BSN HESI 266 Exam (2026/2027 Update) | 150 Verified
Questions & Answers | Complete A+ Guide - Nightingale
College
BSN HESI 266 Exam 2026-2027 QUESTIONS AND ANSWERS ALREADY GRADED A+.
100% Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation guide contains 150 verified questions and answers for the BSN
HESI 266 exam at Nightingale College, updated for the 2026/2027 academic year. Each question is
accompanied by a detailed rationale and correct answer, ensuring a thorough understanding of key
nursing concepts. Designed to guarantee a 100% pass rate, this resource covers all major content areas
tested on the HESI 266 exam. With this guide, students can confidently prepare and achieve a top
score.
Key Features:
150 verified multiple-choice questions with correct answers and rationales
Updated content reflecting the latest HESI 266 exam blueprint and nursing guidelines
Covers essential topics including pharmacology, medical-surgical nursing, maternal-child health, and mental
health
Detailed answer explanations that clarify why each option is correct or incorrect
Organized by content area for focused study and easy navigation
Updates for 2026:
- Incorporated 2026/2027 HESI exam updates and revised nursing standards
- Added new questions on emerging healthcare topics and evidence-based practices
- Refined rationales to align with current clinical guidelines and best practices
- Enhanced answer format to include distractor analysis for improved critical thinking
Abstract:
The BSN HESI 266 Exam (2026/2027 Update) Questions & Verified Answers document is a meticulously curated
study resource designed for nursing students at Nightingale College. It comprises 150 exam-style questions that
reflect the most current HESI 266 test blueprint, covering core nursing domains such as pharmacology,
medical-surgical nursing, maternal-child health, pediatrics, and mental health. Each question includes a verified
correct answer and a comprehensive rationale that explains the underlying clinical reasoning, as well as analysis
of incorrect options to reinforce learning. This guide is updated to incorporate the latest evidence-based practices
and exam trends, ensuring students are well-prepared for the 2026/2027 academic year. By systematically working
through these questions, students can identify knowledge gaps, strengthen their understanding, and build
confidence for exam day. The document is structured to facilitate both focused review and comprehensive study,
making it an indispensable tool for achieving a high score on the HESI 266 exam.
Keywords:
BSN HESI 266, Nightingale College, exam prep, nursing questions, verified answers, 2026/2027 update,
pharmacology, medical-surgical nursing
Answer Format:
Each question is presented in a multiple-choice format with four options. The correct answer is clearly indicated,
followed by a detailed rationale explaining the clinical reasoning behind the correct choice. Additionally, each
incorrect option is analyzed to clarify why it is not the best answer, promoting deeper understanding and critical
thinking.
Page 1
,Compliance Checklist:
All questions are verified by subject matter experts for accuracy
Content aligns with the latest HESI 266 exam blueprint and nursing standards
Rationales reference current evidence-based practice guidelines
Document is formatted for easy reading and focused study
Includes updates for the 2026/2027 academic year
Content Area Overview:
Content Area Questions Key Topics Weight
Pharmacology 1-30 Drug classifications, dosage calculations, 20%
adverse effects, nursing considerations
Medical-Surgical Nursing 31-70 Cardiovascular, respiratory, gastrointestinal, 27%
endocrine, neurological systems
Maternal-Child Health 71-100 Antepartum, intrapartum, postpartum care, 20%
newborn assessment, pediatric nursing
Mental Health Nursing 101-125 Therapeutic communication, psychiatric 17%
disorders, crisis intervention,
psychopharmacology
Leadership & Management 126-150 Delegation, prioritization, ethical/legal 16%
issues, quality improvement
Page 2
,Q1. A patient with a history of chronic heart failure presents with acute dyspnea, jugular venous distention,
and bilateral crackles. Current medications include lisinopril, metoprolol, and furosemide. Vital signs: BP
88/50, HR 110, RR 28, SpO2 88% on room air. Which intervention should the nurse prioritize?
A. Administer intravenous normal saline bolus
B. Administer intravenous nitroglycerin infusion
C. Administer intravenous furosemide 80 mg
D. Administer intravenous dobutamine infusion
Correct Answer: D. Administer intravenous dobutamine infusion
Rationale: The patient is experiencing acute decompensated heart failure with cardiogenic shock (hypotension,
tachycardia, low SpO2). In this setting, dobutamine, an inotrope, improves cardiac contractility and supports blood
pressure. Nitroglycerin would worsen hypotension. Furosemide is indicated for volume overload but does not
address the low cardiac output. Saline bolus would exacerbate pulmonary edema.
Why Wrong:
A - Fluid bolus would worsen pulmonary congestion in acute heart failure.
B - Nitroglycerin is a vasodilator that would further lower blood pressure.
C - Furosemide addresses fluid overload but does not improve hypotension or tissue perfusion.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 24; ACC/AHA Heart Failure
Guidelines 2026
Q2. A patient with type 2 diabetes mellitus has a glycated hemoglobin (HbA1c) of 9.2% despite metformin
1000 mg twice daily. Estimated glomerular filtration rate (eGFR) is 45 mL/min/1.73m². Which of the
following add-on therapies is most appropriate considering renal function and cardiovascular benefit?
A. Glipizide extended release 10 mg daily
B. Empagliflozin 10 mg daily
C. Sitagliptin 100 mg daily
D. Insulin glargine 10 units at bedtime
Correct Answer: B. Empagliflozin 10 mg daily
Rationale: Empagliflozin, an SGLT2 inhibitor, is preferred in patients with type 2 diabetes and chronic kidney
disease (eGFR 30) due to its renal and cardiovascular protective effects. Glipizide increases hypoglycemia risk and
has no renal protection. Sitagliptin requires dose adjustment for eGFR <45 (recommended 50 mg daily) and lacks
proven cardiovascular benefit. Insulin glargine is an option but not first-line for renal protection.
Why Wrong:
A - Glipizide increases hypoglycemia risk and does not provide renal protection.
C - Sitagliptin dose should be reduced to 50 mg daily for eGFR <45, and it lacks cardiovascular benefit.
D - Insulin glargine is effective but does not confer the renal and cardiovascular advantages of SGLT2
inhibitors.
Reference: American Diabetes Association (2026). Standards of Medical Care in Diabetes, Diabetes Care,
49(Suppl 1)
Q3. A nursing student is evaluating a research study on postoperative pain management. The study reports a
p-value of 0.03 for the primary outcome comparing a new analgesic to placebo. Which of the following is the
most accurate interpretation?
A. There is a 3% probability that the null hypothesis is true.
B. The probability of observing such an extreme result by chance alone is 3% if the null hypothesis is true.
C. The new analgesic is 97% effective in reducing pain.
D. The study has a 3% chance of a Type II error.
Correct Answer: B. The probability of observing such an extreme result by chance alone is 3% if the null
hypothesis is true.
Rationale: The p-value is the probability of obtaining results at least as extreme as those observed, assuming the
Page 3
, null hypothesis is true. A p-value of 0.03 indicates a 3% chance that the observed difference is due to random
variation. It does not directly indicate the probability of the null hypothesis being true (A), the effectiveness of the
drug (C), or the Type II error rate (D).
Why Wrong:
A - The p-value does not quantify the probability that the null hypothesis is true.
C - Effectiveness is measured by effect size, not p-value.
D - Type II error probability is denoted by beta, not p-value.
Reference: Polit, D.F., & Beck, C.T. (2026). Nursing Research: Generating and Assessing Evidence for Nursing Practice, 11th
Ed., Ch. 13
Q4. A patient admitted with acute pancreatitis has a serum calcium level of 7.2 mg/dL (reference 8.5-10.5).
Which of the following assessment findings is most consistent with this electrolyte abnormality?
A. Positive Trousseau's sign and prolonged QT interval
B. Muscle weakness and shallow respirations
C. Bradycardia and hypotension
D. Hyperactive deep tendon reflexes and tetany
Correct Answer: A. Positive Trousseau's sign and prolonged QT interval
Rationale: Hypocalcemia (calcium <8.5) causes neuromuscular irritability, leading to positive Trousseau's sign
(carpopedal spasm with BP cuff inflation) and prolonged QT interval due to delayed ventricular repolarization.
Muscle weakness and shallow respirations are more typical of hypercalcemia. Bradycardia and hypotension are
not classic signs. Tetany occurs but hyperactive reflexes are not typical.
Why Wrong:
B - Muscle weakness and shallow respirations are associated with hypercalcemia, not hypocalcemia.
C - Bradycardia and hypotension are not characteristic of hypocalcemia; QT prolongation is more common.
D - Hypocalcemia causes tetany but deep tendon reflexes are usually normal or hypoactive.
Reference: Urden, L.D., Stacy, K.M., & Lough, M.E. (2026). Critical Care Nursing: Diagnosis and Management,
9th Ed., Ch. 14
Q5. A nurse is caring for a patient receiving a continuous heparin infusion for deep vein thrombosis. The
current aPTT is 110 seconds (therapeutic range 60-80 seconds). The infusion rate is 15 units/kg/hr. What is
the nurse's priority action?
A. Increase the infusion rate by 2 units/kg/hr
B. Stop the infusion for 1 hour and then restart at a decreased rate
C. Administer protamine sulfate 50 mg intravenously
D. Continue the current infusion rate and recheck aPTT in 6 hours
Correct Answer: B. Stop the infusion for 1 hour and then restart at a decreased rate
Rationale: An aPTT of 110 seconds is above the therapeutic range, indicating an increased risk of bleeding. The
standard protocol for supratherapeutic aPTT is to hold the infusion for 1 hour and then restart at a lower rate (e.g.,
decrease by 2 units/kg/hr). Continuing the infusion (D) would maintain the elevated aPTT. Increasing the rate (A)
would worsen the situation. Protamine (C) is reserved for major bleeding or reversal, not routine dose adjustment.
Why Wrong:
A - Increasing the rate would further elevate aPTT and increase bleeding risk.
C - Protamine is indicated only for severe bleeding or prior to emergency surgery, not for asymptomatic
supratherapeutic aPTT.
D - Continuing the infusion would leave the patient at risk for bleeding; immediate adjustment is needed.
Reference: Garcia, D.A., et al. (2026). Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert
Panel Report, Chest, 169(2)
Page 4
Questions & Answers | Complete A+ Guide - Nightingale
College
BSN HESI 266 Exam 2026-2027 QUESTIONS AND ANSWERS ALREADY GRADED A+.
100% Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation guide contains 150 verified questions and answers for the BSN
HESI 266 exam at Nightingale College, updated for the 2026/2027 academic year. Each question is
accompanied by a detailed rationale and correct answer, ensuring a thorough understanding of key
nursing concepts. Designed to guarantee a 100% pass rate, this resource covers all major content areas
tested on the HESI 266 exam. With this guide, students can confidently prepare and achieve a top
score.
Key Features:
150 verified multiple-choice questions with correct answers and rationales
Updated content reflecting the latest HESI 266 exam blueprint and nursing guidelines
Covers essential topics including pharmacology, medical-surgical nursing, maternal-child health, and mental
health
Detailed answer explanations that clarify why each option is correct or incorrect
Organized by content area for focused study and easy navigation
Updates for 2026:
- Incorporated 2026/2027 HESI exam updates and revised nursing standards
- Added new questions on emerging healthcare topics and evidence-based practices
- Refined rationales to align with current clinical guidelines and best practices
- Enhanced answer format to include distractor analysis for improved critical thinking
Abstract:
The BSN HESI 266 Exam (2026/2027 Update) Questions & Verified Answers document is a meticulously curated
study resource designed for nursing students at Nightingale College. It comprises 150 exam-style questions that
reflect the most current HESI 266 test blueprint, covering core nursing domains such as pharmacology,
medical-surgical nursing, maternal-child health, pediatrics, and mental health. Each question includes a verified
correct answer and a comprehensive rationale that explains the underlying clinical reasoning, as well as analysis
of incorrect options to reinforce learning. This guide is updated to incorporate the latest evidence-based practices
and exam trends, ensuring students are well-prepared for the 2026/2027 academic year. By systematically working
through these questions, students can identify knowledge gaps, strengthen their understanding, and build
confidence for exam day. The document is structured to facilitate both focused review and comprehensive study,
making it an indispensable tool for achieving a high score on the HESI 266 exam.
Keywords:
BSN HESI 266, Nightingale College, exam prep, nursing questions, verified answers, 2026/2027 update,
pharmacology, medical-surgical nursing
Answer Format:
Each question is presented in a multiple-choice format with four options. The correct answer is clearly indicated,
followed by a detailed rationale explaining the clinical reasoning behind the correct choice. Additionally, each
incorrect option is analyzed to clarify why it is not the best answer, promoting deeper understanding and critical
thinking.
Page 1
,Compliance Checklist:
All questions are verified by subject matter experts for accuracy
Content aligns with the latest HESI 266 exam blueprint and nursing standards
Rationales reference current evidence-based practice guidelines
Document is formatted for easy reading and focused study
Includes updates for the 2026/2027 academic year
Content Area Overview:
Content Area Questions Key Topics Weight
Pharmacology 1-30 Drug classifications, dosage calculations, 20%
adverse effects, nursing considerations
Medical-Surgical Nursing 31-70 Cardiovascular, respiratory, gastrointestinal, 27%
endocrine, neurological systems
Maternal-Child Health 71-100 Antepartum, intrapartum, postpartum care, 20%
newborn assessment, pediatric nursing
Mental Health Nursing 101-125 Therapeutic communication, psychiatric 17%
disorders, crisis intervention,
psychopharmacology
Leadership & Management 126-150 Delegation, prioritization, ethical/legal 16%
issues, quality improvement
Page 2
,Q1. A patient with a history of chronic heart failure presents with acute dyspnea, jugular venous distention,
and bilateral crackles. Current medications include lisinopril, metoprolol, and furosemide. Vital signs: BP
88/50, HR 110, RR 28, SpO2 88% on room air. Which intervention should the nurse prioritize?
A. Administer intravenous normal saline bolus
B. Administer intravenous nitroglycerin infusion
C. Administer intravenous furosemide 80 mg
D. Administer intravenous dobutamine infusion
Correct Answer: D. Administer intravenous dobutamine infusion
Rationale: The patient is experiencing acute decompensated heart failure with cardiogenic shock (hypotension,
tachycardia, low SpO2). In this setting, dobutamine, an inotrope, improves cardiac contractility and supports blood
pressure. Nitroglycerin would worsen hypotension. Furosemide is indicated for volume overload but does not
address the low cardiac output. Saline bolus would exacerbate pulmonary edema.
Why Wrong:
A - Fluid bolus would worsen pulmonary congestion in acute heart failure.
B - Nitroglycerin is a vasodilator that would further lower blood pressure.
C - Furosemide addresses fluid overload but does not improve hypotension or tissue perfusion.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 24; ACC/AHA Heart Failure
Guidelines 2026
Q2. A patient with type 2 diabetes mellitus has a glycated hemoglobin (HbA1c) of 9.2% despite metformin
1000 mg twice daily. Estimated glomerular filtration rate (eGFR) is 45 mL/min/1.73m². Which of the
following add-on therapies is most appropriate considering renal function and cardiovascular benefit?
A. Glipizide extended release 10 mg daily
B. Empagliflozin 10 mg daily
C. Sitagliptin 100 mg daily
D. Insulin glargine 10 units at bedtime
Correct Answer: B. Empagliflozin 10 mg daily
Rationale: Empagliflozin, an SGLT2 inhibitor, is preferred in patients with type 2 diabetes and chronic kidney
disease (eGFR 30) due to its renal and cardiovascular protective effects. Glipizide increases hypoglycemia risk and
has no renal protection. Sitagliptin requires dose adjustment for eGFR <45 (recommended 50 mg daily) and lacks
proven cardiovascular benefit. Insulin glargine is an option but not first-line for renal protection.
Why Wrong:
A - Glipizide increases hypoglycemia risk and does not provide renal protection.
C - Sitagliptin dose should be reduced to 50 mg daily for eGFR <45, and it lacks cardiovascular benefit.
D - Insulin glargine is effective but does not confer the renal and cardiovascular advantages of SGLT2
inhibitors.
Reference: American Diabetes Association (2026). Standards of Medical Care in Diabetes, Diabetes Care,
49(Suppl 1)
Q3. A nursing student is evaluating a research study on postoperative pain management. The study reports a
p-value of 0.03 for the primary outcome comparing a new analgesic to placebo. Which of the following is the
most accurate interpretation?
A. There is a 3% probability that the null hypothesis is true.
B. The probability of observing such an extreme result by chance alone is 3% if the null hypothesis is true.
C. The new analgesic is 97% effective in reducing pain.
D. The study has a 3% chance of a Type II error.
Correct Answer: B. The probability of observing such an extreme result by chance alone is 3% if the null
hypothesis is true.
Rationale: The p-value is the probability of obtaining results at least as extreme as those observed, assuming the
Page 3
, null hypothesis is true. A p-value of 0.03 indicates a 3% chance that the observed difference is due to random
variation. It does not directly indicate the probability of the null hypothesis being true (A), the effectiveness of the
drug (C), or the Type II error rate (D).
Why Wrong:
A - The p-value does not quantify the probability that the null hypothesis is true.
C - Effectiveness is measured by effect size, not p-value.
D - Type II error probability is denoted by beta, not p-value.
Reference: Polit, D.F., & Beck, C.T. (2026). Nursing Research: Generating and Assessing Evidence for Nursing Practice, 11th
Ed., Ch. 13
Q4. A patient admitted with acute pancreatitis has a serum calcium level of 7.2 mg/dL (reference 8.5-10.5).
Which of the following assessment findings is most consistent with this electrolyte abnormality?
A. Positive Trousseau's sign and prolonged QT interval
B. Muscle weakness and shallow respirations
C. Bradycardia and hypotension
D. Hyperactive deep tendon reflexes and tetany
Correct Answer: A. Positive Trousseau's sign and prolonged QT interval
Rationale: Hypocalcemia (calcium <8.5) causes neuromuscular irritability, leading to positive Trousseau's sign
(carpopedal spasm with BP cuff inflation) and prolonged QT interval due to delayed ventricular repolarization.
Muscle weakness and shallow respirations are more typical of hypercalcemia. Bradycardia and hypotension are
not classic signs. Tetany occurs but hyperactive reflexes are not typical.
Why Wrong:
B - Muscle weakness and shallow respirations are associated with hypercalcemia, not hypocalcemia.
C - Bradycardia and hypotension are not characteristic of hypocalcemia; QT prolongation is more common.
D - Hypocalcemia causes tetany but deep tendon reflexes are usually normal or hypoactive.
Reference: Urden, L.D., Stacy, K.M., & Lough, M.E. (2026). Critical Care Nursing: Diagnosis and Management,
9th Ed., Ch. 14
Q5. A nurse is caring for a patient receiving a continuous heparin infusion for deep vein thrombosis. The
current aPTT is 110 seconds (therapeutic range 60-80 seconds). The infusion rate is 15 units/kg/hr. What is
the nurse's priority action?
A. Increase the infusion rate by 2 units/kg/hr
B. Stop the infusion for 1 hour and then restart at a decreased rate
C. Administer protamine sulfate 50 mg intravenously
D. Continue the current infusion rate and recheck aPTT in 6 hours
Correct Answer: B. Stop the infusion for 1 hour and then restart at a decreased rate
Rationale: An aPTT of 110 seconds is above the therapeutic range, indicating an increased risk of bleeding. The
standard protocol for supratherapeutic aPTT is to hold the infusion for 1 hour and then restart at a lower rate (e.g.,
decrease by 2 units/kg/hr). Continuing the infusion (D) would maintain the elevated aPTT. Increasing the rate (A)
would worsen the situation. Protamine (C) is reserved for major bleeding or reversal, not routine dose adjustment.
Why Wrong:
A - Increasing the rate would further elevate aPTT and increase bleeding risk.
C - Protamine is indicated only for severe bleeding or prior to emergency surgery, not for asymptomatic
supratherapeutic aPTT.
D - Continuing the infusion would leave the patient at risk for bleeding; immediate adjustment is needed.
Reference: Garcia, D.A., et al. (2026). Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert
Panel Report, Chest, 169(2)
Page 4
