BSN HESI 266 Exam 2026/2027 - 200 Verified
Questions with Rationales
Nightingale College Complete Study Guide |
100% Guaranteed Pass
EXAM OVERVIEW & BLUEPRINT
The BSN 266 HESI Med-Surg Exam is a comprehensive medical-
surgical nursing assessment for BSN students at Nightingale
College. This guide contains 200 verified questions with
detailed rationales aligned with the latest HESI blueprint
(2026/2027) and incorporates Next Generation NCLEX (NGN)-
style formats including case studies and clinical judgment
scenarios .
,Content Area Approximate Questions
Cardiovascular System 40
Respiratory System 35
Gastrointestinal System 30
Renal & Urinary System 25
Endocrine & Metabolic Disorders 25
Neurological System 20
Musculoskeletal System 15
Oncology & Infectious Diseases 10
SECTION 1: CARDIOVASCULAR SYSTEM (Questions 1-40)
,Question 1
A client who underwent cardiac stent placement 4 days ago
arrives to the emergency department reporting sudden onset of
chest pressure and shortness of breath. Which action should the
nurse take next?
A) Listen for extra heart sounds, murmurs, and rhythm with the
bell of the stethoscope
B) Evaluate upper and lower extremities for perfusion, pulse
volume, and pitting edema
C) Obtain a 12-lead electrocardiogram (ECG) and begin
continuous cardiac monitoring
D) Prepare the client for immediate cardiac catheterization
Answer: C) Obtain a 12-lead electrocardiogram (ECG) and
begin continuous cardiac monitoring
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 (MI). Immediate acquisition of a 12-lead
ECG is critical to assess for ischemic changes and to prioritize
timely reperfusion therapy if needed. Continuous cardiac
monitoring is essential to detect life-threatening arrhythmias .
Question 2
A patient with chest pain has an ECG showing ST-segment
elevation in leads II, III, and aVF. Which coronary artery is most
likely occluded?
A) Left anterior descending artery
B) Left circumflex artery
C) Right coronary artery
D) Posterior descending artery
Answer: C) Right coronary artery
Rationale: Leads II, III, and aVF represent the inferior wall of the
heart, which is supplied by the right coronary artery (RCA).
Questions with Rationales
Nightingale College Complete Study Guide |
100% Guaranteed Pass
EXAM OVERVIEW & BLUEPRINT
The BSN 266 HESI Med-Surg Exam is a comprehensive medical-
surgical nursing assessment for BSN students at Nightingale
College. This guide contains 200 verified questions with
detailed rationales aligned with the latest HESI blueprint
(2026/2027) and incorporates Next Generation NCLEX (NGN)-
style formats including case studies and clinical judgment
scenarios .
,Content Area Approximate Questions
Cardiovascular System 40
Respiratory System 35
Gastrointestinal System 30
Renal & Urinary System 25
Endocrine & Metabolic Disorders 25
Neurological System 20
Musculoskeletal System 15
Oncology & Infectious Diseases 10
SECTION 1: CARDIOVASCULAR SYSTEM (Questions 1-40)
,Question 1
A client who underwent cardiac stent placement 4 days ago
arrives to the emergency department reporting sudden onset of
chest pressure and shortness of breath. Which action should the
nurse take next?
A) Listen for extra heart sounds, murmurs, and rhythm with the
bell of the stethoscope
B) Evaluate upper and lower extremities for perfusion, pulse
volume, and pitting edema
C) Obtain a 12-lead electrocardiogram (ECG) and begin
continuous cardiac monitoring
D) Prepare the client for immediate cardiac catheterization
Answer: C) Obtain a 12-lead electrocardiogram (ECG) and
begin continuous cardiac monitoring
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 (MI). Immediate acquisition of a 12-lead
ECG is critical to assess for ischemic changes and to prioritize
timely reperfusion therapy if needed. Continuous cardiac
monitoring is essential to detect life-threatening arrhythmias .
Question 2
A patient with chest pain has an ECG showing ST-segment
elevation in leads II, III, and aVF. Which coronary artery is most
likely occluded?
A) Left anterior descending artery
B) Left circumflex artery
C) Right coronary artery
D) Posterior descending artery
Answer: C) Right coronary artery
Rationale: Leads II, III, and aVF represent the inferior wall of the
heart, which is supplied by the right coronary artery (RCA).
