BSN HESI 266 MED SURG ACTUAL EXAM 2026/2027 |
Questions & Verified Answers 100% Correct | Grade A |
Nightingale | Pass Guaranteed - A+ Graded
Section 1: Cardiovascular Disorders
Q1: A 72-year-old patient with chronic heart failure is being discharged home. The nurse
is reviewing daily weight monitoring. Which statement by the patient indicates correct
understanding of this self-management strategy?
A. "I should weigh myself once a week after breakfast."
B. "I'll call the doctor if I gain more than 2 to 3 pounds in a day or 3 to 5 pounds in a
week." [CORRECT]
C. "Weight gain doesn't matter as long as my ankles aren't swollen."
D. "I'll only weigh myself if I feel short of breath."
Correct Answer: B
Rationale: The correct answer is B. On the HESI, remember that sudden weight gain is
often the earliest sign of fluid retention in heart failure—patients need to catch that
trend before it turns into acute pulmonary edema. That's correct because in Med-Surg
nursing, we teach daily weights at the same time each morning, and any gain over 2–3
pounds in a single day means it's time to call the provider.
Q2: A patient admitted with chest pain is diagnosed with an acute ST-elevation
myocardial infarction. Which action should the nurse take first?
,A. Administer sublingual nitroglycerin every 5 minutes
B. Obtain a 12-lead ECG and establish IV access [CORRECT]
C. Give enteric-coated aspirin to swallow whole
D. Prepare the patient for immediate discharge teaching
Correct Answer: B
Rationale: The correct answer is B. The priority in an acute MI is rapid assessment and
access—getting that ECG within 10 minutes and IV access lets the team move quickly
toward reperfusion therapy. This aligns with HESI testing strategies where you always
stabilize and assess before medicating, and time is muscle when it comes to STEMI.
Q3: A patient with newly diagnosed hypertension asks why lifestyle changes are
important if medication will control the blood pressure. Which response by the nurse is
most appropriate?
A. "Medications work better when combined with a low-sodium diet, regular exercise,
and weight management." [CORRECT]
B. "You'll be able to stop your medications completely within six months."
C. "Lifestyle changes aren't necessary once you start medication."
D. "Your blood pressure will normalize regardless of diet as long as you take the pills."
Correct Answer: A
Rationale: The correct answer is A. In Med-Surg nursing, we know that antihypertensives
aren't a free pass—diet and exercise are foundational to reducing cardiovascular risk
,and often allow for lower medication doses. Think about it this way: even the best
medication can't fully overcome a high-sodium diet and sedentary lifestyle.
Q4: Which modifiable risk factor is most strongly associated with the development of
coronary artery disease?
A. Family history of early heart disease
B. Age over 65 years
C. Cigarette smoking [CORRECT]
D. Male gender
Correct Answer: C
Rationale: The correct answer is C. Smoking is the big one we can actually do
something about—it damages endothelium, promotes thrombosis, and drops HDL all at
once. On the HESI, remember that family history, age, and gender are non-modifiable, so
when the question asks what the patient can change, smoking cessation tops the list.
Q5: The nurse receives report on four patients. Which patient should the nurse assess
first?
A. A patient with atrial fibrillation who is scheduled for a cardioversion in two hours
B. A patient with a new permanent pacemaker who is requesting pain medication for
incisional soreness
C. A patient with acute coronary syndrome who just developed ventricular tachycardia
with a pulse of 160 [CORRECT]
, D. A patient with stable angina who is due for a scheduled walk before lunch
Correct Answer: C
Rationale: The correct answer is C. The priority action is always the unstable,
life-threatening rhythm—ventricular tachycardia in an ACS patient can deteriorate into
V-fib quickly, so this patient needs immediate assessment and intervention. On the
HESI, use the ABCs and unstable vs. stable logic; a lethal arrhythmia always wins over
scheduled procedures or comfort needs.
Q6: A patient with atrial fibrillation is prescribed warfarin. Which laboratory value will the
nurse monitor to evaluate therapeutic effect?
A. Activated partial thromboplastin time (aPTT)
B. International normalized ratio (INR) [CORRECT]
C. Platelet count
D. Prothrombin time (PT) alone
Correct Answer: B
Rationale: The correct answer is B. Warfarin therapy is monitored with INR because it
standardizes PT results across different labs and reagents, with a therapeutic range
usually around 2.0 to 3.0 for A-fib. That's correct because in Med-Surg nursing, we don't
rely on PT alone anymore—INR is the gold standard for warfarin monitoring.
Q7: A patient in cardiogenic shock has the following hemodynamic readings: BP 78/52
mmHg, CVP 14 mmHg, PAOP 24 mmHg, cardiac index 1.8 L/min/m². Which
assessment finding is consistent with these values?
Questions & Verified Answers 100% Correct | Grade A |
Nightingale | Pass Guaranteed - A+ Graded
Section 1: Cardiovascular Disorders
Q1: A 72-year-old patient with chronic heart failure is being discharged home. The nurse
is reviewing daily weight monitoring. Which statement by the patient indicates correct
understanding of this self-management strategy?
A. "I should weigh myself once a week after breakfast."
B. "I'll call the doctor if I gain more than 2 to 3 pounds in a day or 3 to 5 pounds in a
week." [CORRECT]
C. "Weight gain doesn't matter as long as my ankles aren't swollen."
D. "I'll only weigh myself if I feel short of breath."
Correct Answer: B
Rationale: The correct answer is B. On the HESI, remember that sudden weight gain is
often the earliest sign of fluid retention in heart failure—patients need to catch that
trend before it turns into acute pulmonary edema. That's correct because in Med-Surg
nursing, we teach daily weights at the same time each morning, and any gain over 2–3
pounds in a single day means it's time to call the provider.
Q2: A patient admitted with chest pain is diagnosed with an acute ST-elevation
myocardial infarction. Which action should the nurse take first?
,A. Administer sublingual nitroglycerin every 5 minutes
B. Obtain a 12-lead ECG and establish IV access [CORRECT]
C. Give enteric-coated aspirin to swallow whole
D. Prepare the patient for immediate discharge teaching
Correct Answer: B
Rationale: The correct answer is B. The priority in an acute MI is rapid assessment and
access—getting that ECG within 10 minutes and IV access lets the team move quickly
toward reperfusion therapy. This aligns with HESI testing strategies where you always
stabilize and assess before medicating, and time is muscle when it comes to STEMI.
Q3: A patient with newly diagnosed hypertension asks why lifestyle changes are
important if medication will control the blood pressure. Which response by the nurse is
most appropriate?
A. "Medications work better when combined with a low-sodium diet, regular exercise,
and weight management." [CORRECT]
B. "You'll be able to stop your medications completely within six months."
C. "Lifestyle changes aren't necessary once you start medication."
D. "Your blood pressure will normalize regardless of diet as long as you take the pills."
Correct Answer: A
Rationale: The correct answer is A. In Med-Surg nursing, we know that antihypertensives
aren't a free pass—diet and exercise are foundational to reducing cardiovascular risk
,and often allow for lower medication doses. Think about it this way: even the best
medication can't fully overcome a high-sodium diet and sedentary lifestyle.
Q4: Which modifiable risk factor is most strongly associated with the development of
coronary artery disease?
A. Family history of early heart disease
B. Age over 65 years
C. Cigarette smoking [CORRECT]
D. Male gender
Correct Answer: C
Rationale: The correct answer is C. Smoking is the big one we can actually do
something about—it damages endothelium, promotes thrombosis, and drops HDL all at
once. On the HESI, remember that family history, age, and gender are non-modifiable, so
when the question asks what the patient can change, smoking cessation tops the list.
Q5: The nurse receives report on four patients. Which patient should the nurse assess
first?
A. A patient with atrial fibrillation who is scheduled for a cardioversion in two hours
B. A patient with a new permanent pacemaker who is requesting pain medication for
incisional soreness
C. A patient with acute coronary syndrome who just developed ventricular tachycardia
with a pulse of 160 [CORRECT]
, D. A patient with stable angina who is due for a scheduled walk before lunch
Correct Answer: C
Rationale: The correct answer is C. The priority action is always the unstable,
life-threatening rhythm—ventricular tachycardia in an ACS patient can deteriorate into
V-fib quickly, so this patient needs immediate assessment and intervention. On the
HESI, use the ABCs and unstable vs. stable logic; a lethal arrhythmia always wins over
scheduled procedures or comfort needs.
Q6: A patient with atrial fibrillation is prescribed warfarin. Which laboratory value will the
nurse monitor to evaluate therapeutic effect?
A. Activated partial thromboplastin time (aPTT)
B. International normalized ratio (INR) [CORRECT]
C. Platelet count
D. Prothrombin time (PT) alone
Correct Answer: B
Rationale: The correct answer is B. Warfarin therapy is monitored with INR because it
standardizes PT results across different labs and reagents, with a therapeutic range
usually around 2.0 to 3.0 for A-fib. That's correct because in Med-Surg nursing, we don't
rely on PT alone anymore—INR is the gold standard for warfarin monitoring.
Q7: A patient in cardiogenic shock has the following hemodynamic readings: BP 78/52
mmHg, CVP 14 mmHg, PAOP 24 mmHg, cardiac index 1.8 L/min/m². Which
assessment finding is consistent with these values?
