BSN 266 – HESI Medical-Surgical Practice
Exam V2 (Nightingale College, 2025/2026) –
Verified Questions, Answers, and Rationales
(Grade A, 100% Correct)
Verified Questions, Answers & Rationales | Grade A+ (100% Correct) 70 Questions –
Answers in red – Full Expert Rationales
(Updated November 16, 2025 – Verified for Nightingale College BSN 266 HESI Med-Surg V2)
CARDIOVASCULAR (1–10)
1. A client post-MI is prescribed metoprolol. The nurse monitors for: Bradycardia
Rationale: Beta-1 blockade ↓ HR and contractility. Hold if HR <60 bpm.
2. A client with heart failure has crackles and +2 edema. The nurse anticipates: Furosemide
IV
Rationale: Loop diuretic reduces preload and pulmonary congestion. Monitor K⁺.
3. The earliest sign of left ventricular failure is: Dyspnea on exertion
Rationale: ↑ left atrial pressure → pulmonary congestion.
4. A client on warfarin has INR 5.2. The nurse should: Hold warfarin and notify provider
Rationale: Therapeutic INR 2.0–3.0. >5 → bleeding risk. Vitamin K if active bleed.
5. A client with atrial fibrillation has HR 140. First action: Assess for hemodynamic
stability
, Rationale: Unstable (hypotension, chest pain) → synchronized cardioversion.
6. Post-cardiac cath, the nurse monitors the femoral site for: Hematoma and pulsatile mass
Rationale: Retroperitoneal bleed or pseudoaneurysm. Apply pressure if bleeding.
7. A client with DVT is prescribed enoxaparin. Teaching includes: Report black stools or
bruising
Rationale: LMWH → bleeding risk. No routine monitoring needed.
8. The nurse auscultates an S3 in a client with HF. This indicates: Ventricular overload
Rationale: Rapid filling in early diastole. Common in decompensated HF.
9. A client post-CABG has chest tube output 300 mL/hr. Action: Notify surgeon
immediately
Rationale: >200 mL/hr → mediastinal bleeding → return to OR.
10. The priority assessment for a client on nitroglycerin drip is: Blood pressure
Rationale: Vasodilation → hypotension. Hold if SBP <90 mm Hg.
RESPIRATORY (11–18)
11. A client with COPD exacerbation has SpO₂ 88%. First intervention: Apply 2–4 L O₂ via
nasal cannula
Rationale: Target SpO₂ 88–92% to avoid suppressing hypoxic drive.
Exam V2 (Nightingale College, 2025/2026) –
Verified Questions, Answers, and Rationales
(Grade A, 100% Correct)
Verified Questions, Answers & Rationales | Grade A+ (100% Correct) 70 Questions –
Answers in red – Full Expert Rationales
(Updated November 16, 2025 – Verified for Nightingale College BSN 266 HESI Med-Surg V2)
CARDIOVASCULAR (1–10)
1. A client post-MI is prescribed metoprolol. The nurse monitors for: Bradycardia
Rationale: Beta-1 blockade ↓ HR and contractility. Hold if HR <60 bpm.
2. A client with heart failure has crackles and +2 edema. The nurse anticipates: Furosemide
IV
Rationale: Loop diuretic reduces preload and pulmonary congestion. Monitor K⁺.
3. The earliest sign of left ventricular failure is: Dyspnea on exertion
Rationale: ↑ left atrial pressure → pulmonary congestion.
4. A client on warfarin has INR 5.2. The nurse should: Hold warfarin and notify provider
Rationale: Therapeutic INR 2.0–3.0. >5 → bleeding risk. Vitamin K if active bleed.
5. A client with atrial fibrillation has HR 140. First action: Assess for hemodynamic
stability
, Rationale: Unstable (hypotension, chest pain) → synchronized cardioversion.
6. Post-cardiac cath, the nurse monitors the femoral site for: Hematoma and pulsatile mass
Rationale: Retroperitoneal bleed or pseudoaneurysm. Apply pressure if bleeding.
7. A client with DVT is prescribed enoxaparin. Teaching includes: Report black stools or
bruising
Rationale: LMWH → bleeding risk. No routine monitoring needed.
8. The nurse auscultates an S3 in a client with HF. This indicates: Ventricular overload
Rationale: Rapid filling in early diastole. Common in decompensated HF.
9. A client post-CABG has chest tube output 300 mL/hr. Action: Notify surgeon
immediately
Rationale: >200 mL/hr → mediastinal bleeding → return to OR.
10. The priority assessment for a client on nitroglycerin drip is: Blood pressure
Rationale: Vasodilation → hypotension. Hold if SBP <90 mm Hg.
RESPIRATORY (11–18)
11. A client with COPD exacerbation has SpO₂ 88%. First intervention: Apply 2–4 L O₂ via
nasal cannula
Rationale: Target SpO₂ 88–92% to avoid suppressing hypoxic drive.
