HESI BSN 366 RN Exit Exam Questions
and Correct Answers 2026/2027 |
Detailed Rationales | Just Released PDF
HESI BSN 366 RN EXIT EXAM 2026/2027 - STUDY GUIDE
Overview:
• This comprehensive study guide contains 200 practice questions designed to
simulate the HESI RN Exit Exam format and content coverage, helping you assess
readiness for the NCLEX-RN examination.
• Use this material to identify knowledge gaps across all major nursing content
areas, practice time management strategies, and build confidence with detailed
rationales for every answer.
1. A 45-year-old male client is admitted to the unit with acute myocardial
infarction (AMI). He is complaining of severe substernal chest pain radiating
to his left arm. What is the priority nursing action?
A) Administer aspirin and document the time of chest pain onset
B) Place the client on continuous cardiac monitoring and obtain a 12-lead ECG
C) Elevate the head of the bed and apply oxygen therapy
D) Notify the physician immediately and prepare for cardiac catheterization
E) Administer morphine and reassure the client
✓ CORRECT ANSWER: B) Place the client on continuous cardiac monitoring and
obtain a 12-lead ECG
Rationale: In acute myocardial infarction, the priority nursing action is to establish
continuous cardiac monitoring and obtain a 12-lead ECG within the first 10 minutes
of symptom onset. This allows for rapid identification of ST-segment elevation or
other ECG changes that confirm MI and guide treatment decisions. While oxygen,
aspirin, and pain management are important, establishing diagnostic monitoring
and assessment is the priority action that informs all subsequent interventions. The
,ECG is the gold standard for confirming acute coronary syndrome and determining
treatment urgency.
2. A 28-year-old primigravida at 38 weeks gestation presents to the labor and
delivery unit with a complaint of vaginal bleeding. Upon inspection, you note
bright red bleeding from the vagina. What is the most appropriate nursing
action?
A) Perform a sterile vaginal examination to assess cervical dilation
B) Insert a Foley catheter and prepare for immediate delivery
C) Assess vital signs, apply continuous fetal monitoring, and notify the provider
D) Administer oxytocin to enhance uterine contractions
E) Inform the client that bleeding is normal at term and continue routine care
✓ CORRECT ANSWER: C) Assess vital signs, apply continuous fetal monitoring,
and notify the provider
Rationale: Vaginal bleeding in late pregnancy is concerning and could indicate
placenta previa, placental abruption, or other complications. The priority is to
maintain maternal and fetal assessment without disturbing the area. A digital
vaginal examination is contraindicated in the presence of vaginal bleeding until
placenta previa is ruled out, as it could trigger massive hemorrhage. Continuous
fetal monitoring, vital sign assessment, and immediate provider notification are
essential. The client should be kept NPO pending evaluation and potential delivery.
3. A 62-year-old client with COPD is receiving oxygen therapy. Which
statement by the client indicates a correct understanding of home oxygen
safety?
A) "I can adjust my oxygen flow rate based on how I'm feeling each day"
,B) "I will keep my oxygen concentrator away from open flames and smoking areas"
C) "I don't need to worry about oxygen while cooking on my electric stove"
D) "Using oxygen during sleep will make me dependent on it"
E) "Petroleum-based products are safe to use with oxygen therapy"
✓ CORRECT ANSWER: B) "I will keep my oxygen concentrator away from open
flames and smoking areas"
Rationale: Oxygen is a combustible gas that supports and accelerates combustion.
The client must understand critical safety measures, including keeping oxygen
equipment away from heat sources, open flames, and smoking areas. Oxygen flow
rates must not be adjusted without provider orders, as this can cause hyperoxia or
hypoxia. Oxygen does not cause dependence but rather supports oxygenation.
Electric stoves and appliances can generate heat that poses a fire risk near oxygen.
Petroleum-based products should be avoided as they are flammable; water-based
lubricants should be used instead. Proper education prevents serious fire hazards
in the home.
4. A 35-year-old female client admitted with severe burns covering 40% of her
body surface area (BSA). The client is 5 hours post-injury. Using the Parkland
Formula, approximately how much IV fluid should this client have received in
the first 8 hours post-burn?
A) 1,000 mL of normal saline
B) 3,200 mL of Lactated Ringer's solution
C) 6,400 mL of Lactated Ringer's solution
D) 8,000 mL of normal saline
E) 2,000 mL of hypertonic saline
✓ CORRECT ANSWER: C) 6,400 mL of Lactated Ringer's solution
, Rationale: The Parkland Formula calculates fluid replacement for major burns: 4
mL × %BSA × body weight (kg). For a 40% BSA burn on an assumed 70-kg client: 4 ×
40 × 70 = 11,200 mL total for 24 hours. Half (5,600 mL) should be given in the first 8
hours post-burn. However, this client is 5 hours post-injury, so approximately 6,400
mL should have been administered by the 8-hour mark to account for fluid loss
rates. Lactated Ringer's solution is the preferred fluid for burn resuscitation as it
replaces lost electrolytes and is less likely to cause pulmonary edema compared to
normal saline. The goal is to maintain urine output of 0.5 mL/kg/hr for adults.
5. A 72-year-old male client with a history of hypertension and diabetes
mellitus type 2 is admitted with acute stroke symptoms. Which intervention
should the nurse prioritize?
A) Administer nitroglycerin to reduce blood pressure immediately
B) Establish IV access, draw blood work, and obtain a non-contrast CT scan of the
brain
C) Apply heat to the affected extremities to promote circulation
D) Administer aspirin and prepare for thrombolytic therapy
E) Keep the client NPO and position flat in bed
✓ CORRECT ANSWER: B) Establish IV access, draw blood work, and obtain a
non-contrast CT scan of the brain
Rationale: In acute stroke, the priority is rapid assessment to differentiate between
ischemic and hemorrhagic stroke, as treatment differs significantly. Non-contrast
CT scan of the brain must be obtained immediately to rule out hemorrhage before
any thrombolytic therapy is administered. IV access and blood work (including
coagulation studies, glucose, and troponin) are essential. Aggressive blood pressure
reduction in acute stroke can worsen outcomes. Aspirin and other interventions
depend on stroke type confirmation. The client should be kept on bed rest with
head of bed elevated 30 degrees to promote cerebral circulation. Time is brain
tissue—rapid intervention within the thrombolytic window (4.5 hours) is critical.
and Correct Answers 2026/2027 |
Detailed Rationales | Just Released PDF
HESI BSN 366 RN EXIT EXAM 2026/2027 - STUDY GUIDE
Overview:
• This comprehensive study guide contains 200 practice questions designed to
simulate the HESI RN Exit Exam format and content coverage, helping you assess
readiness for the NCLEX-RN examination.
• Use this material to identify knowledge gaps across all major nursing content
areas, practice time management strategies, and build confidence with detailed
rationales for every answer.
1. A 45-year-old male client is admitted to the unit with acute myocardial
infarction (AMI). He is complaining of severe substernal chest pain radiating
to his left arm. What is the priority nursing action?
A) Administer aspirin and document the time of chest pain onset
B) Place the client on continuous cardiac monitoring and obtain a 12-lead ECG
C) Elevate the head of the bed and apply oxygen therapy
D) Notify the physician immediately and prepare for cardiac catheterization
E) Administer morphine and reassure the client
✓ CORRECT ANSWER: B) Place the client on continuous cardiac monitoring and
obtain a 12-lead ECG
Rationale: In acute myocardial infarction, the priority nursing action is to establish
continuous cardiac monitoring and obtain a 12-lead ECG within the first 10 minutes
of symptom onset. This allows for rapid identification of ST-segment elevation or
other ECG changes that confirm MI and guide treatment decisions. While oxygen,
aspirin, and pain management are important, establishing diagnostic monitoring
and assessment is the priority action that informs all subsequent interventions. The
,ECG is the gold standard for confirming acute coronary syndrome and determining
treatment urgency.
2. A 28-year-old primigravida at 38 weeks gestation presents to the labor and
delivery unit with a complaint of vaginal bleeding. Upon inspection, you note
bright red bleeding from the vagina. What is the most appropriate nursing
action?
A) Perform a sterile vaginal examination to assess cervical dilation
B) Insert a Foley catheter and prepare for immediate delivery
C) Assess vital signs, apply continuous fetal monitoring, and notify the provider
D) Administer oxytocin to enhance uterine contractions
E) Inform the client that bleeding is normal at term and continue routine care
✓ CORRECT ANSWER: C) Assess vital signs, apply continuous fetal monitoring,
and notify the provider
Rationale: Vaginal bleeding in late pregnancy is concerning and could indicate
placenta previa, placental abruption, or other complications. The priority is to
maintain maternal and fetal assessment without disturbing the area. A digital
vaginal examination is contraindicated in the presence of vaginal bleeding until
placenta previa is ruled out, as it could trigger massive hemorrhage. Continuous
fetal monitoring, vital sign assessment, and immediate provider notification are
essential. The client should be kept NPO pending evaluation and potential delivery.
3. A 62-year-old client with COPD is receiving oxygen therapy. Which
statement by the client indicates a correct understanding of home oxygen
safety?
A) "I can adjust my oxygen flow rate based on how I'm feeling each day"
,B) "I will keep my oxygen concentrator away from open flames and smoking areas"
C) "I don't need to worry about oxygen while cooking on my electric stove"
D) "Using oxygen during sleep will make me dependent on it"
E) "Petroleum-based products are safe to use with oxygen therapy"
✓ CORRECT ANSWER: B) "I will keep my oxygen concentrator away from open
flames and smoking areas"
Rationale: Oxygen is a combustible gas that supports and accelerates combustion.
The client must understand critical safety measures, including keeping oxygen
equipment away from heat sources, open flames, and smoking areas. Oxygen flow
rates must not be adjusted without provider orders, as this can cause hyperoxia or
hypoxia. Oxygen does not cause dependence but rather supports oxygenation.
Electric stoves and appliances can generate heat that poses a fire risk near oxygen.
Petroleum-based products should be avoided as they are flammable; water-based
lubricants should be used instead. Proper education prevents serious fire hazards
in the home.
4. A 35-year-old female client admitted with severe burns covering 40% of her
body surface area (BSA). The client is 5 hours post-injury. Using the Parkland
Formula, approximately how much IV fluid should this client have received in
the first 8 hours post-burn?
A) 1,000 mL of normal saline
B) 3,200 mL of Lactated Ringer's solution
C) 6,400 mL of Lactated Ringer's solution
D) 8,000 mL of normal saline
E) 2,000 mL of hypertonic saline
✓ CORRECT ANSWER: C) 6,400 mL of Lactated Ringer's solution
, Rationale: The Parkland Formula calculates fluid replacement for major burns: 4
mL × %BSA × body weight (kg). For a 40% BSA burn on an assumed 70-kg client: 4 ×
40 × 70 = 11,200 mL total for 24 hours. Half (5,600 mL) should be given in the first 8
hours post-burn. However, this client is 5 hours post-injury, so approximately 6,400
mL should have been administered by the 8-hour mark to account for fluid loss
rates. Lactated Ringer's solution is the preferred fluid for burn resuscitation as it
replaces lost electrolytes and is less likely to cause pulmonary edema compared to
normal saline. The goal is to maintain urine output of 0.5 mL/kg/hr for adults.
5. A 72-year-old male client with a history of hypertension and diabetes
mellitus type 2 is admitted with acute stroke symptoms. Which intervention
should the nurse prioritize?
A) Administer nitroglycerin to reduce blood pressure immediately
B) Establish IV access, draw blood work, and obtain a non-contrast CT scan of the
brain
C) Apply heat to the affected extremities to promote circulation
D) Administer aspirin and prepare for thrombolytic therapy
E) Keep the client NPO and position flat in bed
✓ CORRECT ANSWER: B) Establish IV access, draw blood work, and obtain a
non-contrast CT scan of the brain
Rationale: In acute stroke, the priority is rapid assessment to differentiate between
ischemic and hemorrhagic stroke, as treatment differs significantly. Non-contrast
CT scan of the brain must be obtained immediately to rule out hemorrhage before
any thrombolytic therapy is administered. IV access and blood work (including
coagulation studies, glucose, and troponin) are essential. Aggressive blood pressure
reduction in acute stroke can worsen outcomes. Aspirin and other interventions
depend on stroke type confirmation. The client should be kept on bed rest with
head of bed elevated 30 degrees to promote cerebral circulation. Time is brain
tissue—rapid intervention within the thrombolytic window (4.5 hours) is critical.
