BSN HESI 266 Med Surg Exam (Latest 2026/2027) Questions & Correct Answers With Rationales, 100% Guaranteed Pass || Complete A+ Guide - Nightingale
OBJECTIVE ASSESSMENT - EXAM
BSN HESI 266 Med Surg Exam (Latest
2026/2027) Questions & Correct Answers
With Rationales, 100% Guaranteed Pass ||
Complete A+ Guide - Nightingale
Nightingale Complete A+ Verification & Study Guide
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Cardiovascular Disorders & Hematology Endocrine & Immunologic Functions
Pulmonary & Respiratory Care Neurological & Musculoskeletal Care
Gastrointestinal & Renal Management Perioperative & Oncological Nursing
COVER PAGE -- 1
, SECTION 1 | CARDIOVASCULAR AND HEMATOLOGIC SYSTEMS | Q1-Q20 | BSN HESI 266 Med Surg Exam (Latest 2026/2027) Questions & Correct Answers W
Q1 Question 1 of 100
A 62-year-old male is admitted with an exacerbation of left-sided heart failure. He exhibits bilateral crackles, a
heart rate of 112 bpm, and a pulse oximetry reading of 88% on room air. Which action should the nurse
implement first to stabilize the patient?
A. Administer the scheduled oral dose of furosemide 40 mg
B. Place the patient in high-Fowler's position and apply supplemental oxygen
C. Prepare the patient for a diagnostic 12-lead electrocardiogram
D. Obtain a blood specimen to measure the brain natriuretic peptide (BNP) level
Correct Answer: B
Rationale:
Placing the patient in high-Fowler's position decreases venous return (preload) and enhances thoracic
expansion, which immediately improves gas exchange while supplemental oxygen treats hypoxia. Oral diuretics
take hours to work, and diagnostic tests (ECG, BNP) are important but do not address the acute respiratory
compromise.
Q2 Question 2 of 100
A 55-year-old female presents to the emergency department with substernal chest pain radiating to her left
jaw, accompanied by diaphoresis and nausea. Her electrocardiogram shows ST-segment elevation in leads
II, III, and aVF. Which nursing action is the top priority for this patient?
A. Administer sublingual nitroglycerin as prescribed
B. Obtain a sample for cardiac troponin levels
C. Administer morphine sulfate intravenously
D. Place the patient on a continuous cardiac monitor
Correct Answer: A
Rationale:
Sublingual nitroglycerin acts rapidly as a vasodilator to improve coronary artery perfusion and decrease
myocardial oxygen demand, addressing the acute ischemic injury. Morphine can be given if pain is unresolved,
troponin levels are diagnostic but do not treat the ischemia, and cardiac monitoring is essential but secondary to
active ischemia relief.
ed Surg Exam (Latest 2026/2027) Questions & Correct Answers With Rationales, 100% Guaranteed Pass || Complete A+ Guide - Nightingale -- 2026/2027 | Passing Score: 8
, Q3 Question 3 of 100
A patient is receiving an intravenous infusion of heparin for a deep vein thrombosis (DVT) in the left lower
extremity. The nurse reviews the laboratory results and notes that the activated partial thromboplastin time
(aPTT) is 110 seconds, and the patient has active hematuria. Which medication should the nurse prepare to
administer?
A. Vitamin K
B. Protamine sulfate
C. Aminocaproic acid
D. Platelet transfusion
Correct Answer: B
Rationale:
Protamine sulfate is the specific antidote for heparin-induced anticoagulation, which is indicated here given the
dangerously high aPTT (normal therapeutic range is 1.5 to 2.5 times control, roughly 60-80 seconds) and active
bleeding. Vitamin K is the antidote for warfarin, aminocaproic acid is a fibrinolytic inhibitor, and platelet
transfusions are for thrombocytopenia.
Q4 Question 4 of 100
A nurse is assessing a patient with chronic venous insufficiency of the lower extremities. Which clinical
manifestation should the nurse expect to observe during the physical assessment?
A. Pale, cool skin with diminished dorsalis pedis pulses
B. Brownish skin discoloration (hemosiderin staining) and edema around the ankles
C. Sharp, severe calf pain that worsens with leg elevation
D. Punched-out, deep ulcers on the tips of the toes with minimal drainage
Correct Answer: B
Rationale:
Chronic venous insufficiency leads to venous hypertension, causing extravasation of red blood cells into the
subcutaneous tissue, which break down and leave hemosiderin deposits (brownish discoloration), along with
significant edema. Pale, cool skin, sharp pain with elevation, and punched-out toe ulcers are characteristic of
chronic arterial disease.
ed Surg Exam (Latest 2026/2027) Questions & Correct Answers With Rationales, 100% Guaranteed Pass || Complete A+ Guide - Nightingale -- 2026/2027 | Passing Score: 8
, Q5 Question 5 of 100
ECG Rhythm Strip
Amplitude (mV)
Time (ms)
A patient is admitted with reports of palpitations and dizziness. The nurse obtains an electrocardiogram
(ECG) and notices the waveform pattern depicted below. What is the nurse's first action?
A. Administer a 150 mg bolus of intravenous amiodarone
B. Perform immediate unsynchronized cardioversion (defibrillation)
C. Assess the patient's carotid pulse and level of consciousness
D. Initiate immediate high-quality cardiopulmonary resuscitation (CPR)
Correct Answer: C
Rationale:
Before implementing any medical or electrical therapy based on an ECG rhythm strip, the nurse must assess the
patient's hemodynamic stability (pulse and responsiveness). If a pulse is present, the intervention matches
stable/unstable tachycardia protocols; if pulseless, CPR and defibrillation are indicated.
Q6 Question 6 of 100
A patient is diagnosed with infective endocarditis and is prescribed prolonged intravenous antibiotic therapy.
During the assessment, the nurse notes small, painful, erythematous nodules on the pads of the patient's
fingers and toes. How should the nurse document this finding?
A. Osler's nodes
B. Janeway lesions
C. Splinter hemorrhages
D. Roth's spots
Correct Answer: A
Rationale:
Osler's nodes are painful, tender, red, raised nodules on the fingers or toes associated with infective endocarditis.
Janeway lesions are flat, painless, red spots on the palms and soles; splinter hemorrhages are dark streaks
under the fingernails; Roth's spots are retinal hemorrhages.
ed Surg Exam (Latest 2026/2027) Questions & Correct Answers With Rationales, 100% Guaranteed Pass || Complete A+ Guide - Nightingale -- 2026/2027 | Passing Score: 8
OBJECTIVE ASSESSMENT - EXAM
BSN HESI 266 Med Surg Exam (Latest
2026/2027) Questions & Correct Answers
With Rationales, 100% Guaranteed Pass ||
Complete A+ Guide - Nightingale
Nightingale Complete A+ Verification & Study Guide
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Cardiovascular Disorders & Hematology Endocrine & Immunologic Functions
Pulmonary & Respiratory Care Neurological & Musculoskeletal Care
Gastrointestinal & Renal Management Perioperative & Oncological Nursing
COVER PAGE -- 1
, SECTION 1 | CARDIOVASCULAR AND HEMATOLOGIC SYSTEMS | Q1-Q20 | BSN HESI 266 Med Surg Exam (Latest 2026/2027) Questions & Correct Answers W
Q1 Question 1 of 100
A 62-year-old male is admitted with an exacerbation of left-sided heart failure. He exhibits bilateral crackles, a
heart rate of 112 bpm, and a pulse oximetry reading of 88% on room air. Which action should the nurse
implement first to stabilize the patient?
A. Administer the scheduled oral dose of furosemide 40 mg
B. Place the patient in high-Fowler's position and apply supplemental oxygen
C. Prepare the patient for a diagnostic 12-lead electrocardiogram
D. Obtain a blood specimen to measure the brain natriuretic peptide (BNP) level
Correct Answer: B
Rationale:
Placing the patient in high-Fowler's position decreases venous return (preload) and enhances thoracic
expansion, which immediately improves gas exchange while supplemental oxygen treats hypoxia. Oral diuretics
take hours to work, and diagnostic tests (ECG, BNP) are important but do not address the acute respiratory
compromise.
Q2 Question 2 of 100
A 55-year-old female presents to the emergency department with substernal chest pain radiating to her left
jaw, accompanied by diaphoresis and nausea. Her electrocardiogram shows ST-segment elevation in leads
II, III, and aVF. Which nursing action is the top priority for this patient?
A. Administer sublingual nitroglycerin as prescribed
B. Obtain a sample for cardiac troponin levels
C. Administer morphine sulfate intravenously
D. Place the patient on a continuous cardiac monitor
Correct Answer: A
Rationale:
Sublingual nitroglycerin acts rapidly as a vasodilator to improve coronary artery perfusion and decrease
myocardial oxygen demand, addressing the acute ischemic injury. Morphine can be given if pain is unresolved,
troponin levels are diagnostic but do not treat the ischemia, and cardiac monitoring is essential but secondary to
active ischemia relief.
ed Surg Exam (Latest 2026/2027) Questions & Correct Answers With Rationales, 100% Guaranteed Pass || Complete A+ Guide - Nightingale -- 2026/2027 | Passing Score: 8
, Q3 Question 3 of 100
A patient is receiving an intravenous infusion of heparin for a deep vein thrombosis (DVT) in the left lower
extremity. The nurse reviews the laboratory results and notes that the activated partial thromboplastin time
(aPTT) is 110 seconds, and the patient has active hematuria. Which medication should the nurse prepare to
administer?
A. Vitamin K
B. Protamine sulfate
C. Aminocaproic acid
D. Platelet transfusion
Correct Answer: B
Rationale:
Protamine sulfate is the specific antidote for heparin-induced anticoagulation, which is indicated here given the
dangerously high aPTT (normal therapeutic range is 1.5 to 2.5 times control, roughly 60-80 seconds) and active
bleeding. Vitamin K is the antidote for warfarin, aminocaproic acid is a fibrinolytic inhibitor, and platelet
transfusions are for thrombocytopenia.
Q4 Question 4 of 100
A nurse is assessing a patient with chronic venous insufficiency of the lower extremities. Which clinical
manifestation should the nurse expect to observe during the physical assessment?
A. Pale, cool skin with diminished dorsalis pedis pulses
B. Brownish skin discoloration (hemosiderin staining) and edema around the ankles
C. Sharp, severe calf pain that worsens with leg elevation
D. Punched-out, deep ulcers on the tips of the toes with minimal drainage
Correct Answer: B
Rationale:
Chronic venous insufficiency leads to venous hypertension, causing extravasation of red blood cells into the
subcutaneous tissue, which break down and leave hemosiderin deposits (brownish discoloration), along with
significant edema. Pale, cool skin, sharp pain with elevation, and punched-out toe ulcers are characteristic of
chronic arterial disease.
ed Surg Exam (Latest 2026/2027) Questions & Correct Answers With Rationales, 100% Guaranteed Pass || Complete A+ Guide - Nightingale -- 2026/2027 | Passing Score: 8
, Q5 Question 5 of 100
ECG Rhythm Strip
Amplitude (mV)
Time (ms)
A patient is admitted with reports of palpitations and dizziness. The nurse obtains an electrocardiogram
(ECG) and notices the waveform pattern depicted below. What is the nurse's first action?
A. Administer a 150 mg bolus of intravenous amiodarone
B. Perform immediate unsynchronized cardioversion (defibrillation)
C. Assess the patient's carotid pulse and level of consciousness
D. Initiate immediate high-quality cardiopulmonary resuscitation (CPR)
Correct Answer: C
Rationale:
Before implementing any medical or electrical therapy based on an ECG rhythm strip, the nurse must assess the
patient's hemodynamic stability (pulse and responsiveness). If a pulse is present, the intervention matches
stable/unstable tachycardia protocols; if pulseless, CPR and defibrillation are indicated.
Q6 Question 6 of 100
A patient is diagnosed with infective endocarditis and is prescribed prolonged intravenous antibiotic therapy.
During the assessment, the nurse notes small, painful, erythematous nodules on the pads of the patient's
fingers and toes. How should the nurse document this finding?
A. Osler's nodes
B. Janeway lesions
C. Splinter hemorrhages
D. Roth's spots
Correct Answer: A
Rationale:
Osler's nodes are painful, tender, red, raised nodules on the fingers or toes associated with infective endocarditis.
Janeway lesions are flat, painless, red spots on the palms and soles; splinter hemorrhages are dark streaks
under the fingernails; Roth's spots are retinal hemorrhages.
ed Surg Exam (Latest 2026/2027) Questions & Correct Answers With Rationales, 100% Guaranteed Pass || Complete A+ Guide - Nightingale -- 2026/2027 | Passing Score: 8
