, BSN 366 / BSN366 EXIT HESI: 200 Practice Questions with Answers, Rationales, and
NGN-Style Case Studies Covering Medical-Surgical Nursing, Pharmacology,
Maternal-Newborn, Pediatrics, Psychiatric Nursing, Leadership, and Prioritization for
the RN Exit Exam
Exam Information
Course: BSN 366 / BSN366 EXIT HESI
Target Audience: Nursing students preparing for the HESI RN Exit Exam and NCLEX-RN
Exam Structure: 160 questions per version, multiple versions (V1–V7), includes NGN-style
questions
Core Domains Covered: Safe and Effective Care Environment, Health Promotion and
Maintenance, Psychosocial Integrity, Physiological Integrity (Pharmacology, Medical-
Surgical, Maternal-Newborn, Pediatrics, Critical Care)
Reference: Elsevier Evolve platform, NCSBN Clinical Judgment Measurement Model
Key Topics to Study
Category Specific Focus Areas
Medical-Surgical Cardiovascular, respiratory, GI, renal, endocrine,
Nursing neurological, musculoskeletal disorders
, Pharmacology Medication indications, side effects, contraindications,
interactions, patient education
Maternal-Newborn Antepartum, intrapartum, postpartum care, newborn
assessment, complications
Pediatrics Growth and development, pediatric illnesses,
immunizations, child safety
Psychiatric Nursing Mental health disorders, therapeutic communication,
psychopharmacology
Leadership & Prioritization, delegation, ethical/legal issues, quality
Management improvement
NGN-Style Questions Case studies, clinical judgment, SATA, ordered response
SECTION 1: MEDICAL-SURGICAL NURSING (Questions 1-60)
1. A nurse is caring for a client with heart failure who has gained 2 kg (4.4 lbs) in 24
hours. Which assessment finding is the priority?
A) Blood pressure 138/88 mmHg
B) Heart rate 92 bpm
C) Jugular venous distention
, D) Crackles auscultated halfway up the lung fields
Answer: D. Crackles halfway up the lung fields indicate pulmonary edema, a life-
threatening complication requiring immediate intervention. While JVD, tachycardia, and
elevated BP are also concerning, crackles indicate fluid in the lungs that can compromise
gas exchange.
2. A client with heart failure is prescribed digoxin. Which finding indicates digoxin
toxicity?
A) Heart rate of 68 bpm
B) Serum potassium of 3.8 mEq/L
C) Yellow-green halos around visual fields
D) Blood pressure of 120/78 mmHg
Answer: C. Yellow-green halos (xanthopsia) is a classic sign of digoxin toxicity. Other signs
include nausea, vomiting, anorexia, and bradycardia. Digoxin toxicity is more likely with
hypokalemia (K+ < 3.5 mEq/L).
3. A nurse is providing discharge teaching to a client with angina. Which statement
indicates a need for further teaching?
A) "I should stop taking my nitroglycerin if I develop a headache."
B) "I will take my nitroglycerin as prescribed."
NGN-Style Case Studies Covering Medical-Surgical Nursing, Pharmacology,
Maternal-Newborn, Pediatrics, Psychiatric Nursing, Leadership, and Prioritization for
the RN Exit Exam
Exam Information
Course: BSN 366 / BSN366 EXIT HESI
Target Audience: Nursing students preparing for the HESI RN Exit Exam and NCLEX-RN
Exam Structure: 160 questions per version, multiple versions (V1–V7), includes NGN-style
questions
Core Domains Covered: Safe and Effective Care Environment, Health Promotion and
Maintenance, Psychosocial Integrity, Physiological Integrity (Pharmacology, Medical-
Surgical, Maternal-Newborn, Pediatrics, Critical Care)
Reference: Elsevier Evolve platform, NCSBN Clinical Judgment Measurement Model
Key Topics to Study
Category Specific Focus Areas
Medical-Surgical Cardiovascular, respiratory, GI, renal, endocrine,
Nursing neurological, musculoskeletal disorders
, Pharmacology Medication indications, side effects, contraindications,
interactions, patient education
Maternal-Newborn Antepartum, intrapartum, postpartum care, newborn
assessment, complications
Pediatrics Growth and development, pediatric illnesses,
immunizations, child safety
Psychiatric Nursing Mental health disorders, therapeutic communication,
psychopharmacology
Leadership & Prioritization, delegation, ethical/legal issues, quality
Management improvement
NGN-Style Questions Case studies, clinical judgment, SATA, ordered response
SECTION 1: MEDICAL-SURGICAL NURSING (Questions 1-60)
1. A nurse is caring for a client with heart failure who has gained 2 kg (4.4 lbs) in 24
hours. Which assessment finding is the priority?
A) Blood pressure 138/88 mmHg
B) Heart rate 92 bpm
C) Jugular venous distention
, D) Crackles auscultated halfway up the lung fields
Answer: D. Crackles halfway up the lung fields indicate pulmonary edema, a life-
threatening complication requiring immediate intervention. While JVD, tachycardia, and
elevated BP are also concerning, crackles indicate fluid in the lungs that can compromise
gas exchange.
2. A client with heart failure is prescribed digoxin. Which finding indicates digoxin
toxicity?
A) Heart rate of 68 bpm
B) Serum potassium of 3.8 mEq/L
C) Yellow-green halos around visual fields
D) Blood pressure of 120/78 mmHg
Answer: C. Yellow-green halos (xanthopsia) is a classic sign of digoxin toxicity. Other signs
include nausea, vomiting, anorexia, and bradycardia. Digoxin toxicity is more likely with
hypokalemia (K+ < 3.5 mEq/L).
3. A nurse is providing discharge teaching to a client with angina. Which statement
indicates a need for further teaching?
A) "I should stop taking my nitroglycerin if I develop a headache."
B) "I will take my nitroglycerin as prescribed."
