BSN HESI 266
OBJECTIVE ASSESSMENT - EXAM
BSN HESI 266 Med Surg Exam
(Latest 2026/2027) Questions &
Correct Answers With Rationales,
100% Guaranteed Pass || Complete
A+ Guide - Nightingale
Medical-Surgical Nursing Exit Exam
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Heart Failure & Dysrhythmias Diabetes & Thyroid Disorders
COPD & Acute Respiratory Failure Stroke & Seizure Disorders
GI Bleeding & Liver Disease Musculoskeletal Trauma & Joint Replacement
COVER PAGE - 1
,
, SECTION 1 | Cardiovascular & Hematologic Disorders | Q1-Q20 | BSN HESI 266 Med Surg Exam (Latest 2026/2027) Qu
Q1 Question 1 of 100
A 68-year-old male is admitted with acute decompensated heart failure. His vital signs
are BP 162/94 mmHg, HR 112 bpm, RR 26/min, and SpO2 88% on room air. He reports
severe dyspnea and orthopnea. Which intervention should the nurse prioritize first?
A. Administer IV furosemide 40 mg as ordered
B. Apply supplemental oxygen via non-rebreather mask
C. Insert a Foley catheter to monitor hourly urine output
D. Obtain a 12-lead ECG within 15 minutes
Correct Answer: B
Rationale:
The patient has SpO2 88% with severe dyspnea, indicating life-threatening hypoxemia. Oxygenation takes
priority over diuresis, catheterization, or ECG acquisition per the ABC framework. Furosemide and ECG are
important but secondary until oxygenation is stabilized.
Q2 Question 2 of 100
A 55-year-old female with a history of atrial fibrillation is prescribed warfarin 5 mg
daily. Her INR today is 3.8, and she reports dark tarry stools. Which action by the
nurse is most appropriate?
A. Hold the next dose of warfarin and notify the provider immediately
B. Instruct the patient to increase vitamin K-rich foods at dinner
C. Administer the scheduled warfarin dose because the therapeutic INR range is 2.0-4.0
D. Document the finding and recheck the INR in 48 hours
Correct Answer: A
Rationale:
An INR of 3.8 with signs of GI bleeding (dark tarry stools) indicates supratherapeutic anticoagulation with
active hemorrhage. The nurse must hold warfarin and notify the provider promptly. Increasing vitamin K is
not an appropriate acute intervention, and waiting 48 hours could worsen bleeding.
d Surg Exam (Latest 2026/2027) Questions & Correct Answers With Rationales, 100% Guaranteed Pass || Complete A+ Guide - Nightingale -- 2026/2027 | Passing Score: 80
, SECTION 1 | Cardiovascular & Hematologic Disorders | Q1-Q20 | BSN HESI 266 Med Surg Exam (Latest 2026/2027) Qu
Q3 Question 3 of 100
A 72-year-old male 4 hours post-MI suddenly develops crackles bilaterally, frothy pink
sputum, and an SpO2 of 84%. He is anxious and diaphoretic. Which pathophysiologic
process best explains these findings?
A. Left ventricular failure causing pulmonary venous congestion
B. Right ventricular infarction leading to systemic venous backup
C. Papillary muscle rupture producing acute mitral regurgitation
D. Ventricular septal defect creating a left-to-right shunt
Correct Answer: A
Rationale:
Bilateral crackles, pink frothy sputum, and severe hypoxemia after MI are classic for acute pulmonary edema
from left ventricular failure. Right ventricular infarction would present with JVD and hypotension without
pulmonary congestion. Papillary muscle rupture causes a new murmur, and VSD causes a harsh
holosystolic murmur with a step-up in O2 saturation.
Q4 Question 4 of 100
A nurse is caring for a patient with a new permanent pacemaker. Which discharge
instruction is most important for the nurse to include?
A. Avoid lifting the affected arm above shoulder level for 4-6 weeks
B. Take a daily aspirin 325 mg to prevent pacemaker thrombosis
C. Return to full-contact sports after 2 weeks with provider clearance
D. Keep the incision site dry by applying petroleum jelly daily
Correct Answer: A
Rationale:
Post-pacemaker patients must avoid lifting the affected arm above shoulder level for 4-6 weeks to prevent
lead dislodgement. Aspirin is not standard prophylaxis, full-contact sports are contraindicated, and petroleum
jelly is not recommended for incision care.
d Surg Exam (Latest 2026/2027) Questions & Correct Answers With Rationales, 100% Guaranteed Pass || Complete A+ Guide - Nightingale -- 2026/2027 | Passing Score: 80
OBJECTIVE ASSESSMENT - EXAM
BSN HESI 266 Med Surg Exam
(Latest 2026/2027) Questions &
Correct Answers With Rationales,
100% Guaranteed Pass || Complete
A+ Guide - Nightingale
Medical-Surgical Nursing Exit Exam
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Heart Failure & Dysrhythmias Diabetes & Thyroid Disorders
COPD & Acute Respiratory Failure Stroke & Seizure Disorders
GI Bleeding & Liver Disease Musculoskeletal Trauma & Joint Replacement
COVER PAGE - 1
,
, SECTION 1 | Cardiovascular & Hematologic Disorders | Q1-Q20 | BSN HESI 266 Med Surg Exam (Latest 2026/2027) Qu
Q1 Question 1 of 100
A 68-year-old male is admitted with acute decompensated heart failure. His vital signs
are BP 162/94 mmHg, HR 112 bpm, RR 26/min, and SpO2 88% on room air. He reports
severe dyspnea and orthopnea. Which intervention should the nurse prioritize first?
A. Administer IV furosemide 40 mg as ordered
B. Apply supplemental oxygen via non-rebreather mask
C. Insert a Foley catheter to monitor hourly urine output
D. Obtain a 12-lead ECG within 15 minutes
Correct Answer: B
Rationale:
The patient has SpO2 88% with severe dyspnea, indicating life-threatening hypoxemia. Oxygenation takes
priority over diuresis, catheterization, or ECG acquisition per the ABC framework. Furosemide and ECG are
important but secondary until oxygenation is stabilized.
Q2 Question 2 of 100
A 55-year-old female with a history of atrial fibrillation is prescribed warfarin 5 mg
daily. Her INR today is 3.8, and she reports dark tarry stools. Which action by the
nurse is most appropriate?
A. Hold the next dose of warfarin and notify the provider immediately
B. Instruct the patient to increase vitamin K-rich foods at dinner
C. Administer the scheduled warfarin dose because the therapeutic INR range is 2.0-4.0
D. Document the finding and recheck the INR in 48 hours
Correct Answer: A
Rationale:
An INR of 3.8 with signs of GI bleeding (dark tarry stools) indicates supratherapeutic anticoagulation with
active hemorrhage. The nurse must hold warfarin and notify the provider promptly. Increasing vitamin K is
not an appropriate acute intervention, and waiting 48 hours could worsen bleeding.
d Surg Exam (Latest 2026/2027) Questions & Correct Answers With Rationales, 100% Guaranteed Pass || Complete A+ Guide - Nightingale -- 2026/2027 | Passing Score: 80
, SECTION 1 | Cardiovascular & Hematologic Disorders | Q1-Q20 | BSN HESI 266 Med Surg Exam (Latest 2026/2027) Qu
Q3 Question 3 of 100
A 72-year-old male 4 hours post-MI suddenly develops crackles bilaterally, frothy pink
sputum, and an SpO2 of 84%. He is anxious and diaphoretic. Which pathophysiologic
process best explains these findings?
A. Left ventricular failure causing pulmonary venous congestion
B. Right ventricular infarction leading to systemic venous backup
C. Papillary muscle rupture producing acute mitral regurgitation
D. Ventricular septal defect creating a left-to-right shunt
Correct Answer: A
Rationale:
Bilateral crackles, pink frothy sputum, and severe hypoxemia after MI are classic for acute pulmonary edema
from left ventricular failure. Right ventricular infarction would present with JVD and hypotension without
pulmonary congestion. Papillary muscle rupture causes a new murmur, and VSD causes a harsh
holosystolic murmur with a step-up in O2 saturation.
Q4 Question 4 of 100
A nurse is caring for a patient with a new permanent pacemaker. Which discharge
instruction is most important for the nurse to include?
A. Avoid lifting the affected arm above shoulder level for 4-6 weeks
B. Take a daily aspirin 325 mg to prevent pacemaker thrombosis
C. Return to full-contact sports after 2 weeks with provider clearance
D. Keep the incision site dry by applying petroleum jelly daily
Correct Answer: A
Rationale:
Post-pacemaker patients must avoid lifting the affected arm above shoulder level for 4-6 weeks to prevent
lead dislodgement. Aspirin is not standard prophylaxis, full-contact sports are contraindicated, and petroleum
jelly is not recommended for incision care.
d Surg Exam (Latest 2026/2027) Questions & Correct Answers With Rationales, 100% Guaranteed Pass || Complete A+ Guide - Nightingale -- 2026/2027 | Passing Score: 80
