BSN 266 – MedSurg HESI 2026 |
Actual Questions and Answers WITH
RATIONALES | NGN Study Guide |
Latest Updated Version
THIS EXAM CONTAINS:
• 100+ exam-style questions
• Verified answers with detailed rationales
• Next Generation Nursing (NGN) case scenarios
• Prioritization and delegation questions
• SATA (Select All That Apply) items
• Bow-tie and unfolding case studies
, BSN 266 – MedSurg HESI 2026 | Actual
Questions and Answers WITH
RATIONALES | NGN Study Guide | Latest
Updated Version
Question 1
A client who underwent cardiac stent placement four days ago arrives to
the emergency department reporting a sudden onset of chest pressure and
shortness of breath. Which action should the nurse take next?
A) Obtain a 12-lead electrocardiogram and begin continuous cardiac
monitoring
B) Administer sublingual nitroglycerin
C) Draw cardiac enzyme levels
D) Notify the healthcare provider immediately
Answer: A) Obtain a 12-lead electrocardiogram and begin continuous
cardiac monitoring
Rationale: The client is exhibiting signs of possible acute coronary
syndrome or stent thrombosis, which is a life-threatening complication
following cardiac stent placement. The priority action is to obtain an ECG to
assess for ST-segment changes or new arrhythmias and begin continuous
cardiac monitoring to detect any life-threatening dysrhythmias. Early
recognition and treatment of stent thrombosis is critical to prevent
myocardial infarction. While nitroglycerin, cardiac enzymes, and provider
,notification are important, the immediate priority is obtaining the ECG to
guide further interventions.
Question 2
While completing a health assessment for a client with migraine headaches,
the nurse assesses bilateral weakness in the client's hand grips. The client
reports joint pain and trouble twisting a door knob due to weakness. Which
action should the nurse take in response to these findings?
A) Gather additional assessment data about the pain and weakness
B) Refer the client to physical therapy
C) Notify the healthcare provider immediately
D) Document the findings and reassess in 4 hours
Answer: A) Gather additional assessment data about the pain and
weakness
Rationale: Bilateral weakness with joint pain and difficulty with fine motor
tasks (twisting a doorknob) may indicate a neurological or musculoskeletal
condition. The nurse should first gather additional assessment data,
including onset, duration, quality of pain, exacerbating and relieving
factors, and any associated symptoms. This comprehensive assessment will
help determine if the findings are related to the migraine disorder or
another condition such as carpal tunnel syndrome, rheumatoid arthritis, or
a neurological disorder. Rushing to notify the provider without complete
data is premature.
, Question 3
When assessing a male client's respiratory status, which technique should
the nurse use to assess his anterior-posterior chest diameter?
A) Tenderness upon palpation and generalized erythema
B) Measure the ratio of anteroposterior diameter to transverse diameter
C) Auscultate breath sounds in all lung fields
D) Percuss the chest wall for resonance
Answer: B) Measure the ratio of anteroposterior diameter to
transverse diameter
Rationale: Anterior-posterior chest diameter is assessed by measuring the
distance from the sternum to the vertebrae and comparing it to the
transverse (side-to-side) diameter. A normal AP:transverse ratio is 1:2. An
increased ratio (barrel chest) is seen in conditions like COPD and
emphysema. Options A (tenderness and erythema) relate to skin
assessment, C relates to auscultation, and D relates to percussion—none of
which assess chest diameter.
Question 4
An adult client who had a gastric bypass surgery 2 weeks ago is admitted
with possible anastomosis leakage. The client's abdomen is tender to
touch, and vital signs are temperature 101°F (38.3°C), heart rate 130
beats/minute, respiratory rate 26 breaths/minute, and blood pressure
100/50 mmHg. Which intervention is most important for the nurse to
include in the client's plan of care?
Actual Questions and Answers WITH
RATIONALES | NGN Study Guide |
Latest Updated Version
THIS EXAM CONTAINS:
• 100+ exam-style questions
• Verified answers with detailed rationales
• Next Generation Nursing (NGN) case scenarios
• Prioritization and delegation questions
• SATA (Select All That Apply) items
• Bow-tie and unfolding case studies
, BSN 266 – MedSurg HESI 2026 | Actual
Questions and Answers WITH
RATIONALES | NGN Study Guide | Latest
Updated Version
Question 1
A client who underwent cardiac stent placement four days ago arrives to
the emergency department reporting a sudden onset of chest pressure and
shortness of breath. Which action should the nurse take next?
A) Obtain a 12-lead electrocardiogram and begin continuous cardiac
monitoring
B) Administer sublingual nitroglycerin
C) Draw cardiac enzyme levels
D) Notify the healthcare provider immediately
Answer: A) Obtain a 12-lead electrocardiogram and begin continuous
cardiac monitoring
Rationale: The client is exhibiting signs of possible acute coronary
syndrome or stent thrombosis, which is a life-threatening complication
following cardiac stent placement. The priority action is to obtain an ECG to
assess for ST-segment changes or new arrhythmias and begin continuous
cardiac monitoring to detect any life-threatening dysrhythmias. Early
recognition and treatment of stent thrombosis is critical to prevent
myocardial infarction. While nitroglycerin, cardiac enzymes, and provider
,notification are important, the immediate priority is obtaining the ECG to
guide further interventions.
Question 2
While completing a health assessment for a client with migraine headaches,
the nurse assesses bilateral weakness in the client's hand grips. The client
reports joint pain and trouble twisting a door knob due to weakness. Which
action should the nurse take in response to these findings?
A) Gather additional assessment data about the pain and weakness
B) Refer the client to physical therapy
C) Notify the healthcare provider immediately
D) Document the findings and reassess in 4 hours
Answer: A) Gather additional assessment data about the pain and
weakness
Rationale: Bilateral weakness with joint pain and difficulty with fine motor
tasks (twisting a doorknob) may indicate a neurological or musculoskeletal
condition. The nurse should first gather additional assessment data,
including onset, duration, quality of pain, exacerbating and relieving
factors, and any associated symptoms. This comprehensive assessment will
help determine if the findings are related to the migraine disorder or
another condition such as carpal tunnel syndrome, rheumatoid arthritis, or
a neurological disorder. Rushing to notify the provider without complete
data is premature.
, Question 3
When assessing a male client's respiratory status, which technique should
the nurse use to assess his anterior-posterior chest diameter?
A) Tenderness upon palpation and generalized erythema
B) Measure the ratio of anteroposterior diameter to transverse diameter
C) Auscultate breath sounds in all lung fields
D) Percuss the chest wall for resonance
Answer: B) Measure the ratio of anteroposterior diameter to
transverse diameter
Rationale: Anterior-posterior chest diameter is assessed by measuring the
distance from the sternum to the vertebrae and comparing it to the
transverse (side-to-side) diameter. A normal AP:transverse ratio is 1:2. An
increased ratio (barrel chest) is seen in conditions like COPD and
emphysema. Options A (tenderness and erythema) relate to skin
assessment, C relates to auscultation, and D relates to percussion—none of
which assess chest diameter.
Question 4
An adult client who had a gastric bypass surgery 2 weeks ago is admitted
with possible anastomosis leakage. The client's abdomen is tender to
touch, and vital signs are temperature 101°F (38.3°C), heart rate 130
beats/minute, respiratory rate 26 breaths/minute, and blood pressure
100/50 mmHg. Which intervention is most important for the nurse to
include in the client's plan of care?
