BSN HESI 266 Med Surg Exam
2025/2026 Real Assessment Q&A | 100 Items | Verified Expert Answers | A+ Study
Choice
EXAM OVERVIEW
This 2025/2026 validated resource contains the complete BSN HESI 266 Med Surg
Exam with actual questions and verified answers. The examination measures analytical
reasoning, professional judgment, and practical application through 100 evidence-
based scenarios that assess competency in contemporary professional practice.
EXAM FEATURES
• 100 Evidence-Based Multiple Choice Questions
• Comprehensive Answer Keys with Clinical Rationales
• Critical Analysis and Applied Reasoning Emphasis
• Current 2025 Evidence-Based Practice Standards Integration
• 8 Professional Domains Comprehensively Assessed
• Real-World Application Scenarios with Professional Context
CORE TESTING AREAS
→ **1. Cardiovascular**
→ **2. Respiratory**
→ **3. Neurologic**
→ **4. Endocrine**
→ **5. Renal & Fluid/Electrolytes**
→ **6. Gastrointestinal**
→ **7. Musculoskeletal & Immobility**
→ **8. Hematologic**
Page 1
,Question 1
Heart failure can be classified as systolic or diastolic based on ventricular function. In
systolic (or reduced ejection fraction) heart failure, specific hemodynamic alterations
occur due to impaired contractility, including changes in preload, afterload, and stroke
volume. Which of the following changes most accurately describes the typical
hemodynamic profile observed in systolic heart failure?
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
Correct Answer
Increased left ventricular end‑diastolic volume with reduced ejection fraction
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.
Page 2
,Question 2
Cardiac biomarkers are essential for diagnosing acute myocardial infarction. Among the
commonly measured markers-troponin I, CK‑MB, myoglobin, and LDH-each has a distinct
release pattern and specificity. In clinical practice, early and accurate identification of
cardiac muscle damage guides reperfusion therapy and risk stratification. Which
biomarker provides the greatest specificity for myocardial injury?
A. Troponin I
B. CK‑MB
C. Myoglobin
D. Lactate dehydrogenase (LDH)
Correct Answer
Troponin I
Rationale:
Troponin I is cardiac‑specific, rises within 3-6 hours, and remains elevated, making it the most specific
marker for myocardial injury in clinical diagnosis.
Question 3
Ventricular tachycardia is a life‑threatening arrhythmia that originates from the ventricles
and is identified on electrocardiography. It typically presents with a rapid regular rhythm,
may cause hemodynamic compromise, and requires immediate recognition to initiate
appropriate therapy. Which of the following electrocardiographic findings is the defining
characteristic of ventricular tachycardia?
A. Wide QRS complexes (>120 ms) with regular rhythm
B. Narrow QRS complexes with irregular rhythm
C. Presence of P waves preceding each QRS complex
D. ST‑segment elevation in leads V1‑V3
Correct Answer
Wide QRS complexes (>120 ms) with regular rhythm
Rationale:
Ventricular tachycardia originates below the AV node, producing wide (>120 ms) QRS complexes at a regular
rapid rate on the ECG.
Page 3
, Question 4
The JNC 8 guidelines recommend specific first‑line antihypertensive classes based on
patient demographics and comorbidities. For a 58‑year‑old African American patient with
stage 1 hypertension (SBP 145 mmHg, DBP 92 mmHg) and no chronic kidney disease,
evidence suggests that certain drug classes provide superior blood pressure control and
reduce cardiovascular events in this population. Which medication class is recommended
as initial therapy?
A. Thiazide‑type diuretic
B. ACE inhibitor
C. Calcium channel blocker
D. Beta‑blocker
Correct Answer
Thiazide‑type diuretic
Rationale:
JNC 8 recommends thiazide diuretics or calcium‑channel blockers as first‑line therapy for African American
patients without CKD, improving blood pressure control.
Page 4
2025/2026 Real Assessment Q&A | 100 Items | Verified Expert Answers | A+ Study
Choice
EXAM OVERVIEW
This 2025/2026 validated resource contains the complete BSN HESI 266 Med Surg
Exam with actual questions and verified answers. The examination measures analytical
reasoning, professional judgment, and practical application through 100 evidence-
based scenarios that assess competency in contemporary professional practice.
EXAM FEATURES
• 100 Evidence-Based Multiple Choice Questions
• Comprehensive Answer Keys with Clinical Rationales
• Critical Analysis and Applied Reasoning Emphasis
• Current 2025 Evidence-Based Practice Standards Integration
• 8 Professional Domains Comprehensively Assessed
• Real-World Application Scenarios with Professional Context
CORE TESTING AREAS
→ **1. Cardiovascular**
→ **2. Respiratory**
→ **3. Neurologic**
→ **4. Endocrine**
→ **5. Renal & Fluid/Electrolytes**
→ **6. Gastrointestinal**
→ **7. Musculoskeletal & Immobility**
→ **8. Hematologic**
Page 1
,Question 1
Heart failure can be classified as systolic or diastolic based on ventricular function. In
systolic (or reduced ejection fraction) heart failure, specific hemodynamic alterations
occur due to impaired contractility, including changes in preload, afterload, and stroke
volume. Which of the following changes most accurately describes the typical
hemodynamic profile observed in systolic heart failure?
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
Correct Answer
Increased left ventricular end‑diastolic volume with reduced ejection fraction
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.
Page 2
,Question 2
Cardiac biomarkers are essential for diagnosing acute myocardial infarction. Among the
commonly measured markers-troponin I, CK‑MB, myoglobin, and LDH-each has a distinct
release pattern and specificity. In clinical practice, early and accurate identification of
cardiac muscle damage guides reperfusion therapy and risk stratification. Which
biomarker provides the greatest specificity for myocardial injury?
A. Troponin I
B. CK‑MB
C. Myoglobin
D. Lactate dehydrogenase (LDH)
Correct Answer
Troponin I
Rationale:
Troponin I is cardiac‑specific, rises within 3-6 hours, and remains elevated, making it the most specific
marker for myocardial injury in clinical diagnosis.
Question 3
Ventricular tachycardia is a life‑threatening arrhythmia that originates from the ventricles
and is identified on electrocardiography. It typically presents with a rapid regular rhythm,
may cause hemodynamic compromise, and requires immediate recognition to initiate
appropriate therapy. Which of the following electrocardiographic findings is the defining
characteristic of ventricular tachycardia?
A. Wide QRS complexes (>120 ms) with regular rhythm
B. Narrow QRS complexes with irregular rhythm
C. Presence of P waves preceding each QRS complex
D. ST‑segment elevation in leads V1‑V3
Correct Answer
Wide QRS complexes (>120 ms) with regular rhythm
Rationale:
Ventricular tachycardia originates below the AV node, producing wide (>120 ms) QRS complexes at a regular
rapid rate on the ECG.
Page 3
, Question 4
The JNC 8 guidelines recommend specific first‑line antihypertensive classes based on
patient demographics and comorbidities. For a 58‑year‑old African American patient with
stage 1 hypertension (SBP 145 mmHg, DBP 92 mmHg) and no chronic kidney disease,
evidence suggests that certain drug classes provide superior blood pressure control and
reduce cardiovascular events in this population. Which medication class is recommended
as initial therapy?
A. Thiazide‑type diuretic
B. ACE inhibitor
C. Calcium channel blocker
D. Beta‑blocker
Correct Answer
Thiazide‑type diuretic
Rationale:
JNC 8 recommends thiazide diuretics or calcium‑channel blockers as first‑line therapy for African American
patients without CKD, improving blood pressure control.
Page 4
