BSN 366 EXIT HESI STUDY EXAM 300 ACTUAL
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST UPDATE ALREADY GRADED A+
ASSURED PASS
This comprehensive question bank contains 300 unique, multiple-choice practice
questions designed to prepare candidates for the BSN 366 Exit HESI examination.
The questions are organized into six distinct sections covering all key exam
competencies: Prioritization, Delegation, and Leadership; Medical-Surgical
Nursing; Pharmacology and Medication Safety; Maternal-Child Nursing;
Psychiatric-Mental Health Nursing; and Fundamentals with Comprehensive
Review. Each question includes the correct answer and a detailed rationale
explaining the underlying nursing concept, priority principle, or clinical reasoning.
This resource serves as an essential study tool for nursing students seeking to
master high-stakes content and successfully complete the Exit HESI examination.
| Section | Question Range | Topic |
| 1 | 1-40 | Prioritization, Delegation, and Leadership |
| 2 | 41-100 | Medical-Surgical Nursing |
| 3 | 101-150 | Pharmacology and Medication Safety |
| 4 | 151-200 | Maternal-Child Nursing |
| 5 | 201-240 | Psychiatric-Mental Health Nursing |
| 6 | 241-300 | Fundamentals, Leadership, and Comprehensive Review |
Section 1: Prioritization, Delegation, and Leadership (Questions 1-40)
Question 1
The charge nurse is planning assignments for the shift and has an RN and a PN on
the team. Which client should the charge nurse assign to the RN?
,A) A 75-year-old client with renal calculi who requires urine straining
B) A 64-year-old client who had a total hip replacement the previous day
C) A 30-year-old depressed client who admits to suicide ideation
D) An adolescent with multiple contusions due to a fall that occurred 2 days ago
Correct Answer: C
Rationale: The client with suicide ideation requires comprehensive psychiatric
assessment, safety planning, and therapeutic communication—skills within the RN
scope of practice. The PN can appropriately care for stable clients with routine
needs such as urine straining, post-hip replacement care, and contusion monitoring.
Question 2
The nurse observes a UAP applying alcohol-based hand rub while leaving a client's
room after taking vital signs. Which action should the nurse take?
A) Report the UAP to the nursing supervisor immediately
B) Remind the UAP to continue rubbing the hands together until they are dry
C) Instruct the UAP to wash with soap and water instead
D) Document the observation in the UAP's personnel file
Correct Answer: B
Rationale: The UAP's technique is correct but incomplete. Alcohol-based hand rub
requires rubbing hands together until completely dry for maximum efficacy. This
is a teachable moment that does not require immediate escalation.
Question 3
Which client should the nurse assess first after receiving the shift report?
A) Client with a temperature of 100.8°F and productive cough
B) Client with O2 saturation of 85% on room air
C) Client requesting pain medication rated 7/10
D) Client with blood glucose of 180 mg/dL
Correct Answer: B
Rationale: Hypoxemia (O2 sat 85%) is life-threatening and must be addressed
before pain or fever. Prioritization uses the ABCs—airway, breathing, circulation.
Question 4
A client who had a cesarean section two weeks ago is admitted for an infected
surgical abdominal wound. Which room is best for the nurse to assign this client?
A) A negative pressure room
B) A semi-private room on a surgical unit
,C) A postpartum room in the birthing center
D) A private room on a medical unit
Correct Answer: D
Rationale: A private room on a medical unit is most appropriate because the client
requires isolation for a wound infection and is no longer postpartum. Negative
pressure is for airborne precautions, not wound infections.
Question 5
The nurse is caring for four clients. Which client should be seen first?
A) Client with a temperature of 100.8°F and productive cough
B) Client with O2 saturation of 85% on room air
C) Client requesting pain medication rated 7/10
D) Client with blood glucose of 180 mg/dL
Correct Answer: B
Rationale: Hypoxemia is life-threatening and must be addressed before pain or
fever. Prioritization uses ABCs.
Question 6
The nurse is managing care for a client with Cushing syndrome. Which
interventions should the nurse delegate to the UAP? Select all that apply.
A) Note and report the client's food and liquid intake during meals and snacks
B) Report any client mention of pain or discomfort
C) Weigh the client and report any weight gain
D) Assess the client's skin integrity for breakdown
E) Monitor the client's blood glucose levels
Correct Answer: A, B, C
Rationale: UAPs can perform basic observations and report findings such as
intake, pain reports, and weights. Assessment of skin integrity and monitoring
blood glucose require nursing judgment and are within the RN scope.
Question 7
A nurse receives a client from PACU who is drowsy but arousable. What is the
first action?
A) Monitor vital signs
B) Assess airway patency
C) Check IV site
D) Review intake and output
, Correct Answer: B
Rationale: Airway is always the priority in post-anesthesia care (ABCs).
Monitoring vital signs follows after airway is confirmed.
Question 8
The charge nurse is planning assignments for a medical-surgical unit. Which client
should be assigned to the most experienced RN?
A) Client with pneumonia requiring IV antibiotics
B) Client with newly diagnosed diabetes requiring education
C) Client with unstable angina on a cardiac monitor
D) Client with a fractured hip scheduled for surgery
Correct Answer: C
Rationale: The client with unstable angina requires continuous monitoring,
potential emergency interventions, and advanced cardiac assessment skills. This
client should be assigned to the most experienced RN to ensure safe care.
Question 9
The nurse finds a fire in a client's room. Which action should the nurse take first?
A) Pull the fire alarm
B) Attempt to extinguish the fire
C) Rescue the client from the room
D) Close the door
Correct Answer: C
Rationale: Follow RACE (Rescue, Alarm, Contain, Extinguish). Safety of the
client comes first.
Question 10
A confused elderly client keeps trying to pull out their IV. What is the best nursing
intervention?
A) Apply wrist restraints
B) Cover the IV site with a protective sleeve
C) Remove the IV
D) Ask family to stay with the client
Correct Answer: B
Rationale: The least restrictive option that still protects the client should always be
chosen before restraints.
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST UPDATE ALREADY GRADED A+
ASSURED PASS
This comprehensive question bank contains 300 unique, multiple-choice practice
questions designed to prepare candidates for the BSN 366 Exit HESI examination.
The questions are organized into six distinct sections covering all key exam
competencies: Prioritization, Delegation, and Leadership; Medical-Surgical
Nursing; Pharmacology and Medication Safety; Maternal-Child Nursing;
Psychiatric-Mental Health Nursing; and Fundamentals with Comprehensive
Review. Each question includes the correct answer and a detailed rationale
explaining the underlying nursing concept, priority principle, or clinical reasoning.
This resource serves as an essential study tool for nursing students seeking to
master high-stakes content and successfully complete the Exit HESI examination.
| Section | Question Range | Topic |
| 1 | 1-40 | Prioritization, Delegation, and Leadership |
| 2 | 41-100 | Medical-Surgical Nursing |
| 3 | 101-150 | Pharmacology and Medication Safety |
| 4 | 151-200 | Maternal-Child Nursing |
| 5 | 201-240 | Psychiatric-Mental Health Nursing |
| 6 | 241-300 | Fundamentals, Leadership, and Comprehensive Review |
Section 1: Prioritization, Delegation, and Leadership (Questions 1-40)
Question 1
The charge nurse is planning assignments for the shift and has an RN and a PN on
the team. Which client should the charge nurse assign to the RN?
,A) A 75-year-old client with renal calculi who requires urine straining
B) A 64-year-old client who had a total hip replacement the previous day
C) A 30-year-old depressed client who admits to suicide ideation
D) An adolescent with multiple contusions due to a fall that occurred 2 days ago
Correct Answer: C
Rationale: The client with suicide ideation requires comprehensive psychiatric
assessment, safety planning, and therapeutic communication—skills within the RN
scope of practice. The PN can appropriately care for stable clients with routine
needs such as urine straining, post-hip replacement care, and contusion monitoring.
Question 2
The nurse observes a UAP applying alcohol-based hand rub while leaving a client's
room after taking vital signs. Which action should the nurse take?
A) Report the UAP to the nursing supervisor immediately
B) Remind the UAP to continue rubbing the hands together until they are dry
C) Instruct the UAP to wash with soap and water instead
D) Document the observation in the UAP's personnel file
Correct Answer: B
Rationale: The UAP's technique is correct but incomplete. Alcohol-based hand rub
requires rubbing hands together until completely dry for maximum efficacy. This
is a teachable moment that does not require immediate escalation.
Question 3
Which client should the nurse assess first after receiving the shift report?
A) Client with a temperature of 100.8°F and productive cough
B) Client with O2 saturation of 85% on room air
C) Client requesting pain medication rated 7/10
D) Client with blood glucose of 180 mg/dL
Correct Answer: B
Rationale: Hypoxemia (O2 sat 85%) is life-threatening and must be addressed
before pain or fever. Prioritization uses the ABCs—airway, breathing, circulation.
Question 4
A client who had a cesarean section two weeks ago is admitted for an infected
surgical abdominal wound. Which room is best for the nurse to assign this client?
A) A negative pressure room
B) A semi-private room on a surgical unit
,C) A postpartum room in the birthing center
D) A private room on a medical unit
Correct Answer: D
Rationale: A private room on a medical unit is most appropriate because the client
requires isolation for a wound infection and is no longer postpartum. Negative
pressure is for airborne precautions, not wound infections.
Question 5
The nurse is caring for four clients. Which client should be seen first?
A) Client with a temperature of 100.8°F and productive cough
B) Client with O2 saturation of 85% on room air
C) Client requesting pain medication rated 7/10
D) Client with blood glucose of 180 mg/dL
Correct Answer: B
Rationale: Hypoxemia is life-threatening and must be addressed before pain or
fever. Prioritization uses ABCs.
Question 6
The nurse is managing care for a client with Cushing syndrome. Which
interventions should the nurse delegate to the UAP? Select all that apply.
A) Note and report the client's food and liquid intake during meals and snacks
B) Report any client mention of pain or discomfort
C) Weigh the client and report any weight gain
D) Assess the client's skin integrity for breakdown
E) Monitor the client's blood glucose levels
Correct Answer: A, B, C
Rationale: UAPs can perform basic observations and report findings such as
intake, pain reports, and weights. Assessment of skin integrity and monitoring
blood glucose require nursing judgment and are within the RN scope.
Question 7
A nurse receives a client from PACU who is drowsy but arousable. What is the
first action?
A) Monitor vital signs
B) Assess airway patency
C) Check IV site
D) Review intake and output
, Correct Answer: B
Rationale: Airway is always the priority in post-anesthesia care (ABCs).
Monitoring vital signs follows after airway is confirmed.
Question 8
The charge nurse is planning assignments for a medical-surgical unit. Which client
should be assigned to the most experienced RN?
A) Client with pneumonia requiring IV antibiotics
B) Client with newly diagnosed diabetes requiring education
C) Client with unstable angina on a cardiac monitor
D) Client with a fractured hip scheduled for surgery
Correct Answer: C
Rationale: The client with unstable angina requires continuous monitoring,
potential emergency interventions, and advanced cardiac assessment skills. This
client should be assigned to the most experienced RN to ensure safe care.
Question 9
The nurse finds a fire in a client's room. Which action should the nurse take first?
A) Pull the fire alarm
B) Attempt to extinguish the fire
C) Rescue the client from the room
D) Close the door
Correct Answer: C
Rationale: Follow RACE (Rescue, Alarm, Contain, Extinguish). Safety of the
client comes first.
Question 10
A confused elderly client keeps trying to pull out their IV. What is the best nursing
intervention?
A) Apply wrist restraints
B) Cover the IV site with a protective sleeve
C) Remove the IV
D) Ask family to stay with the client
Correct Answer: B
Rationale: The least restrictive option that still protects the client should always be
chosen before restraints.
