BSN 366 HESI RN Exit Exam Test Bank 2026/2027
| 300 Verified Questions with Rationales | All
Content Areas | Graded A+
Section 1: Medical-Surgical Nursing (Questions 1-40)
1. A client is admitted with low T3 and T4 levels and an elevated TSH level. On initial
assessment, the nurse would anticipate which finding?
A) Lethargy
B) Heat intolerance
C) Diarrhea
D) Skin eruptions
Correct Answer: A
Rationale: Low T3 and T4 with elevated TSH indicates hypothyroidism. Lethargy is a classic
manifestation. Heat intolerance and diarrhea are associated with hyperthyroidism .
, 2. Which laboratory value is most concerning and requires immediate nursing
action?
A) Sodium 140 mEq/L
B) Potassium 6.5 mEq/L
C) Hemoglobin 13 g/dL
D) Calcium 9.2 mg/dL
Correct Answer: B
Rationale: A potassium level of 6.5 mEq/L represents severe hyperkalemia, which can
cause lethal cardiac dysrhythmias. Normal potassium range is 3.5–5.0 mEq/L, and this
value requires immediate intervention such as cardiac monitoring and medication
administration .
3. A 68-year-old client with heart failure reports sudden weight gain of 2.3 kg (5 lb)
over 3 days. Which assessment finding should the nurse anticipate?
A) Decreased jugular venous distension
B) Bilateral crackles in the lung bases
C) Hypertension with supine positioning
D) Bradycardia with premature ventricular contractions
Correct Answer: B
Rationale: Rapid weight gain in heart failure indicates fluid retention and worsening volume
overload, which commonly presents as bilateral basilar crackles due to pulmonary venous
congestion. Jugular venous distension would increase, not decrease, with fluid overload .
, 4. A client is receiving an intramuscular injection at the ventrogluteal site. At what
angle should the nurse insert the needle?
A) 45 degrees
B) 60 degrees
C) 90 degrees
D) 15 degrees
Correct Answer: C
Rationale: The ventrogluteal site is the preferred IM site for adults, requiring a 90-degree
angle insertion to reach the muscle tissue .
5. A nurse is caring for a patient with a central line. The patient develops sudden
dyspnea, chest pain, and hypotension during a flush. What should the nurse
suspect?
A) Pulmonary embolism
B) Air embolism
C) Pneumothorax
D) Anaphylaxis
Correct Answer: B
Rationale: Air embolism can occur during central line manipulation. The patient should be
placed in left lateral decubitus (Trendelenburg) position to trap air in the right atrium .
, 6. A client is admitted with diabetic ketoacidosis (DKA). Which intervention is
priority?
A) Administer IV insulin infusion
B) Begin IV fluids with normal saline
C) Monitor urine output
D) Provide potassium supplements
Correct Answer: B
Rationale: In DKA, fluid replacement with isotonic saline is the first priority to restore
perfusion, followed by insulin administration .
7. A nurse is teaching a client about the DASH diet for hypertension. Which statement
indicates understanding?
A) "I will reduce my intake of fruits and vegetables."
B) "I will increase whole grains and lean meats."
C) "I will avoid dairy products."
D) "I will increase foods high in sodium."
Correct Answer: B
Rationale: The DASH diet emphasizes fruits, vegetables, whole grains, and lean proteins
while reducing sodium and saturated fat .
| 300 Verified Questions with Rationales | All
Content Areas | Graded A+
Section 1: Medical-Surgical Nursing (Questions 1-40)
1. A client is admitted with low T3 and T4 levels and an elevated TSH level. On initial
assessment, the nurse would anticipate which finding?
A) Lethargy
B) Heat intolerance
C) Diarrhea
D) Skin eruptions
Correct Answer: A
Rationale: Low T3 and T4 with elevated TSH indicates hypothyroidism. Lethargy is a classic
manifestation. Heat intolerance and diarrhea are associated with hyperthyroidism .
, 2. Which laboratory value is most concerning and requires immediate nursing
action?
A) Sodium 140 mEq/L
B) Potassium 6.5 mEq/L
C) Hemoglobin 13 g/dL
D) Calcium 9.2 mg/dL
Correct Answer: B
Rationale: A potassium level of 6.5 mEq/L represents severe hyperkalemia, which can
cause lethal cardiac dysrhythmias. Normal potassium range is 3.5–5.0 mEq/L, and this
value requires immediate intervention such as cardiac monitoring and medication
administration .
3. A 68-year-old client with heart failure reports sudden weight gain of 2.3 kg (5 lb)
over 3 days. Which assessment finding should the nurse anticipate?
A) Decreased jugular venous distension
B) Bilateral crackles in the lung bases
C) Hypertension with supine positioning
D) Bradycardia with premature ventricular contractions
Correct Answer: B
Rationale: Rapid weight gain in heart failure indicates fluid retention and worsening volume
overload, which commonly presents as bilateral basilar crackles due to pulmonary venous
congestion. Jugular venous distension would increase, not decrease, with fluid overload .
, 4. A client is receiving an intramuscular injection at the ventrogluteal site. At what
angle should the nurse insert the needle?
A) 45 degrees
B) 60 degrees
C) 90 degrees
D) 15 degrees
Correct Answer: C
Rationale: The ventrogluteal site is the preferred IM site for adults, requiring a 90-degree
angle insertion to reach the muscle tissue .
5. A nurse is caring for a patient with a central line. The patient develops sudden
dyspnea, chest pain, and hypotension during a flush. What should the nurse
suspect?
A) Pulmonary embolism
B) Air embolism
C) Pneumothorax
D) Anaphylaxis
Correct Answer: B
Rationale: Air embolism can occur during central line manipulation. The patient should be
placed in left lateral decubitus (Trendelenburg) position to trap air in the right atrium .
, 6. A client is admitted with diabetic ketoacidosis (DKA). Which intervention is
priority?
A) Administer IV insulin infusion
B) Begin IV fluids with normal saline
C) Monitor urine output
D) Provide potassium supplements
Correct Answer: B
Rationale: In DKA, fluid replacement with isotonic saline is the first priority to restore
perfusion, followed by insulin administration .
7. A nurse is teaching a client about the DASH diet for hypertension. Which statement
indicates understanding?
A) "I will reduce my intake of fruits and vegetables."
B) "I will increase whole grains and lean meats."
C) "I will avoid dairy products."
D) "I will increase foods high in sodium."
Correct Answer: B
Rationale: The DASH diet emphasizes fruits, vegetables, whole grains, and lean proteins
while reducing sodium and saturated fat .
