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Nightingale College BSN 366 Exit HESI –
Exam Prep Q&A with Answers
Prepare for the BSN 366 HESI RN Exit Exam with this
focused practice question bank. Covers medical-surgical,
pharmacology, maternal-newborn, pediatrics, mental
health, community health, and leadership content.
Includes NGN-style case studies, prioritization questions,
and detailed rationales to strengthen clinical judgment.
Aligned with 2025-2026 test plans for nursing students
preparing for the exit HESI and NCLEX-RN readiness.
Question 1
A nurse is assessing a client with acute respiratory distress syndrome. Which finding
is expected?
A. Increased lung compliance
B. Refractory hypoxemia
C. Bradycardia
D. Decreased respiratory rate
Answer: B
Rationale: Refractory hypoxemia despite oxygen therapy is a hallmark of ARDS.
Question 2
A nurse is teaching a client about a new prescription for carvedilol. Which instruction
is correct?
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A. Take the medication with food
B. Take the medication on an empty stomach
C. Expect tachycardia
D. Stop the medication if the pulse is below 60
Answer: A
Rationale: Carvedilol should be taken with food to slow absorption and reduce
orthostatic hypotension.
Question 3
A nurse is assessing a client with a new above-the-knee amputation. Which finding
requires immediate notification?
A. Phantom limb pain
B. Excessive bleeding from the stump
C. Mild swelling of the stump
D. Incisional pain
Answer: B
Rationale: Excessive bleeding from the stump requires immediate notification.
Question 4
A nurse is teaching a client about a new prescription for sertraline. Which instruction
is correct?
A. Take the medication in the morning
B. Take the medication at bedtime
C. Expect immediate improvement
D. Stop the medication if feeling better
Answer: A
Rationale: Sertraline is taken in the morning to prevent insomnia.
Question 5
A nurse is assessing a client with a new arteriovenous graft. Which finding requires
immediate notification?
A. Thrill palpated at the site
B. Absent bruit at the site
C. Mild swelling at the site
D. Incisional pain
Answer: B
Rationale: An absent bruit indicates graft failure and requires immediate notification.
Question 6
A nurse is caring for a client with a new chest tube. Which action is correct?
A. Strip the chest tube routinely
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B. Keep the drainage system below the client's chest
C. Clamp the tube during transport
D. Elevate the drainage system above the chest
Answer: B
Rationale: The drainage system should be kept below the client's chest to prevent fluid
from flowing back into the pleural space.
Question 7
A nurse is assessing a client with a new pacemaker. Which finding requires
immediate notification?
A. Hiccups
B. Palpitations
C. Mild incisional pain
D. Bruising at the site
Answer: B
Rationale: Palpitations may indicate pacemaker malfunction and require immediate
notification.
Question 8
A nurse is teaching a client about a new prescription for furosemide. Which
instruction is correct?
A. Increase intake of potassium-rich foods
B. Take the medication at bedtime
C. Avoid sunlight exposure
D. Decrease fluid intake to 500 mL per day
Answer: A
Rationale: Furosemide is a loop diuretic that depletes potassium, so potassium-rich
foods are encouraged.
Question 9
A nurse is assessing a client with a new ileostomy. Which finding requires immediate
notification?
A. Output of 500 mL in 24 hours
B. Stoma is pink and moist
C. Output is liquid initially
D. Stoma is dusky and dry
Answer: D
Rationale: A dusky, dry stoma indicates inadequate perfusion and requires immediate
notification.
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Question 10
A nurse is caring for a client with a new tracheostomy. Which action is correct when
changing the trach ties?
A. Change ties daily
B. Have a second nurse hold the trach in place
C. Remove the old ties before securing new ones
D. Change ties only when soiled
Answer: B
Rationale: Having a second nurse hold the trach prevents accidental dislodgement
during tie changes.
Question 11
A nurse is assessing a client with a new nephrostomy tube. Which action is correct?
A. Clamp the tube routinely
B. Maintain sterile technique when emptying
C. Irrigate the tube daily
D. Position the drainage bag above the kidney
Answer: B
Rationale: Sterile technique is essential when emptying a nephrostomy tube to prevent
infection.
Question 12
A nurse is teaching a client about a new prescription for metoprolol. Which
instruction is correct?
A. Take the pulse before each dose
B. Take the medication with food
C. Expect tachycardia
D. Stop the medication if the pulse is below 60
Answer: A
Rationale: Clients should check their pulse before taking metoprolol and hold if below
60 beats/min.
Question 13
A nurse is assessing a client with a new colostomy. Which finding requires immediate
notification?
A. Stoma is pink and moist
B. Stoma is dusky and dry
C. Small amount of bleeding
D. Liquid output
Nightingale College BSN 366 Exit HESI –
Exam Prep Q&A with Answers
Prepare for the BSN 366 HESI RN Exit Exam with this
focused practice question bank. Covers medical-surgical,
pharmacology, maternal-newborn, pediatrics, mental
health, community health, and leadership content.
Includes NGN-style case studies, prioritization questions,
and detailed rationales to strengthen clinical judgment.
Aligned with 2025-2026 test plans for nursing students
preparing for the exit HESI and NCLEX-RN readiness.
Question 1
A nurse is assessing a client with acute respiratory distress syndrome. Which finding
is expected?
A. Increased lung compliance
B. Refractory hypoxemia
C. Bradycardia
D. Decreased respiratory rate
Answer: B
Rationale: Refractory hypoxemia despite oxygen therapy is a hallmark of ARDS.
Question 2
A nurse is teaching a client about a new prescription for carvedilol. Which instruction
is correct?
,2|Page
A. Take the medication with food
B. Take the medication on an empty stomach
C. Expect tachycardia
D. Stop the medication if the pulse is below 60
Answer: A
Rationale: Carvedilol should be taken with food to slow absorption and reduce
orthostatic hypotension.
Question 3
A nurse is assessing a client with a new above-the-knee amputation. Which finding
requires immediate notification?
A. Phantom limb pain
B. Excessive bleeding from the stump
C. Mild swelling of the stump
D. Incisional pain
Answer: B
Rationale: Excessive bleeding from the stump requires immediate notification.
Question 4
A nurse is teaching a client about a new prescription for sertraline. Which instruction
is correct?
A. Take the medication in the morning
B. Take the medication at bedtime
C. Expect immediate improvement
D. Stop the medication if feeling better
Answer: A
Rationale: Sertraline is taken in the morning to prevent insomnia.
Question 5
A nurse is assessing a client with a new arteriovenous graft. Which finding requires
immediate notification?
A. Thrill palpated at the site
B. Absent bruit at the site
C. Mild swelling at the site
D. Incisional pain
Answer: B
Rationale: An absent bruit indicates graft failure and requires immediate notification.
Question 6
A nurse is caring for a client with a new chest tube. Which action is correct?
A. Strip the chest tube routinely
,3|Page
B. Keep the drainage system below the client's chest
C. Clamp the tube during transport
D. Elevate the drainage system above the chest
Answer: B
Rationale: The drainage system should be kept below the client's chest to prevent fluid
from flowing back into the pleural space.
Question 7
A nurse is assessing a client with a new pacemaker. Which finding requires
immediate notification?
A. Hiccups
B. Palpitations
C. Mild incisional pain
D. Bruising at the site
Answer: B
Rationale: Palpitations may indicate pacemaker malfunction and require immediate
notification.
Question 8
A nurse is teaching a client about a new prescription for furosemide. Which
instruction is correct?
A. Increase intake of potassium-rich foods
B. Take the medication at bedtime
C. Avoid sunlight exposure
D. Decrease fluid intake to 500 mL per day
Answer: A
Rationale: Furosemide is a loop diuretic that depletes potassium, so potassium-rich
foods are encouraged.
Question 9
A nurse is assessing a client with a new ileostomy. Which finding requires immediate
notification?
A. Output of 500 mL in 24 hours
B. Stoma is pink and moist
C. Output is liquid initially
D. Stoma is dusky and dry
Answer: D
Rationale: A dusky, dry stoma indicates inadequate perfusion and requires immediate
notification.
, 4|Page
Question 10
A nurse is caring for a client with a new tracheostomy. Which action is correct when
changing the trach ties?
A. Change ties daily
B. Have a second nurse hold the trach in place
C. Remove the old ties before securing new ones
D. Change ties only when soiled
Answer: B
Rationale: Having a second nurse hold the trach prevents accidental dislodgement
during tie changes.
Question 11
A nurse is assessing a client with a new nephrostomy tube. Which action is correct?
A. Clamp the tube routinely
B. Maintain sterile technique when emptying
C. Irrigate the tube daily
D. Position the drainage bag above the kidney
Answer: B
Rationale: Sterile technique is essential when emptying a nephrostomy tube to prevent
infection.
Question 12
A nurse is teaching a client about a new prescription for metoprolol. Which
instruction is correct?
A. Take the pulse before each dose
B. Take the medication with food
C. Expect tachycardia
D. Stop the medication if the pulse is below 60
Answer: A
Rationale: Clients should check their pulse before taking metoprolol and hold if below
60 beats/min.
Question 13
A nurse is assessing a client with a new colostomy. Which finding requires immediate
notification?
A. Stoma is pink and moist
B. Stoma is dusky and dry
C. Small amount of bleeding
D. Liquid output
