,BSN 366 EXIT HESI EXAM
Complete Question Bank with Answers &
Rationales
Updated for 2026 | 530+ Questions | Graded A+
SECTION 1: MEDICAL-SURGICAL NURSING (Questions 1-
120)
Question 1
A 64-year-old client scheduled for surgery with a general anesthetic refuses to remove a
set of dentures prior to leaving the unit for the operating room. What would be
the most appropriate intervention by the nurse?
A) Insist the client remove the dentures immediately
B) Notify the surgeon and cancel the surgery
C) Ask the client if the preference would be to remove the dentures in the operating
room receiving area
D) Document the refusal and proceed with transport
Answer: C
Expert Rationale: The most appropriate intervention is to offer the client the option to
remove dentures in the operating room receiving area. This respects the client's
autonomy while ensuring safety. Dentures must be removed before general anesthesia
,to prevent aspiration or airway obstruction. Asking the client about their preference for
removal location maintains dignity and cooperation.
Question 2
After receiving report on an inpatient acute care unit, which client should the nurse
assess FIRST?
A) The client who had surgery yesterday and is experiencing a paralytic ileus with absent
bowel sounds
B) The client with a small bowel obstruction who has a nasogastric tube that is draining
greenish fluid
C) The client with an obstruction of the large intestine who is experiencing abdominal
distention
D) The client with a bowel obstruction due to a volvulus who is experiencing abdominal
rigidity
Answer: D
Expert Rationale: Abdominal rigidity in a client with a volvulus indicates peritonitis or
bowel perforation, which is a surgical emergency. This client requires immediate
assessment and intervention. Absent bowel sounds with paralytic ileus, NG tube
draining greenish fluid, and abdominal distention are expected findings but do not
indicate the same level of urgency as peritoneal signs.
Question 3
The healthcare provider prescribes acarbose, an alpha-glucosidase inhibitor, for a client
with type 2 diabetes. Which information provides the best indicator of the drug's
effectiveness?
A) Body mass index between 20 and 24
B) Blood pressure readings less than 120/80
C) Self-reported glucose levels 120 to 150
D) Hemoglobin A1c readings less than 7%
, Answer: D
Expert Rationale: Hemoglobin A1c reflects average blood glucose over the previous 2-
3 months and is the gold standard for evaluating long-term glycemic control. A level
less than 7% indicates effective diabetes management. Acarbose works by delaying
carbohydrate absorption, and A1c is the most reliable measure of its effectiveness.
Question 4
A client presents at the emergency department reporting a raspy voice, cold intolerance,
and fatigue. Laboratory tests indicate an elevated thyroid-stimulating hormone (TSH)
level. Which condition does the nurse suspect?
A) Hyperthyroidism
B) Hypothyroidism
C) Thyroid storm
D) Graves' disease
Answer: B
Expert Rationale: Cold intolerance, fatigue, and a raspy voice (due to myxedema of the
vocal cords) are classic symptoms of hypothyroidism. An elevated TSH confirms the
diagnosis, as the pituitary gland produces more TSH in response to low thyroid
hormone levels. Hyperthyroidism would present with heat intolerance, weight loss, and
tachycardia.
Question 5
The nurse has been teaching adult clients about cardiac risks when they visit the
hypertension clinic. Which form of evaluation would best measure learning?
A) Verbal repetition of teaching points
B) Written test scores
C) Reported behavioral changes
D) Client satisfaction survey
Complete Question Bank with Answers &
Rationales
Updated for 2026 | 530+ Questions | Graded A+
SECTION 1: MEDICAL-SURGICAL NURSING (Questions 1-
120)
Question 1
A 64-year-old client scheduled for surgery with a general anesthetic refuses to remove a
set of dentures prior to leaving the unit for the operating room. What would be
the most appropriate intervention by the nurse?
A) Insist the client remove the dentures immediately
B) Notify the surgeon and cancel the surgery
C) Ask the client if the preference would be to remove the dentures in the operating
room receiving area
D) Document the refusal and proceed with transport
Answer: C
Expert Rationale: The most appropriate intervention is to offer the client the option to
remove dentures in the operating room receiving area. This respects the client's
autonomy while ensuring safety. Dentures must be removed before general anesthesia
,to prevent aspiration or airway obstruction. Asking the client about their preference for
removal location maintains dignity and cooperation.
Question 2
After receiving report on an inpatient acute care unit, which client should the nurse
assess FIRST?
A) The client who had surgery yesterday and is experiencing a paralytic ileus with absent
bowel sounds
B) The client with a small bowel obstruction who has a nasogastric tube that is draining
greenish fluid
C) The client with an obstruction of the large intestine who is experiencing abdominal
distention
D) The client with a bowel obstruction due to a volvulus who is experiencing abdominal
rigidity
Answer: D
Expert Rationale: Abdominal rigidity in a client with a volvulus indicates peritonitis or
bowel perforation, which is a surgical emergency. This client requires immediate
assessment and intervention. Absent bowel sounds with paralytic ileus, NG tube
draining greenish fluid, and abdominal distention are expected findings but do not
indicate the same level of urgency as peritoneal signs.
Question 3
The healthcare provider prescribes acarbose, an alpha-glucosidase inhibitor, for a client
with type 2 diabetes. Which information provides the best indicator of the drug's
effectiveness?
A) Body mass index between 20 and 24
B) Blood pressure readings less than 120/80
C) Self-reported glucose levels 120 to 150
D) Hemoglobin A1c readings less than 7%
, Answer: D
Expert Rationale: Hemoglobin A1c reflects average blood glucose over the previous 2-
3 months and is the gold standard for evaluating long-term glycemic control. A level
less than 7% indicates effective diabetes management. Acarbose works by delaying
carbohydrate absorption, and A1c is the most reliable measure of its effectiveness.
Question 4
A client presents at the emergency department reporting a raspy voice, cold intolerance,
and fatigue. Laboratory tests indicate an elevated thyroid-stimulating hormone (TSH)
level. Which condition does the nurse suspect?
A) Hyperthyroidism
B) Hypothyroidism
C) Thyroid storm
D) Graves' disease
Answer: B
Expert Rationale: Cold intolerance, fatigue, and a raspy voice (due to myxedema of the
vocal cords) are classic symptoms of hypothyroidism. An elevated TSH confirms the
diagnosis, as the pituitary gland produces more TSH in response to low thyroid
hormone levels. Hyperthyroidism would present with heat intolerance, weight loss, and
tachycardia.
Question 5
The nurse has been teaching adult clients about cardiac risks when they visit the
hypertension clinic. Which form of evaluation would best measure learning?
A) Verbal repetition of teaching points
B) Written test scores
C) Reported behavioral changes
D) Client satisfaction survey
