BSN 266 HESI Med Surg Proctored
Exam 2025/2026 – 100% Verified Full
Exam with A+ Answers | Actual Test
Bank | Nightingale College
100% Verified Full Exam | Actual Test Bank with A+ Answers & Rationales
This comprehensive A+ prep guide for the BSN 266 HESI Med Surg Proctored Exam
(2025/2026) at Nightingale College compiles 50+ high-yield multiple-choice questions from
verified sources, including surgical prep, respiratory distress, GI disorders, endocrine
emergencies, and more. Questions mirror the exam format (select-all-that-apply, prioritization,
pharmacology). Correct answers are in red, with expert rationales for remediation. Focus on
critical thinking and patient safety—pair with HESI case studies for 90%+ mastery. Updated for
current guidelines (e.g., AHA, GOLD).
1 The nurse is preparing a client for orthopedic surgery on the left leg and completing a safety
checklist before transport to the operating room. Which items should the nurse remove from the
client? (Select all that apply.) A. Nail polish B. Hearing aid C. Wedding band D. Left leg brace
E. Contact lenses F. Partial dentures
A, E, F Rationale: Nail polish interferes with pulse oximetry and capillary refill assessment (A).
Contact lenses (E) and partial dentures (F) pose aspiration risks under anesthesia. Hearing aids
(B) and wedding bands (C) can stay if secure; braces (D) are needed for positioning.
────────────────────────────
2 The nurse should explain to a client with lung cancer that pleurodesis is performed to achieve
which expected outcome? A. Prevent the formation of effusion fluid B. Remove fluid from the
intrapleural space C. Debulk tumor to maintain patency of air passages D. Relieve empyema
after pneumonectomy
A Rationale: Pleurodesis uses a sclerosing agent to fuse pleural layers, preventing recurrent
effusions (A). It does not remove existing fluid (B), debulk tumors (C), or treat empyema post-
surgery (D).
────────────────────────────
3 A client with a peptic ulcer has been instructed to avoid intense physical activity and stress.
Which strategy should the client incorporate into the home care plan? A. Use relaxation
, techniques to reduce stress B. Increase aerobic exercise to 30 minutes daily C. Limit meals to
three large ones per day D. Take antacids immediately after eating
A Rationale: Stress exacerbates acid secretion in peptic ulcers; relaxation (e.g., deep breathing)
reduces it (A). Avoid intense exercise (B) to prevent bleeding; small frequent meals (not large,
C) and antacids 1-3 hr post-meal (D) are better.
────────────────────────────
4 A client who underwent cardiac stent placement four days ago arrives to the emergency
department reporting sudden chest pressure and shortness of breath. Which action should the
nurse take first? A. Administer oxygen at 2 L/min via nasal cannula B. Obtain a 12-lead ECG C.
Assess vital signs D. Prepare for thrombolytic therapy
C Rationale: ABCs prioritize—assess vital signs first (C) to detect instability (e.g., hypotension).
Then ECG (B) for stent thrombosis; oxygen (A) if hypoxic; thrombolytics (D) not for stents.
────────────────────────────
5 The nurse is administering a saturated solution of potassium iodide (SSKI). The nurse should:
A. Pour the solution over ice chips B. Mix the solution with an antacid C. Dilute the solution
with water, milk, or fruit juice and have the client drink it with a straw D. Disguise the solution
in a pureed fruit or vegetable
C Rationale: SSKI is bitter/salty; dilute in liquid (C) and use straw to minimize taste/esophageal
irritation. Ice (A) may not help; antacids (B) interact; disguising (D) risks inaccurate dosing.
────────────────────────────
6 Following a subtotal thyroidectomy, the nurse asks the client to speak immediately upon
regaining consciousness. The client is unable to speak. What is the nurse's priority action? A.
Check for the presence of a hematoma B. Assess respiratory rate and depth C. Notify the surgeon
D. Prepare for emergency reintubation
B Rationale: Hoarseness may indicate recurrent laryngeal nerve damage, but airway patency is
priority (B). Hematoma (A) causes stridor; notify surgeon (C) after assessment; reintubate (D) if
obstructed.
────────────────────────────
7 What types of medications should the nurse expect to administer to a client during an acute
respiratory distress episode? A. Antihypertensives and diuretics B. Analgesics and sedatives C.
Anticoagulants and expectorants D. Bronchodilators and steroids
D Rationale: ARDS requires bronchodilators (e.g., albuterol) for airway patency and steroids
(e.g., methylprednisolone) for inflammation (D). Others are not primary for respiratory distress.
Exam 2025/2026 – 100% Verified Full
Exam with A+ Answers | Actual Test
Bank | Nightingale College
100% Verified Full Exam | Actual Test Bank with A+ Answers & Rationales
This comprehensive A+ prep guide for the BSN 266 HESI Med Surg Proctored Exam
(2025/2026) at Nightingale College compiles 50+ high-yield multiple-choice questions from
verified sources, including surgical prep, respiratory distress, GI disorders, endocrine
emergencies, and more. Questions mirror the exam format (select-all-that-apply, prioritization,
pharmacology). Correct answers are in red, with expert rationales for remediation. Focus on
critical thinking and patient safety—pair with HESI case studies for 90%+ mastery. Updated for
current guidelines (e.g., AHA, GOLD).
1 The nurse is preparing a client for orthopedic surgery on the left leg and completing a safety
checklist before transport to the operating room. Which items should the nurse remove from the
client? (Select all that apply.) A. Nail polish B. Hearing aid C. Wedding band D. Left leg brace
E. Contact lenses F. Partial dentures
A, E, F Rationale: Nail polish interferes with pulse oximetry and capillary refill assessment (A).
Contact lenses (E) and partial dentures (F) pose aspiration risks under anesthesia. Hearing aids
(B) and wedding bands (C) can stay if secure; braces (D) are needed for positioning.
────────────────────────────
2 The nurse should explain to a client with lung cancer that pleurodesis is performed to achieve
which expected outcome? A. Prevent the formation of effusion fluid B. Remove fluid from the
intrapleural space C. Debulk tumor to maintain patency of air passages D. Relieve empyema
after pneumonectomy
A Rationale: Pleurodesis uses a sclerosing agent to fuse pleural layers, preventing recurrent
effusions (A). It does not remove existing fluid (B), debulk tumors (C), or treat empyema post-
surgery (D).
────────────────────────────
3 A client with a peptic ulcer has been instructed to avoid intense physical activity and stress.
Which strategy should the client incorporate into the home care plan? A. Use relaxation
, techniques to reduce stress B. Increase aerobic exercise to 30 minutes daily C. Limit meals to
three large ones per day D. Take antacids immediately after eating
A Rationale: Stress exacerbates acid secretion in peptic ulcers; relaxation (e.g., deep breathing)
reduces it (A). Avoid intense exercise (B) to prevent bleeding; small frequent meals (not large,
C) and antacids 1-3 hr post-meal (D) are better.
────────────────────────────
4 A client who underwent cardiac stent placement four days ago arrives to the emergency
department reporting sudden chest pressure and shortness of breath. Which action should the
nurse take first? A. Administer oxygen at 2 L/min via nasal cannula B. Obtain a 12-lead ECG C.
Assess vital signs D. Prepare for thrombolytic therapy
C Rationale: ABCs prioritize—assess vital signs first (C) to detect instability (e.g., hypotension).
Then ECG (B) for stent thrombosis; oxygen (A) if hypoxic; thrombolytics (D) not for stents.
────────────────────────────
5 The nurse is administering a saturated solution of potassium iodide (SSKI). The nurse should:
A. Pour the solution over ice chips B. Mix the solution with an antacid C. Dilute the solution
with water, milk, or fruit juice and have the client drink it with a straw D. Disguise the solution
in a pureed fruit or vegetable
C Rationale: SSKI is bitter/salty; dilute in liquid (C) and use straw to minimize taste/esophageal
irritation. Ice (A) may not help; antacids (B) interact; disguising (D) risks inaccurate dosing.
────────────────────────────
6 Following a subtotal thyroidectomy, the nurse asks the client to speak immediately upon
regaining consciousness. The client is unable to speak. What is the nurse's priority action? A.
Check for the presence of a hematoma B. Assess respiratory rate and depth C. Notify the surgeon
D. Prepare for emergency reintubation
B Rationale: Hoarseness may indicate recurrent laryngeal nerve damage, but airway patency is
priority (B). Hematoma (A) causes stridor; notify surgeon (C) after assessment; reintubate (D) if
obstructed.
────────────────────────────
7 What types of medications should the nurse expect to administer to a client during an acute
respiratory distress episode? A. Antihypertensives and diuretics B. Analgesics and sedatives C.
Anticoagulants and expectorants D. Bronchodilators and steroids
D Rationale: ARDS requires bronchodilators (e.g., albuterol) for airway patency and steroids
(e.g., methylprednisolone) for inflammation (D). Others are not primary for respiratory distress.
