BSN 366 Exit HESI Final Nursing Exam Review –
Full-Length Practice Test with Clinical Scenarios &
Explanations
NGN: 1800: The client is a female neonate born at 37 weeks of gestation to a G 2 P 1 mother,
who was diagnosed with gestational diabetes. Following a spontaneous vaginal birth, she
received Apgar scores of seven at one minute and eight at five minutes. The client weighs
4036.97g (8lbs 9oz) and appears pink with acrocyanosis and a moderate amount of
subcutaneous fat. She is noted to be slightly jittery at 30min of age. Axillary temperature 96F,
pulse 140, RR 80. Blood glucose 35, Billy Rubin seven, fontanelles soft, mongolian spot noted
on lower back, Ballard maturity rating 37 weeks.
(Click to highlight notes that demonstrate a positive outcome)
Day 2, 0630: Vitals have remained stable throughout the night. Oxygen 98% on nasal canal.
Mother to breastfeed in the nursery on demand. Able to tolerate breastmilk. Glucose after
feeding was 60, temp 97.8F, when returned to warmer and bili light. CXR and echo results
were
Glucose after feeding was 60
Direct bili 5
Temp 97.8
Oxygen 98%
Able to tolerate breastmilk
??????????
A client with pancreatitis complains of severe epigastric pain, so the nurse administers a
prescribed narcotic analgesic. Ten minutes later, the client insists on sitting up and leaning
forward. Which intervention should the nurse implement?
A) Rains HOB to 90 degrees
B) Position bedside table so the client can lean across it
C) Place bed in a reverse tren posiiton
D) Encourage rest until the analgesic becomes effective.
B) Position bedside table so the client can lean across it
,The nurse is caring for a client who arrives to the ED with reports of experiencing dizziness and
difficulty walking to the bathroom. The nurse observes R-sided weakness and sluggish
enunciation of speech. The nurse should immediately take which action?
A) Maintain elevated positioning of the dependent joints on the affected side.
B) Keep the bed in the lowest position and initiate seizure and fall precautions
C) Place an indwelling urinary catheter and measure strict I/Os
D) Start two large-bore IV catheters and review inclusion criteria for IV fibrinolytic therapy.
D) Start two large-bore IV catheters and review inclusion criteria for IV fibrinolytic therapy
A male client with a brain tumor is scheduled for a biopsy in the morning. During the admission
procedure, the client has a tonic colonic seizure that last 50 seconds. Following the seizure, the
client is lethargic and confused, and his wife tells the nurse that her husband has never had a
seizure before and has always been alert and communicative. Which action should the nurse
take?
A) ask the wife to wait outside the room until the nurse can talk with her.
B) keep orienting the client the client to time in space until he is less confused
C) notify the emergency response team of the client's seizure
D) explain the postictal state that usually follows seizures
D) explain the postical state that usually follows seizures
A nurse is providing lifestyle change education for a client to slow the progression of coronary
artery disease. Which statement made by the client should the nurse recognize as needing
additional education?
A) Keep a food diary.
B) Eat more canned vegetables.
C) Consume foods with saturated fat.
D) Walk 30 minutes per day.
E) Include oatmeal for breakfast.
F) Use a salt substitute
B) Eat more canned vegetables.
C) Consume foods with saturated fats.
,While caring for a toddler receiving oxygen via facemask, the nurse observes that the child's
lips and nares are dry and cracked. Which intervention should the nurse implement?
A) Use a water-soluble lubricant on affected oral and nasal mucosa.
B) Use a topical lidocaine analgesic for cracked lips.
C) Ask the mother what she usually uses on the child's lips and nose.
D) Apply a petroleum jelly to the child's nose and lips.
A) use a water-soluble lubricant on affected oral and nasal mucosa
When assessing a multigravida on the first postpartum day, the nurse finds a moderate
amount of lochia rubra, with the uterus firm, and three finger breaths above the umbilicus.
What action should the nurse implement first?
A) Increase IV infusion.
B) Massage the uterus to decrease attorney.
C) Review the hemoglobin to determine hemorrhage.
D)Check for a distended bladder.
D) Check for a distended bladder
The nurse is caring for a client on the first day post-operative for a descending aortic aneurysm
repair. Which assessment finding should the nurse prioritize reporting to the healthcare
provider?
A) Serum potassium 4.8.
B) Electrocardiogram ST segment elevation.
C) Urine output 30 mils per hour.
D) Blood pressure 130/80
B) Electrocardiogram ST segment elevation
The healthcare provider prescribes a low-fiber diet for a client with ulcerative colitis. Which
food selection indicates to the nurse that the client understands the prescribed diet?
A) Roast pork, fresh strawberries.
, B) Baked potato with skin, raw carrots.
C) Roasted turkey, canned vegetables.
D) Pancakes, whole-grain cereals.
C) Roasted turkey, canned vegetables.
The psychiatric nurse is caring for clients in an adolescent unit. Which client requires the
nurse's immediate attention?
A) An 18-year-old client with antisocial behavior who is being yelled at by other clients.
B) A 17-year-old client diagnosed with bipolar disorder who is pacing around the lobby.
C) A 16-year-old client diagnosed with major depression who refuses to participate in a room.
D) A 14-year-old client with anorexia nervosa who is refusing to eat the evening snack
A) An 18-year-old client with antisocial behavior who is being yelled at by other clients.
A client recovering from pneumonia who has a history of severe chronic obstructive pulmonary
disease and peripheral vascular disease is being discharged from the skilled nursing facility.
Which action is most important for the nurse to implement?
A) Explain exercise daily regimen.
B) Demonstrate specific strengthening exercises.
C) Provide typed instructions for healthy diet selection.
D) Reinforce need for adequate hydration.
C) Provide typed instructions for healthy diet selection.
A six week old infant with pyloric stenosis is scheduled for a pyloromyotomy which pre-
operative nursing action has the highest priority?
A) Instruct Parents regarding care of the incisional area.
B) Mark and outline of the olive shaped mass in the right epigastric area.
C) Initiate a continuous infusion of IV fluids per prescription.
D) Monitor the amount of intake and infant's response to feedings.
C) Initiate a continuous infusion of IV fluids per prescription.
Full-Length Practice Test with Clinical Scenarios &
Explanations
NGN: 1800: The client is a female neonate born at 37 weeks of gestation to a G 2 P 1 mother,
who was diagnosed with gestational diabetes. Following a spontaneous vaginal birth, she
received Apgar scores of seven at one minute and eight at five minutes. The client weighs
4036.97g (8lbs 9oz) and appears pink with acrocyanosis and a moderate amount of
subcutaneous fat. She is noted to be slightly jittery at 30min of age. Axillary temperature 96F,
pulse 140, RR 80. Blood glucose 35, Billy Rubin seven, fontanelles soft, mongolian spot noted
on lower back, Ballard maturity rating 37 weeks.
(Click to highlight notes that demonstrate a positive outcome)
Day 2, 0630: Vitals have remained stable throughout the night. Oxygen 98% on nasal canal.
Mother to breastfeed in the nursery on demand. Able to tolerate breastmilk. Glucose after
feeding was 60, temp 97.8F, when returned to warmer and bili light. CXR and echo results
were
Glucose after feeding was 60
Direct bili 5
Temp 97.8
Oxygen 98%
Able to tolerate breastmilk
??????????
A client with pancreatitis complains of severe epigastric pain, so the nurse administers a
prescribed narcotic analgesic. Ten minutes later, the client insists on sitting up and leaning
forward. Which intervention should the nurse implement?
A) Rains HOB to 90 degrees
B) Position bedside table so the client can lean across it
C) Place bed in a reverse tren posiiton
D) Encourage rest until the analgesic becomes effective.
B) Position bedside table so the client can lean across it
,The nurse is caring for a client who arrives to the ED with reports of experiencing dizziness and
difficulty walking to the bathroom. The nurse observes R-sided weakness and sluggish
enunciation of speech. The nurse should immediately take which action?
A) Maintain elevated positioning of the dependent joints on the affected side.
B) Keep the bed in the lowest position and initiate seizure and fall precautions
C) Place an indwelling urinary catheter and measure strict I/Os
D) Start two large-bore IV catheters and review inclusion criteria for IV fibrinolytic therapy.
D) Start two large-bore IV catheters and review inclusion criteria for IV fibrinolytic therapy
A male client with a brain tumor is scheduled for a biopsy in the morning. During the admission
procedure, the client has a tonic colonic seizure that last 50 seconds. Following the seizure, the
client is lethargic and confused, and his wife tells the nurse that her husband has never had a
seizure before and has always been alert and communicative. Which action should the nurse
take?
A) ask the wife to wait outside the room until the nurse can talk with her.
B) keep orienting the client the client to time in space until he is less confused
C) notify the emergency response team of the client's seizure
D) explain the postictal state that usually follows seizures
D) explain the postical state that usually follows seizures
A nurse is providing lifestyle change education for a client to slow the progression of coronary
artery disease. Which statement made by the client should the nurse recognize as needing
additional education?
A) Keep a food diary.
B) Eat more canned vegetables.
C) Consume foods with saturated fat.
D) Walk 30 minutes per day.
E) Include oatmeal for breakfast.
F) Use a salt substitute
B) Eat more canned vegetables.
C) Consume foods with saturated fats.
,While caring for a toddler receiving oxygen via facemask, the nurse observes that the child's
lips and nares are dry and cracked. Which intervention should the nurse implement?
A) Use a water-soluble lubricant on affected oral and nasal mucosa.
B) Use a topical lidocaine analgesic for cracked lips.
C) Ask the mother what she usually uses on the child's lips and nose.
D) Apply a petroleum jelly to the child's nose and lips.
A) use a water-soluble lubricant on affected oral and nasal mucosa
When assessing a multigravida on the first postpartum day, the nurse finds a moderate
amount of lochia rubra, with the uterus firm, and three finger breaths above the umbilicus.
What action should the nurse implement first?
A) Increase IV infusion.
B) Massage the uterus to decrease attorney.
C) Review the hemoglobin to determine hemorrhage.
D)Check for a distended bladder.
D) Check for a distended bladder
The nurse is caring for a client on the first day post-operative for a descending aortic aneurysm
repair. Which assessment finding should the nurse prioritize reporting to the healthcare
provider?
A) Serum potassium 4.8.
B) Electrocardiogram ST segment elevation.
C) Urine output 30 mils per hour.
D) Blood pressure 130/80
B) Electrocardiogram ST segment elevation
The healthcare provider prescribes a low-fiber diet for a client with ulcerative colitis. Which
food selection indicates to the nurse that the client understands the prescribed diet?
A) Roast pork, fresh strawberries.
, B) Baked potato with skin, raw carrots.
C) Roasted turkey, canned vegetables.
D) Pancakes, whole-grain cereals.
C) Roasted turkey, canned vegetables.
The psychiatric nurse is caring for clients in an adolescent unit. Which client requires the
nurse's immediate attention?
A) An 18-year-old client with antisocial behavior who is being yelled at by other clients.
B) A 17-year-old client diagnosed with bipolar disorder who is pacing around the lobby.
C) A 16-year-old client diagnosed with major depression who refuses to participate in a room.
D) A 14-year-old client with anorexia nervosa who is refusing to eat the evening snack
A) An 18-year-old client with antisocial behavior who is being yelled at by other clients.
A client recovering from pneumonia who has a history of severe chronic obstructive pulmonary
disease and peripheral vascular disease is being discharged from the skilled nursing facility.
Which action is most important for the nurse to implement?
A) Explain exercise daily regimen.
B) Demonstrate specific strengthening exercises.
C) Provide typed instructions for healthy diet selection.
D) Reinforce need for adequate hydration.
C) Provide typed instructions for healthy diet selection.
A six week old infant with pyloric stenosis is scheduled for a pyloromyotomy which pre-
operative nursing action has the highest priority?
A) Instruct Parents regarding care of the incisional area.
B) Mark and outline of the olive shaped mass in the right epigastric area.
C) Initiate a continuous infusion of IV fluids per prescription.
D) Monitor the amount of intake and infant's response to feedings.
C) Initiate a continuous infusion of IV fluids per prescription.
