BSN 266 – MedSurg HESI 2026 | Actual
s s s s s s s
s Questions and Answers WITH s s s
s RATIONALES | NGN Study Guide | s s s s s
s Latest Updated Version s s
THIS EXAM CONTAINS: s s
• 100+ exam-style questions
s s s
• Verified answers with detailed rationales
s s s s s
• Next Generation Nursing (NGN) case scenarios
s s s s s s
• Prioritization and delegation questions s s s s
• SATA (Select All That Apply) items
s s s s s s
• Bow-tie and unfolding case studies
s s s s s
, BSN 266 – MedSurg HESI 2026 | Actual s s s s s s s
s Questions and Answers WITH RATIONALES s s s s
| NGN Study Guide | Latest Updated Version
s s s s s s s s
Question 1 s
A client who underwent cardiac stent placement four days ago arrives to the
s s s s s s s s s s s s
emergency department reporting a sudden onset of chest pressure and
s s s s s s s s s s
shortness of breath. Which action should the nurse take next?
s s s s s s s s s s
A) Obtain a 12-lead electrocardiogram and begin continuous cardiac
s s s s s s s s
monitoring
s
B) Administer sublingual nitroglycerin
s s s
C) Draw cardiac enzyme levels
s s s s
D) Notify the healthcare provider immediately
s s s s s
Answer: A) Obtain a 12-lead electrocardiogram and begin continuous
s s s s s s s s
cardiac monitoring
s s
Rationale: The client is exhibiting signs of possible acute coronary syndrome
s s s s s s s s s s
or stent thrombosis, which is a life-threatening complication following
s s s s s s s s s
cardiac stent placement. The priority action is to obtain an ECG to assess for
s s s s s s s s s s s s s s
ST-segment changes or new arrhythmias and begin continuous cardiac
s s s s s s s s s
monitoring to detect any life-threatening dysrhythmias. Early recognition
s s s s s s s s
and treatment of stent thrombosis is critical to prevent myocardial infarction.
s s s s s s s s s s s
While nitroglycerin, cardiac enzymes, and provider notification are
s s s s s s s s
important, the immediate priority is obtaining the ECG to guide further
s s s s s s s s s s s
interventions.
s
,Question 2 s
While completing a health assessment for a client with migraine headaches,
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the nurse assesses bilateral weakness in the client's hand grips. The client
s s s s s s s s s s s s
reports joint pain and trouble twisting a door knob due to weakness. Which
s s s s s s s s s s s s s
action should the nurse take in response to these findings?
s s s s s s s s s s
A) Gather additional assessment data about the pain and weakness
s s s s s s s s s
B) Refer the client to physical therapy
s s s s s s
C) Notify the healthcare provider immediately
s s s s s
D) Document the findings and reassess in 4 hours
s s s s s s s s
Answer: A) Gather additional assessment data about the pain and
s s s s s s s s s
weakness
s
Rationale: Bilateral weakness with joint pain and difficulty with fine motor
s s s s s s s s s s
tasks (twisting a doorknob) may indicate a neurological or musculoskeletal
s s s s s s s s s s
condition. The nurse should first gather additional assessment data,
s s s s s s s s s
including onset, duration, quality of pain, exacerbating and relieving factors,
s s s s s s s s s s
and any associated symptoms. This comprehensive assessment will help
s s s s s s s s s
determine if the findings are related to the migraine disorder or another
s s s s s s s s s s s s
condition such as carpal tunnel syndrome, rheumatoid arthritis, or a
s s s s s s s s s s
neurological disorder. Rushing to notify the provider without complete data
s s s s s s s s s s
is premature.
s s
Question 3 s
, When assessing a male client's respiratory status, which technique should the
s s s s s s s s s s
nurse use to assess his anterior-posterior chest diameter?
s s s s s s s s
A) Tenderness upon palpation and generalized erythema
s s s s s s
B) Measure the ratio of anteroposterior diameter to transverse diameter
s s s s s s s s s
C) Auscultate breath sounds in all lung fields
s s s s s s s
D) Percuss the chest wall for resonance
s s s s s s
Answer: B) Measure the ratio of anteroposterior diameter to transverse
s s s s s s s s s
diameter
s
Rationale: Anterior-posterior chest diameter is assessed by measuring the
s s s s s s s s
distance from the sternum to the vertebrae and comparing it to the
s s s s s s s s s s s s
transverse (side-to-side) diameter. A normal AP:transverse ratio is 1:2. An
s s s s s s s s s s
increased ratio (barrel chest) is seen in conditions like COPD and
s s s s s s s s s s s
emphysema. Options A (tenderness and erythema) relate to skin assessment,
s s s s s s s s s s
C relates to auscultation, and D relates to percussion—none of which assess
s s s s s s s s s s s s
chest diameter.
s s
Question 4 s
An adult client who had a gastric bypass surgery 2 weeks ago is admitted with
s s s s s s s s s s s s s s
possible anastomosis leakage. The client's abdomen is tender to touch, and
s s s s s s s s s s s
vital signs are temperature 101°F (38.3°C), heart rate 130 beats/minute,
s s s s s s s s s s
respiratory rate 26 breaths/minute, and blood pressure 100/50 mmHg.
s s s s s s s s s
Which intervention is most important for the nurse to include in the client's
s s s s s s s s s s s s s
plan of care?
s s s
A) Strict IV fluid replacement
s s s s
B) Administer antipyretics
s s
s s s s s s s
s Questions and Answers WITH s s s
s RATIONALES | NGN Study Guide | s s s s s
s Latest Updated Version s s
THIS EXAM CONTAINS: s s
• 100+ exam-style questions
s s s
• Verified answers with detailed rationales
s s s s s
• Next Generation Nursing (NGN) case scenarios
s s s s s s
• Prioritization and delegation questions s s s s
• SATA (Select All That Apply) items
s s s s s s
• Bow-tie and unfolding case studies
s s s s s
, BSN 266 – MedSurg HESI 2026 | Actual s s s s s s s
s Questions and Answers WITH RATIONALES s s s s
| NGN Study Guide | Latest Updated Version
s s s s s s s s
Question 1 s
A client who underwent cardiac stent placement four days ago arrives to the
s s s s s s s s s s s s
emergency department reporting a sudden onset of chest pressure and
s s s s s s s s s s
shortness of breath. Which action should the nurse take next?
s s s s s s s s s s
A) Obtain a 12-lead electrocardiogram and begin continuous cardiac
s s s s s s s s
monitoring
s
B) Administer sublingual nitroglycerin
s s s
C) Draw cardiac enzyme levels
s s s s
D) Notify the healthcare provider immediately
s s s s s
Answer: A) Obtain a 12-lead electrocardiogram and begin continuous
s s s s s s s s
cardiac monitoring
s s
Rationale: The client is exhibiting signs of possible acute coronary syndrome
s s s s s s s s s s
or stent thrombosis, which is a life-threatening complication following
s s s s s s s s s
cardiac stent placement. The priority action is to obtain an ECG to assess for
s s s s s s s s s s s s s s
ST-segment changes or new arrhythmias and begin continuous cardiac
s s s s s s s s s
monitoring to detect any life-threatening dysrhythmias. Early recognition
s s s s s s s s
and treatment of stent thrombosis is critical to prevent myocardial infarction.
s s s s s s s s s s s
While nitroglycerin, cardiac enzymes, and provider notification are
s s s s s s s s
important, the immediate priority is obtaining the ECG to guide further
s s s s s s s s s s s
interventions.
s
,Question 2 s
While completing a health assessment for a client with migraine headaches,
s s s s s s s s s s
the nurse assesses bilateral weakness in the client's hand grips. The client
s s s s s s s s s s s s
reports joint pain and trouble twisting a door knob due to weakness. Which
s s s s s s s s s s s s s
action should the nurse take in response to these findings?
s s s s s s s s s s
A) Gather additional assessment data about the pain and weakness
s s s s s s s s s
B) Refer the client to physical therapy
s s s s s s
C) Notify the healthcare provider immediately
s s s s s
D) Document the findings and reassess in 4 hours
s s s s s s s s
Answer: A) Gather additional assessment data about the pain and
s s s s s s s s s
weakness
s
Rationale: Bilateral weakness with joint pain and difficulty with fine motor
s s s s s s s s s s
tasks (twisting a doorknob) may indicate a neurological or musculoskeletal
s s s s s s s s s s
condition. The nurse should first gather additional assessment data,
s s s s s s s s s
including onset, duration, quality of pain, exacerbating and relieving factors,
s s s s s s s s s s
and any associated symptoms. This comprehensive assessment will help
s s s s s s s s s
determine if the findings are related to the migraine disorder or another
s s s s s s s s s s s s
condition such as carpal tunnel syndrome, rheumatoid arthritis, or a
s s s s s s s s s s
neurological disorder. Rushing to notify the provider without complete data
s s s s s s s s s s
is premature.
s s
Question 3 s
, When assessing a male client's respiratory status, which technique should the
s s s s s s s s s s
nurse use to assess his anterior-posterior chest diameter?
s s s s s s s s
A) Tenderness upon palpation and generalized erythema
s s s s s s
B) Measure the ratio of anteroposterior diameter to transverse diameter
s s s s s s s s s
C) Auscultate breath sounds in all lung fields
s s s s s s s
D) Percuss the chest wall for resonance
s s s s s s
Answer: B) Measure the ratio of anteroposterior diameter to transverse
s s s s s s s s s
diameter
s
Rationale: Anterior-posterior chest diameter is assessed by measuring the
s s s s s s s s
distance from the sternum to the vertebrae and comparing it to the
s s s s s s s s s s s s
transverse (side-to-side) diameter. A normal AP:transverse ratio is 1:2. An
s s s s s s s s s s
increased ratio (barrel chest) is seen in conditions like COPD and
s s s s s s s s s s s
emphysema. Options A (tenderness and erythema) relate to skin assessment,
s s s s s s s s s s
C relates to auscultation, and D relates to percussion—none of which assess
s s s s s s s s s s s s
chest diameter.
s s
Question 4 s
An adult client who had a gastric bypass surgery 2 weeks ago is admitted with
s s s s s s s s s s s s s s
possible anastomosis leakage. The client's abdomen is tender to touch, and
s s s s s s s s s s s
vital signs are temperature 101°F (38.3°C), heart rate 130 beats/minute,
s s s s s s s s s s
respiratory rate 26 breaths/minute, and blood pressure 100/50 mmHg.
s s s s s s s s s
Which intervention is most important for the nurse to include in the client's
s s s s s s s s s s s s s
plan of care?
s s s
A) Strict IV fluid replacement
s s s s
B) Administer antipyretics
s s
