BSN 266 HESI Updated: Comprehensive Medical-Surgical Nursing
Review (Latest 2026/2027 Update) | Q&A | Grade A | 100% Correct
(Verified Answers) – Nursing Program
Subject: BSN 266 HESI – COPD, MS, TURP, Graves Disease, Meningitis, DM Complications,
Cirrhosis, Stroke, Skin Cancer, Post-Op Care, Glomerulonephritis, Nephrectomy, Lithotripsy,
Crohn's, Pheochromocytoma, Diabetes Insipidus, Fracture Assessment, Pre-op Care, PUD,
Herpes Zoster, AAA, AKI, Raynaud's, Cataract, Ciprofloxacin, Degenerative Joint Disease, SLE,
Ulna Fracture, Parkinson's, Right Heart Failure, Thoracentesis, Spinal Cord Injury, NGN Cases
(Liver Disorder, Folic Acid Deficiency, DVT, BPH, Gallstones)
Source: HESI Comprehensive Review / Medical-Surgical Nursing / NGN Practice
Format: Q&A Guide with Clinical Rationale | 100% Verified
1: An older adult client with a long history of COPD is admitted with progressive shortness
of breath, persistent cough, anxiety, and dry mouth. Which intervention should the nurse
implement?
Correct Answer: B. Assist client to an upright position
1. Upright position optimizes diaphragmatic excursion and lung expansion.
2. High Fowler's position reduces work of breathing; priority before fluids or sedatives.
2: A client with multiple sclerosis reports fatigue, muscle weakness, and diplopia. Which
actions reduce fall risk? (SATA)
Correct Answer: A. Provide assistance to bedside commode; C. Schedule frequent rest periods; E.
Teach to patch one eye while walking
1. Patching one eye reduces diplopia and improves depth perception.
2. Frequent rest periods conserve energy; assisted mobility prevents falls.
3: A client after MVA has increasing dyspnea and absent breath sounds on left side. Which
procedure should the nurse prepare for?
Correct Answer: B. Chest tube insertion
1. Absent breath sounds after trauma suggests pneumothorax or hemothorax.
2. Chest tube re-expands lung and drains air/blood.
4: Following TURP, a client is discharged with an indwelling urinary catheter. Which
instruction is most important?
Correct Answer: B. Drink 3 liters of water each day
1. High fluid intake flushes clots and prevents catheter obstruction.
2. Crucial to maintain urine output and prevent infection.
, 5: An adult woman with Graves disease is admitted with severe dehydration, malnutrition,
restlessness, and refusing to eat. Which action is most important?
Correct Answer: C. Maintain a patent intravenous site
1. Severe dehydration and malnutrition require IV access for fluids and nutrition.
2. Thyroid storm risk; IV access for medications and hydration is priority.
6: A client reports burning on urination after sexual intercourse with a casual acquaintance
4 days ago. Which action should the nurse implement?
Correct Answer: A. Obtain a specimen of urethral drainage for culture
1. Urethral discharge culture identifies gonorrhea or chlamydia.
2. Nucleic acid amplification test (NAAT) is gold standard.
7: A client admitted with suspected bacterial meningitis. Which diagnostic procedure
should the nurse prepare for?
Correct Answer: A. Lumbar puncture
1. LP obtains CSF for cell count, protein, glucose, and culture.
2. Definitive diagnosis of meningitis.
8: An older adult with long-term type 2 DM is seen for routine health assessment. Which
assessments determine long-term complications? (SATA)
Correct Answer: A. Sensation in feet and legs; B. Skin condition of lower extremities; C. Visual acuity;
D. Serum creatinine and BUN
1. Monofilament test for neuropathy; skin checks for ulcers.
2. Dilated eye exam for retinopathy; BUN/Cr for nephropathy.
9: A client with cirrhosis has 4+ pitting edema and massive ascites. Which mechanism
contributes to edema and ascites?
Correct Answer: B. Hypoalbuminemia that results in decreased colloidal oncotic pressure
1. Liver damage decreases albumin synthesis → low oncotic pressure.
2. Fluid leaks from vessels into interstitial space and peritoneal cavity.
10: An older adult client with expressive aphasia (Broca's) after CVA becomes frustrated.
Which intervention should the nurse implement?
Correct Answer: A. Encourage client's use of picture charts
1. Picture charts and communication boards facilitate expression.
2. Reduces frustration when verbal output is impaired.
11: Which client has the highest risk for developing skin cancer?
Correct Answer: B. A 65 year old fair skinned client who works as a construction worker
1. Fair skin + chronic sun exposure = highest risk for melanoma and non-melanoma skin cancers.
2. Cumulative UV exposure is major risk factor.
Review (Latest 2026/2027 Update) | Q&A | Grade A | 100% Correct
(Verified Answers) – Nursing Program
Subject: BSN 266 HESI – COPD, MS, TURP, Graves Disease, Meningitis, DM Complications,
Cirrhosis, Stroke, Skin Cancer, Post-Op Care, Glomerulonephritis, Nephrectomy, Lithotripsy,
Crohn's, Pheochromocytoma, Diabetes Insipidus, Fracture Assessment, Pre-op Care, PUD,
Herpes Zoster, AAA, AKI, Raynaud's, Cataract, Ciprofloxacin, Degenerative Joint Disease, SLE,
Ulna Fracture, Parkinson's, Right Heart Failure, Thoracentesis, Spinal Cord Injury, NGN Cases
(Liver Disorder, Folic Acid Deficiency, DVT, BPH, Gallstones)
Source: HESI Comprehensive Review / Medical-Surgical Nursing / NGN Practice
Format: Q&A Guide with Clinical Rationale | 100% Verified
1: An older adult client with a long history of COPD is admitted with progressive shortness
of breath, persistent cough, anxiety, and dry mouth. Which intervention should the nurse
implement?
Correct Answer: B. Assist client to an upright position
1. Upright position optimizes diaphragmatic excursion and lung expansion.
2. High Fowler's position reduces work of breathing; priority before fluids or sedatives.
2: A client with multiple sclerosis reports fatigue, muscle weakness, and diplopia. Which
actions reduce fall risk? (SATA)
Correct Answer: A. Provide assistance to bedside commode; C. Schedule frequent rest periods; E.
Teach to patch one eye while walking
1. Patching one eye reduces diplopia and improves depth perception.
2. Frequent rest periods conserve energy; assisted mobility prevents falls.
3: A client after MVA has increasing dyspnea and absent breath sounds on left side. Which
procedure should the nurse prepare for?
Correct Answer: B. Chest tube insertion
1. Absent breath sounds after trauma suggests pneumothorax or hemothorax.
2. Chest tube re-expands lung and drains air/blood.
4: Following TURP, a client is discharged with an indwelling urinary catheter. Which
instruction is most important?
Correct Answer: B. Drink 3 liters of water each day
1. High fluid intake flushes clots and prevents catheter obstruction.
2. Crucial to maintain urine output and prevent infection.
, 5: An adult woman with Graves disease is admitted with severe dehydration, malnutrition,
restlessness, and refusing to eat. Which action is most important?
Correct Answer: C. Maintain a patent intravenous site
1. Severe dehydration and malnutrition require IV access for fluids and nutrition.
2. Thyroid storm risk; IV access for medications and hydration is priority.
6: A client reports burning on urination after sexual intercourse with a casual acquaintance
4 days ago. Which action should the nurse implement?
Correct Answer: A. Obtain a specimen of urethral drainage for culture
1. Urethral discharge culture identifies gonorrhea or chlamydia.
2. Nucleic acid amplification test (NAAT) is gold standard.
7: A client admitted with suspected bacterial meningitis. Which diagnostic procedure
should the nurse prepare for?
Correct Answer: A. Lumbar puncture
1. LP obtains CSF for cell count, protein, glucose, and culture.
2. Definitive diagnosis of meningitis.
8: An older adult with long-term type 2 DM is seen for routine health assessment. Which
assessments determine long-term complications? (SATA)
Correct Answer: A. Sensation in feet and legs; B. Skin condition of lower extremities; C. Visual acuity;
D. Serum creatinine and BUN
1. Monofilament test for neuropathy; skin checks for ulcers.
2. Dilated eye exam for retinopathy; BUN/Cr for nephropathy.
9: A client with cirrhosis has 4+ pitting edema and massive ascites. Which mechanism
contributes to edema and ascites?
Correct Answer: B. Hypoalbuminemia that results in decreased colloidal oncotic pressure
1. Liver damage decreases albumin synthesis → low oncotic pressure.
2. Fluid leaks from vessels into interstitial space and peritoneal cavity.
10: An older adult client with expressive aphasia (Broca's) after CVA becomes frustrated.
Which intervention should the nurse implement?
Correct Answer: A. Encourage client's use of picture charts
1. Picture charts and communication boards facilitate expression.
2. Reduces frustration when verbal output is impaired.
11: Which client has the highest risk for developing skin cancer?
Correct Answer: B. A 65 year old fair skinned client who works as a construction worker
1. Fair skin + chronic sun exposure = highest risk for melanoma and non-melanoma skin cancers.
2. Cumulative UV exposure is major risk factor.
