BSN 266 HESI
MED SURG STUDY GUIDE
(NGN-Style & Case Scenarios)
400+ Qs & Ans to Pass the Exam
This Hesi test contains:
400+ Qs & Ans
passing score Guarantee
Format Set of Multiple-choice
questions with incorporating Next Generation NCLEX (NGN)
and Case Scenarios
Expert-Verified Explanations & Solutions
,### 1.
A client who underwent cardiac stent placement 4 days ago arrives to the emergency
department reporting sudden onset chest pressure and shortness of breath.
Which action should the nurse take next?
Answer Choices:
a. Administer prescribed nitroglycerin sublingually.
b. Obtain a 12-lead electrocardiogram (ECG) and begin continuous cardiac monitoring.
c. Give oxygen at 2 liters per minute via nasal cannula.
d. Prepare the client for immediate cardiac catheterization.
Correct Answer:
b. Obtain a 12-lead electrocardiogram (ECG) and begin continuous cardiac monitoring.
Expert Rationale:
A client with sudden chest pressure and shortness of breath after recent stenting is at high
risk for acute stent thrombosis or myocardial infarction (MI). Immediate acquisition of a 12-
lead ECG is critical to assess for ischemic changes and to prioritize timely reperfusion
therapy if needed. Continuous cardiac monitoring is essential to detect arrhythmias.
Although oxygen and nitroglycerin may be administered per protocol, assessment data
guides further interventions. Immediate preparation for catheterization is premature before
diagnostic confirmation.
---
### 2.
,While completing a health assessment for a client with migraine headaches, the nurse
identifies bilateral weakness in the client’s hand grips. The client reports joint pain and
difficulty twisting a door knob due to weakness.
Which action should the nurse take next?
Answer Choices:
a. Teach the client relaxation techniques to manage migraine pain.
b. Document the findings and continue with the neurological assessment.
c. Gather additional assessment data about the pain and weakness.
d. Refer the client immediately to a neurologist.
Correct Answer:
c. Gather additional assessment data about the pain and weakness.
Expert Rationale:
Bilateral hand weakness and joint pain suggest possible systemic or neurological disease
beyond migraines (e.g., rheumatoid arthritis, neuropathy). Further assessment to clarify
onset, duration, associated symptoms, and functional impact is needed before specialist
referral. Immediate referral without data may delay appropriate care; documenting without
further inquiry risks missing early diagnostic clues.
---
### 3.
The nurse is caring for a client diagnosed with psoriasis vulgaris receiving psoralen and
ultraviolet A light (PUVA) treatment.
Which assessment finding indicates overexposure to treatment?
, Answer Choices:
a. Increased thickening and scaling of plaques.
b. Tenderness upon palpation and generalized erythema.
c. Development of vesicular lesions on treated skin.
d. Mild tanning of treated areas.
Correct Answer:
b. Tenderness upon palpation and generalized erythema.
Expert Rationale:
PUVA therapy carries a risk of phototoxic reactions causing erythema, tenderness, and
burning which signal overexposure. Tenderness with generalized erythema suggests a burn-
like reaction requiring treatment modification. Vesicular lesions are rare but possible. Mild
tanning is expected, while increased plaque scaling indicates disease progression, not
treatment toxicity.
---
### 4.
An adult client who had gastric bypass surgery 2 weeks ago presents with abdominal
tenderness and vital signs: temp 101°F (38.3°C), HR 130 bpm, RR 26, BP 100/50 mmHg.
Which intervention is most important for the nurse to include in the care plan?
Answer Choices:
a. Encourage oral fluids as tolerated.
b. Administer analgesics as prescribed.
MED SURG STUDY GUIDE
(NGN-Style & Case Scenarios)
400+ Qs & Ans to Pass the Exam
This Hesi test contains:
400+ Qs & Ans
passing score Guarantee
Format Set of Multiple-choice
questions with incorporating Next Generation NCLEX (NGN)
and Case Scenarios
Expert-Verified Explanations & Solutions
,### 1.
A client who underwent cardiac stent placement 4 days ago arrives to the emergency
department reporting sudden onset chest pressure and shortness of breath.
Which action should the nurse take next?
Answer Choices:
a. Administer prescribed nitroglycerin sublingually.
b. Obtain a 12-lead electrocardiogram (ECG) and begin continuous cardiac monitoring.
c. Give oxygen at 2 liters per minute via nasal cannula.
d. Prepare the client for immediate cardiac catheterization.
Correct Answer:
b. Obtain a 12-lead electrocardiogram (ECG) and begin continuous cardiac monitoring.
Expert Rationale:
A client with sudden chest pressure and shortness of breath after recent stenting is at high
risk for acute stent thrombosis or myocardial infarction (MI). Immediate acquisition of a 12-
lead ECG is critical to assess for ischemic changes and to prioritize timely reperfusion
therapy if needed. Continuous cardiac monitoring is essential to detect arrhythmias.
Although oxygen and nitroglycerin may be administered per protocol, assessment data
guides further interventions. Immediate preparation for catheterization is premature before
diagnostic confirmation.
---
### 2.
,While completing a health assessment for a client with migraine headaches, the nurse
identifies bilateral weakness in the client’s hand grips. The client reports joint pain and
difficulty twisting a door knob due to weakness.
Which action should the nurse take next?
Answer Choices:
a. Teach the client relaxation techniques to manage migraine pain.
b. Document the findings and continue with the neurological assessment.
c. Gather additional assessment data about the pain and weakness.
d. Refer the client immediately to a neurologist.
Correct Answer:
c. Gather additional assessment data about the pain and weakness.
Expert Rationale:
Bilateral hand weakness and joint pain suggest possible systemic or neurological disease
beyond migraines (e.g., rheumatoid arthritis, neuropathy). Further assessment to clarify
onset, duration, associated symptoms, and functional impact is needed before specialist
referral. Immediate referral without data may delay appropriate care; documenting without
further inquiry risks missing early diagnostic clues.
---
### 3.
The nurse is caring for a client diagnosed with psoriasis vulgaris receiving psoralen and
ultraviolet A light (PUVA) treatment.
Which assessment finding indicates overexposure to treatment?
, Answer Choices:
a. Increased thickening and scaling of plaques.
b. Tenderness upon palpation and generalized erythema.
c. Development of vesicular lesions on treated skin.
d. Mild tanning of treated areas.
Correct Answer:
b. Tenderness upon palpation and generalized erythema.
Expert Rationale:
PUVA therapy carries a risk of phototoxic reactions causing erythema, tenderness, and
burning which signal overexposure. Tenderness with generalized erythema suggests a burn-
like reaction requiring treatment modification. Vesicular lesions are rare but possible. Mild
tanning is expected, while increased plaque scaling indicates disease progression, not
treatment toxicity.
---
### 4.
An adult client who had gastric bypass surgery 2 weeks ago presents with abdominal
tenderness and vital signs: temp 101°F (38.3°C), HR 130 bpm, RR 26, BP 100/50 mmHg.
Which intervention is most important for the nurse to include in the care plan?
Answer Choices:
a. Encourage oral fluids as tolerated.
b. Administer analgesics as prescribed.
