BSN HESI 266 MED SURG PREPARATION
FINAL EXAM 2026/2027 WITH ACTUAL
CORRECT QUESTIONS AND VERIFIED
DETAILED RATIONALES ANSWERS
|CURRENTLY TESTING QUESTIONS AND
SOLUTIONS|ALREADY GRADED A+|NEWEST
|JUST RELEASED!!|GUARANTEED
PASS|NIGHTINGALE COLLEGE
After the fourth dose of gentamicin sulfate (Garamycin) IV, the nurse plans to draw blood
samples to determine peak and trough levels. When are the best times to draw these samples?
A. 15 minutes before and 15 minutes after the next dose.
B. One hour before and one hour after the next dose.
C. 5 minutes before and 30 minutes after the next dose.
D. 30 minutes before and 30 minutes after the next dose.
C. 5 minutes before and 30 minutes after the next dose.
Rationale
Peak drug serum levels are achieved 30 minutes after the completion of the IV infusion of
gentamicin sulfate. The best time to draw a trough is the closest time to the next
administration.
A client's susceptibility to ulcerative colitis is most likely due to which aspect in the client's
history?
A. Jewish European ancestry.
B. H. pylori bowel infection.
C. Family history of irritable bowel syndrome.
D. Age between 25 and 55 years.
1|Page
,A. Jewish European ancestry.
Rationale
Ulcerative colitis is 4 to 5 times more common among individuals of Jewish European or
Ashkenazi ancestry.
During a health fair, a 72-year-old male client tells the nurse that he is experiencing shortness of
breath. Auscultation reveals crackles and wheezing in both lungs. Suspecting that the client
might have chronic bronchitis, which classic symptom would the nurse expect this client to
have?
A. Racing pulse with exertion.
B. Clubbing of the fingers.
C. An increased chest diameter.
D. Productive cough with grayish-white sputum.
D. Productive cough with grayish-white sputum.
Rationale
Smoking is the most common cause of chronic bronchitis, one of the diseases comprising the
diagnosis of COPD, it is characterized by a productive cough with grayish-white sputum.
Smokers generally experience this cough when they first awaken and rise in the morning.
A 49-year-old female client arrives at the clinic for an annual exam and asks the nurse why she
becomes excessively diaphoretic and feels warm during nighttime. What is the nurse's best
response?
A. Explain the effect of the follicle-stimulating and luteinizing hormones.
B. Discuss perimenopause and related comfort measures.
C. Assess lung fields and for a cough productive of blood-tinged mucous.
D. Ask if a fever above 101 F (38.3 C) has occurred in the last 24 hours.
B. Discuss perimenopause and related comfort measures.
Rationale
The perimenopausal period begins about 10 years before menopause with the cessation of
menstruation at the average ages of 52 to 54. Lower estrogen levels causes FSH and LH
2|Page
,secretion in bursts (surges), which triggers vasomotor instability, night sweats, and hot
flashes, so discussions about the perimenopausal body's changes, comfort measures, and
treatment options should be provided.
A client with a completed ischemic stroke has a blood pressure of 180/90 mm Hg. Which action
should the nurse implement?
A. Position the head of the bed (HOB) flat.
B. Withhold intravenous fluids.
C. Administer a bolus of IV fluids.
D. Give an antihypertensive medication.
D. Give an antihypertensive medication.
Rationale
Most ischemic strokes occur during sleep when baseline blood pressure declines or blood
viscosity increases due to minimal fluid intake. Completed strokes usually produce neurologic
deficits within an hour, and the client's current elevated blood pressure requires
antihypertensive medication.
A client who is receiving chemotherapy asks the nurse, "Why is so much of my hair falling out
each day?" Which response by the nurse best explains the reason for alopecia?
A. "Chemotherapy affects the cells of the body that grow rapidly, both normal and malignant."
B. "Alopecia is a common side effect you will experience during long-term steroid therapy."
C. "Your hair will grow back completely after your course of chemotherapy is completed."
D. "The chemotherapy causes permanent alterations in your hair follicles that lead to hair loss."
A. "Chemotherapy affects the cells of the body that grow rapidly, both normal and malignant."
Rationale
The common adverse effects of chemotherapy (nausea, vomiting, alopecia, bone marrow
depression) are due to chemotherapy's effect on the rapidly reproducing cells, both normal
and malignant.
After checking the urinary drainage system for kinks in the tubing, the nurse determines that a
client who has returned from the post-anesthesia care has a dark, concentrated urinary output
3|Page
, of 54 ml for the last 2 hours. What priority nursing action should be implemented?
A. Report the findings to the surgeon.
B. Irrigate the indwelling urinary catheter.
C. Apply manual pressure to the bladder.
D. Increase the IV flow rate for 15 minutes.
A. Report the findings to the surgeon.
Rationale
An adult who weighs 132 pounds (60 kg) should produce about 60 ml of urine hourly (1
ml/kg/hour). Dark, concentrated, and low volume of urine output should be reported to the
surgeon.
A male client who smokes two packs of cigarettes a day states he understands that smoking
cigarettes is contributing to the difficulty that he and his wife are having in getting pregnant and
wants to know if other factors could be contributing to their difficulty. What information is best
for the nurse to provide? (Select all that apply.)
Select all that apply
A. Marijuana cigarettes do not affect sperm count.
B. Alcohol consumption can cause erectile dysfunction.
C. Low testosterone levels affect sperm production.
D. Cessation of smoking improves general health and fertility.
E. Obesity has no effect on sperm production.
B, C and D
Rationale
Use of tobacco, alcohol, and marijuana may affect sperm counts. Sperm count is also
negatively affected by low testerone levels and obesity.
A client with gastroesophageal reflux disease (GERD) has been experiencing severe reflux during
sleep. Which recommendation by the nurse is most effective to assist the client?
A. Losing weight.
4|Page
FINAL EXAM 2026/2027 WITH ACTUAL
CORRECT QUESTIONS AND VERIFIED
DETAILED RATIONALES ANSWERS
|CURRENTLY TESTING QUESTIONS AND
SOLUTIONS|ALREADY GRADED A+|NEWEST
|JUST RELEASED!!|GUARANTEED
PASS|NIGHTINGALE COLLEGE
After the fourth dose of gentamicin sulfate (Garamycin) IV, the nurse plans to draw blood
samples to determine peak and trough levels. When are the best times to draw these samples?
A. 15 minutes before and 15 minutes after the next dose.
B. One hour before and one hour after the next dose.
C. 5 minutes before and 30 minutes after the next dose.
D. 30 minutes before and 30 minutes after the next dose.
C. 5 minutes before and 30 minutes after the next dose.
Rationale
Peak drug serum levels are achieved 30 minutes after the completion of the IV infusion of
gentamicin sulfate. The best time to draw a trough is the closest time to the next
administration.
A client's susceptibility to ulcerative colitis is most likely due to which aspect in the client's
history?
A. Jewish European ancestry.
B. H. pylori bowel infection.
C. Family history of irritable bowel syndrome.
D. Age between 25 and 55 years.
1|Page
,A. Jewish European ancestry.
Rationale
Ulcerative colitis is 4 to 5 times more common among individuals of Jewish European or
Ashkenazi ancestry.
During a health fair, a 72-year-old male client tells the nurse that he is experiencing shortness of
breath. Auscultation reveals crackles and wheezing in both lungs. Suspecting that the client
might have chronic bronchitis, which classic symptom would the nurse expect this client to
have?
A. Racing pulse with exertion.
B. Clubbing of the fingers.
C. An increased chest diameter.
D. Productive cough with grayish-white sputum.
D. Productive cough with grayish-white sputum.
Rationale
Smoking is the most common cause of chronic bronchitis, one of the diseases comprising the
diagnosis of COPD, it is characterized by a productive cough with grayish-white sputum.
Smokers generally experience this cough when they first awaken and rise in the morning.
A 49-year-old female client arrives at the clinic for an annual exam and asks the nurse why she
becomes excessively diaphoretic and feels warm during nighttime. What is the nurse's best
response?
A. Explain the effect of the follicle-stimulating and luteinizing hormones.
B. Discuss perimenopause and related comfort measures.
C. Assess lung fields and for a cough productive of blood-tinged mucous.
D. Ask if a fever above 101 F (38.3 C) has occurred in the last 24 hours.
B. Discuss perimenopause and related comfort measures.
Rationale
The perimenopausal period begins about 10 years before menopause with the cessation of
menstruation at the average ages of 52 to 54. Lower estrogen levels causes FSH and LH
2|Page
,secretion in bursts (surges), which triggers vasomotor instability, night sweats, and hot
flashes, so discussions about the perimenopausal body's changes, comfort measures, and
treatment options should be provided.
A client with a completed ischemic stroke has a blood pressure of 180/90 mm Hg. Which action
should the nurse implement?
A. Position the head of the bed (HOB) flat.
B. Withhold intravenous fluids.
C. Administer a bolus of IV fluids.
D. Give an antihypertensive medication.
D. Give an antihypertensive medication.
Rationale
Most ischemic strokes occur during sleep when baseline blood pressure declines or blood
viscosity increases due to minimal fluid intake. Completed strokes usually produce neurologic
deficits within an hour, and the client's current elevated blood pressure requires
antihypertensive medication.
A client who is receiving chemotherapy asks the nurse, "Why is so much of my hair falling out
each day?" Which response by the nurse best explains the reason for alopecia?
A. "Chemotherapy affects the cells of the body that grow rapidly, both normal and malignant."
B. "Alopecia is a common side effect you will experience during long-term steroid therapy."
C. "Your hair will grow back completely after your course of chemotherapy is completed."
D. "The chemotherapy causes permanent alterations in your hair follicles that lead to hair loss."
A. "Chemotherapy affects the cells of the body that grow rapidly, both normal and malignant."
Rationale
The common adverse effects of chemotherapy (nausea, vomiting, alopecia, bone marrow
depression) are due to chemotherapy's effect on the rapidly reproducing cells, both normal
and malignant.
After checking the urinary drainage system for kinks in the tubing, the nurse determines that a
client who has returned from the post-anesthesia care has a dark, concentrated urinary output
3|Page
, of 54 ml for the last 2 hours. What priority nursing action should be implemented?
A. Report the findings to the surgeon.
B. Irrigate the indwelling urinary catheter.
C. Apply manual pressure to the bladder.
D. Increase the IV flow rate for 15 minutes.
A. Report the findings to the surgeon.
Rationale
An adult who weighs 132 pounds (60 kg) should produce about 60 ml of urine hourly (1
ml/kg/hour). Dark, concentrated, and low volume of urine output should be reported to the
surgeon.
A male client who smokes two packs of cigarettes a day states he understands that smoking
cigarettes is contributing to the difficulty that he and his wife are having in getting pregnant and
wants to know if other factors could be contributing to their difficulty. What information is best
for the nurse to provide? (Select all that apply.)
Select all that apply
A. Marijuana cigarettes do not affect sperm count.
B. Alcohol consumption can cause erectile dysfunction.
C. Low testosterone levels affect sperm production.
D. Cessation of smoking improves general health and fertility.
E. Obesity has no effect on sperm production.
B, C and D
Rationale
Use of tobacco, alcohol, and marijuana may affect sperm counts. Sperm count is also
negatively affected by low testerone levels and obesity.
A client with gastroesophageal reflux disease (GERD) has been experiencing severe reflux during
sleep. Which recommendation by the nurse is most effective to assist the client?
A. Losing weight.
4|Page
