1|Page
BSN 266 HESI EXAM/ BSN 266 HESI VERSION 2
NEWEST Final Exam Newest Exam Preparation With
Complete Questions And Correct Answers With
Rationales | Already Graded A+||Brand New Version!!
Question 1
A client with chronic kidney disease is scheduled for hemodialysis.
Which laboratory value should the nurse monitor most closely before
the procedure?
A. Serum potassium
B. Serum sodium
C. Serum calcium
D. Serum albumin
Answer: A. Serum potassium
Rationale: Hyperkalemia is a life-threatening complication of chronic
kidney disease. Before hemodialysis, the serum potassium level must be
monitored closely because elevated potassium can cause cardiac
dysrhythmias. Dialysis helps remove excess potassium, but knowing the
baseline level is critical for determining the urgency and safety of the
,2|Page
procedure. While sodium, calcium, and albumin are important,
potassium poses the most immediate risk of fatal cardiac events.
Question 2
A postoperative client reports sudden chest pain and shortness of
breath. The nurse notes tachycardia and hypotension. Which condition
should the nurse suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Pneumothorax
D. Myocardial infarction
Answer: B. Pulmonary embolism
Rationale: The sudden onset of chest pain, shortness of breath,
tachycardia, and hypotension in a postoperative client is highly
suggestive of a pulmonary embolism. Immobility after surgery increases
the risk of deep vein thrombosis, which can embolize to the pulmonary
circulation. Atelectasis typically presents with gradual onset and low-
grade fever. Pneumothorax would likely be associated with decreased
breath sounds on one side. Myocardial infarction is possible but less
likely without other cardiac risk factors or ECG changes.
Question 3
A client with heart failure is prescribed furosemide. Which assessment
finding indicates that the medication is effective?
,3|Page
A. Increased jugular venous distention
B. Decreased peripheral edema
C. Increased blood pressure
D. Decreased urine output
Answer: B. Decreased peripheral edema
Rationale: Furosemide is a loop diuretic used to reduce fluid volume in
heart failure. Effective therapy is indicated by decreased peripheral
edema, reduced pulmonary congestion, and improved breathing.
Jugular venous distention should decrease, not increase. Blood pressure
may decrease slightly due to reduced preload. Urine output should
increase as the medication promotes diuresis.
Question 4
A client with diabetes mellitus type 2 is admitted with hyperglycemic
hyperosmolar syndrome (HHS). Which clinical manifestation is most
characteristic of this condition?
A. Kussmaul respirations
B. Fruity breath odor
C. Severe dehydration
D. Ketosis
Answer: C. Severe dehydration
, 4|Page
Rationale: Hyperglycemic hyperosmolar syndrome is characterized by
extreme hyperglycemia, severe dehydration, and hyperosmolarity
without significant ketosis. Clients often present with profound fluid
volume deficit, neurologic changes, and serum glucose levels exceeding
600 mg/dL. Kussmaul respirations and fruity breath odor are more
typical of diabetic ketoacidosis, which involves ketone production.
Question 5
The nurse is caring for a client with a nasogastric tube attached to low
intermittent suction. Which electrolyte imbalance is most likely to
occur?
A. Hyperkalemia
B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
Answer: C. Hypokalemia
Rationale: Nasogastric suction removes gastric secretions that contain
potassium and hydrogen ions. Prolonged suction can lead to metabolic
alkalosis and hypokalemia. The loss of gastric acid also contributes to
alkalosis, which further drives potassium into cells, exacerbating
hypokalemia. Sodium loss can occur but is less pronounced. Calcium and
potassium levels are not typically affected by NG suction.
Question 6
BSN 266 HESI EXAM/ BSN 266 HESI VERSION 2
NEWEST Final Exam Newest Exam Preparation With
Complete Questions And Correct Answers With
Rationales | Already Graded A+||Brand New Version!!
Question 1
A client with chronic kidney disease is scheduled for hemodialysis.
Which laboratory value should the nurse monitor most closely before
the procedure?
A. Serum potassium
B. Serum sodium
C. Serum calcium
D. Serum albumin
Answer: A. Serum potassium
Rationale: Hyperkalemia is a life-threatening complication of chronic
kidney disease. Before hemodialysis, the serum potassium level must be
monitored closely because elevated potassium can cause cardiac
dysrhythmias. Dialysis helps remove excess potassium, but knowing the
baseline level is critical for determining the urgency and safety of the
,2|Page
procedure. While sodium, calcium, and albumin are important,
potassium poses the most immediate risk of fatal cardiac events.
Question 2
A postoperative client reports sudden chest pain and shortness of
breath. The nurse notes tachycardia and hypotension. Which condition
should the nurse suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Pneumothorax
D. Myocardial infarction
Answer: B. Pulmonary embolism
Rationale: The sudden onset of chest pain, shortness of breath,
tachycardia, and hypotension in a postoperative client is highly
suggestive of a pulmonary embolism. Immobility after surgery increases
the risk of deep vein thrombosis, which can embolize to the pulmonary
circulation. Atelectasis typically presents with gradual onset and low-
grade fever. Pneumothorax would likely be associated with decreased
breath sounds on one side. Myocardial infarction is possible but less
likely without other cardiac risk factors or ECG changes.
Question 3
A client with heart failure is prescribed furosemide. Which assessment
finding indicates that the medication is effective?
,3|Page
A. Increased jugular venous distention
B. Decreased peripheral edema
C. Increased blood pressure
D. Decreased urine output
Answer: B. Decreased peripheral edema
Rationale: Furosemide is a loop diuretic used to reduce fluid volume in
heart failure. Effective therapy is indicated by decreased peripheral
edema, reduced pulmonary congestion, and improved breathing.
Jugular venous distention should decrease, not increase. Blood pressure
may decrease slightly due to reduced preload. Urine output should
increase as the medication promotes diuresis.
Question 4
A client with diabetes mellitus type 2 is admitted with hyperglycemic
hyperosmolar syndrome (HHS). Which clinical manifestation is most
characteristic of this condition?
A. Kussmaul respirations
B. Fruity breath odor
C. Severe dehydration
D. Ketosis
Answer: C. Severe dehydration
, 4|Page
Rationale: Hyperglycemic hyperosmolar syndrome is characterized by
extreme hyperglycemia, severe dehydration, and hyperosmolarity
without significant ketosis. Clients often present with profound fluid
volume deficit, neurologic changes, and serum glucose levels exceeding
600 mg/dL. Kussmaul respirations and fruity breath odor are more
typical of diabetic ketoacidosis, which involves ketone production.
Question 5
The nurse is caring for a client with a nasogastric tube attached to low
intermittent suction. Which electrolyte imbalance is most likely to
occur?
A. Hyperkalemia
B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
Answer: C. Hypokalemia
Rationale: Nasogastric suction removes gastric secretions that contain
potassium and hydrogen ions. Prolonged suction can lead to metabolic
alkalosis and hypokalemia. The loss of gastric acid also contributes to
alkalosis, which further drives potassium into cells, exacerbating
hypokalemia. Sodium loss can occur but is less pronounced. Calcium and
potassium levels are not typically affected by NG suction.
Question 6
