Indicates 73-96 Acute, Finding, Intervention, First, Receiving
Intervention 97-120 Acute, Indicates, Finding, Receiving, Failure
Injury 121-143 Finding, Intervention, Acute, Appropriate, Receiving
TOTAL 143 All questions include answers and detailed rationales
,Section A - BSN HESI 266 MED SURG Medical Surgical
Nursing 2026/2027 AND 100 Detailed Rationales PASS
Guaranteed A Medical-surgical Nursing Undergraduate
YEAR 3 - BSN
Q1.
A patient with acute decompensated heart failure is receiving intravenous furosemide.
Which assessment finding most urgently indicates a need to hold the dose and notify the
provider?
A. Serum potassium 3.1 mEq/L with B. Urine output 50 mL/hr for the past 2
new-onset U waves on ECG hours
C. Blood pressure 102/68 mm Hg D. Serum sodium 134 mEq/L
Correct: A - Serum potassium 3.1 mEq/L with new-onset U waves on ECG
Rationale:Hypokalemia (K+ <3.5) with U waves increases risk for lethal dysrhythmias;
furosemide should be held and potassium replaced. The other findings are expected or not
immediately life-threatening.
Q2.
Which arterial blood gas value in a patient with COPD exacerbation indicates impending
respiratory failure requiring immediate intervention?
A. pH 7.28, PaCO2 68 mm Hg, HCO3- 30 B. pH 7.36, PaCO2 55 mm Hg, HCO3- 32
mEq/L mEq/L
C. pH 7.44, PaCO2 48 mm Hg, HCO3- 28 D. pH 7.32, PaCO2 50 mm Hg, HCO3- 24
mEq/L mEq/L
Correct: D - pH 7.32, PaCO2 50 mm Hg, HCO3- 24 mEq/L
Rationale:A pH of 7.32 with elevated PaCO2 and normal HCO3- indicates acute respiratory
acidosis without metabolic compensation, signaling acute ventilatory failure. The other options
show either compensated or less severe states.
Q3.
A patient with chronic kidney disease (CKD) stage 4 has a hemoglobin of 8.9 g/dL. Which
laboratory value must be assessed before administering epoetin alfa?
A. Serum ferritin and transferrin saturation B. Serum potassium and creatinine
C. Serum calcium and phosphorus D. White blood cell count and platelets
Page 3
, Section A - BSN HESI 266 MED SURG Medical Surgical Nursing 2026/2027 AND 100 Detailed Rationales PASS Guaranteed A Medical-surgical
Nursing Undergraduate YEAR 3 - BSN
Correct: A - Serum ferritin and transferrin saturation
Rationale:Epoetin alfa requires adequate iron stores for effective erythropoiesis; ferritin and
transferrin saturation must be evaluated and corrected if low. The other labs are important for
CKD but not directly required before epoetin administration.
Q4.
Which finding in a patient receiving levothyroxine for hypothyroidism most strongly
suggests excessive replacement?
A. Heart rate 112 bpm and weight loss B. Heart rate 58 bpm and fatigue
C. Blood pressure 150/90 mm Hg and D. Constipation and dry skin
headache
Correct: A - Heart rate 112 bpm and weight loss
Rationale:Tachycardia and weight loss indicate iatrogenic hyperthyroidism from
over-replacement. Bradycardia, fatigue, constipation, and dry skin suggest
under-replacement; hypertension alone is nonspecific.
Q5.
A patient with acute ischemic stroke is being evaluated for intravenous thrombolytic
therapy. Which condition is an absolute contraindication?
A. Blood pressure 185/110 mm Hg B. Platelet count 90,000/mm³
C. International normalized ratio (INR) 2.5 D. Serum glucose 180 mg/dL
Correct: B - Platelet count 90,000/mm³
Rationale:Platelet count <100,000/mm³ is an absolute contraindication due to high bleeding
risk. Blood pressure >185/110 is a relative contraindication that can be lowered; INR >1.7 is a
contraindication but 2.5 is absolute; glucose >180 is not a contraindication.
Q6.
Which assessment finding in a patient with a new ileostomy requires immediate nursing
intervention?
A. Stoma is dark blue and dry B. Output is 500 mL in 24 hours
C. Stoma is pink and moist D. Peristomal skin is intact
Correct: A - Stoma is dark blue and dry
Rationale:A dark blue, dry stoma indicates ischemia and requires immediate notification of
the surgeon. The other findings are normal or expected for a new ileostomy.
Page 4
