BSN 366 RN Exit HESI Comprehensive Exam 2026/2027… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
BSN 366 RN Exit HESI Comprehensive Exam 2026/2027
UPDATE |Nightingale
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,BSN 366 RN Exit HESI Comprehensive Exam 2026/2027… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A client is admitted with a diagnosis of Acute Respiratory Distress Syndrome (ARDS).
Which clinical manifestation should the nurse anticipate first?
A. Intercostal retractions and use of accessory muscles
B. Increased restlessness and apprehension
C. Cyanosis and decreased level of consciousness
D. Presence of diffuse crackles on lung auscultation
Answer: B
Rationale: Restlessness and apprehension are early signs of hypoxia. Cyanosis and retractions occur
later as the condition worsens. Exam questions often test whether you can pick the most practical and
safe choice for the client in real situations. Focus on what the nurse can actually do right now. Exam
questions often test whether you can pick the most practical and safe choice for the client in real
situations. Focus on what the nurse can actually do right now.
2. The nurse is caring for a client with Chronic Obstructive Pulmonary Disease (COPD) who
is receiving oxygen at 2 L/min via nasal cannula. Which finding requires immediate
intervention?
A. Respiratory rate of 10 breaths per minute
B. Oxygen saturation of 89% on the pulse oximeter
C. Clubbing of the fingers
D. who is receiving oxygen at 2 L/min via nasal cannula. Which finding requires immediate
intervention?
Answer: A
Rationale: A respiratory rate of 10 is low and may indicate respiratory depression caused by high CO2
levels in a COPD patient, potentially due to excessive oxygen therapy suppressing the hypoxic drive.
Exam questions often test whether you can pick the most practical and safe choice for the client in real
situations. Focus on what the nurse can actually do right now. Exam questions often test whether you
can pick the most practical and safe choice for the client in real situations. Focus on what the nurse
can actually do right now.
Exam (Elaborations) • Detailed Rationales Page 2
, BSN 366 RN Exit HESI Comprehensive Exam 2026/2027… 2026/2027 • Verified • Assured Grade A+
3. A client with heart failure is prescribed Digoxin. Which laboratory value should the nurse
monitor most closely to prevent toxicity?
A. Serum sodium
B. Serum potassium
C. Blood Urea Nitrogen (BUN)
D. Serum calcium
Answer: B
Rationale: Hypokalemia (low potassium) significantly increases the risk of Digoxin toxicity because
potassium and digoxin compete for binding sites on the sodium-potassium ATPase pump.
Understanding this helps the nurse notice early warning signs and act before the problem gets worse.
Early action often prevents bigger complications for the client. Knowing the reason behind the correct
answer makes it easier to rule out the wrong options quickly. Look for the choice that protects the client
and matches the priority need.
4. The nurse is assigned to four clients. Which client should be assessed first?
A. A client with a chest tube whose drainage was 100 mL in the last hour
B. A client with a blood glucose of 220 mg/dL
C. A client 2 days post-op reporting pain of 8 on a scale of 10
D. A client with a history of asthma reporting shortness of breath and high-pitched wheezing
Answer: D
Rationale: The asthma client is experiencing an acute respiratory issue (Airway/Breathing), which
takes priority over stable drainage, post-op pain, and moderate hyperglycemia. This knowledge
supports safe care and helps the nurse teach the client and family clearly and simply. Clear teaching
improves cooperation and reduces anxiety. Exam questions often test whether you can pick the most
practical and safe choice for the client in real situations. Focus on what the nurse can actually do right
now.
Exam (Elaborations) • Detailed Rationales Page 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
BSN 366 RN Exit HESI Comprehensive Exam 2026/2027
UPDATE |Nightingale
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,BSN 366 RN Exit HESI Comprehensive Exam 2026/2027… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A client is admitted with a diagnosis of Acute Respiratory Distress Syndrome (ARDS).
Which clinical manifestation should the nurse anticipate first?
A. Intercostal retractions and use of accessory muscles
B. Increased restlessness and apprehension
C. Cyanosis and decreased level of consciousness
D. Presence of diffuse crackles on lung auscultation
Answer: B
Rationale: Restlessness and apprehension are early signs of hypoxia. Cyanosis and retractions occur
later as the condition worsens. Exam questions often test whether you can pick the most practical and
safe choice for the client in real situations. Focus on what the nurse can actually do right now. Exam
questions often test whether you can pick the most practical and safe choice for the client in real
situations. Focus on what the nurse can actually do right now.
2. The nurse is caring for a client with Chronic Obstructive Pulmonary Disease (COPD) who
is receiving oxygen at 2 L/min via nasal cannula. Which finding requires immediate
intervention?
A. Respiratory rate of 10 breaths per minute
B. Oxygen saturation of 89% on the pulse oximeter
C. Clubbing of the fingers
D. who is receiving oxygen at 2 L/min via nasal cannula. Which finding requires immediate
intervention?
Answer: A
Rationale: A respiratory rate of 10 is low and may indicate respiratory depression caused by high CO2
levels in a COPD patient, potentially due to excessive oxygen therapy suppressing the hypoxic drive.
Exam questions often test whether you can pick the most practical and safe choice for the client in real
situations. Focus on what the nurse can actually do right now. Exam questions often test whether you
can pick the most practical and safe choice for the client in real situations. Focus on what the nurse
can actually do right now.
Exam (Elaborations) • Detailed Rationales Page 2
, BSN 366 RN Exit HESI Comprehensive Exam 2026/2027… 2026/2027 • Verified • Assured Grade A+
3. A client with heart failure is prescribed Digoxin. Which laboratory value should the nurse
monitor most closely to prevent toxicity?
A. Serum sodium
B. Serum potassium
C. Blood Urea Nitrogen (BUN)
D. Serum calcium
Answer: B
Rationale: Hypokalemia (low potassium) significantly increases the risk of Digoxin toxicity because
potassium and digoxin compete for binding sites on the sodium-potassium ATPase pump.
Understanding this helps the nurse notice early warning signs and act before the problem gets worse.
Early action often prevents bigger complications for the client. Knowing the reason behind the correct
answer makes it easier to rule out the wrong options quickly. Look for the choice that protects the client
and matches the priority need.
4. The nurse is assigned to four clients. Which client should be assessed first?
A. A client with a chest tube whose drainage was 100 mL in the last hour
B. A client with a blood glucose of 220 mg/dL
C. A client 2 days post-op reporting pain of 8 on a scale of 10
D. A client with a history of asthma reporting shortness of breath and high-pitched wheezing
Answer: D
Rationale: The asthma client is experiencing an acute respiratory issue (Airway/Breathing), which
takes priority over stable drainage, post-op pain, and moderate hyperglycemia. This knowledge
supports safe care and helps the nurse teach the client and family clearly and simply. Clear teaching
improves cooperation and reduces anxiety. Exam questions often test whether you can pick the most
practical and safe choice for the client in real situations. Focus on what the nurse can actually do right
now.
Exam (Elaborations) • Detailed Rationales Page 3
