BSN 266 HESI Practice Exam | Comprehensive
Practice Exam with Verified Questions , Correct
Answers & Detailed Rationales | Latest Update
2026/2027 | Nightingale College - Graded A+
Question 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.
Answer: D
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. The head of the bed should be elevated, not flat (A), to reduce
intracranial pressure. IV fluids should not be withheld (B) or given as a
bolus (C) without specific indications.
Question 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."
pg. 1
,Answer: A
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. Hair
follicles are rapidly dividing cells, making them susceptible to
chemotherapy. Steroid therapy (B) does not typically cause alopecia. Hair
growth (C) is not guaranteed to be complete. Hair follicle changes (D) are
not typically permanent.
Question 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.
Answer: A
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. Irrigating the catheter
(B), applying manual pressure (C), or increasing the IV rate (D) without
provider orders is inappropriate.
Question 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.
pg. 2
,E. Obesity has no effect on sperm production.
Answer: B, C, D
Rationale: Use of tobacco, alcohol, and marijuana may affect sperm
counts. Sperm count is also negatively affected by low testosterone levels
and obesity. Marijuana (A) does affect sperm count. Obesity (E) does affect
sperm production. Alcohol consumption (B) can cause erectile dysfunction.
Low testosterone (C) affects sperm production. Smoking cessation (D)
improves general health and fertility.
Question 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
Answer: D
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. Weight loss (A), decreasing caffeine
(B), and avoiding large meals (C) are helpful but less effective for nighttime
reflux.
Question 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.
Answer: A
pg. 3
, 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. Low-residue diet (B) is not typically
recommended for ulcers. Weight loss (C) is important but secondary to
smoking cessation. Milk (D) can actually increase gastric acid secretion.
Question 7
What types of medications should the nurse expect to administer to a client
during an acute respiratory distress episode?
A. Vasodilators and hormones.
B. Analgesics and sedatives.
C. Anticoagulants and expectorants.
D. Bronchodilators and steroids.
Answer: D
Rationale: Besides supplemental oxygen, this client with ARDS needs
medications to widen air passages, increase air space, and reduce alveolar
membrane inflammation, such as bronchodilators and steroids.
Vasodilators (A), analgesics/sedatives (B), and anticoagulants/expectorants
(C) are not the primary medications for acute respiratory distress.
Question 8
A female client is brought to the clinic by her daughter for a flu shot. She
has lost significant weight since the last visit. She has poor personal hygiene
and inadequate clothing for the weather. The client states that she lives
alone and denies problems or concerns. What action should the nurse
implement?
A. Notify social services immediately of suspected elderly abuse.
B. Discuss the need for mental health counseling with the daughter.
C. Explain to the client that she needs to take better care of herself.
D. Collect further data to determine whether self-neglect is occurring.
Answer: D
Rationale: Changes in weight and hygiene may be indicators of self-
neglect or neglect by family members. Further assessment is needed before
notifying social services (A) or discussing the need for counseling (B).
Explaining that she needs to take better care of herself (C) is not
pg. 4
Practice Exam with Verified Questions , Correct
Answers & Detailed Rationales | Latest Update
2026/2027 | Nightingale College - Graded A+
Question 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.
Answer: D
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. The head of the bed should be elevated, not flat (A), to reduce
intracranial pressure. IV fluids should not be withheld (B) or given as a
bolus (C) without specific indications.
Question 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."
pg. 1
,Answer: A
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. Hair
follicles are rapidly dividing cells, making them susceptible to
chemotherapy. Steroid therapy (B) does not typically cause alopecia. Hair
growth (C) is not guaranteed to be complete. Hair follicle changes (D) are
not typically permanent.
Question 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.
Answer: A
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. Irrigating the catheter
(B), applying manual pressure (C), or increasing the IV rate (D) without
provider orders is inappropriate.
Question 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.
pg. 2
,E. Obesity has no effect on sperm production.
Answer: B, C, D
Rationale: Use of tobacco, alcohol, and marijuana may affect sperm
counts. Sperm count is also negatively affected by low testosterone levels
and obesity. Marijuana (A) does affect sperm count. Obesity (E) does affect
sperm production. Alcohol consumption (B) can cause erectile dysfunction.
Low testosterone (C) affects sperm production. Smoking cessation (D)
improves general health and fertility.
Question 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
Answer: D
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. Weight loss (A), decreasing caffeine
(B), and avoiding large meals (C) are helpful but less effective for nighttime
reflux.
Question 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.
Answer: A
pg. 3
, 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. Low-residue diet (B) is not typically
recommended for ulcers. Weight loss (C) is important but secondary to
smoking cessation. Milk (D) can actually increase gastric acid secretion.
Question 7
What types of medications should the nurse expect to administer to a client
during an acute respiratory distress episode?
A. Vasodilators and hormones.
B. Analgesics and sedatives.
C. Anticoagulants and expectorants.
D. Bronchodilators and steroids.
Answer: D
Rationale: Besides supplemental oxygen, this client with ARDS needs
medications to widen air passages, increase air space, and reduce alveolar
membrane inflammation, such as bronchodilators and steroids.
Vasodilators (A), analgesics/sedatives (B), and anticoagulants/expectorants
(C) are not the primary medications for acute respiratory distress.
Question 8
A female client is brought to the clinic by her daughter for a flu shot. She
has lost significant weight since the last visit. She has poor personal hygiene
and inadequate clothing for the weather. The client states that she lives
alone and denies problems or concerns. What action should the nurse
implement?
A. Notify social services immediately of suspected elderly abuse.
B. Discuss the need for mental health counseling with the daughter.
C. Explain to the client that she needs to take better care of herself.
D. Collect further data to determine whether self-neglect is occurring.
Answer: D
Rationale: Changes in weight and hygiene may be indicators of self-
neglect or neglect by family members. Further assessment is needed before
notifying social services (A) or discussing the need for counseling (B).
Explaining that she needs to take better care of herself (C) is not
pg. 4
