classmerit.com — The Marketplace to Buy and Sell Study Materials
BSN HESI
MEDICAL-SURGICAL EXAM MASTERY
2026/2027 Edition
200 Multiple-Choice Questions
Comprehensive Adult Health Nursing Competency Assessment
for RN Licensure Readiness
Elsevier Evolve / NCSBN CJMM Alignment
Passing Score: 850 HESI / 75-80% (150-160/200)
Testing Time: 180 Minutes
Downloaded by: Want to earn $1,500
Distribution of this document is illegal extra per year?
, classmerit.com — The Marketplace to Buy and Sell Study Materials
TABLE OF CONTENTS
Domain 1: Management of Care (30 Questions)
Domain 2: Safety and Infection Control (24 Questions)
Domain 3: Basic Care and Comfort (24 Questions)
Domain 4: Pharmacological and Parenteral Therapies (30 Questions)
Domain 5: Reduction of Risk Potential (28 Questions)
Domain 6: Physiological Adaptation (24 Questions)
Domain 7: Cardiovascular & Respiratory Disorders (20 Questions)
Domain 8: GI, Endocrine, Neuro, Musculoskeletal Disorders (20 Questions)
Answer Key
Domain Score Tracker
References
Downloaded by: Want to earn $1,500
Distribution of this document is illegal extra per year?
, classmerit.com — The Marketplace to Buy and Sell Study Materials
EXAMINATION OVERVIEW
Domain Questions Key Topics Weight
Management of Care 30 Delegation, 15%
Supervision,
Prioritization,
Legal/Ethical Issues,
Case Management,
Resource Allocation
Safety and Infection 24 Standard Precautions, 12%
Control Isolation, Fall
Prevention, Error
Prevention, Emergency
Response, Hand
Hygiene
Basic Care and Comfort 24 ADLs, Pain 12%
Management,
Nutrition, Elimination,
Mobility, Rest/Sleep,
Comfort Measures
Pharmacological and 30 Medication 15%
Parenteral Therapies Administration, Rights
of Medication, Side
Effects, Interactions, IV
Therapy, Dosage
Calculations, High-
Alert Medications
Reduction of Risk 28 Diagnostic Tests, Vital 14%
Potential Signs, Complication
Prevention,
Therapeutic
Procedures, Pre/Post-
Op Care, Lab Values
Physiological 24 Acute/Chronic 12%
Adaptation Conditions,
Fluid/Electrolytes,
Pathophysiology,
Emergency Care,
Wound Healing, Multi-
System Disorders
Cardiovascular & 20 ACS, Heart Failure, 10%
Respiratory Disorders Dysrhythmias, COPD,
Asthma, Pneumonia,
PE, Mechanical
Ventilation
GI, Endocrine, Neuro, 20 Diabetes, Thyroid, GI 10%
Musculoskeletal Bleed, IBD, Stroke,
Disorders Seizures, Fractures,
Arthritis, Spinal Cord
Injury
Downloaded by: Want to earn $1,500
Distribution of this document is illegal extra per year?
, classmerit.com — The Marketplace to Buy and Sell Study Materials
DOMAIN 1: MANAGEMENT OF CARE (30 Questions | 15%)
1. The charge nurse is making client assignments for the night shift. Which client should be
assigned to the licensed practical nurse (LPN) under the supervision of the registered
nurse (RN)?
A. A client who is 12 hours postoperative following a subtotal thyroidectomy and requires
assessment for signs of hypocalcemia
B. A client admitted with heart failure exacerbation who has crackles bilaterally and needs a
furosemide IV push
C. A client with a stage III pressure injury requiring wound irrigation, debridement, and evaluation
of healing progress
D. A client who is 2 days post-appendectomy with an abdominal incision that needs
vital signs monitoring and pain management
Rationale: The LPN scope of practice includes stable clients with predictable outcomes who require
nursing interventions within established care plans. The post-appendectomy client at day 2 is stable
with expected recovery, and monitoring vital signs and administering PRN pain medications fall within
the LPN's scope under RN supervision. The thyroidectomy client requires complex assessment for
hypocalcemia (Chvostek's and Trousseau's signs), the heart failure client needs ongoing evaluation of
fluid status and IV diuretic administration with careful monitoring, and the stage III pressure injury
requires advanced wound assessment and care decisions that are RN-level responsibilities per the
NCSBN Guidelines for Delegation.
2. A nurse manager receives the following morning report on four clients. Which nursing
task should the nurse manager delegate to the unlicensed assistive personnel (UAP)?
A. Measuring and recording intake and output for a client with continuous bladder
irrigation
B. Assessing the skin integrity of a bedridden client with a recent cerebrovascular accident
C. Evaluating the effectiveness of patient-controlled analgesia (PCA) in a postoperative client
D. Teaching a newly diagnosed diabetic client how to perform self-monitoring of blood glucose
Rationale: The Five Rights of Delegation include the right task, the right circumstance, the right
person, the right direction/communication, and the right supervision/feedback. Measuring and
recording intake and output is a repetitive, standardized task within the UAP's scope of practice and
does not require nursing judgment. Assessment of skin integrity requires clinical evaluation and
decision-making, which is an RN responsibility. Evaluating PCA effectiveness involves assessing pain
levels, sedation scores, and respiratory status, which requires RN-level judgment. Patient education is
an independent nursing function that cannot be delegated to UAP. The nurse must provide clear
directions and supervise the UAP in performing the delegated task.
3. The RN is caring for four clients on a medical-surgical unit. Which task is most
appropriate to delegate to the licensed practical nurse (LPN)?
A. Performing the initial admission assessment on a client newly diagnosed with deep vein
thrombosis
B. Developing a nursing care plan for a client with chronic obstructive pulmonary disease admitted
for pneumonia
C. Administering scheduled oral medications to a stable client recovering from a total
hip arthroplasty
D. Interpreting arterial blood gas results for a client in acute respiratory distress
Rationale: Administering scheduled oral medications to a stable client is within the LPN scope of
practice under RN supervision. The client recovering from a total hip arthroplasty has a predictable
Downloaded by: Want to earn $1,500
Distribution of this document is illegal extra per year?
BSN HESI
MEDICAL-SURGICAL EXAM MASTERY
2026/2027 Edition
200 Multiple-Choice Questions
Comprehensive Adult Health Nursing Competency Assessment
for RN Licensure Readiness
Elsevier Evolve / NCSBN CJMM Alignment
Passing Score: 850 HESI / 75-80% (150-160/200)
Testing Time: 180 Minutes
Downloaded by: Want to earn $1,500
Distribution of this document is illegal extra per year?
, classmerit.com — The Marketplace to Buy and Sell Study Materials
TABLE OF CONTENTS
Domain 1: Management of Care (30 Questions)
Domain 2: Safety and Infection Control (24 Questions)
Domain 3: Basic Care and Comfort (24 Questions)
Domain 4: Pharmacological and Parenteral Therapies (30 Questions)
Domain 5: Reduction of Risk Potential (28 Questions)
Domain 6: Physiological Adaptation (24 Questions)
Domain 7: Cardiovascular & Respiratory Disorders (20 Questions)
Domain 8: GI, Endocrine, Neuro, Musculoskeletal Disorders (20 Questions)
Answer Key
Domain Score Tracker
References
Downloaded by: Want to earn $1,500
Distribution of this document is illegal extra per year?
, classmerit.com — The Marketplace to Buy and Sell Study Materials
EXAMINATION OVERVIEW
Domain Questions Key Topics Weight
Management of Care 30 Delegation, 15%
Supervision,
Prioritization,
Legal/Ethical Issues,
Case Management,
Resource Allocation
Safety and Infection 24 Standard Precautions, 12%
Control Isolation, Fall
Prevention, Error
Prevention, Emergency
Response, Hand
Hygiene
Basic Care and Comfort 24 ADLs, Pain 12%
Management,
Nutrition, Elimination,
Mobility, Rest/Sleep,
Comfort Measures
Pharmacological and 30 Medication 15%
Parenteral Therapies Administration, Rights
of Medication, Side
Effects, Interactions, IV
Therapy, Dosage
Calculations, High-
Alert Medications
Reduction of Risk 28 Diagnostic Tests, Vital 14%
Potential Signs, Complication
Prevention,
Therapeutic
Procedures, Pre/Post-
Op Care, Lab Values
Physiological 24 Acute/Chronic 12%
Adaptation Conditions,
Fluid/Electrolytes,
Pathophysiology,
Emergency Care,
Wound Healing, Multi-
System Disorders
Cardiovascular & 20 ACS, Heart Failure, 10%
Respiratory Disorders Dysrhythmias, COPD,
Asthma, Pneumonia,
PE, Mechanical
Ventilation
GI, Endocrine, Neuro, 20 Diabetes, Thyroid, GI 10%
Musculoskeletal Bleed, IBD, Stroke,
Disorders Seizures, Fractures,
Arthritis, Spinal Cord
Injury
Downloaded by: Want to earn $1,500
Distribution of this document is illegal extra per year?
, classmerit.com — The Marketplace to Buy and Sell Study Materials
DOMAIN 1: MANAGEMENT OF CARE (30 Questions | 15%)
1. The charge nurse is making client assignments for the night shift. Which client should be
assigned to the licensed practical nurse (LPN) under the supervision of the registered
nurse (RN)?
A. A client who is 12 hours postoperative following a subtotal thyroidectomy and requires
assessment for signs of hypocalcemia
B. A client admitted with heart failure exacerbation who has crackles bilaterally and needs a
furosemide IV push
C. A client with a stage III pressure injury requiring wound irrigation, debridement, and evaluation
of healing progress
D. A client who is 2 days post-appendectomy with an abdominal incision that needs
vital signs monitoring and pain management
Rationale: The LPN scope of practice includes stable clients with predictable outcomes who require
nursing interventions within established care plans. The post-appendectomy client at day 2 is stable
with expected recovery, and monitoring vital signs and administering PRN pain medications fall within
the LPN's scope under RN supervision. The thyroidectomy client requires complex assessment for
hypocalcemia (Chvostek's and Trousseau's signs), the heart failure client needs ongoing evaluation of
fluid status and IV diuretic administration with careful monitoring, and the stage III pressure injury
requires advanced wound assessment and care decisions that are RN-level responsibilities per the
NCSBN Guidelines for Delegation.
2. A nurse manager receives the following morning report on four clients. Which nursing
task should the nurse manager delegate to the unlicensed assistive personnel (UAP)?
A. Measuring and recording intake and output for a client with continuous bladder
irrigation
B. Assessing the skin integrity of a bedridden client with a recent cerebrovascular accident
C. Evaluating the effectiveness of patient-controlled analgesia (PCA) in a postoperative client
D. Teaching a newly diagnosed diabetic client how to perform self-monitoring of blood glucose
Rationale: The Five Rights of Delegation include the right task, the right circumstance, the right
person, the right direction/communication, and the right supervision/feedback. Measuring and
recording intake and output is a repetitive, standardized task within the UAP's scope of practice and
does not require nursing judgment. Assessment of skin integrity requires clinical evaluation and
decision-making, which is an RN responsibility. Evaluating PCA effectiveness involves assessing pain
levels, sedation scores, and respiratory status, which requires RN-level judgment. Patient education is
an independent nursing function that cannot be delegated to UAP. The nurse must provide clear
directions and supervise the UAP in performing the delegated task.
3. The RN is caring for four clients on a medical-surgical unit. Which task is most
appropriate to delegate to the licensed practical nurse (LPN)?
A. Performing the initial admission assessment on a client newly diagnosed with deep vein
thrombosis
B. Developing a nursing care plan for a client with chronic obstructive pulmonary disease admitted
for pneumonia
C. Administering scheduled oral medications to a stable client recovering from a total
hip arthroplasty
D. Interpreting arterial blood gas results for a client in acute respiratory distress
Rationale: Administering scheduled oral medications to a stable client is within the LPN scope of
practice under RN supervision. The client recovering from a total hip arthroplasty has a predictable
Downloaded by: Want to earn $1,500
Distribution of this document is illegal extra per year?
