1
BSN 366 HESI RN Exit Exam V1
(Latest Update 2024/2025) –
Nightingale College | Verified
Questions & Answers | A+ Graded
Question Bank
Medical-Surgical Nursing (Questions 1–15)
1. A 65-year-old patient with heart failure is prescribed furosemide 40 mg IV. What
should the nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
Correct Answer: B) Hypokalemia
Rationale: Furosemide, a loop diuretic, increases potassium excretion, leading to a risk
of hypokalemia. Monitoring potassium levels is critical to prevent arrhythmias.
Hyperkalemia, hypernatremia, and hypocalcemia are not primary concerns with
furosemide.
2. A patient with a new diagnosis of pneumonia has a fever of 101.8°F. What is the
priority nursing action?
A) Administer antibiotics immediately.
B) Apply a cooling blanket.
C) Assess respiratory status and oxygen saturation.
D) Encourage fluid restriction.
Correct Answer: C) Assess respiratory status and oxygen saturation.
Rationale: Pneumonia impairs oxygenation, so assessing respiratory status and oxygen
saturation is the priority to ensure airway and breathing adequacy. Antibiotics, cooling,
and fluid management are secondary after stabilizing breathing.
3. A patient post-myocardial infarction reports chest pain. What is the nurse’s first
action?
A) Administer morphine as ordered.
B) Notify the healthcare provider.
C) Administer oxygen and assess pain.
D) Obtain a 12-lead ECG.
Correct Answer: C) Administer oxygen and assess pain.
Rationale: Oxygen administration and pain assessment address immediate ischemia and
, 2
discomfort in myocardial infarction. Morphine, notifying the provider, and ECG are
important but follow initial stabilization.
4. A patient with type 2 diabetes has a blood glucose level of 350 mg/dL. What is the
priority intervention?
A) Administer regular insulin per sliding scale.
B) Encourage oral fluid intake.
C) Restrict all carbohydrate intake.
D) Monitor for diabetic ketoacidosis (DKA).
Correct Answer: A) Administer regular insulin per sliding scale.
Rationale: Hyperglycemia requires insulin to lower blood glucose levels, per sliding
scale orders. Fluid intake, dietary restrictions, and monitoring for DKA are secondary
after initiating insulin therapy.
5. A patient with chronic obstructive pulmonary disease (COPD) has a PaO2 of 60
mmHg. What should the nurse do?
A) Increase oxygen to 6 L/min via nasal cannula.
B) Maintain oxygen at 2–4 L/min and monitor.
C) Remove oxygen to stimulate breathing.
D) Administer a bronchodilator immediately.
Correct Answer: B) Maintain oxygen at 2–4 L/min and monitor.
Rationale: COPD patients require low-flow oxygen (2–4 L/min) to maintain PaO2
without suppressing respiratory drive. High-flow oxygen, removal, or bronchodilators are
not the first action.
6. A patient with a new colostomy reports leakage around the stoma. What should the
nurse assess first?
A) Stoma color and size
B) Skin integrity around the stoma
C) Type of ostomy appliance
D) Patient’s dietary intake
Correct Answer: B) Skin integrity around the stoma
Rationale: Leakage can cause skin breakdown, so assessing skin integrity is the priority
to prevent complications. Stoma assessment, appliance type, and diet are secondary.
7. A patient with a fractured femur is in traction. What is a key nursing intervention?
A) Remove weights to reposition the patient.
B) Assess neurovascular status regularly.
C) Encourage weight-bearing on the affected leg.
D) Avoid inspecting pin sites.
Correct Answer: B) Assess neurovascular status regularly.
Rationale: Neurovascular checks detect complications like compartment syndrome in
traction patients. Removing weights, encouraging weight-bearing, or avoiding pin site
care is unsafe.
8. A patient with cirrhosis has ascites. What dietary modification should the nurse
recommend?
A) High-sodium diet
B) Low-sodium diet
C) High-protein diet
D) Low-carbohydrate diet
BSN 366 HESI RN Exit Exam V1
(Latest Update 2024/2025) –
Nightingale College | Verified
Questions & Answers | A+ Graded
Question Bank
Medical-Surgical Nursing (Questions 1–15)
1. A 65-year-old patient with heart failure is prescribed furosemide 40 mg IV. What
should the nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
Correct Answer: B) Hypokalemia
Rationale: Furosemide, a loop diuretic, increases potassium excretion, leading to a risk
of hypokalemia. Monitoring potassium levels is critical to prevent arrhythmias.
Hyperkalemia, hypernatremia, and hypocalcemia are not primary concerns with
furosemide.
2. A patient with a new diagnosis of pneumonia has a fever of 101.8°F. What is the
priority nursing action?
A) Administer antibiotics immediately.
B) Apply a cooling blanket.
C) Assess respiratory status and oxygen saturation.
D) Encourage fluid restriction.
Correct Answer: C) Assess respiratory status and oxygen saturation.
Rationale: Pneumonia impairs oxygenation, so assessing respiratory status and oxygen
saturation is the priority to ensure airway and breathing adequacy. Antibiotics, cooling,
and fluid management are secondary after stabilizing breathing.
3. A patient post-myocardial infarction reports chest pain. What is the nurse’s first
action?
A) Administer morphine as ordered.
B) Notify the healthcare provider.
C) Administer oxygen and assess pain.
D) Obtain a 12-lead ECG.
Correct Answer: C) Administer oxygen and assess pain.
Rationale: Oxygen administration and pain assessment address immediate ischemia and
, 2
discomfort in myocardial infarction. Morphine, notifying the provider, and ECG are
important but follow initial stabilization.
4. A patient with type 2 diabetes has a blood glucose level of 350 mg/dL. What is the
priority intervention?
A) Administer regular insulin per sliding scale.
B) Encourage oral fluid intake.
C) Restrict all carbohydrate intake.
D) Monitor for diabetic ketoacidosis (DKA).
Correct Answer: A) Administer regular insulin per sliding scale.
Rationale: Hyperglycemia requires insulin to lower blood glucose levels, per sliding
scale orders. Fluid intake, dietary restrictions, and monitoring for DKA are secondary
after initiating insulin therapy.
5. A patient with chronic obstructive pulmonary disease (COPD) has a PaO2 of 60
mmHg. What should the nurse do?
A) Increase oxygen to 6 L/min via nasal cannula.
B) Maintain oxygen at 2–4 L/min and monitor.
C) Remove oxygen to stimulate breathing.
D) Administer a bronchodilator immediately.
Correct Answer: B) Maintain oxygen at 2–4 L/min and monitor.
Rationale: COPD patients require low-flow oxygen (2–4 L/min) to maintain PaO2
without suppressing respiratory drive. High-flow oxygen, removal, or bronchodilators are
not the first action.
6. A patient with a new colostomy reports leakage around the stoma. What should the
nurse assess first?
A) Stoma color and size
B) Skin integrity around the stoma
C) Type of ostomy appliance
D) Patient’s dietary intake
Correct Answer: B) Skin integrity around the stoma
Rationale: Leakage can cause skin breakdown, so assessing skin integrity is the priority
to prevent complications. Stoma assessment, appliance type, and diet are secondary.
7. A patient with a fractured femur is in traction. What is a key nursing intervention?
A) Remove weights to reposition the patient.
B) Assess neurovascular status regularly.
C) Encourage weight-bearing on the affected leg.
D) Avoid inspecting pin sites.
Correct Answer: B) Assess neurovascular status regularly.
Rationale: Neurovascular checks detect complications like compartment syndrome in
traction patients. Removing weights, encouraging weight-bearing, or avoiding pin site
care is unsafe.
8. A patient with cirrhosis has ascites. What dietary modification should the nurse
recommend?
A) High-sodium diet
B) Low-sodium diet
C) High-protein diet
D) Low-carbohydrate diet
