BSN HESI 266 Med Surg Exam
ACTUAL EXAM 2025/2026 | Nightingale
College | Complete Question Bank with
Verified Answers | Verified Q&A | Pass
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SECTION 1: CARDIOVASCULAR DISORDERS (Questions
1–42)
Q1: A 68-year-old male is admitted with acute chest pain. Vital signs: BP 88/52 mmHg, HR 118 bpm
(irregular), RR 28/min, SpO₂ 89% on room air. ECG shows ST elevation in leads II, III, and aVF.
Which action should the nurse take first?
A. Administer sublingual nitroglycerin 0.4 mg
B. Start oxygen at 2 L/min via nasal cannula
C. Establish IV access and prepare for thrombolytics [CORRECT]
D. Obtain a 12-lead ECG
,Q2: A patient is 2 hours post-cardiac catheterization with femoral access. The patient reports
sudden severe back pain. Vital signs: BP 92/60 mmHg, HR 122 bpm, RR 24/min. The puncture site
dressing is dry and intact. Which is the priority nursing action?
A. Apply firm pressure to the groin site
B. Notify the provider and prepare for emergency intervention [CORRECT]
C. Administer prescribed morphine sulfate 2 mg IV
D. Elevate the head of bed to 30 degrees
Q3: Which patient should the charge nurse assess first?
A. Patient with atrial fibrillation, HR 102 bpm, awaiting cardioversion scheduled in 2 hours
B. Patient 4 hours post-MI with occasional unifocal PVCs
C. Patient with new-onset heart failure reporting increasing dyspnea and orthopnea [CORRECT]
D. Patient status post pacemaker insertion with stable rhythm at 70 bpm
Q4: A patient with chronic heart failure is prescribed lisinopril 10 mg daily, furosemide 40 mg daily,
and digoxin 0.125 mg daily. Which laboratory value requires immediate nursing intervention?
,A. Sodium 138 mEq/L
B. Potassium 3.0 mEq/L [CORRECT]
C. BUN 22 mg/dL
D. Creatinine 1.3 mg/dL
Q5: [SATA] A patient with hypertrophic cardiomyopathy (HCM) is being discharged. Which
instructions should the nurse include? (Select all that apply)
A. Avoid strenuous exercise and competitive sports [CORRECT]
B. Maintain adequate hydration [CORRECT]
C. Take prophylactic antibiotics before dental procedures [CORRECT]
D. Perform Valsalva maneuver when having palpitations
E. Avoid sudden position changes [CORRECT]
Correct Answer: A, B, C, E
Q6: A patient with end-stage heart failure is receiving dobutamine 5 mcg/kg/min. Which
assessment finding indicates the medication is effective?
, A. Decreased heart rate from 110 to 95 bpm
B. Increased urine output from 20 mL/hr to 60 mL/hr [CORRECT]
C. Blood pressure decreased from 142/88 to 118/72 mmHg
D. Respiratory rate increased from 18 to 24/min
Q7: A patient with unstable angina is receiving IV heparin. The aPTT is 95 seconds (therapeutic
range 60-80 seconds). Which nursing action is appropriate?
A. Continue current infusion rate
B. Increase infusion rate by 2 units/kg/hr
C. Hold infusion for 1 hour and reduce rate per protocol [CORRECT]
D. Administer protamine sulfate 10 mg IV
Q8: [Dosage Calculation] A patient is prescribed amiodarone 150 mg IV push over 10 minutes. The
available concentration is 50 mg/mL. How many mL should the nurse administer?
A. 2 mL
B. 3 mL [CORRECT]
ACTUAL EXAM 2025/2026 | Nightingale
College | Complete Question Bank with
Verified Answers | Verified Q&A | Pass
Guaranteed - A+ Graded
SECTION 1: CARDIOVASCULAR DISORDERS (Questions
1–42)
Q1: A 68-year-old male is admitted with acute chest pain. Vital signs: BP 88/52 mmHg, HR 118 bpm
(irregular), RR 28/min, SpO₂ 89% on room air. ECG shows ST elevation in leads II, III, and aVF.
Which action should the nurse take first?
A. Administer sublingual nitroglycerin 0.4 mg
B. Start oxygen at 2 L/min via nasal cannula
C. Establish IV access and prepare for thrombolytics [CORRECT]
D. Obtain a 12-lead ECG
,Q2: A patient is 2 hours post-cardiac catheterization with femoral access. The patient reports
sudden severe back pain. Vital signs: BP 92/60 mmHg, HR 122 bpm, RR 24/min. The puncture site
dressing is dry and intact. Which is the priority nursing action?
A. Apply firm pressure to the groin site
B. Notify the provider and prepare for emergency intervention [CORRECT]
C. Administer prescribed morphine sulfate 2 mg IV
D. Elevate the head of bed to 30 degrees
Q3: Which patient should the charge nurse assess first?
A. Patient with atrial fibrillation, HR 102 bpm, awaiting cardioversion scheduled in 2 hours
B. Patient 4 hours post-MI with occasional unifocal PVCs
C. Patient with new-onset heart failure reporting increasing dyspnea and orthopnea [CORRECT]
D. Patient status post pacemaker insertion with stable rhythm at 70 bpm
Q4: A patient with chronic heart failure is prescribed lisinopril 10 mg daily, furosemide 40 mg daily,
and digoxin 0.125 mg daily. Which laboratory value requires immediate nursing intervention?
,A. Sodium 138 mEq/L
B. Potassium 3.0 mEq/L [CORRECT]
C. BUN 22 mg/dL
D. Creatinine 1.3 mg/dL
Q5: [SATA] A patient with hypertrophic cardiomyopathy (HCM) is being discharged. Which
instructions should the nurse include? (Select all that apply)
A. Avoid strenuous exercise and competitive sports [CORRECT]
B. Maintain adequate hydration [CORRECT]
C. Take prophylactic antibiotics before dental procedures [CORRECT]
D. Perform Valsalva maneuver when having palpitations
E. Avoid sudden position changes [CORRECT]
Correct Answer: A, B, C, E
Q6: A patient with end-stage heart failure is receiving dobutamine 5 mcg/kg/min. Which
assessment finding indicates the medication is effective?
, A. Decreased heart rate from 110 to 95 bpm
B. Increased urine output from 20 mL/hr to 60 mL/hr [CORRECT]
C. Blood pressure decreased from 142/88 to 118/72 mmHg
D. Respiratory rate increased from 18 to 24/min
Q7: A patient with unstable angina is receiving IV heparin. The aPTT is 95 seconds (therapeutic
range 60-80 seconds). Which nursing action is appropriate?
A. Continue current infusion rate
B. Increase infusion rate by 2 units/kg/hr
C. Hold infusion for 1 hour and reduce rate per protocol [CORRECT]
D. Administer protamine sulfate 10 mg IV
Q8: [Dosage Calculation] A patient is prescribed amiodarone 150 mg IV push over 10 minutes. The
available concentration is 50 mg/mL. How many mL should the nurse administer?
A. 2 mL
B. 3 mL [CORRECT]
