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BSN 366 HESI RN Exit Exam V1 Bank Actual
Exam 2026/2027 | Complete Exam-Style
Questions | 100% Verified – Detailed Rationales –
Pass Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Safe and Effective Care Environment | Q1 – Q40
Section 2 | Health Promotion and Maintenance | Q41 – Q80
Section 3 | Psychosocial Integrity | Q81 – Q120
Section 4 | Physiological Integrity | Q121 – Q160
Instructions: Choose the single best answer. Pass: 75% (850 scaled) in 240 minutes.
══════════════════════════════════════
SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT Q1 – Q40
══════════════════════════════════════
Question 1 of 160
A 45-year-old male client is admitted to the medical-surgical unit with a diagnosis of deep vein
thrombosis (DVT). He has been prescribed unfractionated heparin intravenously. The nurse
reviews the laboratory results and notes that the activated partial thromboplastin time (aPTT) is
90 seconds. The control aPTT is 30 seconds. Which action should the nurse take first?
A. Administer the next dose of heparin as scheduled
B. Stop the heparin infusion immediately
C. Reduce the heparin infusion rate by 500 units/hr
D. Notify the healthcare provider to increase the dose
Correct Answer: B
,2
Rationale: The aPTT is significantly elevated (90 seconds), which places the client at high risk
for bleeding, so the heparin infusion must be stopped immediately to prevent harm.
Administering the dose or reducing the rate without stopping the infusion fails to address the
critical safety issue of potential hemorrhage. Clinical protocols typically require holding the
infusion until the aPTT returns to a therapeutic range, usually around 1.5 to 2.5 times the control.
Question 2 of 160
The nurse is caring for four clients on a busy medical unit. Which client should the nurse assess
first after receiving the change-of-shift report?
A. A 62-year-old with type 2 diabetes reporting hunger and a blood glucose of 70 mg/dL
B. A 55-year-old with pneumonia who has a productive cough and temperature of 100.4°F
(38°C)
C. A 70-year-old with heart failure who reports dyspnea after walking to the bathroom
D. A 48-year-old with pancreatitis requesting pain medication for abdominal pain
Correct Answer: C
Rationale: Dyspnea in a client with heart failure is a sign of potential fluid overload and
worsening cardiac status, requiring immediate assessment to prevent respiratory failure. While
the hypoglycemic client needs intervention, oral glucose can often be administered quickly by
unlicensed assistive personnel if protocols allow. The client with pneumonia and the client with
pancreatitis have stable, expected symptoms that do not require immediate life-saving
intervention.
Question 3 of 160
A client is placed on contact precautions due to a wound infection with methicillin-resistant
Staphylococcus aureus (MRSA). The nurse is preparing to administer oral medications to the
client. Which personal protective equipment (PPE) is required to enter the room?
,3
A. Gown and gloves only
B. Gown, gloves, and face shield
C. Gloves and surgical mask
D. N95 respirator and gown
Correct Answer: A
Rationale: Contact precautions require the use of a gown and gloves to prevent direct contact
with the client or contaminated objects in the room. A face shield or mask is not indicated for
MRSA unless splashing of bodily fluids is likely, and an N95 respirator is used for airborne
pathogens, not contact infections. Proper hand hygiene is also essential before and after contact.
Question 4 of 160
The nurse is supervising a licensed practical nurse (LPN) and an assistive personnel (AP) on the
shift. Which task is most appropriate for the nurse to delegate to the AP?
A. Measuring the intake and output for a client with acute kidney injury
B. Administering a dose of bisacodyl suppository to a client with constipation
C. Performing the initial admission assessment on a new stable client
D. Teaching a client how to use a glucose meter at home
Correct Answer: A
Rationale: Measuring intake and output is a standardized, non-invasive task that falls within the
scope of practice for assistive personnel. Administering a suppository requires medication
administration skills typically delegated to LPNs, while initial assessments and client education
are responsibilities of the registered nurse. Delegation should always consider the education level
and legal scope of the delegate.
Question 5 of 160
, 4
A 28-year-old client presents to the emergency department with severe agitation, hallucinations,
and fever. The client is diaphoretic and has pinpoint pupils. The nurse suspects opioid
withdrawal. Which medication should the nurse anticipate administering to treat this client's
symptoms?
A. Naloxone (Narcan)
B. Methadone
C. Lorazepam (Ativan)
D. Diazepam (Valium)
Correct Answer: B
Rationale: Methadone is a long-acting opioid agonist used to suppress withdrawal symptoms and
reduce cravings in opioid-dependent clients. Naloxone is an opioid antagonist used to reverse
opioid overdose, which would precipitate severe withdrawal symptoms if given to a dependent
client. Benzodiazepines like lorazepam or diazepam are not the primary treatment for opioid
withdrawal.
Question 6 of 160
The nurse is performing an admission assessment on a 78-year-old client with dementia. The
client becomes increasingly agitated and combative when the nurse attempts to take vital signs.
Which action is the most appropriate?
A. Instruct the client to calm down and explain the necessity of the procedure
B. Request a prescription for a chemical restraint from the provider
C. Leave the room and return later to attempt the procedure again
D. Approach the client slowly and maintain eye contact while speaking softly
Correct Answer: D
BSN 366 HESI RN Exit Exam V1 Bank Actual
Exam 2026/2027 | Complete Exam-Style
Questions | 100% Verified – Detailed Rationales –
Pass Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Safe and Effective Care Environment | Q1 – Q40
Section 2 | Health Promotion and Maintenance | Q41 – Q80
Section 3 | Psychosocial Integrity | Q81 – Q120
Section 4 | Physiological Integrity | Q121 – Q160
Instructions: Choose the single best answer. Pass: 75% (850 scaled) in 240 minutes.
══════════════════════════════════════
SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT Q1 – Q40
══════════════════════════════════════
Question 1 of 160
A 45-year-old male client is admitted to the medical-surgical unit with a diagnosis of deep vein
thrombosis (DVT). He has been prescribed unfractionated heparin intravenously. The nurse
reviews the laboratory results and notes that the activated partial thromboplastin time (aPTT) is
90 seconds. The control aPTT is 30 seconds. Which action should the nurse take first?
A. Administer the next dose of heparin as scheduled
B. Stop the heparin infusion immediately
C. Reduce the heparin infusion rate by 500 units/hr
D. Notify the healthcare provider to increase the dose
Correct Answer: B
,2
Rationale: The aPTT is significantly elevated (90 seconds), which places the client at high risk
for bleeding, so the heparin infusion must be stopped immediately to prevent harm.
Administering the dose or reducing the rate without stopping the infusion fails to address the
critical safety issue of potential hemorrhage. Clinical protocols typically require holding the
infusion until the aPTT returns to a therapeutic range, usually around 1.5 to 2.5 times the control.
Question 2 of 160
The nurse is caring for four clients on a busy medical unit. Which client should the nurse assess
first after receiving the change-of-shift report?
A. A 62-year-old with type 2 diabetes reporting hunger and a blood glucose of 70 mg/dL
B. A 55-year-old with pneumonia who has a productive cough and temperature of 100.4°F
(38°C)
C. A 70-year-old with heart failure who reports dyspnea after walking to the bathroom
D. A 48-year-old with pancreatitis requesting pain medication for abdominal pain
Correct Answer: C
Rationale: Dyspnea in a client with heart failure is a sign of potential fluid overload and
worsening cardiac status, requiring immediate assessment to prevent respiratory failure. While
the hypoglycemic client needs intervention, oral glucose can often be administered quickly by
unlicensed assistive personnel if protocols allow. The client with pneumonia and the client with
pancreatitis have stable, expected symptoms that do not require immediate life-saving
intervention.
Question 3 of 160
A client is placed on contact precautions due to a wound infection with methicillin-resistant
Staphylococcus aureus (MRSA). The nurse is preparing to administer oral medications to the
client. Which personal protective equipment (PPE) is required to enter the room?
,3
A. Gown and gloves only
B. Gown, gloves, and face shield
C. Gloves and surgical mask
D. N95 respirator and gown
Correct Answer: A
Rationale: Contact precautions require the use of a gown and gloves to prevent direct contact
with the client or contaminated objects in the room. A face shield or mask is not indicated for
MRSA unless splashing of bodily fluids is likely, and an N95 respirator is used for airborne
pathogens, not contact infections. Proper hand hygiene is also essential before and after contact.
Question 4 of 160
The nurse is supervising a licensed practical nurse (LPN) and an assistive personnel (AP) on the
shift. Which task is most appropriate for the nurse to delegate to the AP?
A. Measuring the intake and output for a client with acute kidney injury
B. Administering a dose of bisacodyl suppository to a client with constipation
C. Performing the initial admission assessment on a new stable client
D. Teaching a client how to use a glucose meter at home
Correct Answer: A
Rationale: Measuring intake and output is a standardized, non-invasive task that falls within the
scope of practice for assistive personnel. Administering a suppository requires medication
administration skills typically delegated to LPNs, while initial assessments and client education
are responsibilities of the registered nurse. Delegation should always consider the education level
and legal scope of the delegate.
Question 5 of 160
, 4
A 28-year-old client presents to the emergency department with severe agitation, hallucinations,
and fever. The client is diaphoretic and has pinpoint pupils. The nurse suspects opioid
withdrawal. Which medication should the nurse anticipate administering to treat this client's
symptoms?
A. Naloxone (Narcan)
B. Methadone
C. Lorazepam (Ativan)
D. Diazepam (Valium)
Correct Answer: B
Rationale: Methadone is a long-acting opioid agonist used to suppress withdrawal symptoms and
reduce cravings in opioid-dependent clients. Naloxone is an opioid antagonist used to reverse
opioid overdose, which would precipitate severe withdrawal symptoms if given to a dependent
client. Benzodiazepines like lorazepam or diazepam are not the primary treatment for opioid
withdrawal.
Question 6 of 160
The nurse is performing an admission assessment on a 78-year-old client with dementia. The
client becomes increasingly agitated and combative when the nurse attempts to take vital signs.
Which action is the most appropriate?
A. Instruct the client to calm down and explain the necessity of the procedure
B. Request a prescription for a chemical restraint from the provider
C. Leave the room and return later to attempt the procedure again
D. Approach the client slowly and maintain eye contact while speaking softly
Correct Answer: D
