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BSN366 EXIT HESI COMPREHENSIVE ACTUAL
EXAM PREP 2026 ALL QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES ALREADY A GRADED WITH
EXPERT FEEDBACK |NEW AND REVISED
|CURRENTLY TESTING
1. A nurse is caring for a client with heart failure who has been
prescribed furosemide 40 mg IV. Which laboratory value requires
the most immediate intervention?
A) Sodium 135 mEq/L
B) Glucose 110 mg/dL
C) Potassium 2.9 mEq/L
D) Creatinine 0.9 mg/dL
*Rationale: Hypokalemia (K <3.5 mEq/L) increases the risk of
cardiac arrhythmias, especially in clients taking digoxin.
Furosemide causes potassium wasting. The nurse should notify
the provider and prepare for potassium replacement.*
2. A client with chronic obstructive pulmonary disease (COPD) has
an oxygen saturation of 88% on room air. The nurse applies a nasal
cannula at 2 L/min. Which finding indicates the therapy is
effective without risk of hypercapnia?
A) Respiratory rate increases from 20 to 26 breaths/min
B) SpO₂ rises to 100%
C) SpO₂ improves to 92% and the client is alert
D) The client becomes drowsy with a respiratory rate of 8
breaths/min
Rationale: In COPD, target SpO₂ is 88-92% to avoid suppressing
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hypoxic drive. Improvement to 92% with stable mental status
indicates effective therapy. A high SpO₂ or respiratory depression
suggests excessive oxygen.
3. A nurse is assessing a client 2 hours after a transurethral resection
of the prostate (TURP). The client reports a strong urge to urinate
and bladder spasms. The nurse notes continuous bloody drainage
around the indwelling urinary catheter. What is the priority action?
A) Administer prescribed oxybutynin for spasms
B) Encourage fluid intake to flush the bladder
C) Assess the catheter for patency and gently irrigate if
ordered
D) Remove the catheter and prepare for reinsertion
Rationale: The urge to urinate and bladder spasms with bloody
drainage often indicate a blocked catheter by clots. The nurse
should first assess for patency and irrigate per protocol.
Administering antispasmodics without relieving obstruction can
worsen distention.
4. A nurse is providing discharge teaching to a client after a
myocardial infarction. Which statement by the client indicates a
need for further teaching?
A) “I will take a baby aspirin every day.”
B) “I will call 911 if my chest pain lasts more than 5 minutes.”
C) “I will resume my usual exercise routine immediately,
including heavy lifting.”
D) “I will attend cardiac rehabilitation sessions.”
Rationale: After MI, activity should be gradually increased;
heavy lifting is discouraged initially. Daily aspirin, calling 911
for persistent pain, and cardiac rehab are correct.
5. A client with major depressive disorder is prescribed phenelzine, a
monoamine oxidase inhibitor (MAOI). Which food should the
nurse instruct the client to avoid?
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A) Apples
B) Rice
C) Aged cheese
D) Broccoli
Rationale: MAOIs interact with tyramine-containing foods (aged
cheese, cured meats, fermented products) to cause hypertensive
crisis. Apples, rice, and broccoli are safe.
6. A nurse is caring for a client in active labor. The fetal heart rate
tracing shows late decelerations with absent variability. Which
action should the nurse take first?
A) Prepare for immediate cesarean section
B) Reposition the mother to her left side
C) Increase the IV oxytocin infusion
D) Administer oxygen at 2 L/min via nasal cannula
Rationale: Late decelerations indicate uteroplacental
insufficiency. The first actions are to reposition (left lateral) to
improve placental perfusion, increase IV fluids, and give oxygen.
Oxytocin should be stopped, not increased.
7. A nurse is preparing to administer a blood transfusion to a client
with anemia. Which intravenous solution is compatible with
packed red blood cells?
A) Lactated Ringer’s
B) 0.9% normal saline
C) 5% dextrose in water (D5W)
D) 0.45% normal saline (half-normal saline)
Rationale: Only 0.9% normal saline is compatible with PRBCs.
Other solutions can cause hemolysis or clotting. Lactated
Ringer’s contains calcium, which can cause coagulation.
8. A client is admitted with acute pancreatitis. The nurse expects
which laboratory finding?
A) Decreased serum amylase
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B) Elevated serum lipase
C) Hypoglycemia
D) Decreased white blood cell count
Rationale: Lipase and amylase are elevated in acute pancreatitis.
Lipase is more specific. WBC count is usually elevated.
Hypoglycemia is not typical; hyperglycemia may occur.
9. A nurse is assessing a client with Guillain-Barré syndrome. Which
finding is most concerning?
A) Ascending weakness starting in the lower extremities
B) Diminished deep tendon reflexes
C) Paresthesias in the hands and feet
D) Difficulty speaking and decreased breath sounds
Rationale: Respiratory muscle weakness is the most
life-threatening complication of Guillain-Barré. Difficulty
speaking and decreased breath sounds indicate impending
respiratory failure, requiring immediate assessment and possible
intubation.
10. A client with chronic kidney disease (CKD) has a potassium
level of 6.2 mEq/L. The nurse should immediately assess which
parameter?
A) Blood glucose
B) Cardiac rhythm
C) Respiratory rate
D) Level of consciousness
Rationale: Hyperkalemia (K >5.5) can cause life-threatening
cardiac arrhythmias, including peaked T waves, wide QRS, and
asystole. The priority is to obtain a 12-lead ECG and monitor the
cardiac rhythm.
11. A nurse is teaching a client with type 1 diabetes about sick
day management. Which statement indicates understanding?
A) “I will stop my insulin if I cannot eat.”
BSN366 EXIT HESI COMPREHENSIVE ACTUAL
EXAM PREP 2026 ALL QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES ALREADY A GRADED WITH
EXPERT FEEDBACK |NEW AND REVISED
|CURRENTLY TESTING
1. A nurse is caring for a client with heart failure who has been
prescribed furosemide 40 mg IV. Which laboratory value requires
the most immediate intervention?
A) Sodium 135 mEq/L
B) Glucose 110 mg/dL
C) Potassium 2.9 mEq/L
D) Creatinine 0.9 mg/dL
*Rationale: Hypokalemia (K <3.5 mEq/L) increases the risk of
cardiac arrhythmias, especially in clients taking digoxin.
Furosemide causes potassium wasting. The nurse should notify
the provider and prepare for potassium replacement.*
2. A client with chronic obstructive pulmonary disease (COPD) has
an oxygen saturation of 88% on room air. The nurse applies a nasal
cannula at 2 L/min. Which finding indicates the therapy is
effective without risk of hypercapnia?
A) Respiratory rate increases from 20 to 26 breaths/min
B) SpO₂ rises to 100%
C) SpO₂ improves to 92% and the client is alert
D) The client becomes drowsy with a respiratory rate of 8
breaths/min
Rationale: In COPD, target SpO₂ is 88-92% to avoid suppressing
,2|Page
hypoxic drive. Improvement to 92% with stable mental status
indicates effective therapy. A high SpO₂ or respiratory depression
suggests excessive oxygen.
3. A nurse is assessing a client 2 hours after a transurethral resection
of the prostate (TURP). The client reports a strong urge to urinate
and bladder spasms. The nurse notes continuous bloody drainage
around the indwelling urinary catheter. What is the priority action?
A) Administer prescribed oxybutynin for spasms
B) Encourage fluid intake to flush the bladder
C) Assess the catheter for patency and gently irrigate if
ordered
D) Remove the catheter and prepare for reinsertion
Rationale: The urge to urinate and bladder spasms with bloody
drainage often indicate a blocked catheter by clots. The nurse
should first assess for patency and irrigate per protocol.
Administering antispasmodics without relieving obstruction can
worsen distention.
4. A nurse is providing discharge teaching to a client after a
myocardial infarction. Which statement by the client indicates a
need for further teaching?
A) “I will take a baby aspirin every day.”
B) “I will call 911 if my chest pain lasts more than 5 minutes.”
C) “I will resume my usual exercise routine immediately,
including heavy lifting.”
D) “I will attend cardiac rehabilitation sessions.”
Rationale: After MI, activity should be gradually increased;
heavy lifting is discouraged initially. Daily aspirin, calling 911
for persistent pain, and cardiac rehab are correct.
5. A client with major depressive disorder is prescribed phenelzine, a
monoamine oxidase inhibitor (MAOI). Which food should the
nurse instruct the client to avoid?
,3|Page
A) Apples
B) Rice
C) Aged cheese
D) Broccoli
Rationale: MAOIs interact with tyramine-containing foods (aged
cheese, cured meats, fermented products) to cause hypertensive
crisis. Apples, rice, and broccoli are safe.
6. A nurse is caring for a client in active labor. The fetal heart rate
tracing shows late decelerations with absent variability. Which
action should the nurse take first?
A) Prepare for immediate cesarean section
B) Reposition the mother to her left side
C) Increase the IV oxytocin infusion
D) Administer oxygen at 2 L/min via nasal cannula
Rationale: Late decelerations indicate uteroplacental
insufficiency. The first actions are to reposition (left lateral) to
improve placental perfusion, increase IV fluids, and give oxygen.
Oxytocin should be stopped, not increased.
7. A nurse is preparing to administer a blood transfusion to a client
with anemia. Which intravenous solution is compatible with
packed red blood cells?
A) Lactated Ringer’s
B) 0.9% normal saline
C) 5% dextrose in water (D5W)
D) 0.45% normal saline (half-normal saline)
Rationale: Only 0.9% normal saline is compatible with PRBCs.
Other solutions can cause hemolysis or clotting. Lactated
Ringer’s contains calcium, which can cause coagulation.
8. A client is admitted with acute pancreatitis. The nurse expects
which laboratory finding?
A) Decreased serum amylase
, 4|Page
B) Elevated serum lipase
C) Hypoglycemia
D) Decreased white blood cell count
Rationale: Lipase and amylase are elevated in acute pancreatitis.
Lipase is more specific. WBC count is usually elevated.
Hypoglycemia is not typical; hyperglycemia may occur.
9. A nurse is assessing a client with Guillain-Barré syndrome. Which
finding is most concerning?
A) Ascending weakness starting in the lower extremities
B) Diminished deep tendon reflexes
C) Paresthesias in the hands and feet
D) Difficulty speaking and decreased breath sounds
Rationale: Respiratory muscle weakness is the most
life-threatening complication of Guillain-Barré. Difficulty
speaking and decreased breath sounds indicate impending
respiratory failure, requiring immediate assessment and possible
intubation.
10. A client with chronic kidney disease (CKD) has a potassium
level of 6.2 mEq/L. The nurse should immediately assess which
parameter?
A) Blood glucose
B) Cardiac rhythm
C) Respiratory rate
D) Level of consciousness
Rationale: Hyperkalemia (K >5.5) can cause life-threatening
cardiac arrhythmias, including peaked T waves, wide QRS, and
asystole. The priority is to obtain a 12-lead ECG and monitor the
cardiac rhythm.
11. A nurse is teaching a client with type 1 diabetes about sick
day management. Which statement indicates understanding?
A) “I will stop my insulin if I cannot eat.”
