Chamberlain University
662 · ISEH NSB
★ ★
C College of Nursing & Public Health
EST. 1889
E X C E L L E N C E · I N N O V AT I O N · I N T E G R I T Y · W O R L D C L A S S S E R V I C E
BSN HESI 266
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 Chamberlain University PROGRAM Bachelor of Science in Nursing —
HESI Review
COURSE CODE BSN HESI 266 COURSE TITLE Comprehensive Nursing Practice
ACADEMIC YEAR EXAM TITLE BSN HESI 266
TOTAL QUESTIONS 82 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 – 82
1. Client is recovering from a transurethral prostatectomy. Which activity should be limited
until after the first postoperative visit with the healthcare provider?
A. Drink 3L of fluids daily
B. Walking short distances
C. Lifting heavy objects
D. Sitting in a recliner
CORRECT ANSWER A — Drink 3L of fluids daily
RATIONALE After a transurethral prostatectomy, the client should limit activities that increase
intra-abdominal pressure, such as heavy lifting, straining, and prolonged sitting.
Drinking adequate fluids is encouraged to maintain urine flow and prevent clot
formation.
2. A client with stage IV bone cancer is admitted to the hospital for pain management on a 1-
10 scale. Which intervention should the nurse implement?
A. Administer opioid and non-opioid medications simultaneously
B. Administer pain medication only when the client requests it
C. Use only non-pharmacological pain management techniques
D. Administer pain medication intramuscularly for better absorption
CORRECT ANSWER A — Administer opioid and non-opioid medications simultaneously
RATIONALE For cancer pain management, administering opioid and non-opioid medications
simultaneously provides multimodal analgesia, improving pain control while
potentially reducing opioid side effects. This is the standard of care for severe
cancer pain.
,3. A client experiences an ABO incompatibility reaction after multiple blood transfusions.
Which finding should the nurse report immediately to the healthcare provider?
A. Low back pain and hypotension
B. Rhinitis and nasal stuffiness
C. Delayed painful rash with urticaria
D. Arthritic joint changes and chronic pain
CORRECT ANSWER A — Low back pain and hypotension
RATIONALE Low back pain and hypotension are classic signs of an acute hemolytic
transfusion reaction (ABO incompatibility). These findings indicate a life-
threatening emergency requiring immediate intervention. The nurse should stop
the transfusion and notify the healthcare provider immediately.
4. When conducting discharge teaching for a client diagnosed with diverticulosis, which diet
instruction should the nurse include?
A. Have small frequent meals and sit up for at least two hours after meals
B. Eat a bland diet and avoid spicy foods
C. Eat a high fiber diet and increase fluid intake
D. Eat a soft diet with increased intake of milk and milk products
CORRECT ANSWER C — Eat a high fiber diet and increase fluid intake
RATIONALE For diverticulosis, a high-fiber diet with increased fluid intake helps promote
regular bowel movements and reduces pressure in the colon, preventing the
formation of diverticula. This is the primary dietary recommendation for
managing diverticulosis.
, 5. The nurse observes an increased number of blood clots in the drainage tubing of a client
with continuous bladder irrigation following a transurethral resection of the prostate
(TURP). What is the best initial nursing action?
A. Provide additional oral fluid intake
B. Measure the client's intake and output
C. Increase the flow of the bladder irrigation
D. Administer a PRN dose of an antispasmodic agent
CORRECT ANSWER C — Increase the flow of the bladder irrigation
RATIONALE When blood clots are observed in the drainage tubing during continuous bladder
irrigation, the nurse should increase the flow of the bladder irrigation to help
flush out clots and maintain catheter patency. This is the best initial nursing
action.
6. A client with lung cancer who wears a subcutaneous morphine sulfate patch for pain is
short of breath and difficult to arouse. When performing a head-to-toe assessment, the
nurse discovers four analgesic patches on the client's body. What should the nurse do?
A. Remove all morphine patches
B. Apply a fifth patch for breakthrough pain
C. Notify the healthcare provider for a naloxone order
D. Document the finding and continue monitoring
CORRECT ANSWER A — Remove all morphine patches
RATIONALE The client is showing signs of opioid overdose (shortness of breath, difficult to
arouse). Removing all patches is the priority to stop further medication
absorption. The healthcare provider should be notified, and naloxone may be
needed.
662 · ISEH NSB
★ ★
C College of Nursing & Public Health
EST. 1889
E X C E L L E N C E · I N N O V AT I O N · I N T E G R I T Y · W O R L D C L A S S S E R V I C E
BSN HESI 266
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 Chamberlain University PROGRAM Bachelor of Science in Nursing —
HESI Review
COURSE CODE BSN HESI 266 COURSE TITLE Comprehensive Nursing Practice
ACADEMIC YEAR EXAM TITLE BSN HESI 266
TOTAL QUESTIONS 82 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 – 82
1. Client is recovering from a transurethral prostatectomy. Which activity should be limited
until after the first postoperative visit with the healthcare provider?
A. Drink 3L of fluids daily
B. Walking short distances
C. Lifting heavy objects
D. Sitting in a recliner
CORRECT ANSWER A — Drink 3L of fluids daily
RATIONALE After a transurethral prostatectomy, the client should limit activities that increase
intra-abdominal pressure, such as heavy lifting, straining, and prolonged sitting.
Drinking adequate fluids is encouraged to maintain urine flow and prevent clot
formation.
2. A client with stage IV bone cancer is admitted to the hospital for pain management on a 1-
10 scale. Which intervention should the nurse implement?
A. Administer opioid and non-opioid medications simultaneously
B. Administer pain medication only when the client requests it
C. Use only non-pharmacological pain management techniques
D. Administer pain medication intramuscularly for better absorption
CORRECT ANSWER A — Administer opioid and non-opioid medications simultaneously
RATIONALE For cancer pain management, administering opioid and non-opioid medications
simultaneously provides multimodal analgesia, improving pain control while
potentially reducing opioid side effects. This is the standard of care for severe
cancer pain.
,3. A client experiences an ABO incompatibility reaction after multiple blood transfusions.
Which finding should the nurse report immediately to the healthcare provider?
A. Low back pain and hypotension
B. Rhinitis and nasal stuffiness
C. Delayed painful rash with urticaria
D. Arthritic joint changes and chronic pain
CORRECT ANSWER A — Low back pain and hypotension
RATIONALE Low back pain and hypotension are classic signs of an acute hemolytic
transfusion reaction (ABO incompatibility). These findings indicate a life-
threatening emergency requiring immediate intervention. The nurse should stop
the transfusion and notify the healthcare provider immediately.
4. When conducting discharge teaching for a client diagnosed with diverticulosis, which diet
instruction should the nurse include?
A. Have small frequent meals and sit up for at least two hours after meals
B. Eat a bland diet and avoid spicy foods
C. Eat a high fiber diet and increase fluid intake
D. Eat a soft diet with increased intake of milk and milk products
CORRECT ANSWER C — Eat a high fiber diet and increase fluid intake
RATIONALE For diverticulosis, a high-fiber diet with increased fluid intake helps promote
regular bowel movements and reduces pressure in the colon, preventing the
formation of diverticula. This is the primary dietary recommendation for
managing diverticulosis.
, 5. The nurse observes an increased number of blood clots in the drainage tubing of a client
with continuous bladder irrigation following a transurethral resection of the prostate
(TURP). What is the best initial nursing action?
A. Provide additional oral fluid intake
B. Measure the client's intake and output
C. Increase the flow of the bladder irrigation
D. Administer a PRN dose of an antispasmodic agent
CORRECT ANSWER C — Increase the flow of the bladder irrigation
RATIONALE When blood clots are observed in the drainage tubing during continuous bladder
irrigation, the nurse should increase the flow of the bladder irrigation to help
flush out clots and maintain catheter patency. This is the best initial nursing
action.
6. A client with lung cancer who wears a subcutaneous morphine sulfate patch for pain is
short of breath and difficult to arouse. When performing a head-to-toe assessment, the
nurse discovers four analgesic patches on the client's body. What should the nurse do?
A. Remove all morphine patches
B. Apply a fifth patch for breakthrough pain
C. Notify the healthcare provider for a naloxone order
D. Document the finding and continue monitoring
CORRECT ANSWER A — Remove all morphine patches
RATIONALE The client is showing signs of opioid overdose (shortness of breath, difficult to
arouse). Removing all patches is the priority to stop further medication
absorption. The healthcare provider should be notified, and naloxone may be
needed.
