BSN HESI 366 RN EXIT EXAM V3 NIGHTINGALE ACTUAL EXAM PREP 2026 ALL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES ALREADY A GRADED WITH EXPERT FEEDBACK |CURRENTLY TESTING |NEW AND REVISED

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BSN HESI 366 RN EXIT EXAM V3 NIGHTINGALE
ACTUAL EXAM PREP 2026 ALL QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES ALREADY A GRADED WITH
EXPERT FEEDBACK |CURRENTLY TESTING
|NEW AND REVISED

1. A client with heart failure is prescribed furosemide (Lasix). Which
laboratory value should the nurse monitor most closely?
 A) Potassium 3.0 mEq/L
 B) Sodium 140 mEq/L
 C) Calcium 9.5 mg/dL
 D) Magnesium 2.0 mg/dL
Rationale: Furosemide is a loop diuretic that causes potassium
wasting through increased excretion in the distal tubule. Hypokalemia
(potassium below 3.5 mEq/L) is the most common and dangerous
electrolyte imbalance associated with loop diuretics because it can
precipitate cardiac dysrhythmias. Sodium 140 mEq/L, calcium 9.5
mg/dL, and magnesium 2.0 mg/dL are all within normal ranges and
are not the priority concern when administering furosemide.
2. A client who had a total hip replacement 2 days ago reports sudden
shortness of breath and chest pain. What is the nurse's priority action?
 A) Administer prescribed PRN oxygen
 B) Elevate the head of the bed
 C) Call the rapid response team
 D) Apply sequential compression devices

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Rationale: Sudden shortness of breath and chest pain in a post-
operative orthopedic patient are classic signs of a pulmonary embolism
(PE), which is a life-threatening emergency. The nurse should
immediately call the rapid response team because PE requires urgent
medical intervention including potential thrombolytic therapy or
anticoagulation. While administering oxygen and elevating the head
of the bed are supportive measures, the priority is to activate the
emergency response so that definitive treatment can begin without
delay.
3. A client with type 2 diabetes mellitus is started on metformin
(Glucophage). Which instruction is most important for the nurse to
include in discharge teaching?
 A) Take the medication on an empty stomach
 B) Avoid consuming alcohol while taking this medication
 C) Expect to gain weight with this medication
 D) Monitor for signs of hyperglycemia only
Rationale: The most critical instruction for a client taking metformin
is to avoid alcohol. Metformin increases the risk of lactic acidosis, and
alcohol consumption further increases this risk because both
metformin and alcohol affect hepatic metabolism. Lactic acidosis is a
rare but potentially fatal condition. Metformin should be taken with
meals to reduce gastrointestinal side effects.
4. A client is admitted with a diagnosis of chronic obstructive pulmonary
disease (COPD) exacerbation. Which arterial blood gas (ABG) finding
would the nurse expect?
 A) pH 7.48, PaCO₂ 30 mmHg, HCO₃⁻ 22 mEq/L
 B) pH 7.30, PaCO₂ 55 mmHg, HCO₃⁻ 28 mEq/L
 C) pH 7.36, PaCO₂ 42 mmHg, HCO₃⁻ 24 mEq/L

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 D) pH 7.50, PaCO₂ 48 mmHg, HCO₃⁻ 30 mEq/L
Rationale: In COPD exacerbation, the client experiences respiratory
acidosis due to impaired gas exchange and carbon dioxide retention.
The ABG would show a decreased pH (< 7.35) and elevated PaCO₂ (>
45 mmHg). The HCO₃⁻ may be elevated as a compensatory response
(metabolic alkalosis). Option B shows pH 7.30 (acidosis), PaCO₂ 55
mmHg (elevated), and HCO₃⁻ 28 mEq/L (compensatory elevation).
5. A nurse is preparing to administer an intravenous (IV) antibiotic to a
client. Which action should the nurse take first?
 A) Assess the client's allergy status
 B) Verify the client's identity using two identifiers
 C) Calculate the medication dosage
 D) Check the expiration date of the medication
Rationale: The first action in medication administration is to verify the
client's identity using two unique identifiers (e.g., name and date of
birth) to ensure the right client receives the medication. While
assessing allergy status, calculating dosage, and checking expiration
dates are important, patient identification is the priority to prevent
medication errors.
6. A client with cirrhosis is admitted with ascites and peripheral edema.
Which nursing intervention is most appropriate?
 A) Encourage a high-sodium diet
 B) Monitor daily weight and abdominal girth
 C) Restrict fluid intake to 500 mL daily
 D) Position the client in a supine position
Rationale: Monitoring daily weight and abdominal girth is essential to
track fluid accumulation in ascites. Sodium restriction (not high

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sodium) is typically prescribed. Fluid restriction may be prescribed but
is not the primary intervention. Supine positioning may worsen
respiratory compromise.
7. A client is receiving a blood transfusion and develops chills, fever,
and low back pain. What is the priority nursing action?
 A) Slow the transfusion rate
 B) Stop the transfusion immediately
 C) Administer an antihistamine
 D) Monitor vital signs
Rationale: Chills, fever, and low back pain are signs of a febrile non-
hemolytic transfusion reaction or potentially a hemolytic reaction. The
transfusion should be stopped immediately, and the healthcare
provider should be notified. Slowing the rate is not sufficient; the
reaction must be stopped to prevent further complications.
8. A client with schizophrenia is prescribed haloperidol. Which side
effect should the nurse monitor for?
 A) Weight gain
 B) Sedation
 C) Extrapyramidal symptoms
 D) Hyponatremia
Rationale: Haloperidol is a typical antipsychotic medication associated
with extrapyramidal symptoms (EPS) including dystonia,
parkinsonism, akathisia, and tardive dyskinesia. Weight gain and
sedation are more commonly associated with atypical antipsychotics.
Hyponatremia is not a typical side effect of haloperidol.
9. A nurse is caring for a client with a chest tube. Which finding requires
immediate intervention?