BSN 366
HESI RN EXIT EXAM V3
(Latest Update )
Questions and Verified Answers
100% Correct | Grade A | Nightingale
Total Questions 150
Number of Sections 9
Cognitive Distribution Recall ~23% / Application ~37% / Analysis ~41%
Question Style 75% Scenario-Based / 25% Direct Knowledge
20 Priority-Setting / 15 Pharmacology / 10 Delegation / 5 Integrated
Special Inclusions
Cases
Nightingale BSN 366 Syllabus, HESI RN Blueprint, NCLEX-RN
Alignment
Test Plan, QSEN
Section Breakdown:
Section 1: Management of Care (20 questions)
Section 2: Safety & Infection Control (15 questions)
Section 3: Health Promotion & Maintenance (15 questions)
Section 4: Psychosocial Integrity (15 questions)
Section 5: Basic Care & Comfort (15 questions)
Section 6: Pharmacological & Parenteral Therapies (20 questions)
Section 7: Reduction of Risk Potential (20 questions)
Section 8: Physiological Adaptation (20 questions)
Section 9: Comprehensive Integrated Scenarios (10 questions)
Nightingale College | BSN Program
,BSN 366 HESI RN Exit Exam V3 (2026/2027) | Nightingale College Grade A | 100% Correct
About This Examination
This comprehensive examination is structured to align with the Nightingale College BSN 366 course objectives, the
HESI RN Exit Exam blueprint, the NCLEX-RN Test Plan, and the QSEN (Quality and Safety Education for Nurses)
competencies. The 150-item examination is designed to evaluate the graduate nurse's readiness to enter professional
practice by assessing integration of nursing knowledge across the four NCLEX-RN Client Needs categories and nine
sub-domains.
Cognitive complexity is distributed to mirror the HESI Exit Examination: approximately 23 percent of items assess
Recall (knowledge of facts, terminology, principles), 37 percent assess Application (use of knowledge in clinical
situations), and 41 percent assess Analysis (clinical judgment, prioritization, and synthesis of multiple data points).
Approximately 75 percent of questions are scenario-based, requiring the test-taker to apply nursing process and
clinical reasoning, while 25 percent are direct knowledge items.
Special inclusions are embedded across all sections: 20 priority-setting questions assessing the ability to determine
which client to see first or which action to take first; 15 pharmacology questions spanning dosage calculations, side
effects, nursing considerations, and patient teaching; 10 delegation questions clarifying RN, LPN, and UAP scope of
practice; and 5 integrated case studies with multiple related questions testing clinical reasoning across systems. Each
question is followed by the correct answer, a *[CORRECT]* marker, and a rationale referencing the BSN 366
curriculum and HESI RN Exit standards to support learning and self-assessment.
How to use this document: Treat this examination as both a formative learning tool and a summative readiness
assessment. Attempt each question without consulting references, then review the rationale carefully even when the
answer is correct, as the rationale reinforces the clinical reasoning and the curriculum standards. Focus review on any
item where the rationale introduces an unfamiliar concept or contradicts an existing assumption. The integration of
Nightingale College BSN 366 curriculum references with HESI Exit Exam and NCLEX-RN standards provides a
framework for targeted remediation.
Legend
Format Meaning
*[CORRECT]* Marks the correct option
[Cognitive: Recall] Direct knowledge item
[Cognitive: Application] Applied knowledge in a clinical scenario
[Cognitive: Analysis] Clinical reasoning and prioritization item
Page 2
,BSN 366 HESI RN Exit Exam V3 (2026/2027) | Nightingale College Grade A | 100% Correct
Section 1: Management of Care | Questions 1-20
Q1: [Cognitive: Application]
The charge nurse on a medical-surgical unit is preparing assignments for the shift. Which client should the
charge nurse assign to the most experienced RN?
A. A 72-year-old client admitted with pneumonia who is receiving IV antibiotics and needs frequent
repositioning.
B. A 45-year-old client one day postoperative from an open cholecystectomy requiring wound assessment and
discharge teaching.
C. A 60-year-old client with chronic heart failure whose weight increased by 3 pounds overnight and is
reporting dyspnea.
D. A 28-year-old client with a fractured femur in balanced suspension traction who is on scheduled opioid
analgesia.
A. A 72-year-old client admitted with pneumonia who is receiving IV antibiotics and needs frequent
repositioning.
B. A 45-year-client one day postoperative from an open cholecystectomy requiring wound assessment and
discharge teaching.
C. A 60-year-old client with chronic heart failure whose weight increased by 3 pounds overnight and is
reporting dyspnea. *[CORRECT]*
D. A 28-year-old client with a fractured femur in balanced suspension traction who is on scheduled opioid
analgesia.
Correct Answer: C
Rationale: The client with chronic heart failure who has gained 3 pounds overnight and is reporting
dyspnea is experiencing acute decompensation and requires the most experienced RN for ongoing
assessment, IV medication titration, and rapid response to changing hemodynamics. The other clients are
stable or have predictable care needs that can be delegated appropriately. The HESI RN Exit Exam
emphasizes prioritization using the ABC and acute-chronic framework, and this client demonstrates the
highest acuity.
Q2: [Cognitive: Analysis]
An RN delegates vital signs and ambulation for four clients to a UAP. Which task requires the RN to intervene
and reassume responsibility?
A. The UAP ambulates a client two days after appendectomy who is stable and walks independently with a
cane.
B. The UAP measures vital signs on a client receiving a heparin infusion who reports new chest pain.
C. The UAP assists a stable postoperative client with a urinary catheter to the bathroom.
D. The UAP feeds a client with right-sided weakness from a recent stroke who follows commands consistently.
A. The UAP ambulates a client two days after appendectomy who is stable and walks independently with a
cane.
B. The UAP measures vital signs on a client receiving a heparin infusion who reports new chest pain.
*[CORRECT]*
C. The UAP assists a stable postoperative client with a urinary catheter to the bathroom.
Page 3
, BSN 366 HESI RN Exit Exam V3 (2026/2027) | Nightingale College Grade A | 100% Correct
D. The UAP feeds a client with right-sided weakness from a recent stroke who follows commands consistently.
Correct Answer: B
Rationale: The client receiving a heparin infusion who reports new chest pain is experiencing a
potentially life-threatening complication requiring RN assessment, not UAP data collection. The Five
Rights of Delegation require that the task match the client's condition; chest pain in a heparin client
signals possible hemorrhage, pulmonary embolism, or ischemia, demanding RN clinical judgment. The
other tasks are appropriate for UAP scope. The HESI Exit Exam repeatedly tests the principle that UAPs
collect data but cannot interpret it.
Q3: [Cognitive: Application]
A client scheduled for an elective total knee replacement tells the nurse, "I am not sure I want this surgery. My
daughter thinks I should, but it is my body." Which action by the nurse best supports the ethical principle of
autonomy?
A. Reassure the client that the surgeon has performed hundreds of these procedures successfully.
B. Contact the surgeon to explain that the client is hesitant so the surgeon can convince them.
C. Ask the client to discuss their concerns, then notify the surgeon that the client may withdraw consent.
D. Document the client's hesitation and proceed with preoperative preparation as scheduled.
A. Reassure the client that the surgeon has performed hundreds of these procedures successfully.
B. Contact the surgeon to explain that the client is hesitant so the surgeon can convince them.
C. Ask the client to discuss their concerns, then notify the surgeon that the client may withdraw consent.
*[CORRECT]*
D. Document the client's hesitation and proceed with preoperative preparation as scheduled.
Correct Answer: C
Rationale: Autonomy requires that the nurse respect the client's right to self-determination, including the
right to refuse or delay treatment. Asking the client to verbalize their concerns and notifying the surgeon
preserves informed consent and the client's decision-making authority. Persuasion, coercion, or
proceeding against the client's wishes violate autonomy and informed consent. The BSN 366 curriculum
emphasizes that the nurse's role in informed consent is to verify understanding and serve as the client's
advocate, not to obtain consent or pressure the client.
Q4: [Cognitive: Recall]
Which statement by the nurse accurately describes the purpose of a living will?
A. It designates a proxy to make healthcare decisions when the client cannot communicate.
B. It provides specific instructions about life-sustaining treatments the client wishes to receive or refuse in the
event of terminal illness.
C. It allows the healthcare team to override family decisions when there is disagreement about end-of-life care.
D. It is a legal document that automatically appoints the spouse as decision-maker for all medical decisions.
A. It designates a proxy to make healthcare decisions when the client cannot communicate.
B. It provides specific instructions about life-sustaining treatments the client wishes to receive or refuse
in the event of terminal illness. *[CORRECT]*
C. It allows the healthcare team to override family decisions when there is disagreement about end-of-life care.
Page 4
HESI RN EXIT EXAM V3
(Latest Update )
Questions and Verified Answers
100% Correct | Grade A | Nightingale
Total Questions 150
Number of Sections 9
Cognitive Distribution Recall ~23% / Application ~37% / Analysis ~41%
Question Style 75% Scenario-Based / 25% Direct Knowledge
20 Priority-Setting / 15 Pharmacology / 10 Delegation / 5 Integrated
Special Inclusions
Cases
Nightingale BSN 366 Syllabus, HESI RN Blueprint, NCLEX-RN
Alignment
Test Plan, QSEN
Section Breakdown:
Section 1: Management of Care (20 questions)
Section 2: Safety & Infection Control (15 questions)
Section 3: Health Promotion & Maintenance (15 questions)
Section 4: Psychosocial Integrity (15 questions)
Section 5: Basic Care & Comfort (15 questions)
Section 6: Pharmacological & Parenteral Therapies (20 questions)
Section 7: Reduction of Risk Potential (20 questions)
Section 8: Physiological Adaptation (20 questions)
Section 9: Comprehensive Integrated Scenarios (10 questions)
Nightingale College | BSN Program
,BSN 366 HESI RN Exit Exam V3 (2026/2027) | Nightingale College Grade A | 100% Correct
About This Examination
This comprehensive examination is structured to align with the Nightingale College BSN 366 course objectives, the
HESI RN Exit Exam blueprint, the NCLEX-RN Test Plan, and the QSEN (Quality and Safety Education for Nurses)
competencies. The 150-item examination is designed to evaluate the graduate nurse's readiness to enter professional
practice by assessing integration of nursing knowledge across the four NCLEX-RN Client Needs categories and nine
sub-domains.
Cognitive complexity is distributed to mirror the HESI Exit Examination: approximately 23 percent of items assess
Recall (knowledge of facts, terminology, principles), 37 percent assess Application (use of knowledge in clinical
situations), and 41 percent assess Analysis (clinical judgment, prioritization, and synthesis of multiple data points).
Approximately 75 percent of questions are scenario-based, requiring the test-taker to apply nursing process and
clinical reasoning, while 25 percent are direct knowledge items.
Special inclusions are embedded across all sections: 20 priority-setting questions assessing the ability to determine
which client to see first or which action to take first; 15 pharmacology questions spanning dosage calculations, side
effects, nursing considerations, and patient teaching; 10 delegation questions clarifying RN, LPN, and UAP scope of
practice; and 5 integrated case studies with multiple related questions testing clinical reasoning across systems. Each
question is followed by the correct answer, a *[CORRECT]* marker, and a rationale referencing the BSN 366
curriculum and HESI RN Exit standards to support learning and self-assessment.
How to use this document: Treat this examination as both a formative learning tool and a summative readiness
assessment. Attempt each question without consulting references, then review the rationale carefully even when the
answer is correct, as the rationale reinforces the clinical reasoning and the curriculum standards. Focus review on any
item where the rationale introduces an unfamiliar concept or contradicts an existing assumption. The integration of
Nightingale College BSN 366 curriculum references with HESI Exit Exam and NCLEX-RN standards provides a
framework for targeted remediation.
Legend
Format Meaning
*[CORRECT]* Marks the correct option
[Cognitive: Recall] Direct knowledge item
[Cognitive: Application] Applied knowledge in a clinical scenario
[Cognitive: Analysis] Clinical reasoning and prioritization item
Page 2
,BSN 366 HESI RN Exit Exam V3 (2026/2027) | Nightingale College Grade A | 100% Correct
Section 1: Management of Care | Questions 1-20
Q1: [Cognitive: Application]
The charge nurse on a medical-surgical unit is preparing assignments for the shift. Which client should the
charge nurse assign to the most experienced RN?
A. A 72-year-old client admitted with pneumonia who is receiving IV antibiotics and needs frequent
repositioning.
B. A 45-year-old client one day postoperative from an open cholecystectomy requiring wound assessment and
discharge teaching.
C. A 60-year-old client with chronic heart failure whose weight increased by 3 pounds overnight and is
reporting dyspnea.
D. A 28-year-old client with a fractured femur in balanced suspension traction who is on scheduled opioid
analgesia.
A. A 72-year-old client admitted with pneumonia who is receiving IV antibiotics and needs frequent
repositioning.
B. A 45-year-client one day postoperative from an open cholecystectomy requiring wound assessment and
discharge teaching.
C. A 60-year-old client with chronic heart failure whose weight increased by 3 pounds overnight and is
reporting dyspnea. *[CORRECT]*
D. A 28-year-old client with a fractured femur in balanced suspension traction who is on scheduled opioid
analgesia.
Correct Answer: C
Rationale: The client with chronic heart failure who has gained 3 pounds overnight and is reporting
dyspnea is experiencing acute decompensation and requires the most experienced RN for ongoing
assessment, IV medication titration, and rapid response to changing hemodynamics. The other clients are
stable or have predictable care needs that can be delegated appropriately. The HESI RN Exit Exam
emphasizes prioritization using the ABC and acute-chronic framework, and this client demonstrates the
highest acuity.
Q2: [Cognitive: Analysis]
An RN delegates vital signs and ambulation for four clients to a UAP. Which task requires the RN to intervene
and reassume responsibility?
A. The UAP ambulates a client two days after appendectomy who is stable and walks independently with a
cane.
B. The UAP measures vital signs on a client receiving a heparin infusion who reports new chest pain.
C. The UAP assists a stable postoperative client with a urinary catheter to the bathroom.
D. The UAP feeds a client with right-sided weakness from a recent stroke who follows commands consistently.
A. The UAP ambulates a client two days after appendectomy who is stable and walks independently with a
cane.
B. The UAP measures vital signs on a client receiving a heparin infusion who reports new chest pain.
*[CORRECT]*
C. The UAP assists a stable postoperative client with a urinary catheter to the bathroom.
Page 3
, BSN 366 HESI RN Exit Exam V3 (2026/2027) | Nightingale College Grade A | 100% Correct
D. The UAP feeds a client with right-sided weakness from a recent stroke who follows commands consistently.
Correct Answer: B
Rationale: The client receiving a heparin infusion who reports new chest pain is experiencing a
potentially life-threatening complication requiring RN assessment, not UAP data collection. The Five
Rights of Delegation require that the task match the client's condition; chest pain in a heparin client
signals possible hemorrhage, pulmonary embolism, or ischemia, demanding RN clinical judgment. The
other tasks are appropriate for UAP scope. The HESI Exit Exam repeatedly tests the principle that UAPs
collect data but cannot interpret it.
Q3: [Cognitive: Application]
A client scheduled for an elective total knee replacement tells the nurse, "I am not sure I want this surgery. My
daughter thinks I should, but it is my body." Which action by the nurse best supports the ethical principle of
autonomy?
A. Reassure the client that the surgeon has performed hundreds of these procedures successfully.
B. Contact the surgeon to explain that the client is hesitant so the surgeon can convince them.
C. Ask the client to discuss their concerns, then notify the surgeon that the client may withdraw consent.
D. Document the client's hesitation and proceed with preoperative preparation as scheduled.
A. Reassure the client that the surgeon has performed hundreds of these procedures successfully.
B. Contact the surgeon to explain that the client is hesitant so the surgeon can convince them.
C. Ask the client to discuss their concerns, then notify the surgeon that the client may withdraw consent.
*[CORRECT]*
D. Document the client's hesitation and proceed with preoperative preparation as scheduled.
Correct Answer: C
Rationale: Autonomy requires that the nurse respect the client's right to self-determination, including the
right to refuse or delay treatment. Asking the client to verbalize their concerns and notifying the surgeon
preserves informed consent and the client's decision-making authority. Persuasion, coercion, or
proceeding against the client's wishes violate autonomy and informed consent. The BSN 366 curriculum
emphasizes that the nurse's role in informed consent is to verify understanding and serve as the client's
advocate, not to obtain consent or pressure the client.
Q4: [Cognitive: Recall]
Which statement by the nurse accurately describes the purpose of a living will?
A. It designates a proxy to make healthcare decisions when the client cannot communicate.
B. It provides specific instructions about life-sustaining treatments the client wishes to receive or refuse in the
event of terminal illness.
C. It allows the healthcare team to override family decisions when there is disagreement about end-of-life care.
D. It is a legal document that automatically appoints the spouse as decision-maker for all medical decisions.
A. It designates a proxy to make healthcare decisions when the client cannot communicate.
B. It provides specific instructions about life-sustaining treatments the client wishes to receive or refuse
in the event of terminal illness. *[CORRECT]*
C. It allows the healthcare team to override family decisions when there is disagreement about end-of-life care.
Page 4
