Page 1 of 214
BSN 246 HESI Practice Exam ALL 300 RANDOMIZED
PRACTICE QUESTIONS WITH ANSWERS &
RATIONALES LATEST VERSION THIS YEAR
1. A patient with heart failure reports sudden weight gain of 3 pounds in 2 days. What is the nurse’s
priority action?
A) Restrict oral fluids to 500 mL/day
B) Auscultate lung sounds and assess for edema
C) Encourage the patient to increase activity
D) Administer a PRN diuretic immediately
Answer: B
Rapid weight gain suggests fluid retention; the nurse must first assess for signs of worsening HF (crackles,
edema) before intervening.
, Page 2 of 214
2. A client on warfarin has an INR of 5.0. Which assessment finding requires immediate nursing
intervention?
A) Bruising on the extremities
B) Blood in the urine
C) Headache with confusion
D) Petechiae on the chest
Answer: C
Headache with confusion may indicate intracranial hemorrhage, a life-threatening complication of
elevated INR.
3. A patient is admitted with diabetic ketoacidosis (DKA). Which IV fluid should the nurse anticipate
administering initially?
A) 0.9% normal saline
B) 0.45% normal saline
, Page 3 of 214
C) D5W with insulin
D) 3% normal saline
Answer: A
DKA causes severe dehydration; 0.9% NS is the initial fluid of choice to restore intravascular volume.
4. A post-surgical patient has a urinary catheter. Which observation indicates a need for immediate
irrigation?
A) Dark amber urine
B) Urine output of 30 mL/hour
C) No urine output for 4 hours with suprapubic discomfort
D) Cloudy urine with sediment
Answer: C
Absent output with suprapubic pain suggests catheter obstruction; irrigation may be needed to restore
flow.
, Page 4 of 214
5. The nurse is caring for a patient with chest tubes after a pneumothorax. Continuous bubbling in the
water-seal chamber indicates:
A) Normal functioning
B) An air leak in the system
C) The lung has fully re-expanded
D) The suction is too high
Answer: B
Continuous bubbling in the water-seal chamber signals an air leak (patient or system) that requires
immediate assessment.
6. A patient prescribed metformin complains of muscle pain and weakness. Which complication should
the nurse suspect?
A) Hypoglycemia
BSN 246 HESI Practice Exam ALL 300 RANDOMIZED
PRACTICE QUESTIONS WITH ANSWERS &
RATIONALES LATEST VERSION THIS YEAR
1. A patient with heart failure reports sudden weight gain of 3 pounds in 2 days. What is the nurse’s
priority action?
A) Restrict oral fluids to 500 mL/day
B) Auscultate lung sounds and assess for edema
C) Encourage the patient to increase activity
D) Administer a PRN diuretic immediately
Answer: B
Rapid weight gain suggests fluid retention; the nurse must first assess for signs of worsening HF (crackles,
edema) before intervening.
, Page 2 of 214
2. A client on warfarin has an INR of 5.0. Which assessment finding requires immediate nursing
intervention?
A) Bruising on the extremities
B) Blood in the urine
C) Headache with confusion
D) Petechiae on the chest
Answer: C
Headache with confusion may indicate intracranial hemorrhage, a life-threatening complication of
elevated INR.
3. A patient is admitted with diabetic ketoacidosis (DKA). Which IV fluid should the nurse anticipate
administering initially?
A) 0.9% normal saline
B) 0.45% normal saline
, Page 3 of 214
C) D5W with insulin
D) 3% normal saline
Answer: A
DKA causes severe dehydration; 0.9% NS is the initial fluid of choice to restore intravascular volume.
4. A post-surgical patient has a urinary catheter. Which observation indicates a need for immediate
irrigation?
A) Dark amber urine
B) Urine output of 30 mL/hour
C) No urine output for 4 hours with suprapubic discomfort
D) Cloudy urine with sediment
Answer: C
Absent output with suprapubic pain suggests catheter obstruction; irrigation may be needed to restore
flow.
, Page 4 of 214
5. The nurse is caring for a patient with chest tubes after a pneumothorax. Continuous bubbling in the
water-seal chamber indicates:
A) Normal functioning
B) An air leak in the system
C) The lung has fully re-expanded
D) The suction is too high
Answer: B
Continuous bubbling in the water-seal chamber signals an air leak (patient or system) that requires
immediate assessment.
6. A patient prescribed metformin complains of muscle pain and weakness. Which complication should
the nurse suspect?
A) Hypoglycemia
