BSN HESI 266 Med Surg Exam | 250 Verified
Questions & Answers | Guaranteed Pass
Guide
EXAM OVERVIEW & BLUEPRINT
The BSN HESI 266 Med-Surg Exam is a comprehensive
medical-surgical nursing assessment designed for BSN students,
typically at Nightingale College. This guide is aligned with the
latest HESI blueprint and NCLEX-RN standards, covering
essential adult health topics such as cardiovascular, respiratory,
gastrointestinal, endocrine, renal, neurological, and
musculoskeletal disorders . The 250 practice questions in this
guide are based on verified exam content from 2025/2026
resources .
,SECTION 1: CARDIOVASCULAR SYSTEM (Questions 1-40)
Question 1
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, supplied by the right coronary artery (RCA). Anterior wall
MI (V1-V4) is supplied by the LAD; lateral wall MI (I, aVL, V5-V6)
by the left circumflex artery .
,Question 2
A nurse is assessing a client with left-sided heart failure. Which
finding is most indicative?
A) Jugular vein distention
B) Peripheral edema
C) Bibasilar crackles
D) Hepatomegaly
Answer: C) Bibasilar crackles
Rationale: Left-sided heart failure leads to pulmonary congestion,
causing crackles. Jugular vein distention, peripheral edema, and
hepatomegaly indicate right-sided heart failure .
Question 3
A patient with heart failure is prescribed furosemide (Lasix).
Which electrolyte imbalance should the nurse monitor most
closely?
, A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypermagnesemia
Answer: B) Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium
wasting, leading to hypokalemia, which increases the risk of
digoxin toxicity and cardiac arrhythmias .
Question 4
A patient taking digoxin has a potassium level of 3.2 mEq/L. The
nurse should:
A) Administer the digoxin as ordered
B) Hold the digoxin and notify the provider
C) Give potassium supplements before the digoxin
D) Increase the digoxin dose
Questions & Answers | Guaranteed Pass
Guide
EXAM OVERVIEW & BLUEPRINT
The BSN HESI 266 Med-Surg Exam is a comprehensive
medical-surgical nursing assessment designed for BSN students,
typically at Nightingale College. This guide is aligned with the
latest HESI blueprint and NCLEX-RN standards, covering
essential adult health topics such as cardiovascular, respiratory,
gastrointestinal, endocrine, renal, neurological, and
musculoskeletal disorders . The 250 practice questions in this
guide are based on verified exam content from 2025/2026
resources .
,SECTION 1: CARDIOVASCULAR SYSTEM (Questions 1-40)
Question 1
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, supplied by the right coronary artery (RCA). Anterior wall
MI (V1-V4) is supplied by the LAD; lateral wall MI (I, aVL, V5-V6)
by the left circumflex artery .
,Question 2
A nurse is assessing a client with left-sided heart failure. Which
finding is most indicative?
A) Jugular vein distention
B) Peripheral edema
C) Bibasilar crackles
D) Hepatomegaly
Answer: C) Bibasilar crackles
Rationale: Left-sided heart failure leads to pulmonary congestion,
causing crackles. Jugular vein distention, peripheral edema, and
hepatomegaly indicate right-sided heart failure .
Question 3
A patient with heart failure is prescribed furosemide (Lasix).
Which electrolyte imbalance should the nurse monitor most
closely?
, A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypermagnesemia
Answer: B) Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium
wasting, leading to hypokalemia, which increases the risk of
digoxin toxicity and cardiac arrhythmias .
Question 4
A patient taking digoxin has a potassium level of 3.2 mEq/L. The
nurse should:
A) Administer the digoxin as ordered
B) Hold the digoxin and notify the provider
C) Give potassium supplements before the digoxin
D) Increase the digoxin dose
