BSN HESI 366 RN EXIT EXAM V2 (NEW 2026/ 2027 UPDATE)
QUESTIONS AND VERIFIED ANSWERS|100% CORRECT| GRADE A-
NIGHTINGALE
CORE DOMAINS
• Management of Care and Prioritization
• Safety and Infection Control
• Health Promotion and Maintenance
• Psychosocial Integrity
• Basic Care and Comfort
• Pharmacological and Parenteral Therapies
• Reduction of Risk Potential
• Physiological Adaptation
• Maternal-Newborn and Pediatric Nursing
• Delegation, Leadership, and Ethics
INTRODUCTION
This comprehensive examination is designed for Bachelor of Science in
Nursing students at Nightingale College preparing for the HESI RN Exit
Exam Version 2. Updated for the 2026/2027 testing cycle, it assesses the
clinical judgment, prioritization, and delegation skills required for safe entry-
level nursing practice. The examination mirrors the Next Generation
NCLEX (NGN) format with scenario-based questions, case studies, and
multiple-choice items covering all Client Needs categories. Emphasis is
placed on critical thinking, evidence-based practice, and the application of
the nursing process to real-world clinical scenarios. Each question is
accompanied by a verified answer and detailed rationale to support
learning and exam readiness.
SECTION ONE: QUESTIONS 1–50
,1. A nurse is caring for a client who is 1 day postoperative following a
total hip replacement. Which action should the nurse take to prevent
dislocation of the new hip prosthesis?
A. Place a pillow between the client's legs when turning.
B. Keep the client's hips flexed at 90 degrees when sitting.
C. Encourage the client to cross the legs when lying supine.
D. Assist the client to sit in a low chair for meals.
A. Place a pillow between the client's legs when turning.
RATIONALE: Maintaining abduction of the hips with a pillow between
the legs prevents dislocation of the new hip prosthesis. Hip flexion should
be limited to less than 90 degrees, and crossing the legs is contraindicated.
Low chairs increase hip flexion and risk for dislocation.
2. A client with heart failure is prescribed furosemide. Which finding
indicates a therapeutic response to the medication?
A. Weight loss of 2 kg over 3 days
B. Increased jugular venous distension
C. Decreased urine output
D. Weight gain of 1 kg
A. Weight loss of 2 kg over 3 days
RATIONALE: Furosemide is a loop diuretic used to reduce fluid
overload. Therapeutic response is indicated by weight loss, decreased
edema, and decreased jugular venous distension. Increased JVD and
weight gain indicate worsening heart failure.
3. A nurse is assessing a client with a suspected pulmonary
embolism. Which diagnostic test is most definitive?
A. CT pulmonary angiography
B. Chest X-ray
C. D-dimer
D. Arterial blood gas
, A. CT pulmonary angiography
RATIONALE: CT pulmonary angiography is the gold standard for
diagnosing pulmonary embolism. D-dimer is a screening tool, and chest X-
ray and ABG are supportive but not definitive.
4. A client with type 1 diabetes is found unresponsive with a blood
glucose of 40 mg/dL. Which action should the nurse take first?
A. Administer glucagon intramuscularly.
B. Administer orange juice orally.
C. Start an IV line.
D. Notify the healthcare provider.
A. Administer glucagon intramuscularly.
RATIONALE: For an unresponsive client with hypoglycemia, oral intake
is contraindicated due to aspiration risk. Glucagon IM or IV dextrose is the
appropriate emergency treatment.
5. A nurse is teaching a client about the DASH diet. Which statement
indicates understanding?
A. "It is high in sodium."
B. "It emphasizes fruits, vegetables, and whole grains."
C. "It is only for people with diabetes."
D. "It recommends high-fat dairy."
B. "It emphasizes fruits, vegetables, and whole grains."
RATIONALE: The DASH diet is a heart-healthy eating plan that
emphasizes fruits, vegetables, whole grains, lean proteins, and low-fat
dairy while limiting sodium and saturated fat.
6. The nurse is assessing a client with a suspected hip fracture.
Which finding is most characteristic?
A. Shortened, externally rotated leg
B. Lengthened, internally rotated leg
C. Ability to bear weight without pain
D. Positive McMurray's test
QUESTIONS AND VERIFIED ANSWERS|100% CORRECT| GRADE A-
NIGHTINGALE
CORE DOMAINS
• Management of Care and Prioritization
• Safety and Infection Control
• Health Promotion and Maintenance
• Psychosocial Integrity
• Basic Care and Comfort
• Pharmacological and Parenteral Therapies
• Reduction of Risk Potential
• Physiological Adaptation
• Maternal-Newborn and Pediatric Nursing
• Delegation, Leadership, and Ethics
INTRODUCTION
This comprehensive examination is designed for Bachelor of Science in
Nursing students at Nightingale College preparing for the HESI RN Exit
Exam Version 2. Updated for the 2026/2027 testing cycle, it assesses the
clinical judgment, prioritization, and delegation skills required for safe entry-
level nursing practice. The examination mirrors the Next Generation
NCLEX (NGN) format with scenario-based questions, case studies, and
multiple-choice items covering all Client Needs categories. Emphasis is
placed on critical thinking, evidence-based practice, and the application of
the nursing process to real-world clinical scenarios. Each question is
accompanied by a verified answer and detailed rationale to support
learning and exam readiness.
SECTION ONE: QUESTIONS 1–50
,1. A nurse is caring for a client who is 1 day postoperative following a
total hip replacement. Which action should the nurse take to prevent
dislocation of the new hip prosthesis?
A. Place a pillow between the client's legs when turning.
B. Keep the client's hips flexed at 90 degrees when sitting.
C. Encourage the client to cross the legs when lying supine.
D. Assist the client to sit in a low chair for meals.
A. Place a pillow between the client's legs when turning.
RATIONALE: Maintaining abduction of the hips with a pillow between
the legs prevents dislocation of the new hip prosthesis. Hip flexion should
be limited to less than 90 degrees, and crossing the legs is contraindicated.
Low chairs increase hip flexion and risk for dislocation.
2. A client with heart failure is prescribed furosemide. Which finding
indicates a therapeutic response to the medication?
A. Weight loss of 2 kg over 3 days
B. Increased jugular venous distension
C. Decreased urine output
D. Weight gain of 1 kg
A. Weight loss of 2 kg over 3 days
RATIONALE: Furosemide is a loop diuretic used to reduce fluid
overload. Therapeutic response is indicated by weight loss, decreased
edema, and decreased jugular venous distension. Increased JVD and
weight gain indicate worsening heart failure.
3. A nurse is assessing a client with a suspected pulmonary
embolism. Which diagnostic test is most definitive?
A. CT pulmonary angiography
B. Chest X-ray
C. D-dimer
D. Arterial blood gas
, A. CT pulmonary angiography
RATIONALE: CT pulmonary angiography is the gold standard for
diagnosing pulmonary embolism. D-dimer is a screening tool, and chest X-
ray and ABG are supportive but not definitive.
4. A client with type 1 diabetes is found unresponsive with a blood
glucose of 40 mg/dL. Which action should the nurse take first?
A. Administer glucagon intramuscularly.
B. Administer orange juice orally.
C. Start an IV line.
D. Notify the healthcare provider.
A. Administer glucagon intramuscularly.
RATIONALE: For an unresponsive client with hypoglycemia, oral intake
is contraindicated due to aspiration risk. Glucagon IM or IV dextrose is the
appropriate emergency treatment.
5. A nurse is teaching a client about the DASH diet. Which statement
indicates understanding?
A. "It is high in sodium."
B. "It emphasizes fruits, vegetables, and whole grains."
C. "It is only for people with diabetes."
D. "It recommends high-fat dairy."
B. "It emphasizes fruits, vegetables, and whole grains."
RATIONALE: The DASH diet is a heart-healthy eating plan that
emphasizes fruits, vegetables, whole grains, lean proteins, and low-fat
dairy while limiting sodium and saturated fat.
6. The nurse is assessing a client with a suspected hip fracture.
Which finding is most characteristic?
A. Shortened, externally rotated leg
B. Lengthened, internally rotated leg
C. Ability to bear weight without pain
D. Positive McMurray's test
