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BSN 366 HESI RN Exit Exam 2025-
2026 – Practice Questions &
Rationales
Prepare for the BSN 366 HESI RN Exit Exam with this
focused practice question bank. Covers medical-surgical,
pharmacology, maternal-newborn, pediatrics, mental
health, community health, and leadership content.
Includes NGN-style case studies, prioritization questions,
and detailed rationales to strengthen clinical judgment.
Aligned with 2025-2026 test plans for nursing students
preparing for the exit HESI and NCLEX-RN readiness.
Question 1
A nurse is caring for a client receiving digoxin. Which finding should the nurse report
immediately?
A. Heart rate 58 beats/min
B. Serum potassium 3.1 mEq/L
C. Nausea with visual changes
D. Blood pressure 110/70 mm Hg
Answer: C
Rationale: Nausea with visual disturbances such as yellow-green halos is a classic sign
of digoxin toxicity and requires immediate provider notification.
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Question 2
A nurse is prioritizing care for four clients. Which client should the nurse assess first?
A. Client with a fractured femur requesting pain medication
B. Client with COPD and oxygen saturation of 86%
C. Client with diabetes refusing breakfast
D. Client with a urinary tract infection requesting assistance to void
Answer: B
Rationale: An oxygen saturation of 86% indicates severe hypoxemia and takes priority
over non-life-threatening needs.
Question 3
A nurse is teaching a client about warfarin. Which statement indicates
understanding?
A. I will increase my intake of green leafy vegetables.
B. I will use a soft toothbrush and electric razor.
C. I will take aspirin for headaches.
D. I will stop the medication if I see bruising.
Answer: B
Rationale: Warfarin increases bleeding risk, so measures to prevent injury and bleeding
are essential.
Question 4
A nurse is assessing a client with heart failure. Which finding indicates worsening
condition?
A. Weight loss of 1 kg in one week
B. Crackles in the lung bases and jugular venous distention
C. Blood pressure 118/76 mm Hg
D. Heart rate 88 beats/min
Answer: B
Rationale: Crackles and JVD indicate fluid overload and worsening heart failure.
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Question 5
A nurse is caring for a client after abdominal surgery. Which action should the nurse
take first?
A. Administer prescribed pain medication
B. Encourage coughing and deep breathing
C. Assess the surgical dressing for bleeding
D. Ambulate the client in the hallway
Answer: C
Rationale: Assessing the dressing for bleeding is the priority to detect hemorrhage or
complications.
Question 6
A nurse is reviewing lab values for a client with renal failure. Which value is most
concerning?
A. Potassium 6.8 mEq/L
B. BUN 32 mg/dL
C. Creatinine 2.1 mg/dL
D. Hemoglobin 10.5 g/dL
Answer: A
Rationale: Potassium of 6.8 mEq/L is life-threatening and can cause cardiac
dysrhythmias.
Question 7
A nurse is teaching a client about levothyroxine. Which instruction is correct?
A. Take the medication at bedtime.
B. Take the medication with breakfast.
C. Take the medication on an empty stomach in the morning.
D. Take the medication with calcium supplements.
Answer: C
Rationale: Levothyroxine should be taken on an empty stomach in the morning for
optimal absorption.
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Question 8
A nurse is assessing a client with a suspected stroke. Which finding is most
indicative?
A. Sudden facial drooping and arm weakness
B. Gradual onset of headache over 24 hours
C. Bilateral leg weakness
D. Confusion lasting several days
Answer: A
Rationale: Sudden facial drooping and unilateral weakness are classic signs of stroke.
Question 9
A nurse is caring for a client with a chest tube. Which finding requires immediate
intervention?
A. Tidaling in the water seal chamber
B. Continuous bubbling in the water seal chamber
C. Drainage of 50 mL in the first hour
D. Client reporting pain at insertion site
Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak and
requires immediate intervention.
Question 10
A nurse is preparing to administer heparin. Which lab value should be monitored?
A. PT and INR
B. aPTT
C. Platelet count only
D. Hemoglobin and hematocrit
Answer: B
Rationale: aPTT is used to monitor heparin therapy.
Question 11
A nurse is teaching a client about a low-sodium diet. Which food should the client
BSN 366 HESI RN Exit Exam 2025-
2026 – Practice Questions &
Rationales
Prepare for the BSN 366 HESI RN Exit Exam with this
focused practice question bank. Covers medical-surgical,
pharmacology, maternal-newborn, pediatrics, mental
health, community health, and leadership content.
Includes NGN-style case studies, prioritization questions,
and detailed rationales to strengthen clinical judgment.
Aligned with 2025-2026 test plans for nursing students
preparing for the exit HESI and NCLEX-RN readiness.
Question 1
A nurse is caring for a client receiving digoxin. Which finding should the nurse report
immediately?
A. Heart rate 58 beats/min
B. Serum potassium 3.1 mEq/L
C. Nausea with visual changes
D. Blood pressure 110/70 mm Hg
Answer: C
Rationale: Nausea with visual disturbances such as yellow-green halos is a classic sign
of digoxin toxicity and requires immediate provider notification.
,2|Page
Question 2
A nurse is prioritizing care for four clients. Which client should the nurse assess first?
A. Client with a fractured femur requesting pain medication
B. Client with COPD and oxygen saturation of 86%
C. Client with diabetes refusing breakfast
D. Client with a urinary tract infection requesting assistance to void
Answer: B
Rationale: An oxygen saturation of 86% indicates severe hypoxemia and takes priority
over non-life-threatening needs.
Question 3
A nurse is teaching a client about warfarin. Which statement indicates
understanding?
A. I will increase my intake of green leafy vegetables.
B. I will use a soft toothbrush and electric razor.
C. I will take aspirin for headaches.
D. I will stop the medication if I see bruising.
Answer: B
Rationale: Warfarin increases bleeding risk, so measures to prevent injury and bleeding
are essential.
Question 4
A nurse is assessing a client with heart failure. Which finding indicates worsening
condition?
A. Weight loss of 1 kg in one week
B. Crackles in the lung bases and jugular venous distention
C. Blood pressure 118/76 mm Hg
D. Heart rate 88 beats/min
Answer: B
Rationale: Crackles and JVD indicate fluid overload and worsening heart failure.
,3|Page
Question 5
A nurse is caring for a client after abdominal surgery. Which action should the nurse
take first?
A. Administer prescribed pain medication
B. Encourage coughing and deep breathing
C. Assess the surgical dressing for bleeding
D. Ambulate the client in the hallway
Answer: C
Rationale: Assessing the dressing for bleeding is the priority to detect hemorrhage or
complications.
Question 6
A nurse is reviewing lab values for a client with renal failure. Which value is most
concerning?
A. Potassium 6.8 mEq/L
B. BUN 32 mg/dL
C. Creatinine 2.1 mg/dL
D. Hemoglobin 10.5 g/dL
Answer: A
Rationale: Potassium of 6.8 mEq/L is life-threatening and can cause cardiac
dysrhythmias.
Question 7
A nurse is teaching a client about levothyroxine. Which instruction is correct?
A. Take the medication at bedtime.
B. Take the medication with breakfast.
C. Take the medication on an empty stomach in the morning.
D. Take the medication with calcium supplements.
Answer: C
Rationale: Levothyroxine should be taken on an empty stomach in the morning for
optimal absorption.
, 4|Page
Question 8
A nurse is assessing a client with a suspected stroke. Which finding is most
indicative?
A. Sudden facial drooping and arm weakness
B. Gradual onset of headache over 24 hours
C. Bilateral leg weakness
D. Confusion lasting several days
Answer: A
Rationale: Sudden facial drooping and unilateral weakness are classic signs of stroke.
Question 9
A nurse is caring for a client with a chest tube. Which finding requires immediate
intervention?
A. Tidaling in the water seal chamber
B. Continuous bubbling in the water seal chamber
C. Drainage of 50 mL in the first hour
D. Client reporting pain at insertion site
Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak and
requires immediate intervention.
Question 10
A nurse is preparing to administer heparin. Which lab value should be monitored?
A. PT and INR
B. aPTT
C. Platelet count only
D. Hemoglobin and hematocrit
Answer: B
Rationale: aPTT is used to monitor heparin therapy.
Question 11
A nurse is teaching a client about a low-sodium diet. Which food should the client
