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HESI 366 BSN Exit Exam 2026/2027 Complete Nursing Review
with Verified Answers and Detailed Rationales Actual Exam
Questions Grade A Study Guide.
1. A client with type 2 diabetes will be starting exenatide upon discharge. Which
instruction should the nurse include in the teaching plan?
A. "Exenatide acts in the same way as insulin in lowering blood glucose."
B. "Inject exenatide within 30 minutes before or after a meal."
C. "There are no precautions when taking exenatide with other medications."
D. "Notify your healthcare provider if you start having abdominal pain."
CORRECT ANSWER: D
Rationale: Exenatide is a GLP-1 agonist that can cause severe pancreatitis. Abdominal
pain is a key symptom that must be reported immediately. It does not act like insulin, is
injected before meals (not after), and has drug interaction precautions (e.g., slowed
gastric emptying may affect absorption of other drugs).
2. A client is 2 weeks post-injury after her house collapsed during a hurricane. She
states, "I have horrible thoughts and memories about the house collapsing all the time,
and it is keeping me from falling asleep." Which aspect of the assessment requires
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the most urgent attention?
A. Her pain level is 2/10.
B. She requests sleeping medication.
C. She is experiencing intrusive thoughts and memories preventing sleep.
D. She would prefer a quieter room location.
CORRECT ANSWER: C
Rationale: The client is describing symptoms of acute stress or post-traumatic stress,
specifically intrusive thoughts and sleep disruption, which are psychological priorities
that impact recovery and require immediate intervention. While environmental comfort
(D) is valid, the psychological distress is more urgent.
3. A client is admitted with a suspected methicillin-resistant Staphylococcus
aureus (MRSA) infection of a foul-smelling arm incision. Which interventions should the
nurse include in the plan of care? Select all that apply.
A. Explain the purpose of a low-bacteria diet.
B. Send wound drainage for culture and sensitivity.
C. Institute contact precautions for staff and visitors.
D. Use standard precautions and wear a mask.
E. Monitor the client's white blood cell count.
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CORRECT ANSWER: B, C, E
Rationale: Wound culture confirms the organism and guides antibiotic therapy (B).
MRSA requires contact precautions (gown and gloves) to prevent transmission (C).
Monitoring WBC assesses the body's response to infection (E). A low-bacteria diet is not
standard for MRSA. A mask is part of droplet or airborne precautions, not routine
contact precautions for MRSA.
4. An older adult client with difficulty hearing is being discharged after cataract
extraction and lens implantation. Which intervention is most important to ensure
compliance with self-care?
A. Provide written instructions for eye drop administration.
B. Speak clearly and face the client for lip reading.
C. Have the client vocalize the instructions provided.
D. Ensure that someone will stay with the client for 24 hours.
CORRECT ANSWER: A
Rationale: For a client with hearing difficulty, written instructions provide a permanent,
reliable reference for critical post-operative care (e.g., eye drop schedule, signs of
infection) that does not depend on auditory recall. While other options are helpful,
written instructions are the most reliable method to ensure understanding and
compliance.
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5. A client's lab results show an ionized calcium level of 15 mg/dL (4.25 mmol/L).
Reference Range: 4.6-5.1 mg/dL (1.15-1.35 mmol/L). Which intervention is most
important for the nurse to implement?
A. Compare muscle strength bilaterally.
B. Assess strength of deep tendon reflexes.
C. Determine apical pulse rate and rhythm.
D. Observe color and amount of urine.
CORRECT ANSWER: C
Rationale: Severe hypocalcemia (low ionized calcium) increases neuromuscular
excitability and poses a risk for life-threatening cardiac dysrhythmias, such as ventricular
fibrillation or prolonged QT interval. The priority is to assess cardiac status.
6. While changing a postoperative dressing, the nurse observes purulent drainage.
Before reporting this finding, the nurse should check which laboratory result?
A. Creatinine level
B. Platelet count
C. Hematocrit
D. White blood cell (WBC) count
CORRECT ANSWER: D
Rationale: Purulent drainage indicates a probable infection. The white blood cell (WBC)
HESI 366 BSN Exit Exam 2026/2027 Complete Nursing Review
with Verified Answers and Detailed Rationales Actual Exam
Questions Grade A Study Guide.
1. A client with type 2 diabetes will be starting exenatide upon discharge. Which
instruction should the nurse include in the teaching plan?
A. "Exenatide acts in the same way as insulin in lowering blood glucose."
B. "Inject exenatide within 30 minutes before or after a meal."
C. "There are no precautions when taking exenatide with other medications."
D. "Notify your healthcare provider if you start having abdominal pain."
CORRECT ANSWER: D
Rationale: Exenatide is a GLP-1 agonist that can cause severe pancreatitis. Abdominal
pain is a key symptom that must be reported immediately. It does not act like insulin, is
injected before meals (not after), and has drug interaction precautions (e.g., slowed
gastric emptying may affect absorption of other drugs).
2. A client is 2 weeks post-injury after her house collapsed during a hurricane. She
states, "I have horrible thoughts and memories about the house collapsing all the time,
and it is keeping me from falling asleep." Which aspect of the assessment requires
,2|Page
the most urgent attention?
A. Her pain level is 2/10.
B. She requests sleeping medication.
C. She is experiencing intrusive thoughts and memories preventing sleep.
D. She would prefer a quieter room location.
CORRECT ANSWER: C
Rationale: The client is describing symptoms of acute stress or post-traumatic stress,
specifically intrusive thoughts and sleep disruption, which are psychological priorities
that impact recovery and require immediate intervention. While environmental comfort
(D) is valid, the psychological distress is more urgent.
3. A client is admitted with a suspected methicillin-resistant Staphylococcus
aureus (MRSA) infection of a foul-smelling arm incision. Which interventions should the
nurse include in the plan of care? Select all that apply.
A. Explain the purpose of a low-bacteria diet.
B. Send wound drainage for culture and sensitivity.
C. Institute contact precautions for staff and visitors.
D. Use standard precautions and wear a mask.
E. Monitor the client's white blood cell count.
,3|Page
CORRECT ANSWER: B, C, E
Rationale: Wound culture confirms the organism and guides antibiotic therapy (B).
MRSA requires contact precautions (gown and gloves) to prevent transmission (C).
Monitoring WBC assesses the body's response to infection (E). A low-bacteria diet is not
standard for MRSA. A mask is part of droplet or airborne precautions, not routine
contact precautions for MRSA.
4. An older adult client with difficulty hearing is being discharged after cataract
extraction and lens implantation. Which intervention is most important to ensure
compliance with self-care?
A. Provide written instructions for eye drop administration.
B. Speak clearly and face the client for lip reading.
C. Have the client vocalize the instructions provided.
D. Ensure that someone will stay with the client for 24 hours.
CORRECT ANSWER: A
Rationale: For a client with hearing difficulty, written instructions provide a permanent,
reliable reference for critical post-operative care (e.g., eye drop schedule, signs of
infection) that does not depend on auditory recall. While other options are helpful,
written instructions are the most reliable method to ensure understanding and
compliance.
, 4|Page
5. A client's lab results show an ionized calcium level of 15 mg/dL (4.25 mmol/L).
Reference Range: 4.6-5.1 mg/dL (1.15-1.35 mmol/L). Which intervention is most
important for the nurse to implement?
A. Compare muscle strength bilaterally.
B. Assess strength of deep tendon reflexes.
C. Determine apical pulse rate and rhythm.
D. Observe color and amount of urine.
CORRECT ANSWER: C
Rationale: Severe hypocalcemia (low ionized calcium) increases neuromuscular
excitability and poses a risk for life-threatening cardiac dysrhythmias, such as ventricular
fibrillation or prolonged QT interval. The priority is to assess cardiac status.
6. While changing a postoperative dressing, the nurse observes purulent drainage.
Before reporting this finding, the nurse should check which laboratory result?
A. Creatinine level
B. Platelet count
C. Hematocrit
D. White blood cell (WBC) count
CORRECT ANSWER: D
Rationale: Purulent drainage indicates a probable infection. The white blood cell (WBC)
