1
HESI RN Exit Exam V1 – BSN 366
Full 2025/2026 Update with Verified
A+ Answers | Practice Bundle with
Rationales
Core Nursing Knowledge (15 Questions)
1. MCQ
A client with type 2 diabetes has a blood glucose of 300 mg/dL. What is the nurse’s
priority action?
a) Administer oral glucose
b) Administer prescribed insulin
c) Encourage oral fluids
d) Monitor urine output
Rationale: Hyperglycemia (>250 mg/dL) requires insulin to lower blood glucose, per
ADA guidelines, to prevent complications like diabetic ketoacidosis.
2. MCQ
A client with pneumonia has a temperature of 101.5°F. What is the nurse’s first action?
a) Administer PRN ibuprofen
b) Notify the provider
c) Apply a cooling blanket
d) Encourage deep breathing
Rationale: Fever in pneumonia suggests infection; notifying the provider ensures timely
antibiotic administration, per ATS guidelines.
3. NGN Scenario-Based Question
A client post-appendectomy reports severe abdominal pain and a rigid abdomen. Vital
signs: BP 100/60 mmHg, HR 110 bpm. What is the nurse’s priority action?
a) Administer PRN pain medication
b) Notify the surgeon
c) Reposition the client
d) Encourage ambulation
Rationale: Severe pain and rigid abdomen suggest perforation, a surgical emergency,
requiring immediate surgeon notification, per ACS guidelines.
4. MCQ
A client with heart failure has crackles bilaterally and SpO2 90%. What is the nurse’s
first action?
a) Administer PRN morphine
b) Administer oxygen
c) Restrict fluids
, 2
d) Obtain a chest X-ray
Rationale: Crackles and low SpO2 indicate pulmonary edema; oxygen improves
oxygenation, per AHA heart failure guidelines.
5. MCQ
A client with a new colostomy asks about dietary restrictions. What should the nurse
recommend?
a) High-fiber diet immediately
b) Low-residue diet initially
c) No dietary restrictions
d) Liquid diet only
Rationale: A low-residue diet reduces bowel irritation post-colostomy, per WOCN
guidelines.
6. MCQ
A client with COPD reports increased dyspnea. What is the nurse’s first action?
a) Increase oxygen to 6 L/min
b) Administer prescribed bronchodilator
c) Place in supine position
d) Notify the provider
Rationale: Bronchodilators relieve airway obstruction in COPD exacerbations, per
GOLD guidelines.
7. NGN Select-All-That-Apply
A client with sepsis has a lactate level of 5 mmol/L. Which interventions are appropriate?
(Select all that apply.)
a) Administer IV fluids
b) Administer prescribed antibiotics
c) Restrict fluids
d) Monitor vital signs
Rationale: Elevated lactate indicates hypoperfusion; IV fluids, antibiotics, and vital sign
monitoring are critical, per Surviving Sepsis Campaign guidelines.
8. MCQ
A client with a suspected stroke has sudden right-sided weakness. What is the nurse’s
priority action?
a) Administer aspirin
b) Perform a neurological assessment
c) Obtain a CT scan
d) Encourage ambulation
Rationale: A neurological assessment (e.g., NIHSS) confirms stroke symptoms and
guides urgent intervention, per AHA/ASA guidelines.
9. MCQ
A client with chronic kidney disease has a potassium of 6.2 mEq/L. What is the nurse’s
first action?
a) Administer PRN furosemide
b) Notify the provider
c) Encourage potassium-rich foods
d) Monitor urine output
HESI RN Exit Exam V1 – BSN 366
Full 2025/2026 Update with Verified
A+ Answers | Practice Bundle with
Rationales
Core Nursing Knowledge (15 Questions)
1. MCQ
A client with type 2 diabetes has a blood glucose of 300 mg/dL. What is the nurse’s
priority action?
a) Administer oral glucose
b) Administer prescribed insulin
c) Encourage oral fluids
d) Monitor urine output
Rationale: Hyperglycemia (>250 mg/dL) requires insulin to lower blood glucose, per
ADA guidelines, to prevent complications like diabetic ketoacidosis.
2. MCQ
A client with pneumonia has a temperature of 101.5°F. What is the nurse’s first action?
a) Administer PRN ibuprofen
b) Notify the provider
c) Apply a cooling blanket
d) Encourage deep breathing
Rationale: Fever in pneumonia suggests infection; notifying the provider ensures timely
antibiotic administration, per ATS guidelines.
3. NGN Scenario-Based Question
A client post-appendectomy reports severe abdominal pain and a rigid abdomen. Vital
signs: BP 100/60 mmHg, HR 110 bpm. What is the nurse’s priority action?
a) Administer PRN pain medication
b) Notify the surgeon
c) Reposition the client
d) Encourage ambulation
Rationale: Severe pain and rigid abdomen suggest perforation, a surgical emergency,
requiring immediate surgeon notification, per ACS guidelines.
4. MCQ
A client with heart failure has crackles bilaterally and SpO2 90%. What is the nurse’s
first action?
a) Administer PRN morphine
b) Administer oxygen
c) Restrict fluids
, 2
d) Obtain a chest X-ray
Rationale: Crackles and low SpO2 indicate pulmonary edema; oxygen improves
oxygenation, per AHA heart failure guidelines.
5. MCQ
A client with a new colostomy asks about dietary restrictions. What should the nurse
recommend?
a) High-fiber diet immediately
b) Low-residue diet initially
c) No dietary restrictions
d) Liquid diet only
Rationale: A low-residue diet reduces bowel irritation post-colostomy, per WOCN
guidelines.
6. MCQ
A client with COPD reports increased dyspnea. What is the nurse’s first action?
a) Increase oxygen to 6 L/min
b) Administer prescribed bronchodilator
c) Place in supine position
d) Notify the provider
Rationale: Bronchodilators relieve airway obstruction in COPD exacerbations, per
GOLD guidelines.
7. NGN Select-All-That-Apply
A client with sepsis has a lactate level of 5 mmol/L. Which interventions are appropriate?
(Select all that apply.)
a) Administer IV fluids
b) Administer prescribed antibiotics
c) Restrict fluids
d) Monitor vital signs
Rationale: Elevated lactate indicates hypoperfusion; IV fluids, antibiotics, and vital sign
monitoring are critical, per Surviving Sepsis Campaign guidelines.
8. MCQ
A client with a suspected stroke has sudden right-sided weakness. What is the nurse’s
priority action?
a) Administer aspirin
b) Perform a neurological assessment
c) Obtain a CT scan
d) Encourage ambulation
Rationale: A neurological assessment (e.g., NIHSS) confirms stroke symptoms and
guides urgent intervention, per AHA/ASA guidelines.
9. MCQ
A client with chronic kidney disease has a potassium of 6.2 mEq/L. What is the nurse’s
first action?
a) Administer PRN furosemide
b) Notify the provider
c) Encourage potassium-rich foods
d) Monitor urine output
