BSN 366 – HESI RN EXIT EXAM V1 (COMPREHENSIVE
NURSING) 2026–2027 | Questions and Correct Answers |
Clinically Verified Format
Comprehensive Nursing | Key Domains: Medical-Surgical, Pharmacology, Maternal-Newborn,
Pediatrics, Mental Health, Leadership & Management, Delegation, Safety, Evidence-Based
Practice, Patient-Centered Care, and Critical Thinking | Expert-Structured Q&A | Designed for
Full Clinical Competency
Introduction
This BSN 366 HESI RN Exit Exam V1 resource is structured to evaluate broad clinical
competence across all major nursing domains. Content areas reflect real-world nursing
scenarios requiring prioritization, delegation, safe medication administration, evidence-based
interventions, and critical judgment. This format supports high-level clinical reasoning
consistent with national RN readiness standards.
Answer Format
All correct answers appear in bold, followed by clear rationales that reinforce clinical priorities,
patient safety, and professional nursing judgment.
Patient Safety (Questions 1–20)
1. A patient is prescribed warfarin 5 mg daily. The nurse notes the INR is 4.2. What is the
priority action?
A. Administer the dose as ordered
B. Hold the dose and notify the provider
C. Increase the dose to 7.5 mg
D. Administer vitamin K
Rationale: INR >3.5 increases bleeding risk; therapeutic range is 2.0–3.0. Holding the
dose prevents hemorrhage.
2. Which intervention best prevents catheter-associated urinary tract infections (CAUTI)?
A. Daily catheter irrigation with saline
B. Early removal of indwelling catheters
C. Routine antibiotic prophylaxis
D. Changing the catheter weekly
Rationale: Prompt removal of unnecessary catheters is the strongest evidence-based
practice.
3. A patient with a history of falls is admitted. What is the nurse’s first action?
A. Apply soft wrist restraints
B. Complete a fall risk assessment
C. Place the patient in a private room
, D. Administer a sedative
Rationale: Validated tools (e.g., Morse Fall Scale) guide individualized interventions.
4. The nurse is administering medications via a central line. What is the most critical step
to prevent infection?
A. Wear sterile gloves only
B. Scrub the hub for 15 seconds with alcohol
C. Flush with saline before use
D. Change the dressing weekly
Rationale: Hub disinfection for ≥15 seconds prevents CLABSI.
5. A patient reports sudden chest pain and dyspnea. The nurse notes new ST elevation on
telemetry. What is the priority?
A. Administer aspirin 325 mg
B. Activate the STEMI protocol
C. Obtain a 12-lead ECG
D. Apply oxygen at 2 L/min
Rationale: Rapid activation of the cardiac catheterization team is critical for
reperfusion.
6. During medication reconciliation, the nurse discovers the patient takes herbal
supplements. What is the next step?
A. Discontinue all supplements
B. Document and assess for drug interactions
C. Ignore unless prescribed
D. Administer with medications
Rationale: Herbal supplements can alter drug metabolism; full disclosure is required.
7. A patient is scheduled for surgery but ate breakfast. What should the nurse do?
A. Proceed with surgery
B. Notify the surgical team immediately
C. Withhold only clear liquids
D. Administer antiemetics
Rationale: NPO violation increases aspiration risk; surgery may be delayed.
8. The nurse is preparing to administer a blood transfusion. What is the most important
verification step?
A. Check blood type only
B. Two-person verification of patient ID and blood product
C. Verify expiration date only
D. Start infusion at 100 mL/hr
Rationale: Two licensed personnel must verify to prevent ABO incompatibility.
9. A pressure injury is identified on the sacrum. What is the first action?
A. Apply a hydrocolloid dressing
B. Stage the injury and document
C. Cleanse with normal saline
D. Offload pressure immediately
Rationale: Pressure relief is the primary intervention to prevent worsening.
10.The nurse observes a visitor entering with flu-like symptoms. What is the best response?
A. Allow entry with a mask
, B. Restrict visitation and notify infection control
C. Provide hand sanitizer only
D. Permit brief visit
Rationale: Visitors with infectious symptoms pose a transmission risk.
11.A patient on telemetry suddenly develops ventricular tachycardia. What is the first
action?
A. Administer amiodarone
B. Assess pulse and responsiveness
C. Defibrillate at 200 J
D. Call a code blue
Rationale: Stable vs. unstable VT determines treatment; pulse check is first.
12.The nurse is delegating vital signs to a UAP. What must be included?
A. No instructions needed
B. Clear parameters for reporting abnormalities
C. Only blood pressure
D. Delegate all assessments
Rationale: Delegation requires specific reporting criteria (e.g., BP >160/100).
13.A patient with latex allergy is admitted. What is the priority safety measure?
A. Use powder-free gloves
B. Create a latex-safe environment
C. Apply a latex allergy bracelet only
D. Avoid all gloves
Rationale: All latex products must be removed from the patient area.
14.The nurse identifies a medication error. What is the first step?
A. Complete an incident report
B. Assess the patient for adverse effects
C. Notify the pharmacy
D. Inform the nurse manager
Rationale: Patient safety is priority; assessment guides further action.
15.A rapid response is called for respiratory distress. What is the nurse’s role?
A. Wait for the team
B. Provide oxygen and prepare for intervention
C. Leave the room
D. Document only
Rationale: Early intervention improves outcomes; oxygen and airway support are
critical.
16.Hand hygiene compliance is monitored. What is the gold standard?
A. Alcohol-based hand rub
B. Soap and water for 40–60 seconds
C. Gloves only
D. Hand wipes
Rationale: ABHR is effective and efficient for non-soiled hands.
17.A patient is at risk for DVT. What is the best preventive measure?
A. Bed rest
B. Sequential compression devices (SCDs)
NURSING) 2026–2027 | Questions and Correct Answers |
Clinically Verified Format
Comprehensive Nursing | Key Domains: Medical-Surgical, Pharmacology, Maternal-Newborn,
Pediatrics, Mental Health, Leadership & Management, Delegation, Safety, Evidence-Based
Practice, Patient-Centered Care, and Critical Thinking | Expert-Structured Q&A | Designed for
Full Clinical Competency
Introduction
This BSN 366 HESI RN Exit Exam V1 resource is structured to evaluate broad clinical
competence across all major nursing domains. Content areas reflect real-world nursing
scenarios requiring prioritization, delegation, safe medication administration, evidence-based
interventions, and critical judgment. This format supports high-level clinical reasoning
consistent with national RN readiness standards.
Answer Format
All correct answers appear in bold, followed by clear rationales that reinforce clinical priorities,
patient safety, and professional nursing judgment.
Patient Safety (Questions 1–20)
1. A patient is prescribed warfarin 5 mg daily. The nurse notes the INR is 4.2. What is the
priority action?
A. Administer the dose as ordered
B. Hold the dose and notify the provider
C. Increase the dose to 7.5 mg
D. Administer vitamin K
Rationale: INR >3.5 increases bleeding risk; therapeutic range is 2.0–3.0. Holding the
dose prevents hemorrhage.
2. Which intervention best prevents catheter-associated urinary tract infections (CAUTI)?
A. Daily catheter irrigation with saline
B. Early removal of indwelling catheters
C. Routine antibiotic prophylaxis
D. Changing the catheter weekly
Rationale: Prompt removal of unnecessary catheters is the strongest evidence-based
practice.
3. A patient with a history of falls is admitted. What is the nurse’s first action?
A. Apply soft wrist restraints
B. Complete a fall risk assessment
C. Place the patient in a private room
, D. Administer a sedative
Rationale: Validated tools (e.g., Morse Fall Scale) guide individualized interventions.
4. The nurse is administering medications via a central line. What is the most critical step
to prevent infection?
A. Wear sterile gloves only
B. Scrub the hub for 15 seconds with alcohol
C. Flush with saline before use
D. Change the dressing weekly
Rationale: Hub disinfection for ≥15 seconds prevents CLABSI.
5. A patient reports sudden chest pain and dyspnea. The nurse notes new ST elevation on
telemetry. What is the priority?
A. Administer aspirin 325 mg
B. Activate the STEMI protocol
C. Obtain a 12-lead ECG
D. Apply oxygen at 2 L/min
Rationale: Rapid activation of the cardiac catheterization team is critical for
reperfusion.
6. During medication reconciliation, the nurse discovers the patient takes herbal
supplements. What is the next step?
A. Discontinue all supplements
B. Document and assess for drug interactions
C. Ignore unless prescribed
D. Administer with medications
Rationale: Herbal supplements can alter drug metabolism; full disclosure is required.
7. A patient is scheduled for surgery but ate breakfast. What should the nurse do?
A. Proceed with surgery
B. Notify the surgical team immediately
C. Withhold only clear liquids
D. Administer antiemetics
Rationale: NPO violation increases aspiration risk; surgery may be delayed.
8. The nurse is preparing to administer a blood transfusion. What is the most important
verification step?
A. Check blood type only
B. Two-person verification of patient ID and blood product
C. Verify expiration date only
D. Start infusion at 100 mL/hr
Rationale: Two licensed personnel must verify to prevent ABO incompatibility.
9. A pressure injury is identified on the sacrum. What is the first action?
A. Apply a hydrocolloid dressing
B. Stage the injury and document
C. Cleanse with normal saline
D. Offload pressure immediately
Rationale: Pressure relief is the primary intervention to prevent worsening.
10.The nurse observes a visitor entering with flu-like symptoms. What is the best response?
A. Allow entry with a mask
, B. Restrict visitation and notify infection control
C. Provide hand sanitizer only
D. Permit brief visit
Rationale: Visitors with infectious symptoms pose a transmission risk.
11.A patient on telemetry suddenly develops ventricular tachycardia. What is the first
action?
A. Administer amiodarone
B. Assess pulse and responsiveness
C. Defibrillate at 200 J
D. Call a code blue
Rationale: Stable vs. unstable VT determines treatment; pulse check is first.
12.The nurse is delegating vital signs to a UAP. What must be included?
A. No instructions needed
B. Clear parameters for reporting abnormalities
C. Only blood pressure
D. Delegate all assessments
Rationale: Delegation requires specific reporting criteria (e.g., BP >160/100).
13.A patient with latex allergy is admitted. What is the priority safety measure?
A. Use powder-free gloves
B. Create a latex-safe environment
C. Apply a latex allergy bracelet only
D. Avoid all gloves
Rationale: All latex products must be removed from the patient area.
14.The nurse identifies a medication error. What is the first step?
A. Complete an incident report
B. Assess the patient for adverse effects
C. Notify the pharmacy
D. Inform the nurse manager
Rationale: Patient safety is priority; assessment guides further action.
15.A rapid response is called for respiratory distress. What is the nurse’s role?
A. Wait for the team
B. Provide oxygen and prepare for intervention
C. Leave the room
D. Document only
Rationale: Early intervention improves outcomes; oxygen and airway support are
critical.
16.Hand hygiene compliance is monitored. What is the gold standard?
A. Alcohol-based hand rub
B. Soap and water for 40–60 seconds
C. Gloves only
D. Hand wipes
Rationale: ABHR is effective and efficient for non-soiled hands.
17.A patient is at risk for DVT. What is the best preventive measure?
A. Bed rest
B. Sequential compression devices (SCDs)
