BSN366 EXIT HESI RN Exit Exam – 150+ Practice
Questions with Answers & Detailed Explanations
for BSN 366 HESI Exit (2026/2027 Update)
Covering Medical-Surgical, Pharmacology, Mental
Health, Maternity, Pediatrics & Leadership for
Nightingale College
📌 What's Inside:
✅ 150+ realistic multiple-choice and NGN-style questions covering every core
domain of the HESI RN Exit Exam blueprint:
o Medical-Surgical Nursing – cardiac, respiratory, GI, renal, endocrine,
neurology, musculoskeletal, burns, post-op complications
o Pharmacology – medication calculations, drug classifications (warfarin,
heparin, insulin, digoxin, antidepressants, antibiotics), side effects, patient
education
o Maternal-Newborn Nursing – antepartum, intrapartum, postpartum
complications, OB emergencies, newborn assessment
, o Pediatric Nursing – growth and development, pediatric disorders, asthma,
bronchiolitis, scoliosis screening
o Mental Health Nursing – depression, PTSD, suicide risk assessment,
therapeutic communication, psychiatric medications
o Leadership & Management – prioritization, delegation, assignment, legal
and ethical issues (DNR, patient rights, informed consent)
o Pharmacology & Dosage Calculations – drug calculations, IV drip rates,
conversions
o Next Generation NCLEX (NGN) Clinical Judgment – case studies, bow-tie
questions, select-all-that-apply (SATA)
o Prioritization – identifying the most critical client and taking action first in
scenarios
✅ Every correct answer in bold italics – no second-guessing
✅ Detailed explanations for every question – learn the why behind the answer,
not just the letter, reinforcing clinical reasoning and NCLEX-style critical thinking
✅ Verified answers with rationales – based on actual BSN366 Exit HESI exam
content
Table of Contents:
Section 1: Medical-Surgical Nursing (Questions 1–50)
Section 2: Pharmacology & Medication Administration (Questions 51–75)
,Section 3: Maternal-Newborn Nursing (Questions 76–90)
Section 4: Pediatric Nursing (Questions 91–105)
Section 5: Mental Health Nursing (Questions 106–120)
Section 6: Leadership, Management & Legal/Ethical Issues (Questions 121–135)
Section 7: NCLEX Clinical Judgment & NGN-Style Cases (Questions 136–150+)
Includes: Answer Key with Detailed Explanations for Every Question
Covers: BSN366 EXIT HESI RN Exam, HESI Exit, NCLEX-RN Readiness, Clinical
Judgment, Prioritization, Pharmacology, Medical-Surgical, Maternal/Peds, Mental Health,
and Leadership
Section 1: Medical-Surgical Nursing (Questions 1-50)
1. A patient with chronic systolic heart failure (LVEF 35%) on metoprolol succinate
presents with acute dyspnea. Vital signs: BP 92/58 mm Hg, HR 54 bpm, respiratory
rate 28. Crackles half-way up lung fields. Which intervention is most appropriate
regarding the beta-blocker?
A. Continue the beta-blocker at the current dose
B. Withhold the beta-blocker
C. Administer an IV beta-agonist
D. Double the dose of the beta-blocker
Answer: B. Withhold the beta-blocker
Explanation: In acute decompensated heart failure with hemodynamic instability (SBP < 90-
100, bradycardia), beta-blockers should be temporarily withheld. Continuing may worsen
hypotension; IV beta-agonist is not indicated; doubling the dose is dangerous .
, 2. A patient with a history of heart failure (HFrEF) is prescribed digoxin. Which of the
following is a sign of digoxin toxicity?
A. Tachycardia
B. Yellow-green halos
C. Hyperkalemia
D. Weight gain
Answer: B. Yellow-green halos
Explanation: Visual disturbances, including yellow-green halos, are classic signs of digoxin
toxicity. Other signs include nausea, vomiting, bradycardia, and dysrhythmias .
3. A patient is 4 hours post-cardiac catheterization via the femoral artery. Which
finding requires immediate intervention?
A. Small amount of serous drainage at the insertion site
B. Bruising around the insertion site
C. Pain in the affected leg
D. Loss of pulse distal to the insertion site
Answer: D. Loss of pulse distal to the insertion site
Explanation: Loss of distal pulse indicates arterial occlusion and requires immediate
intervention. Bruising and serous drainage are expected; pain may be normal but should be
monitored .
4. Which client statement indicates understanding of clopidogrel teaching?
A. "I will take this medication on an empty stomach."
Questions with Answers & Detailed Explanations
for BSN 366 HESI Exit (2026/2027 Update)
Covering Medical-Surgical, Pharmacology, Mental
Health, Maternity, Pediatrics & Leadership for
Nightingale College
📌 What's Inside:
✅ 150+ realistic multiple-choice and NGN-style questions covering every core
domain of the HESI RN Exit Exam blueprint:
o Medical-Surgical Nursing – cardiac, respiratory, GI, renal, endocrine,
neurology, musculoskeletal, burns, post-op complications
o Pharmacology – medication calculations, drug classifications (warfarin,
heparin, insulin, digoxin, antidepressants, antibiotics), side effects, patient
education
o Maternal-Newborn Nursing – antepartum, intrapartum, postpartum
complications, OB emergencies, newborn assessment
, o Pediatric Nursing – growth and development, pediatric disorders, asthma,
bronchiolitis, scoliosis screening
o Mental Health Nursing – depression, PTSD, suicide risk assessment,
therapeutic communication, psychiatric medications
o Leadership & Management – prioritization, delegation, assignment, legal
and ethical issues (DNR, patient rights, informed consent)
o Pharmacology & Dosage Calculations – drug calculations, IV drip rates,
conversions
o Next Generation NCLEX (NGN) Clinical Judgment – case studies, bow-tie
questions, select-all-that-apply (SATA)
o Prioritization – identifying the most critical client and taking action first in
scenarios
✅ Every correct answer in bold italics – no second-guessing
✅ Detailed explanations for every question – learn the why behind the answer,
not just the letter, reinforcing clinical reasoning and NCLEX-style critical thinking
✅ Verified answers with rationales – based on actual BSN366 Exit HESI exam
content
Table of Contents:
Section 1: Medical-Surgical Nursing (Questions 1–50)
Section 2: Pharmacology & Medication Administration (Questions 51–75)
,Section 3: Maternal-Newborn Nursing (Questions 76–90)
Section 4: Pediatric Nursing (Questions 91–105)
Section 5: Mental Health Nursing (Questions 106–120)
Section 6: Leadership, Management & Legal/Ethical Issues (Questions 121–135)
Section 7: NCLEX Clinical Judgment & NGN-Style Cases (Questions 136–150+)
Includes: Answer Key with Detailed Explanations for Every Question
Covers: BSN366 EXIT HESI RN Exam, HESI Exit, NCLEX-RN Readiness, Clinical
Judgment, Prioritization, Pharmacology, Medical-Surgical, Maternal/Peds, Mental Health,
and Leadership
Section 1: Medical-Surgical Nursing (Questions 1-50)
1. A patient with chronic systolic heart failure (LVEF 35%) on metoprolol succinate
presents with acute dyspnea. Vital signs: BP 92/58 mm Hg, HR 54 bpm, respiratory
rate 28. Crackles half-way up lung fields. Which intervention is most appropriate
regarding the beta-blocker?
A. Continue the beta-blocker at the current dose
B. Withhold the beta-blocker
C. Administer an IV beta-agonist
D. Double the dose of the beta-blocker
Answer: B. Withhold the beta-blocker
Explanation: In acute decompensated heart failure with hemodynamic instability (SBP < 90-
100, bradycardia), beta-blockers should be temporarily withheld. Continuing may worsen
hypotension; IV beta-agonist is not indicated; doubling the dose is dangerous .
, 2. A patient with a history of heart failure (HFrEF) is prescribed digoxin. Which of the
following is a sign of digoxin toxicity?
A. Tachycardia
B. Yellow-green halos
C. Hyperkalemia
D. Weight gain
Answer: B. Yellow-green halos
Explanation: Visual disturbances, including yellow-green halos, are classic signs of digoxin
toxicity. Other signs include nausea, vomiting, bradycardia, and dysrhythmias .
3. A patient is 4 hours post-cardiac catheterization via the femoral artery. Which
finding requires immediate intervention?
A. Small amount of serous drainage at the insertion site
B. Bruising around the insertion site
C. Pain in the affected leg
D. Loss of pulse distal to the insertion site
Answer: D. Loss of pulse distal to the insertion site
Explanation: Loss of distal pulse indicates arterial occlusion and requires immediate
intervention. Bruising and serous drainage are expected; pain may be normal but should be
monitored .
4. Which client statement indicates understanding of clopidogrel teaching?
A. "I will take this medication on an empty stomach."
