NIGHTINGALE COLLEGE
Bachelor of Science in Nursing (BSN)
BSN 366 HESI RN Exit Exam
Academic Year: 2026/2027 Comprehensive Question Bank
Q1 Postoperative Monitoring
The nurse is caring for a client who is three days postoperative colon resection and is
receiving a transfusion of packed RBCs. Which assessment finding requires immediate
action?
A. Temperature 100.2°F
B. Heart rate change from 85 to 155 beats/min persisting for 12 minutes
C. Pain rated 5 on a 0-10 scale
D. Oxygen saturation 95% on room air
Correct answer:
B. Heart rate change from 85 to 155 beats/min persisting for 12 minutes
Rationale
A significant, sustained tachycardia is a red flag for hemodynamic instability, which may
indicate a transfusion reaction. This change should trigger immediate assessment and
provider notification. Mild fever, moderate pain, and normal SpO₂ are expected findings.
, Q2 Acetaminophen Dosage
A client receives a prescription for acetaminophen 1,000 mg by mouth every 8 hours as
needed for pain. The bottle is labeled "Acetaminophen for Oral Suspension, USP 500 mg
per 15 mL." How many tablespoons should the nurse instruct the client to take with each
dose?
A. 1 tablespoon
B. 2 tablespoons
C. 3 tablespoons
D. 4 tablespoons
Correct answer: B. 2 tablespoons
Rationale
500 mg per 15 mL. For 1,000 mg, the client needs 30 mL. One tablespoon is 15 mL, so 30 mL
= 2 tablespoons. The nurse should instruct the client to take 2 tablespoons per dose.
Q3 Safe Meal Preparation
The nurse observes a client preparing a meal in the kitchen of a rehabilitation facility prior
to discharge. Which behaviors indicate the client understands how to maintain balance
safely? (Select all that apply.)
A. Brings a heavy can close to body before lifting
B. Locks knees while preparing food on the counter
C. Widens stance while working near the sink
D. Bends from the waist to pick trash off the floor
E. Leans forward to pull a pan from a high shelf
Correct answer: A and C
Rationale
Bringing a heavy object close to the body and widening the stance are safe balance
behaviors. They lower the center of gravity and reduce strain. Locking knees, bending from
the waist, and leaning forward increase fall risk and should be avoided.
, Q4 DNR Priority
A client with a "do not resuscitate" (DNR) prescription begins to manifest signs of
impending death. After notifying the family of the client's status, what priority action
should the nurse implement?
A. Document the impending signs of death
B. Convey the client's status to the chaplain
C. Determine the client's need for pain medication
D. Update the nurse manager on the client's status
Correct answer: C. Determine the client's need for pain medication
Rationale
In end-of-life care, symptom management (pain, dyspnea, anxiety) is the priority. The nurse
should assess for pain and administer comfort measures. Documentation and notifying the
chaplain are important but secondary to addressing the client's immediate comfort needs.
Q5 Diabetes Foot Assessment
The nurse is assessing the feet of a client with type 1 diabetes mellitus. Which finding
requires immediate intervention?
A. Decreased response to pain discrimination on the dorsal surface of the foot
B. Erythema and edema at the base of the left great toe
C. Hard, painless nodule over the metatarsophalangeal joint of the first toe
D. Painful corns and calluses over hammer toes on both feet
Correct answer: B. Erythema and edema at the base of the left great toe
Rationale
Erythema and edema indicate infection or inflammation. In a client with diabetes, this could
be a sign of cellulitis or osteomyelitis requiring immediate antibiotic therapy. Decreased
sensation is a chronic neuropathy finding, and calluses/corns require routine care but are not
urgent.
, Q6 OSAS Risk Factor
Which information is most important for the nurse to obtain when determining a client's
risk for obstructive sleep apnea syndrome (OSAS)?
A. Body mass index
B. Level of consciousness
C. Self-description of pain
D. Breath sounds
Correct answer: A. Body mass index
Rationale
Obesity (high BMI) is a major risk factor for OSAS. Excess adipose tissue in the neck area can
obstruct the airway during sleep. While other assessments are important, BMI is the most
direct risk factor for OSAS screening.
Q7 Lung Transplant Visitor
The family of an older adult client who received a lung transplant asks if the 2-year-old
grandchild can visit. Which response should the nurse offer?
A. Yes, grandchildren offer emotional support and positive diversion
B. No, protective precautions are required after a lung transplant
C. No, small children are often carriers of infectious organisms
D. Yes, if the child is not ill or has not recently received a live vaccine
Correct answer: D. Yes, if the child is not ill or has not recently received a live vaccine
Rationale
Immunosuppressed transplant recipients are at risk for infection from live vaccines. A healthy
child who is not ill and has not received live vaccines (e.g., MMR, varicella) is safe to visit. This
provides a balanced response that prioritizes safety while allowing family connection.
Bachelor of Science in Nursing (BSN)
BSN 366 HESI RN Exit Exam
Academic Year: 2026/2027 Comprehensive Question Bank
Q1 Postoperative Monitoring
The nurse is caring for a client who is three days postoperative colon resection and is
receiving a transfusion of packed RBCs. Which assessment finding requires immediate
action?
A. Temperature 100.2°F
B. Heart rate change from 85 to 155 beats/min persisting for 12 minutes
C. Pain rated 5 on a 0-10 scale
D. Oxygen saturation 95% on room air
Correct answer:
B. Heart rate change from 85 to 155 beats/min persisting for 12 minutes
Rationale
A significant, sustained tachycardia is a red flag for hemodynamic instability, which may
indicate a transfusion reaction. This change should trigger immediate assessment and
provider notification. Mild fever, moderate pain, and normal SpO₂ are expected findings.
, Q2 Acetaminophen Dosage
A client receives a prescription for acetaminophen 1,000 mg by mouth every 8 hours as
needed for pain. The bottle is labeled "Acetaminophen for Oral Suspension, USP 500 mg
per 15 mL." How many tablespoons should the nurse instruct the client to take with each
dose?
A. 1 tablespoon
B. 2 tablespoons
C. 3 tablespoons
D. 4 tablespoons
Correct answer: B. 2 tablespoons
Rationale
500 mg per 15 mL. For 1,000 mg, the client needs 30 mL. One tablespoon is 15 mL, so 30 mL
= 2 tablespoons. The nurse should instruct the client to take 2 tablespoons per dose.
Q3 Safe Meal Preparation
The nurse observes a client preparing a meal in the kitchen of a rehabilitation facility prior
to discharge. Which behaviors indicate the client understands how to maintain balance
safely? (Select all that apply.)
A. Brings a heavy can close to body before lifting
B. Locks knees while preparing food on the counter
C. Widens stance while working near the sink
D. Bends from the waist to pick trash off the floor
E. Leans forward to pull a pan from a high shelf
Correct answer: A and C
Rationale
Bringing a heavy object close to the body and widening the stance are safe balance
behaviors. They lower the center of gravity and reduce strain. Locking knees, bending from
the waist, and leaning forward increase fall risk and should be avoided.
, Q4 DNR Priority
A client with a "do not resuscitate" (DNR) prescription begins to manifest signs of
impending death. After notifying the family of the client's status, what priority action
should the nurse implement?
A. Document the impending signs of death
B. Convey the client's status to the chaplain
C. Determine the client's need for pain medication
D. Update the nurse manager on the client's status
Correct answer: C. Determine the client's need for pain medication
Rationale
In end-of-life care, symptom management (pain, dyspnea, anxiety) is the priority. The nurse
should assess for pain and administer comfort measures. Documentation and notifying the
chaplain are important but secondary to addressing the client's immediate comfort needs.
Q5 Diabetes Foot Assessment
The nurse is assessing the feet of a client with type 1 diabetes mellitus. Which finding
requires immediate intervention?
A. Decreased response to pain discrimination on the dorsal surface of the foot
B. Erythema and edema at the base of the left great toe
C. Hard, painless nodule over the metatarsophalangeal joint of the first toe
D. Painful corns and calluses over hammer toes on both feet
Correct answer: B. Erythema and edema at the base of the left great toe
Rationale
Erythema and edema indicate infection or inflammation. In a client with diabetes, this could
be a sign of cellulitis or osteomyelitis requiring immediate antibiotic therapy. Decreased
sensation is a chronic neuropathy finding, and calluses/corns require routine care but are not
urgent.
, Q6 OSAS Risk Factor
Which information is most important for the nurse to obtain when determining a client's
risk for obstructive sleep apnea syndrome (OSAS)?
A. Body mass index
B. Level of consciousness
C. Self-description of pain
D. Breath sounds
Correct answer: A. Body mass index
Rationale
Obesity (high BMI) is a major risk factor for OSAS. Excess adipose tissue in the neck area can
obstruct the airway during sleep. While other assessments are important, BMI is the most
direct risk factor for OSAS screening.
Q7 Lung Transplant Visitor
The family of an older adult client who received a lung transplant asks if the 2-year-old
grandchild can visit. Which response should the nurse offer?
A. Yes, grandchildren offer emotional support and positive diversion
B. No, protective precautions are required after a lung transplant
C. No, small children are often carriers of infectious organisms
D. Yes, if the child is not ill or has not recently received a live vaccine
Correct answer: D. Yes, if the child is not ill or has not recently received a live vaccine
Rationale
Immunosuppressed transplant recipients are at risk for infection from live vaccines. A healthy
child who is not ill and has not received live vaccines (e.g., MMR, varicella) is safe to visit. This
provides a balanced response that prioritizes safety while allowing family connection.
