NIGHTINGALE BSN 366 EXAM 4 ACTUAL STYLE V3 | BSN366 HESI RN
EXIT QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED
A+
CORE DOMAINS
Medical-Surgical Nursing (Cardiac, Respiratory, Gastrointestinal, Renal, Neurological, Endocrine,
Musculoskeletal)
Pharmacology and Medication Administration
Maternal-Newborn Nursing
Pediatric Nursing
Mental Health Nursing
Prioritization, Delegation, and Leadership
Safety and Infection Control
Health Promotion and Maintenance
Psychosocial Integrity
Physiological Adaptation
, Fundamentals of Nursing
Evidence-Based Practice and Clinical Judgment
This comprehensive examination preparation resource has been developed for nursing students preparing for the
Nightingale College BSN 366 HESI RN Exit Examination. The assessment evaluates the synthesis of nursing
knowledge across all major content domains including medical-surgical nursing, pharmacology, maternal-
newborn, pediatrics, mental health, and leadership. Questions are presented in multiple-choice format with Next
Generation NCLEX (NGN)-style scenarios designed to assess clinical judgment, critical thinking, prioritization,
delegation, and professional decision-making skills essential for safe and effective nursing practice. Each question
includes a verified correct answer and a detailed rationale to reinforce learning and strengthen examination
readiness. This resource reflects the current HESI testing blueprint and professional nursing standards.
SECTION ONE
QUESTIONS 1–100
1. The charge nurse is making shift assignments on a medical-surgical unit. Which client should the charge
nurse assign to the most experienced registered nurse?
,A. A client with diabetes mellitus requiring insulin administration
B. A client with pneumonia who is stable and receiving IV antibiotics
C. A client who is 2 days post-operative following abdominal surgery with stable vital signs
D. A client who is 1 hour post-return from a cardiac catheterization with a femoral sheath in place
🟢 Correct Answer: D
🔴 RATIONALE: The client with a femoral sheath in place following cardiac catheterization requires close
monitoring for bleeding, hematoma, and vascular complications, making this the most complex assignment
requiring an experienced RN. The other clients are stable with predictable care needs.
2. A nurse is caring for a client with heart failure who has crackles in the lung bases, peripheral edema, and
jugular venous distention. Which of the following medications should the nurse anticipate administering
first?
A. Digoxin
B. Furosemide
C. Metoprolol
D. Enalapril
🟢 Correct Answer: B
🔴 RATIONALE: Furosemide is a loop diuretic that reduces fluid volume by promoting diuresis, addressing the
client's fluid overload symptoms (crackles, edema, JVD). While digoxin, metoprolol, and enalapril are used in
heart failure management, furosemide is the priority for immediate symptom relief of fluid overload.
, 3. A nurse is assessing a client who is 6 hours post-operative following a total hip arthroplasty. Which of the
following findings should the nurse report to the provider immediately?
A. Pain rated 4 on a 0-10 scale
B. Heart rate of 88 beats/min
C. Oxygen saturation of 94% on room air
D. Dusky appearance of the operative extremity with absent pedal pulses
🟢 Correct Answer: D
🔴 RATIONALE: A dusky appearance with absent pedal pulses indicates compromised circulation to the
operative extremity, which could be caused by compartment syndrome, arterial occlusion, or excessive pressure
from the dressing. Pain (A) is expected post-operatively. Heart rate of 88 (B) and oxygen saturation of 94% (C)
are within acceptable limits.
4. A nurse is preparing to administer a blood transfusion to a client. Which of the following actions should
the nurse take first?
A. Obtain the client's vital signs
B. Verify the blood product with another nurse
C. Start an IV line with 0.9% normal saline
D. Assess the client's allergies
EXIT QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED
A+
CORE DOMAINS
Medical-Surgical Nursing (Cardiac, Respiratory, Gastrointestinal, Renal, Neurological, Endocrine,
Musculoskeletal)
Pharmacology and Medication Administration
Maternal-Newborn Nursing
Pediatric Nursing
Mental Health Nursing
Prioritization, Delegation, and Leadership
Safety and Infection Control
Health Promotion and Maintenance
Psychosocial Integrity
Physiological Adaptation
, Fundamentals of Nursing
Evidence-Based Practice and Clinical Judgment
This comprehensive examination preparation resource has been developed for nursing students preparing for the
Nightingale College BSN 366 HESI RN Exit Examination. The assessment evaluates the synthesis of nursing
knowledge across all major content domains including medical-surgical nursing, pharmacology, maternal-
newborn, pediatrics, mental health, and leadership. Questions are presented in multiple-choice format with Next
Generation NCLEX (NGN)-style scenarios designed to assess clinical judgment, critical thinking, prioritization,
delegation, and professional decision-making skills essential for safe and effective nursing practice. Each question
includes a verified correct answer and a detailed rationale to reinforce learning and strengthen examination
readiness. This resource reflects the current HESI testing blueprint and professional nursing standards.
SECTION ONE
QUESTIONS 1–100
1. The charge nurse is making shift assignments on a medical-surgical unit. Which client should the charge
nurse assign to the most experienced registered nurse?
,A. A client with diabetes mellitus requiring insulin administration
B. A client with pneumonia who is stable and receiving IV antibiotics
C. A client who is 2 days post-operative following abdominal surgery with stable vital signs
D. A client who is 1 hour post-return from a cardiac catheterization with a femoral sheath in place
🟢 Correct Answer: D
🔴 RATIONALE: The client with a femoral sheath in place following cardiac catheterization requires close
monitoring for bleeding, hematoma, and vascular complications, making this the most complex assignment
requiring an experienced RN. The other clients are stable with predictable care needs.
2. A nurse is caring for a client with heart failure who has crackles in the lung bases, peripheral edema, and
jugular venous distention. Which of the following medications should the nurse anticipate administering
first?
A. Digoxin
B. Furosemide
C. Metoprolol
D. Enalapril
🟢 Correct Answer: B
🔴 RATIONALE: Furosemide is a loop diuretic that reduces fluid volume by promoting diuresis, addressing the
client's fluid overload symptoms (crackles, edema, JVD). While digoxin, metoprolol, and enalapril are used in
heart failure management, furosemide is the priority for immediate symptom relief of fluid overload.
, 3. A nurse is assessing a client who is 6 hours post-operative following a total hip arthroplasty. Which of the
following findings should the nurse report to the provider immediately?
A. Pain rated 4 on a 0-10 scale
B. Heart rate of 88 beats/min
C. Oxygen saturation of 94% on room air
D. Dusky appearance of the operative extremity with absent pedal pulses
🟢 Correct Answer: D
🔴 RATIONALE: A dusky appearance with absent pedal pulses indicates compromised circulation to the
operative extremity, which could be caused by compartment syndrome, arterial occlusion, or excessive pressure
from the dressing. Pain (A) is expected post-operatively. Heart rate of 88 (B) and oxygen saturation of 94% (C)
are within acceptable limits.
4. A nurse is preparing to administer a blood transfusion to a client. Which of the following actions should
the nurse take first?
A. Obtain the client's vital signs
B. Verify the blood product with another nurse
C. Start an IV line with 0.9% normal saline
D. Assess the client's allergies
