BSN HESI 266 Med Surg Nursing Exam
Actual Exam 2026/2027 – Complete
Exam-Style Questions | 100% Verified –
Pass Guaranteed – A+ Graded
Q1. A nurse is assessing a client with left-sided heart failure. Which
finding is most indicative of this condition?
• A) Jugular vein distention
• B) Peripheral edema
• C) Bibasilar crackles
• D) Hepatomegaly
Correct ,,,answer,,,,: C) Bibasilar crackles
Rationale: Left-sided heart failure leads to pulmonary congestion
due to the left ventricle's inability to pump blood forward. Blood
backs up into the pulmonary circulation, causing crackles
(pulmonary edema), dyspnea, and cough . JVD, peripheral edema,
and hepatomegaly are signs of right-sided heart failure.
Q2. A client is admitted with acute decompensated heart failure
(ADHF). The nurse administers furosemide IV push. Which
assessment finding indicates the medication is effective?
, • A) Blood pressure increases from 90/60 to 110/70
• B) Urine output increases to 150 mL in 2 hours
• C) Heart rate decreases from 120 to 100
• D) Central venous pressure (CVP) increases
Correct ,,,answer,,,,: B) Urine output increases to 150 mL in 2 hours
Rationale: Furosemide is a loop diuretic. The primary goal in ADHF
is to reduce fluid volume overload. Increased urine output (at least
30 mL/hr) indicates effective diuresis, reducing preload and
pulmonary congestion .
Q3. A client is 12 hours post-cardiac catheterization via the right
femoral artery. The nurse observes that the client's right foot is cool
and pale with diminished pulses. Which action should the nurse take
first?
• A) Apply warm compresses to the right foot
• B) Elevate the head of the bed to 45 degrees
• C) Notify the healthcare provider immediately
• D) Encourage the client to ambulate in the room
Correct ,,,answer,,,,: C) Notify the healthcare provider immediately
Rationale: Cool, pale extremity with diminished pulses after cardiac
catheterization suggests arterial occlusion or thrombus formation at
the insertion site. This is a medical emergency requiring immediate
notification of the healthcare provider for possible intervention .
,Q4. A client is prescribed warfarin for atrial fibrillation. The client's
INR is 3.8. What is the most appropriate nursing action?
• A) Administer vitamin K as ordered
• B) Hold the next dose of warfarin
• C) Administer the warfarin as prescribed
• D) Prepare for fresh frozen plasma transfusion
Correct ,,,answer,,,,: C) Administer the warfarin as prescribed
Rationale: For atrial fibrillation, the therapeutic INR goal is typically
2.0-3.0. An INR of 3.8 is slightly above target but not critically high
(critical is >4.5). The standard protocol is to hold the dose only if
INR >4.0 or if there is bleeding .
Q5. A client presents with tearing chest pain radiating to the back,
blood pressure 160/90 in the right arm and 100/60 in the left arm.
What condition does the nurse suspect?
• A) Acute myocardial infarction
• B) Pulmonary embolism
• C) Aortic dissection
• D) Pericarditis
Correct ,,,answer,,,,: C) Aortic dissection
Rationale: Aortic dissection is characterized by sudden, severe,
tearing or ripping chest pain that may radiate to the back. A key sign
is a discrepancy in blood pressure between arms due to the
dissection affecting arterial flow to one subclavian artery .
, Q6. A client with peripheral artery disease (PAD) reports leg pain
that starts after walking for 10 minutes and stops with rest. The
nurse documents this finding as:
• A) Rest pain
• B) Neuropathic pain
• C) Intermittent claudication
• D) Venous stasis pain
Correct ,,,answer,,,,: C) Intermittent claudication
Rationale: Intermittent claudication is the hallmark symptom of
peripheral artery disease. It is described as muscle pain, cramping,
or fatigue in the legs that occurs with exercise and is relieved by
rest. Rest pain is a more advanced symptom indicating severe
ischemia .
Q7. The nurse is caring for a client with hypertension who has been
prescribed hydrochlorothiazide (HCTZ). Which finding indicates the
medication is having the desired effect?
• A) Heart rate 58 beats per minute
• B) Potassium level 4.2 mEq/L
• C) Blood pressure 128/84 mmHg
• D) Urine output 30 mL per hour
Correct ,,,answer,,,,: C) Blood pressure 128/84 mmHg
Actual Exam 2026/2027 – Complete
Exam-Style Questions | 100% Verified –
Pass Guaranteed – A+ Graded
Q1. A nurse is assessing a client with left-sided heart failure. Which
finding is most indicative of this condition?
• A) Jugular vein distention
• B) Peripheral edema
• C) Bibasilar crackles
• D) Hepatomegaly
Correct ,,,answer,,,,: C) Bibasilar crackles
Rationale: Left-sided heart failure leads to pulmonary congestion
due to the left ventricle's inability to pump blood forward. Blood
backs up into the pulmonary circulation, causing crackles
(pulmonary edema), dyspnea, and cough . JVD, peripheral edema,
and hepatomegaly are signs of right-sided heart failure.
Q2. A client is admitted with acute decompensated heart failure
(ADHF). The nurse administers furosemide IV push. Which
assessment finding indicates the medication is effective?
, • A) Blood pressure increases from 90/60 to 110/70
• B) Urine output increases to 150 mL in 2 hours
• C) Heart rate decreases from 120 to 100
• D) Central venous pressure (CVP) increases
Correct ,,,answer,,,,: B) Urine output increases to 150 mL in 2 hours
Rationale: Furosemide is a loop diuretic. The primary goal in ADHF
is to reduce fluid volume overload. Increased urine output (at least
30 mL/hr) indicates effective diuresis, reducing preload and
pulmonary congestion .
Q3. A client is 12 hours post-cardiac catheterization via the right
femoral artery. The nurse observes that the client's right foot is cool
and pale with diminished pulses. Which action should the nurse take
first?
• A) Apply warm compresses to the right foot
• B) Elevate the head of the bed to 45 degrees
• C) Notify the healthcare provider immediately
• D) Encourage the client to ambulate in the room
Correct ,,,answer,,,,: C) Notify the healthcare provider immediately
Rationale: Cool, pale extremity with diminished pulses after cardiac
catheterization suggests arterial occlusion or thrombus formation at
the insertion site. This is a medical emergency requiring immediate
notification of the healthcare provider for possible intervention .
,Q4. A client is prescribed warfarin for atrial fibrillation. The client's
INR is 3.8. What is the most appropriate nursing action?
• A) Administer vitamin K as ordered
• B) Hold the next dose of warfarin
• C) Administer the warfarin as prescribed
• D) Prepare for fresh frozen plasma transfusion
Correct ,,,answer,,,,: C) Administer the warfarin as prescribed
Rationale: For atrial fibrillation, the therapeutic INR goal is typically
2.0-3.0. An INR of 3.8 is slightly above target but not critically high
(critical is >4.5). The standard protocol is to hold the dose only if
INR >4.0 or if there is bleeding .
Q5. A client presents with tearing chest pain radiating to the back,
blood pressure 160/90 in the right arm and 100/60 in the left arm.
What condition does the nurse suspect?
• A) Acute myocardial infarction
• B) Pulmonary embolism
• C) Aortic dissection
• D) Pericarditis
Correct ,,,answer,,,,: C) Aortic dissection
Rationale: Aortic dissection is characterized by sudden, severe,
tearing or ripping chest pain that may radiate to the back. A key sign
is a discrepancy in blood pressure between arms due to the
dissection affecting arterial flow to one subclavian artery .
, Q6. A client with peripheral artery disease (PAD) reports leg pain
that starts after walking for 10 minutes and stops with rest. The
nurse documents this finding as:
• A) Rest pain
• B) Neuropathic pain
• C) Intermittent claudication
• D) Venous stasis pain
Correct ,,,answer,,,,: C) Intermittent claudication
Rationale: Intermittent claudication is the hallmark symptom of
peripheral artery disease. It is described as muscle pain, cramping,
or fatigue in the legs that occurs with exercise and is relieved by
rest. Rest pain is a more advanced symptom indicating severe
ischemia .
Q7. The nurse is caring for a client with hypertension who has been
prescribed hydrochlorothiazide (HCTZ). Which finding indicates the
medication is having the desired effect?
• A) Heart rate 58 beats per minute
• B) Potassium level 4.2 mEq/L
• C) Blood pressure 128/84 mmHg
• D) Urine output 30 mL per hour
Correct ,,,answer,,,,: C) Blood pressure 128/84 mmHg
