BSN HESI 266 MED-SURG VERSION 1 (V1) EXAM ACTUAL EXAM 2026/2027 |
EXPERT VERIFIED | NIGHTINGALE COLLEGE CURRICULUM | REAL EXAM
SIMULATION | ANSWERS & RATIONALES | PASS GUARANTEED - GRADED A+
EXAM OVERVIEW
This examination simulates Version 1 (V1) of the HESI 266 Med-Surg exam at Nightingale College. It
includes multiple-choice and select-all-that-apply (SATA) questions covering all major body systems. Each
question is based on the official 2025-2026 test bank with verified correct answers and rationales.
SECTION 1: CARDIOVASCULAR SYSTEM
Questions 1-15
Q1. A client with heart failure is prescribed furosemide (Lasix) 40 mg IV push. Which laboratory value
requires the most immediate action by the nurse?
A) Sodium 135 mEq/L
B) Potassium 3.1 mEq/L
C) Chloride 98 mEq/L
D) Calcium 9.0 mg/dL
Answer: B) Potassium 3.1 mEq/L
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia (K < 3.5 mEq/L)
increases the risk of cardiac arrhythmias and digoxin toxicity. This value requires immediate intervention.
Q2. A nurse is assessing a client with right-sided heart failure. Which finding is most consistent with this
diagnosis?
A) Crackles in the lung bases
, BSN HESI 266 MED-SURG VERSION 1 (V1) EXAM ACTUAL EXAM 2026/2027 |
EXPERT VERIFIED | NIGHTINGALE COLLEGE CURRICULUM | REAL EXAM
SIMULATION | ANSWERS & RATIONALES | PASS GUARANTEED - GRADED A+
B) Jugular venous distention (JVD)
C) Paroxysmal nocturnal dyspnea (PND)
D) Orthopnea
Answer: B) Jugular venous distention (JVD)
Rationale: Right-sided heart failure causes systemic congestion, leading to jugular venous distention,
peripheral edema, and hepatomegaly. Crackles, PND, and orthopnea are signs of left-sided heart failure.
Q3. A client with hypertension is prescribed lisinopril. The nurse should instruct the client to report which
adverse effect immediately?
A) Dry cough
B) Dizziness
C) Swelling of the face, lips, or tongue
D) Headache
Answer: C) Swelling of the face, lips, or tongue
Rationale: Angioedema (swelling of the face, lips, tongue, or airway) is a serious, potentially life-threatening
adverse effect of ACE inhibitors like lisinopril. The client should seek immediate medical attention.
, BSN HESI 266 MED-SURG VERSION 1 (V1) EXAM ACTUAL EXAM 2026/2027 |
EXPERT VERIFIED | NIGHTINGALE COLLEGE CURRICULUM | REAL EXAM
SIMULATION | ANSWERS & RATIONALES | PASS GUARANTEED - GRADED A+
Q4. A client with atrial fibrillation has a new prescription for warfarin. Which laboratory test should the nurse
monitor to evaluate therapeutic effect?
A) aPTT
B) INR
C) Platelet count
D) Bleeding time
Answer: B) INR
Rationale: Warfarin is monitored using the International Normalized Ratio (INR). The therapeutic INR for
atrial fibrillation is typically 2.0-3.0.
Q5. A client is admitted with acute decompensated heart failure. Which assessment finding is most
concerning?
A) Bilateral +2 pitting edema in the lower extremities
B) Jugular venous distention
C) Crackles that are audible halfway up the lung fields
D) Weight gain of 5 pounds in 24 hours
Answer: D) Weight gain of 5 pounds in 24 hours
, BSN HESI 266 MED-SURG VERSION 1 (V1) EXAM ACTUAL EXAM 2026/2027 |
EXPERT VERIFIED | NIGHTINGALE COLLEGE CURRICULUM | REAL EXAM
SIMULATION | ANSWERS & RATIONALES | PASS GUARANTEED - GRADED A+
Rationale: A weight gain of 2-3 pounds in 24 hours or 5 pounds in a week indicates significant fluid retention
and worsening heart failure. This requires immediate intervention.
Q6. A client with peripheral arterial disease (PAD) reports leg pain when walking that resolves with rest. The
nurse documents this finding as:
A) Rest pain
B) Intermittent claudication
C) Venous stasis
D) Neuropathic pain
Answer: B) Intermittent claudication
Rationale: Intermittent claudication is leg pain that occurs with exercise and resolves with rest due to
inadequate blood flow in the peripheral arteries.
Q7. A nurse is providing discharge teaching to a client with heart failure. Which statement by the client
indicates a need for further teaching?
A) "I will weigh myself every morning before breakfast."
B) "I should call my doctor if I gain more than 2-3 pounds in a day."
C) "I can stop taking my diuretic if I feel better."
EXPERT VERIFIED | NIGHTINGALE COLLEGE CURRICULUM | REAL EXAM
SIMULATION | ANSWERS & RATIONALES | PASS GUARANTEED - GRADED A+
EXAM OVERVIEW
This examination simulates Version 1 (V1) of the HESI 266 Med-Surg exam at Nightingale College. It
includes multiple-choice and select-all-that-apply (SATA) questions covering all major body systems. Each
question is based on the official 2025-2026 test bank with verified correct answers and rationales.
SECTION 1: CARDIOVASCULAR SYSTEM
Questions 1-15
Q1. A client with heart failure is prescribed furosemide (Lasix) 40 mg IV push. Which laboratory value
requires the most immediate action by the nurse?
A) Sodium 135 mEq/L
B) Potassium 3.1 mEq/L
C) Chloride 98 mEq/L
D) Calcium 9.0 mg/dL
Answer: B) Potassium 3.1 mEq/L
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia (K < 3.5 mEq/L)
increases the risk of cardiac arrhythmias and digoxin toxicity. This value requires immediate intervention.
Q2. A nurse is assessing a client with right-sided heart failure. Which finding is most consistent with this
diagnosis?
A) Crackles in the lung bases
, BSN HESI 266 MED-SURG VERSION 1 (V1) EXAM ACTUAL EXAM 2026/2027 |
EXPERT VERIFIED | NIGHTINGALE COLLEGE CURRICULUM | REAL EXAM
SIMULATION | ANSWERS & RATIONALES | PASS GUARANTEED - GRADED A+
B) Jugular venous distention (JVD)
C) Paroxysmal nocturnal dyspnea (PND)
D) Orthopnea
Answer: B) Jugular venous distention (JVD)
Rationale: Right-sided heart failure causes systemic congestion, leading to jugular venous distention,
peripheral edema, and hepatomegaly. Crackles, PND, and orthopnea are signs of left-sided heart failure.
Q3. A client with hypertension is prescribed lisinopril. The nurse should instruct the client to report which
adverse effect immediately?
A) Dry cough
B) Dizziness
C) Swelling of the face, lips, or tongue
D) Headache
Answer: C) Swelling of the face, lips, or tongue
Rationale: Angioedema (swelling of the face, lips, tongue, or airway) is a serious, potentially life-threatening
adverse effect of ACE inhibitors like lisinopril. The client should seek immediate medical attention.
, BSN HESI 266 MED-SURG VERSION 1 (V1) EXAM ACTUAL EXAM 2026/2027 |
EXPERT VERIFIED | NIGHTINGALE COLLEGE CURRICULUM | REAL EXAM
SIMULATION | ANSWERS & RATIONALES | PASS GUARANTEED - GRADED A+
Q4. A client with atrial fibrillation has a new prescription for warfarin. Which laboratory test should the nurse
monitor to evaluate therapeutic effect?
A) aPTT
B) INR
C) Platelet count
D) Bleeding time
Answer: B) INR
Rationale: Warfarin is monitored using the International Normalized Ratio (INR). The therapeutic INR for
atrial fibrillation is typically 2.0-3.0.
Q5. A client is admitted with acute decompensated heart failure. Which assessment finding is most
concerning?
A) Bilateral +2 pitting edema in the lower extremities
B) Jugular venous distention
C) Crackles that are audible halfway up the lung fields
D) Weight gain of 5 pounds in 24 hours
Answer: D) Weight gain of 5 pounds in 24 hours
, BSN HESI 266 MED-SURG VERSION 1 (V1) EXAM ACTUAL EXAM 2026/2027 |
EXPERT VERIFIED | NIGHTINGALE COLLEGE CURRICULUM | REAL EXAM
SIMULATION | ANSWERS & RATIONALES | PASS GUARANTEED - GRADED A+
Rationale: A weight gain of 2-3 pounds in 24 hours or 5 pounds in a week indicates significant fluid retention
and worsening heart failure. This requires immediate intervention.
Q6. A client with peripheral arterial disease (PAD) reports leg pain when walking that resolves with rest. The
nurse documents this finding as:
A) Rest pain
B) Intermittent claudication
C) Venous stasis
D) Neuropathic pain
Answer: B) Intermittent claudication
Rationale: Intermittent claudication is leg pain that occurs with exercise and resolves with rest due to
inadequate blood flow in the peripheral arteries.
Q7. A nurse is providing discharge teaching to a client with heart failure. Which statement by the client
indicates a need for further teaching?
A) "I will weigh myself every morning before breakfast."
B) "I should call my doctor if I gain more than 2-3 pounds in a day."
C) "I can stop taking my diuretic if I feel better."
