NIGHTINGALE BSN HESI 266 MED SURG COMPREHENSIVE EXAM VERIFIED QUESTIONS
ACTUAL TEST BANK UPDATED FOR THE NEW 2026/2027 ACADEMIC YEAR QUESTIONS AND
ANSWERS ALREADY GRADED A+| 100% VERIFIED SOLUTIONS………...
Core Domains
Management of Care and Safety
Cardiovascular and Hematologic Disorders
Respiratory and Fluid-Electrolyte Balance
Gastrointestinal and Renal Disorders
Neurological and Musculoskeletal Disorders
Endocrine and Metabolic Disorders
Perioperative, Integumentary, and Immune Disorders
Introduction
The Nightingale College BSN 266 HESI Medical-Surgical Comprehensive Examination is designed to
evaluate the nursing student's mastery of adult medical-surgical concepts, clinical judgment, and
evidence-based nursing interventions across acute care settings . This assessment measures the
ability to apply the nursing process to clients experiencing complex cardiovascular, respiratory,
gastrointestinal, renal, neurological, musculoskeletal, endocrine, and perioperative conditions. The
,examination emphasizes management of care, safety, pharmacology, regulatory compliance, and
ethical standards . Items are structured as single-best-answer, multiple-choice questions, many of
which are scenario-based, requiring the candidate to analyze clinical data, prioritize nursing
actions, and select the most appropriate intervention. A significant portion of the examination
demands critical thinking and the ability to differentiate between urgent and non-urgent findings,
ensuring that successful candidates demonstrate the competencies required for safe, effective entry-
level professional nursing practice .
Section One: Questions 1–200
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with a blood pressure of 138/88 mm Hg who reports a headache
B. A client with a heart rate of 110/min who is anxious about an upcoming procedure
🟢 C. A client with a respiratory rate of 28/min and an SpO2 of 88% on room air
D. A client with a temperature of 38.2°C (100.8°F) who has a surgical incision
🔴 RATIONALE: According to the ABCs (Airway, Breathing, Circulation) priority framework, the
client with compromised oxygenation (respiratory rate of 28/min and SpO2 of 88%) requires
immediate assessment and intervention because this represents a life-threatening situation.
2. A nurse is delegating tasks to assistive personnel (AP). Which task is appropriate to delegate?
A. Administering oral medications to a stable client
🟢 B. Measuring and recording intake and output for a client with a Foley catheter
,C. Assessing a postoperative client's incision for signs of infection
D. Teaching a client about diabetic foot care
🔴 RATIONALE: Measuring and recording intake and output is a routine, non-invasive task that
falls within the scope of practice for assistive personnel. Medication administration, assessment,
and teaching require the professional judgment of a registered nurse.
3. An older adult client with a long history of chronic obstructive pulmonary disease (COPD) is
admitted with progressive shortness of breath and a persistent cough. The client is anxious
and complaining of a dry mouth. Which intervention should the nurse implement?
A. Administer a prescribed sedative
🟢 B. Assist the client to an upright position
C. Encourage the client to drink water
D. Apply a high-flow Venturi mask
🔴 RATIONALE: Assisting the client to an upright position (high-Fowler's or orthopneic position)
maximizes chest expansion and improves ventilation in COPD.
4. A client with multiple sclerosis (MS) is admitted to the medical unit. The client reports fatigue,
muscle weakness, and diplopia. Which actions should the nurse implement to reduce the
client's risk for falls? (Select all that apply)
🟢 A. Provide assistance to the bedside commode
B. Encourage the client to ambulate independently
🟢 C. Schedule frequent rest periods
, D. Monitor pulse oximetry during activities
🟢 E. Teach the client to patch one eye while walking
🔴 RATIONALE: Fall risk in MS is reduced by assisting with mobility (A), preventing fatigue with
rest periods (C), and teaching monocular patching for diplopia (E) to improve depth perception.
5. A client arrives to the emergency department following a motor vehicle collision. The nurse
observes the client experiencing increasing dyspnea and notes absent breath sounds on the
left side. Which procedure should the nurse prepare for?
A. Bronchoscopy
🟢 B. Chest tube insertion
C. Endotracheal intubation
D. Pulmonary function test
🔴 RATIONALE: Absent breath sounds and dyspnea after trauma suggest a pneumothorax,
which requires chest tube insertion to re-expand the lung.
6. Following a transurethral resection of the prostate (TURP), a client is discharged with an
indwelling urinary catheter. Which instruction is most important for the nurse to include in the
discharge teaching plan?
A. Eliminate all spicy foods from your diet
🟢 B. Drink 3 liters of water each day
C. Clamp the catheter when taking a shower
D. Avoid driving a car for 2 weeks
ACTUAL TEST BANK UPDATED FOR THE NEW 2026/2027 ACADEMIC YEAR QUESTIONS AND
ANSWERS ALREADY GRADED A+| 100% VERIFIED SOLUTIONS………...
Core Domains
Management of Care and Safety
Cardiovascular and Hematologic Disorders
Respiratory and Fluid-Electrolyte Balance
Gastrointestinal and Renal Disorders
Neurological and Musculoskeletal Disorders
Endocrine and Metabolic Disorders
Perioperative, Integumentary, and Immune Disorders
Introduction
The Nightingale College BSN 266 HESI Medical-Surgical Comprehensive Examination is designed to
evaluate the nursing student's mastery of adult medical-surgical concepts, clinical judgment, and
evidence-based nursing interventions across acute care settings . This assessment measures the
ability to apply the nursing process to clients experiencing complex cardiovascular, respiratory,
gastrointestinal, renal, neurological, musculoskeletal, endocrine, and perioperative conditions. The
,examination emphasizes management of care, safety, pharmacology, regulatory compliance, and
ethical standards . Items are structured as single-best-answer, multiple-choice questions, many of
which are scenario-based, requiring the candidate to analyze clinical data, prioritize nursing
actions, and select the most appropriate intervention. A significant portion of the examination
demands critical thinking and the ability to differentiate between urgent and non-urgent findings,
ensuring that successful candidates demonstrate the competencies required for safe, effective entry-
level professional nursing practice .
Section One: Questions 1–200
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with a blood pressure of 138/88 mm Hg who reports a headache
B. A client with a heart rate of 110/min who is anxious about an upcoming procedure
🟢 C. A client with a respiratory rate of 28/min and an SpO2 of 88% on room air
D. A client with a temperature of 38.2°C (100.8°F) who has a surgical incision
🔴 RATIONALE: According to the ABCs (Airway, Breathing, Circulation) priority framework, the
client with compromised oxygenation (respiratory rate of 28/min and SpO2 of 88%) requires
immediate assessment and intervention because this represents a life-threatening situation.
2. A nurse is delegating tasks to assistive personnel (AP). Which task is appropriate to delegate?
A. Administering oral medications to a stable client
🟢 B. Measuring and recording intake and output for a client with a Foley catheter
,C. Assessing a postoperative client's incision for signs of infection
D. Teaching a client about diabetic foot care
🔴 RATIONALE: Measuring and recording intake and output is a routine, non-invasive task that
falls within the scope of practice for assistive personnel. Medication administration, assessment,
and teaching require the professional judgment of a registered nurse.
3. An older adult client with a long history of chronic obstructive pulmonary disease (COPD) is
admitted with progressive shortness of breath and a persistent cough. The client is anxious
and complaining of a dry mouth. Which intervention should the nurse implement?
A. Administer a prescribed sedative
🟢 B. Assist the client to an upright position
C. Encourage the client to drink water
D. Apply a high-flow Venturi mask
🔴 RATIONALE: Assisting the client to an upright position (high-Fowler's or orthopneic position)
maximizes chest expansion and improves ventilation in COPD.
4. A client with multiple sclerosis (MS) is admitted to the medical unit. The client reports fatigue,
muscle weakness, and diplopia. Which actions should the nurse implement to reduce the
client's risk for falls? (Select all that apply)
🟢 A. Provide assistance to the bedside commode
B. Encourage the client to ambulate independently
🟢 C. Schedule frequent rest periods
, D. Monitor pulse oximetry during activities
🟢 E. Teach the client to patch one eye while walking
🔴 RATIONALE: Fall risk in MS is reduced by assisting with mobility (A), preventing fatigue with
rest periods (C), and teaching monocular patching for diplopia (E) to improve depth perception.
5. A client arrives to the emergency department following a motor vehicle collision. The nurse
observes the client experiencing increasing dyspnea and notes absent breath sounds on the
left side. Which procedure should the nurse prepare for?
A. Bronchoscopy
🟢 B. Chest tube insertion
C. Endotracheal intubation
D. Pulmonary function test
🔴 RATIONALE: Absent breath sounds and dyspnea after trauma suggest a pneumothorax,
which requires chest tube insertion to re-expand the lung.
6. Following a transurethral resection of the prostate (TURP), a client is discharged with an
indwelling urinary catheter. Which instruction is most important for the nurse to include in the
discharge teaching plan?
A. Eliminate all spicy foods from your diet
🟢 B. Drink 3 liters of water each day
C. Clamp the catheter when taking a shower
D. Avoid driving a car for 2 weeks
