HESI RN BSN 266 V1 & V2 COMPREHENSIVE
STUDY GUIDE & PRACTICE QUESTIONS
This premium BSN 266 HESI V2 exam preparation guide features highly
detailed multiple-choice questions with verified answers and
comprehensive rationales designed to mirror the actual nursing board
exam. Every question breaks down critical clinical reasoning,
pharmacology monitoring, and emergency nursing interventions to
guarantee maximum retention and concept mastery. It is the ultimate
high-yield study resource for nursing students aiming to ace their HESI
exams and elevate their course grades on the first attempt.
1. A patient with chronic kidney disease (CKD) receives
a prescription for erythropoietin. Which laboratory
value requires immediate intervention by the nurse?
A) Hemoglobin of 9.5 g/dL
B) Platelet count of 150,000/mm³
C) Hemoglobin of 12.5 g/dL
D) Potassium of 4.8 mEq/L
Answer: C
Rationale: Erythropoietin therapy should be held or
reduced if hemoglobin exceeds 11 g/dL due to
severe risks of thromboembolic events, stroke, and
myocardial infarction. A hemoglobin of 9.5 g/dL is
an expected therapeutic progression for CKD
, anemia. Platelets and potassium are within normal
limits.
2. A nurse cares for a patient with a chest tube. The
nurse notes continuous bubbling in the water seal
chamber. What does this finding indicate?
A) The lung has fully re-expanded.
B) There is an air leak in the system.
C) Normal suction is being applied properly.
D) The drainage system is occluded.
Answer: B
Rationale: Continuous bubbling in the water seal
chamber indicates an air leak in the system or from the
patient's lung. Intermittent bubbling during coughing or
exhalation is normal. Continuous bubbling requires
checking the connections and the insertion site. Suction
is controlled in a separate suction control chamber.
3. Which medication order should a nurse clarify for a
patient diagnosed with acute pancreatitis?
A) Intravenous normal saline infusion at 150 mL/hr
B) Morphine sulfate IV push for severe pain
C) Pantoprazole 40 mg IV daily
D) Meperidine 100 mg IM every 4 hours as needed
, Answer: D
Rationale: Meperidine is avoided due to the
accumulation of its toxic metabolite,
normeperidine, which can cause central nervous
system irritability and seizures. Morphine is
acceptable, hydration with IV fluids is essential, and
proton pump inhibitors like pantoprazole reduce
gastric acid production.
4. A patient is admitted with a suspected thyroid
storm. Which clinical manifestation should the nurse
anticipate?
A) Bradycardia and hypothermia
B) Hyperthermia, tachycardia, and delirium
C) Lethargy, weight gain, and dry skin
D) Hypotension and severe bradypnea
Answer: B
Rationale: Thyroid storm is a life-threatening crisis
of severe hyperthyroidism. Key signs include
extreme hyperthermia, severe tachycardia,
hypertension, agitation, and delirium. Bradycardia,
lethargy, and weight gain are characteristic of
severe hypothyroidism or myxedema coma.
5. A nurse administers intravenous magnesium sulfate
to a preeclamptic patient. Which finding indicates
, magnesium toxicity?
A) Deep tendon reflexes of 2+
B) Urinary output of 50 mL over the last 2 hours
C) Respiratory rate of 16 breaths per minute
D) Serum magnesium level of 5.0 mEq/L
Answer: B
Rationale: Magnesium sulfate is excreted by the
kidneys. Oliguria (less than 30 mL/hr) leads to toxin
accumulation. Signs of toxicity include a respiratory
rate under 12, absent deep tendon reflexes, and
decreased urine output. A magnesium level of 5.0
mEq/L is within the therapeutic range (4-7 mEq/L).
6. A patient with atrial fibrillation is prescribed
warfarin. Which dietary instruction is most vital for
the nurse to include?
A) Eliminate all green leafy vegetables from the diet
completely.
B) Maintain a consistent intake of foods high in
Vitamin K.
C) Increase intake of citrus fruits to improve drug
absorption.
D) Drink cranberry juice daily to maximize drug
efficacy.
Answer: B
Rationale: Sudden changes in Vitamin K intake alter
STUDY GUIDE & PRACTICE QUESTIONS
This premium BSN 266 HESI V2 exam preparation guide features highly
detailed multiple-choice questions with verified answers and
comprehensive rationales designed to mirror the actual nursing board
exam. Every question breaks down critical clinical reasoning,
pharmacology monitoring, and emergency nursing interventions to
guarantee maximum retention and concept mastery. It is the ultimate
high-yield study resource for nursing students aiming to ace their HESI
exams and elevate their course grades on the first attempt.
1. A patient with chronic kidney disease (CKD) receives
a prescription for erythropoietin. Which laboratory
value requires immediate intervention by the nurse?
A) Hemoglobin of 9.5 g/dL
B) Platelet count of 150,000/mm³
C) Hemoglobin of 12.5 g/dL
D) Potassium of 4.8 mEq/L
Answer: C
Rationale: Erythropoietin therapy should be held or
reduced if hemoglobin exceeds 11 g/dL due to
severe risks of thromboembolic events, stroke, and
myocardial infarction. A hemoglobin of 9.5 g/dL is
an expected therapeutic progression for CKD
, anemia. Platelets and potassium are within normal
limits.
2. A nurse cares for a patient with a chest tube. The
nurse notes continuous bubbling in the water seal
chamber. What does this finding indicate?
A) The lung has fully re-expanded.
B) There is an air leak in the system.
C) Normal suction is being applied properly.
D) The drainage system is occluded.
Answer: B
Rationale: Continuous bubbling in the water seal
chamber indicates an air leak in the system or from the
patient's lung. Intermittent bubbling during coughing or
exhalation is normal. Continuous bubbling requires
checking the connections and the insertion site. Suction
is controlled in a separate suction control chamber.
3. Which medication order should a nurse clarify for a
patient diagnosed with acute pancreatitis?
A) Intravenous normal saline infusion at 150 mL/hr
B) Morphine sulfate IV push for severe pain
C) Pantoprazole 40 mg IV daily
D) Meperidine 100 mg IM every 4 hours as needed
, Answer: D
Rationale: Meperidine is avoided due to the
accumulation of its toxic metabolite,
normeperidine, which can cause central nervous
system irritability and seizures. Morphine is
acceptable, hydration with IV fluids is essential, and
proton pump inhibitors like pantoprazole reduce
gastric acid production.
4. A patient is admitted with a suspected thyroid
storm. Which clinical manifestation should the nurse
anticipate?
A) Bradycardia and hypothermia
B) Hyperthermia, tachycardia, and delirium
C) Lethargy, weight gain, and dry skin
D) Hypotension and severe bradypnea
Answer: B
Rationale: Thyroid storm is a life-threatening crisis
of severe hyperthyroidism. Key signs include
extreme hyperthermia, severe tachycardia,
hypertension, agitation, and delirium. Bradycardia,
lethargy, and weight gain are characteristic of
severe hypothyroidism or myxedema coma.
5. A nurse administers intravenous magnesium sulfate
to a preeclamptic patient. Which finding indicates
, magnesium toxicity?
A) Deep tendon reflexes of 2+
B) Urinary output of 50 mL over the last 2 hours
C) Respiratory rate of 16 breaths per minute
D) Serum magnesium level of 5.0 mEq/L
Answer: B
Rationale: Magnesium sulfate is excreted by the
kidneys. Oliguria (less than 30 mL/hr) leads to toxin
accumulation. Signs of toxicity include a respiratory
rate under 12, absent deep tendon reflexes, and
decreased urine output. A magnesium level of 5.0
mEq/L is within the therapeutic range (4-7 mEq/L).
6. A patient with atrial fibrillation is prescribed
warfarin. Which dietary instruction is most vital for
the nurse to include?
A) Eliminate all green leafy vegetables from the diet
completely.
B) Maintain a consistent intake of foods high in
Vitamin K.
C) Increase intake of citrus fruits to improve drug
absorption.
D) Drink cranberry juice daily to maximize drug
efficacy.
Answer: B
Rationale: Sudden changes in Vitamin K intake alter
