BSN HESI 266 Med Surg EXAM (2026) UPDATE: Latest Medical-Surgical
Nursing Q&A | Grade A | 100% Correct (Verified Answers) – BSN
Program Guaranteed Success
Subject: BSN HESI 266 – Medical-Surgical Nursing: Oncology, Cardiology, Respiratory, GI, GU,
Neurology, Endocrine, Perioperative Care
Source: HESI Comprehensive Review, NCLEX-RN Standards, Evidence-Based Medical-Surgical
Practice
Format: Q&A Guide with Clinical Rationale | 100% Verified for HESI & NCLEX Preparation
Pleurodesis
Correct Answer: A procedure aimed at preventing the formation of a pleural effusion by causing the pleural
spaces to seal together.
1. Pleurodesis is performed for recurrent malignant pleural effusions or pneumothorax by
inducing inflammation that adheres the visceral and parietal pleura.
2. Chemical agents (talc, doxycycline) or mechanical abrasion are used to create pleural
symphysis.
3. The procedure prevents fluid or air from accumulating in the pleural space.
Radiation therapy consequences
Correct Answer: Chronic esophagitis with gastroesophageal reflux is a potential consequence of radiation
therapy for breast cancer.
1. Radiation to breast/chest wall can damage esophageal mucosa, leading to chronic
inflammation and reflux.
2. Late effects include stricture formation, dysphagia, and aspiration risk.
3. Proton therapy may reduce esophageal exposure compared to conventional radiation.
Pathologic fracture
Correct Answer: Fractures that occur without evidence of trauma, often due to loss of bone density from
radiation damage.
1. Pathologic fractures result from weakened bone due to metastasis, radiation, or primary bone
tumors.
2. Radiation causes osteocyte damage and impaired bone remodeling, increasing fracture risk.
3. Prophylactic fixation may be indicated for weight-bearing bones at high risk.
,Sexual activity after myocardial infarction
Correct Answer: Sexual intercourse after an MI requires no more energy expenditure or cardiac stress than
walking briskly up two flights of stairs.
1. Sexual activity is equivalent to moderate physical exertion (3-5 METs) and is safe for stable
post-MI patients.
2. Patients should be able to climb two flights of stairs without symptoms before resuming
intercourse.
3. Positioning and timing (avoid after heavy meals) may reduce cardiac workload.
Percutaneous endoscopic gastrostomy (PEG) tube
Correct Answer: A type of feeding tube that differs from a gastrostomy tube primarily in the method of
insertion.
1. PEG tube is inserted endoscopically through the esophagus into the stomach; surgical
gastrostomy (GT) requires laparotomy.
2. PEG is held in place by an internal bumper and external retention disc; GT is sutured to the
gastric wall.
3. PEG has lower complication rates and can be placed under sedation rather than general
anesthesia.
PEG tube (detailed)
Correct Answer: A tube inserted endoscopically through the esophagus into the stomach, held in place by a
bumper and a water-filled balloon.
1. The internal bumper prevents accidental dislodgement; some newer tubes use a low-profile
balloon system.
2. Placement confirmed by endoscopic visualization and aspiration of gastric contents.
3. Mature tract takes approximately 7-14 days before tube can be safely changed.
GT
Correct Answer: A tube inserted through an incision in the abdomen and sutured to the gastric wall.
1. Surgical gastrostomy (Stamm or Janeway procedure) is performed under general anesthesia.
2. Indicated when endoscopic placement is not possible (esophageal obstruction, prior gastric
surgery).
3. Suturing the stomach to the abdominal wall reduces risk of tube dislodgement into
peritoneum.
,Proctosigmoidoscopy preparation
Correct Answer: Includes obtaining consent, a clear-liquid diet for 24 to 48 hours prior, administration of an
enema, and fasting on the morning of the procedure.
1. Adequate bowel cleansing ensures visualization and biopsy accuracy.
2. Enemas are administered until returns are clear; Fleet enemas should be used with caution in
renal or cardiac patients.
3. Informed consent includes risks of perforation, bleeding, and cardiopulmonary events.
Dysuria in diabetes
Correct Answer: Elevated fingerstick glucose levels (e.g., 300 mg/dl) need to be reported to adjust the care
plan.
1. Hyperglycemia predisposes to urinary tract infections due to glycosuria and impaired immune
function.
2. Dysuria with elevated glucose suggests possible UTI; culture and sensitivity should be
obtained.
3. Tight glycemic control reduces infection risk and improves treatment response.
Right renal calculi nursing diagnosis priority
Correct Answer: Acute pain related to movement of the stone.
1. Renal colic from obstructing ureteral stones is severe and requires immediate pain
management.
2. Priority interventions include hydration, pain medication (NSAIDs, opioids), and straining urine
for stone retrieval.
3. Other diagnoses (impaired urinary elimination, risk for infection) are addressed after pain
control.
Chemotherapy initiation
Correct Answer: Starting chemotherapy early increases the chance of eradicating cancer cells, as 50% of
tumor cells are killed with each dose.
1. Log-kill hypothesis: chemotherapy kills a constant fraction (logarithmic) of tumor cells, not a
constant number.
2. Early initiation reduces tumor burden and prevents development of drug resistance.
3. Dose intensity and schedule adherence are critical for curative outcomes.
, Asterixis
Correct Answer: A clinical sign of liver disease characterized by a flapping tremor of the hands.
1. Asterixis (liver flap) indicates hepatic encephalopathy from ammonia accumulation.
2. Elicited by having patient extend arms and dorsiflex wrists; irregular flapping movements
appear.
3. Treatment focuses on reducing ammonia via lactulose, rifaximin, and dietary protein
management.
Clear-liquid diet
Correct Answer: A diet consisting of clear fluids, often required 24 to 48 hours before certain medical
procedures.
1. Clear liquids include water, broth, clear juices, gelatin, and tea/coffee without milk.
2. Provides hydration and minimal residue while allowing bowel visualization.
3. Does not provide adequate nutrition for extended periods; transition as soon as clinically
appropriate.
Enema
Correct Answer: A procedure to introduce liquid into the rectum to stimulate a bowel movement or cleanse
the bowel before a procedure.
1. Enemas mechanically distend the rectum and soften stool, triggering defecation.
2. Types include tap water, saline, soapsuds, and Fleet (hypertonic phosphate).
3. Contraindications include neutropenia, severe thrombocytopenia, and recent bowel surgery.
Fasting protocol
Correct Answer: Refraining from all food and drink for a specified period, often required before medical
procedures.
1. Standard NPO (nothing by mouth) is 6-8 hours for solids and 2 hours for clear liquids before
anesthesia.
2. Reduces risk of aspiration pneumonitis during sedation or general anesthesia.
3. Critical medications (cardiac, anti-seizure) may be taken with small sips of water.
Suprapubic pain
Correct Answer: Pain located in the lower abdomen, often associated with urinary issues.
1. Suprapubic pain localizes to the area above the pubic symphysis, overlying the bladder.
2. Common causes: cystitis, urinary retention, obstructing stones, pelvic inflammatory disease.
3. Assessment includes palpation, percussion for bladder distention, and urinalysis.
Nursing Q&A | Grade A | 100% Correct (Verified Answers) – BSN
Program Guaranteed Success
Subject: BSN HESI 266 – Medical-Surgical Nursing: Oncology, Cardiology, Respiratory, GI, GU,
Neurology, Endocrine, Perioperative Care
Source: HESI Comprehensive Review, NCLEX-RN Standards, Evidence-Based Medical-Surgical
Practice
Format: Q&A Guide with Clinical Rationale | 100% Verified for HESI & NCLEX Preparation
Pleurodesis
Correct Answer: A procedure aimed at preventing the formation of a pleural effusion by causing the pleural
spaces to seal together.
1. Pleurodesis is performed for recurrent malignant pleural effusions or pneumothorax by
inducing inflammation that adheres the visceral and parietal pleura.
2. Chemical agents (talc, doxycycline) or mechanical abrasion are used to create pleural
symphysis.
3. The procedure prevents fluid or air from accumulating in the pleural space.
Radiation therapy consequences
Correct Answer: Chronic esophagitis with gastroesophageal reflux is a potential consequence of radiation
therapy for breast cancer.
1. Radiation to breast/chest wall can damage esophageal mucosa, leading to chronic
inflammation and reflux.
2. Late effects include stricture formation, dysphagia, and aspiration risk.
3. Proton therapy may reduce esophageal exposure compared to conventional radiation.
Pathologic fracture
Correct Answer: Fractures that occur without evidence of trauma, often due to loss of bone density from
radiation damage.
1. Pathologic fractures result from weakened bone due to metastasis, radiation, or primary bone
tumors.
2. Radiation causes osteocyte damage and impaired bone remodeling, increasing fracture risk.
3. Prophylactic fixation may be indicated for weight-bearing bones at high risk.
,Sexual activity after myocardial infarction
Correct Answer: Sexual intercourse after an MI requires no more energy expenditure or cardiac stress than
walking briskly up two flights of stairs.
1. Sexual activity is equivalent to moderate physical exertion (3-5 METs) and is safe for stable
post-MI patients.
2. Patients should be able to climb two flights of stairs without symptoms before resuming
intercourse.
3. Positioning and timing (avoid after heavy meals) may reduce cardiac workload.
Percutaneous endoscopic gastrostomy (PEG) tube
Correct Answer: A type of feeding tube that differs from a gastrostomy tube primarily in the method of
insertion.
1. PEG tube is inserted endoscopically through the esophagus into the stomach; surgical
gastrostomy (GT) requires laparotomy.
2. PEG is held in place by an internal bumper and external retention disc; GT is sutured to the
gastric wall.
3. PEG has lower complication rates and can be placed under sedation rather than general
anesthesia.
PEG tube (detailed)
Correct Answer: A tube inserted endoscopically through the esophagus into the stomach, held in place by a
bumper and a water-filled balloon.
1. The internal bumper prevents accidental dislodgement; some newer tubes use a low-profile
balloon system.
2. Placement confirmed by endoscopic visualization and aspiration of gastric contents.
3. Mature tract takes approximately 7-14 days before tube can be safely changed.
GT
Correct Answer: A tube inserted through an incision in the abdomen and sutured to the gastric wall.
1. Surgical gastrostomy (Stamm or Janeway procedure) is performed under general anesthesia.
2. Indicated when endoscopic placement is not possible (esophageal obstruction, prior gastric
surgery).
3. Suturing the stomach to the abdominal wall reduces risk of tube dislodgement into
peritoneum.
,Proctosigmoidoscopy preparation
Correct Answer: Includes obtaining consent, a clear-liquid diet for 24 to 48 hours prior, administration of an
enema, and fasting on the morning of the procedure.
1. Adequate bowel cleansing ensures visualization and biopsy accuracy.
2. Enemas are administered until returns are clear; Fleet enemas should be used with caution in
renal or cardiac patients.
3. Informed consent includes risks of perforation, bleeding, and cardiopulmonary events.
Dysuria in diabetes
Correct Answer: Elevated fingerstick glucose levels (e.g., 300 mg/dl) need to be reported to adjust the care
plan.
1. Hyperglycemia predisposes to urinary tract infections due to glycosuria and impaired immune
function.
2. Dysuria with elevated glucose suggests possible UTI; culture and sensitivity should be
obtained.
3. Tight glycemic control reduces infection risk and improves treatment response.
Right renal calculi nursing diagnosis priority
Correct Answer: Acute pain related to movement of the stone.
1. Renal colic from obstructing ureteral stones is severe and requires immediate pain
management.
2. Priority interventions include hydration, pain medication (NSAIDs, opioids), and straining urine
for stone retrieval.
3. Other diagnoses (impaired urinary elimination, risk for infection) are addressed after pain
control.
Chemotherapy initiation
Correct Answer: Starting chemotherapy early increases the chance of eradicating cancer cells, as 50% of
tumor cells are killed with each dose.
1. Log-kill hypothesis: chemotherapy kills a constant fraction (logarithmic) of tumor cells, not a
constant number.
2. Early initiation reduces tumor burden and prevents development of drug resistance.
3. Dose intensity and schedule adherence are critical for curative outcomes.
, Asterixis
Correct Answer: A clinical sign of liver disease characterized by a flapping tremor of the hands.
1. Asterixis (liver flap) indicates hepatic encephalopathy from ammonia accumulation.
2. Elicited by having patient extend arms and dorsiflex wrists; irregular flapping movements
appear.
3. Treatment focuses on reducing ammonia via lactulose, rifaximin, and dietary protein
management.
Clear-liquid diet
Correct Answer: A diet consisting of clear fluids, often required 24 to 48 hours before certain medical
procedures.
1. Clear liquids include water, broth, clear juices, gelatin, and tea/coffee without milk.
2. Provides hydration and minimal residue while allowing bowel visualization.
3. Does not provide adequate nutrition for extended periods; transition as soon as clinically
appropriate.
Enema
Correct Answer: A procedure to introduce liquid into the rectum to stimulate a bowel movement or cleanse
the bowel before a procedure.
1. Enemas mechanically distend the rectum and soften stool, triggering defecation.
2. Types include tap water, saline, soapsuds, and Fleet (hypertonic phosphate).
3. Contraindications include neutropenia, severe thrombocytopenia, and recent bowel surgery.
Fasting protocol
Correct Answer: Refraining from all food and drink for a specified period, often required before medical
procedures.
1. Standard NPO (nothing by mouth) is 6-8 hours for solids and 2 hours for clear liquids before
anesthesia.
2. Reduces risk of aspiration pneumonitis during sedation or general anesthesia.
3. Critical medications (cardiac, anti-seizure) may be taken with small sips of water.
Suprapubic pain
Correct Answer: Pain located in the lower abdomen, often associated with urinary issues.
1. Suprapubic pain localizes to the area above the pubic symphysis, overlying the bladder.
2. Common causes: cystitis, urinary retention, obstructing stones, pelvic inflammatory disease.
3. Assessment includes palpation, percussion for bladder distention, and urinalysis.
