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 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 HESI
TOTAL QUESTIONS 50 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 – 50
1. A client who underwent cardiac stent placement four days ago arrives to the emergency
department reporting a sudden onset of chest pressure and shortness of breath. Which
action should the nurse take next?
A. Listen for extra heart sounds, murmurs, and rhythm with the bell of the stethoscope
B. Evaluate upper and lower extremities for perfusion, pulse volume, and pitting edema
C. Verify troponin level assessments are scheduled every 3-6 hours for a series of three
D. Obtain a 12-lead electrocardiogram and begin continuous cardiac monitoring
CORRECT ANSWER D — Obtain a 12-lead electrocardiogram and begin continuous cardiac
monitoring
RATIONALE A client with recent cardiac stent placement presenting with chest pressure and
shortness of breath is at risk for stent thrombosis or acute coronary syndrome.
The priority is to obtain a 12-lead ECG and begin continuous cardiac monitoring
to assess for ischemic changes.
2. A client with type 2 diabetes mellitus arrives to the clinic reporting episodes of weakness
and palpitations. Which finding should the nurse recognize as a possible complication?
A. Anxiety and sighing
B. Myalgia in wrists and hands
C. Hyperactive bowel sounds
D. Dark yellow urine
CORRECT ANSWER B — Myalgia in wrists and hands
RATIONALE Myalgia in wrists and hands may indicate diabetic neuropathy or other
complications of diabetes. This finding should be evaluated further to determine
the cause.
, 3. While completing a health assessment for a client with migraine headaches, the nurse
assesses bilateral weakness in the client's hand grips. The client reports joint pain and
trouble twisting a door knob due to weakness. Which action should the nurse take in
response to these findings?
A. Implement fall precautions to reduce the client's risk of injury
B. Explain that relief of the migraine pain will reduce related symptoms
C. Gather additional assessment data about the pain and weakness
D. Consult with the occupational therapist for a functional assessment
CORRECT ANSWER C — Gather additional assessment data about the pain and weakness
RATIONALE The nurse should gather additional assessment data about the pain and
weakness to better understand the client's condition and to determine if there is
an underlying issue or if the symptoms are related to the migraine headaches.
4. A client who has developed acute kidney injury (AKI) due to aminoglycoside antibiotics
has moved from the oliguric phase to the diuretic phase of AKI. Which parameters are
most important for the nurse to plan to carefully monitor?
A. Uremic irritation of mucous membranes and skin surfaces
B. Hypovolemia and electrocardiographic (ECG) changes
C. Side effects of total parenteral nutrition (TPN) and Intralipids
D. Elevated creatinine and blood urea nitrogen (BUN)
CORRECT ANSWER B — Hypovolemia and electrocardiographic (ECG) changes
RATIONALE During the diuretic phase of AKI, the client may experience increased urine
output, which can lead to hypovolemia and electrolyte imbalances. Monitoring
for hypovolemia and ECG changes can help detect any complications or
worsening of the client's condition.
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 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 HESI
TOTAL QUESTIONS 50 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 – 50
1. A client who underwent cardiac stent placement four days ago arrives to the emergency
department reporting a sudden onset of chest pressure and shortness of breath. Which
action should the nurse take next?
A. Listen for extra heart sounds, murmurs, and rhythm with the bell of the stethoscope
B. Evaluate upper and lower extremities for perfusion, pulse volume, and pitting edema
C. Verify troponin level assessments are scheduled every 3-6 hours for a series of three
D. Obtain a 12-lead electrocardiogram and begin continuous cardiac monitoring
CORRECT ANSWER D — Obtain a 12-lead electrocardiogram and begin continuous cardiac
monitoring
RATIONALE A client with recent cardiac stent placement presenting with chest pressure and
shortness of breath is at risk for stent thrombosis or acute coronary syndrome.
The priority is to obtain a 12-lead ECG and begin continuous cardiac monitoring
to assess for ischemic changes.
2. A client with type 2 diabetes mellitus arrives to the clinic reporting episodes of weakness
and palpitations. Which finding should the nurse recognize as a possible complication?
A. Anxiety and sighing
B. Myalgia in wrists and hands
C. Hyperactive bowel sounds
D. Dark yellow urine
CORRECT ANSWER B — Myalgia in wrists and hands
RATIONALE Myalgia in wrists and hands may indicate diabetic neuropathy or other
complications of diabetes. This finding should be evaluated further to determine
the cause.
, 3. While completing a health assessment for a client with migraine headaches, the nurse
assesses bilateral weakness in the client's hand grips. The client reports joint pain and
trouble twisting a door knob due to weakness. Which action should the nurse take in
response to these findings?
A. Implement fall precautions to reduce the client's risk of injury
B. Explain that relief of the migraine pain will reduce related symptoms
C. Gather additional assessment data about the pain and weakness
D. Consult with the occupational therapist for a functional assessment
CORRECT ANSWER C — Gather additional assessment data about the pain and weakness
RATIONALE The nurse should gather additional assessment data about the pain and
weakness to better understand the client's condition and to determine if there is
an underlying issue or if the symptoms are related to the migraine headaches.
4. A client who has developed acute kidney injury (AKI) due to aminoglycoside antibiotics
has moved from the oliguric phase to the diuretic phase of AKI. Which parameters are
most important for the nurse to plan to carefully monitor?
A. Uremic irritation of mucous membranes and skin surfaces
B. Hypovolemia and electrocardiographic (ECG) changes
C. Side effects of total parenteral nutrition (TPN) and Intralipids
D. Elevated creatinine and blood urea nitrogen (BUN)
CORRECT ANSWER B — Hypovolemia and electrocardiographic (ECG) changes
RATIONALE During the diuretic phase of AKI, the client may experience increased urine
output, which can lead to hypovolemia and electrolyte imbalances. Monitoring
for hypovolemia and ECG changes can help detect any complications or
worsening of the client's condition.
