Nightingale College
ISEH · 662 NSB
★ ★
N School of Nursing
EST. 2004
C O M M I T T E D T O E X C E L L E N C E I N N U R S I N G E D U C AT I O N
BSN 266 Practice HESI
CO M P R E H E N S I V E N U RS I N G P RACT I C E A SS E SS M E N T
INSTITUTION Nightingale College PROGRAM Bachelor of Science in Nursing —
HESI Review
COURSE CODE BSN 266 COURSE TITLE Comprehensive Nursing Practice
ACADEMIC YEAR EXAM TITLE BSN 266 Practice HESI
TOTAL QUESTIONS 95 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise instructed.
▸ Medical-surgical nursing, pharmacology, and pathophysiology are all testable content.
▸ Clinical reasoning and priority-setting are emphasized.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All clinical data reflects current evidence-based practice guidelines.
, SECTION I — COMPREHENSIVE NURSING PRACTICE Questions 1 – 95
1. A client with a completed ischemic stroke has a blood pressure of 180/90 mm Hg. Which
action should the nurse implement?
A. Position the head of the bed (HOB) flat
B. Withhold intravenous fluids
C. Administer a bolus of IV fluids
D. Give an antihypertensive medication
CORRECT ANSWER D — Give an antihypertensive medication
RATIONALE Most ischemic strokes occur during sleep when baseline blood pressure declines
or blood viscosity increases due to minimal fluid intake. Completed strokes
usually produce neurologic deficits within an hour, and the client's current
elevated blood pressure requires antihypertensive medication.
2. A client who is receiving chemotherapy asks the nurse, "Why is so much of my hair falling
out each day?" Which response by the nurse best explains the reason for alopecia?
A. "Chemotherapy affects the cells of the body that grow rapidly, both normal and
malignant."
B. "Alopecia is a common side effect you will experience during long-term steroid therapy."
C. "Your hair will grow back completely after your course of chemotherapy is completed."
D. "The chemotherapy causes permanent alterations in your hair follicles that lead to hair
loss."
CORRECT ANSWER A — "Chemotherapy affects the cells of the body that grow rapidly, both
normal and malignant."
RATIONALE The common adverse effects of chemotherapy (nausea, vomiting, alopecia, bone
marrow depression) are due to chemotherapy's effect on the rapidly reproducing
cells, both normal and malignant.
,3. After checking the urinary drainage system for kinks in the tubing, the nurse determines
that a client who has returned from the post-anesthesia care has a dark, concentrated
urinary output of 54 ml for the last 2 hours. What priority nursing action should be
implemented?
A. Report the findings to the surgeon
B. Irrigate the indwelling urinary catheter
C. Apply manual pressure to the bladder
D. Increase the IV flow rate for 15 minutes
CORRECT ANSWER A — Report the findings to the surgeon
RATIONALE An adult who weighs 132 pounds (60 kg) should produce about 60 ml of urine
hourly (1 ml/kg/hour). Dark, concentrated, and low volume of urine output
should be reported to the surgeon.
4. A male client who smokes two packs of cigarettes a day states he understands that
smoking cigarettes is contributing to the difficulty that he and his wife are having in
getting pregnant and wants to know if other factors could be contributing to their
difficulty. What information is best for the nurse to provide? (Select all that apply.)
A. Marijuana cigarettes do not affect sperm count
B. Alcohol consumption can cause erectile dysfunction
C. Low testosterone levels affect sperm production
D. Cessation of smoking improves general health and fertility
E. Obesity has no effect on sperm production
CORRECT ANSWER B, C, D — Alcohol consumption can cause erectile dysfunction; Low
testosterone levels affect sperm production; Cessation of smoking
improves general health and fertility
RATIONALE Use of tobacco, alcohol, and marijuana may affect sperm counts. Sperm count is
also negatively affected by low testosterone levels and obesity.
, 5. A client with gastroesophageal reflux disease (GERD) has been experiencing severe reflux
during sleep. Which recommendation by the nurse is most effective to assist the client?
A. Losing weight
B. Decreasing caffeine intake
C. Avoiding large meals
D. Raising the head of the bed on blocks
CORRECT ANSWER D — Raising the head of the bed on blocks
RATIONALE Raising the head of the bed on blocks (reverse Trendelenburg position) to reduce
reflux and subsequent aspiration is the most non-pharmacological effective
recommendation for a client experiencing severe gastroesophageal reflux during
sleep.
6. A 51-year-old truck driver who smokes two packs of cigarettes a day and is 30 pounds
overweight is diagnosed with having a gastric ulcer. What content is most important for
the nurse to include in the discharge teaching for this client?
A. Information about smoking cessation
B. Diet instructions for a low-residue diet
C. Instructions on a weight-loss program
D. The importance of increasing milk in the diet
CORRECT ANSWER A — Information about smoking cessation
RATIONALE Smoking has been associated with ulcer formation, and stopping or decreasing
the number of cigarettes smoked per day is an important aspect of ulcer
management.
ISEH · 662 NSB
★ ★
N School of Nursing
EST. 2004
C O M M I T T E D T O E X C E L L E N C E I N N U R S I N G E D U C AT I O N
BSN 266 Practice HESI
CO M P R E H E N S I V E N U RS I N G P RACT I C E A SS E SS M E N T
INSTITUTION Nightingale College PROGRAM Bachelor of Science in Nursing —
HESI Review
COURSE CODE BSN 266 COURSE TITLE Comprehensive Nursing Practice
ACADEMIC YEAR EXAM TITLE BSN 266 Practice HESI
TOTAL QUESTIONS 95 Questions FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise instructed.
▸ Medical-surgical nursing, pharmacology, and pathophysiology are all testable content.
▸ Clinical reasoning and priority-setting are emphasized.
▸ Correct answers and clinical rationales appear below each question for board review purposes.
▸ All clinical data reflects current evidence-based practice guidelines.
, SECTION I — COMPREHENSIVE NURSING PRACTICE Questions 1 – 95
1. A client with a completed ischemic stroke has a blood pressure of 180/90 mm Hg. Which
action should the nurse implement?
A. Position the head of the bed (HOB) flat
B. Withhold intravenous fluids
C. Administer a bolus of IV fluids
D. Give an antihypertensive medication
CORRECT ANSWER D — Give an antihypertensive medication
RATIONALE Most ischemic strokes occur during sleep when baseline blood pressure declines
or blood viscosity increases due to minimal fluid intake. Completed strokes
usually produce neurologic deficits within an hour, and the client's current
elevated blood pressure requires antihypertensive medication.
2. A client who is receiving chemotherapy asks the nurse, "Why is so much of my hair falling
out each day?" Which response by the nurse best explains the reason for alopecia?
A. "Chemotherapy affects the cells of the body that grow rapidly, both normal and
malignant."
B. "Alopecia is a common side effect you will experience during long-term steroid therapy."
C. "Your hair will grow back completely after your course of chemotherapy is completed."
D. "The chemotherapy causes permanent alterations in your hair follicles that lead to hair
loss."
CORRECT ANSWER A — "Chemotherapy affects the cells of the body that grow rapidly, both
normal and malignant."
RATIONALE The common adverse effects of chemotherapy (nausea, vomiting, alopecia, bone
marrow depression) are due to chemotherapy's effect on the rapidly reproducing
cells, both normal and malignant.
,3. After checking the urinary drainage system for kinks in the tubing, the nurse determines
that a client who has returned from the post-anesthesia care has a dark, concentrated
urinary output of 54 ml for the last 2 hours. What priority nursing action should be
implemented?
A. Report the findings to the surgeon
B. Irrigate the indwelling urinary catheter
C. Apply manual pressure to the bladder
D. Increase the IV flow rate for 15 minutes
CORRECT ANSWER A — Report the findings to the surgeon
RATIONALE An adult who weighs 132 pounds (60 kg) should produce about 60 ml of urine
hourly (1 ml/kg/hour). Dark, concentrated, and low volume of urine output
should be reported to the surgeon.
4. A male client who smokes two packs of cigarettes a day states he understands that
smoking cigarettes is contributing to the difficulty that he and his wife are having in
getting pregnant and wants to know if other factors could be contributing to their
difficulty. What information is best for the nurse to provide? (Select all that apply.)
A. Marijuana cigarettes do not affect sperm count
B. Alcohol consumption can cause erectile dysfunction
C. Low testosterone levels affect sperm production
D. Cessation of smoking improves general health and fertility
E. Obesity has no effect on sperm production
CORRECT ANSWER B, C, D — Alcohol consumption can cause erectile dysfunction; Low
testosterone levels affect sperm production; Cessation of smoking
improves general health and fertility
RATIONALE Use of tobacco, alcohol, and marijuana may affect sperm counts. Sperm count is
also negatively affected by low testosterone levels and obesity.
, 5. A client with gastroesophageal reflux disease (GERD) has been experiencing severe reflux
during sleep. Which recommendation by the nurse is most effective to assist the client?
A. Losing weight
B. Decreasing caffeine intake
C. Avoiding large meals
D. Raising the head of the bed on blocks
CORRECT ANSWER D — Raising the head of the bed on blocks
RATIONALE Raising the head of the bed on blocks (reverse Trendelenburg position) to reduce
reflux and subsequent aspiration is the most non-pharmacological effective
recommendation for a client experiencing severe gastroesophageal reflux during
sleep.
6. A 51-year-old truck driver who smokes two packs of cigarettes a day and is 30 pounds
overweight is diagnosed with having a gastric ulcer. What content is most important for
the nurse to include in the discharge teaching for this client?
A. Information about smoking cessation
B. Diet instructions for a low-residue diet
C. Instructions on a weight-loss program
D. The importance of increasing milk in the diet
CORRECT ANSWER A — Information about smoking cessation
RATIONALE Smoking has been associated with ulcer formation, and stopping or decreasing
the number of cigarettes smoked per day is an important aspect of ulcer
management.
