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BSN HESI 366 Exit Exam 2026/2027
Comprehensive Nursing Review Actual Exam
Questions with Verified Answers and Detailed
Rationales Grade A Study Guide
1. The nurse is teaching a client with type 2 diabetes mellitus about disease
management. Which client statement indicates understanding?
A) "Using salt, herbs, and spices will improve the flavor of foods."
B) "Get an eye exam with an ophthalmologist annually."
C) "Arrange diet schedule around three regular meals a day."
D) "Inspect feet every month for ingrown nails, cuts, and calluses."
CORRECT ANSWER: B
Rationale: Annual dilated eye exams by an ophthalmologist are critical for clients with
diabetes to screen for and prevent diabetic retinopathy, a leading cause of blindness.
This is a standard recommendation in diabetes management.
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2. A client with recurrent moderate anxiety is being educated about non-
pharmacologic management. Which instruction should the nurse include?
A) "Center attention on positive upbeat music."
B) "Find outlets for more social interaction."
C) "Practice using muscle relaxation techniques."
D) "Think about reasons the episodes occur."
CORRECT ANSWER: C
Rationale: Progressive muscle relaxation is an evidence-based technique that reduces
physiologic arousal associated with anxiety by systematically tensing and relaxing
muscle groups. It provides the client with a direct coping skill.
3. The charge nurse is making assignments. Which client should be assigned to the
Registered Nurse (RN)?
A) A 75-year-old client with renal calculi who requires urine straining.
B) A 64-year-old client who had a total hip replacement the previous day.
C) A 30-year-old depressed client who admits to suicidal ideation.
D) An adolescent with multiple contusions due to a fall 2 days ago.
CORRECT ANSWER: C
Rationale: A client expressing suicidal ideation requires a comprehensive mental health
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assessment, development of a safety plan, and ongoing evaluation—complex nursing
judgments that fall within the scope of an RN, not a PN.
4. NGN - Infant of a Diabetic Mother (IDM): For each finding, indicate if it is associated
with IDM or is a normal newborn presentation.
• Soft Fontanelles: Normal Presentation.
• Blood Glucose 35 mg/dL: Diabetic Finding.
• Axillary Temp 96°F: Diabetic Finding.
• Acrocyanosis: Normal Presentation.
• Ballard Maturity Rating 37 weeks: Diabetic Finding.
CORRECT ANSWERS:
Rationale: Infants of diabetic mothers (IDMs) are at risk for hypoglycemia (BG <40
mg/dL), hypothermia, and may be large-for-gestational-age but have immature
Ballard scores. Acrocyanosis and soft fontanelles are normal findings in a healthy
newborn.
5. NGN - IDM Risks: The nurse recognizes the infant is at risk for:
CORRECT ANSWER: Hyperbilirubinemia, Respiratory Distress Syndrome (RDS), and
Cardiomyopathy.
Rationale: IDMs are at increased risk for hyperbilirubinemia due to polycythemia and
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bruising, RDS due to delayed lung maturity, and hypertrophic cardiomyopathy due to
fetal hyperinsulinemia.
6. NGN - IDM Priority Orders: Which 6 orders take priority?
A) Feed Immediately.
B) Monitor for respiratory distress.
D) Keep in warmer with bilirubin lights.
E) Monitor temp every 30 min.
G) Contact RT for ABG and oxygen therapy.
J) Blood glucose level.
CORRECT ANSWERS: A, B, D, E, G, J
Rationale: Priorities for an IDM are: 1) Thermoregulation (D, E), 2) Glucose
Stabilization (A, J), and 3) Respiratory Support/Monitoring (B, G). These address the
immediate, life-threatening risks of hypothermia, hypoglycemia, and respiratory
distress.
7. NGN - IDM Appropriate Actions: Select all that apply.
A) Keep infant in warmer with bili lights to maintain temp of 97.6°F.
E) Explain to the mother that the baby's RR needs to be below 60.
F) Inform the mother that the baby is stable enough to take out of the warmer.
G) Observe for signs of respiratory distress and monitor O2 with pulse ox.
BSN HESI 366 Exit Exam 2026/2027
Comprehensive Nursing Review Actual Exam
Questions with Verified Answers and Detailed
Rationales Grade A Study Guide
1. The nurse is teaching a client with type 2 diabetes mellitus about disease
management. Which client statement indicates understanding?
A) "Using salt, herbs, and spices will improve the flavor of foods."
B) "Get an eye exam with an ophthalmologist annually."
C) "Arrange diet schedule around three regular meals a day."
D) "Inspect feet every month for ingrown nails, cuts, and calluses."
CORRECT ANSWER: B
Rationale: Annual dilated eye exams by an ophthalmologist are critical for clients with
diabetes to screen for and prevent diabetic retinopathy, a leading cause of blindness.
This is a standard recommendation in diabetes management.
,2|Page
2. A client with recurrent moderate anxiety is being educated about non-
pharmacologic management. Which instruction should the nurse include?
A) "Center attention on positive upbeat music."
B) "Find outlets for more social interaction."
C) "Practice using muscle relaxation techniques."
D) "Think about reasons the episodes occur."
CORRECT ANSWER: C
Rationale: Progressive muscle relaxation is an evidence-based technique that reduces
physiologic arousal associated with anxiety by systematically tensing and relaxing
muscle groups. It provides the client with a direct coping skill.
3. The charge nurse is making assignments. Which client should be assigned to the
Registered Nurse (RN)?
A) A 75-year-old client with renal calculi who requires urine straining.
B) A 64-year-old client who had a total hip replacement the previous day.
C) A 30-year-old depressed client who admits to suicidal ideation.
D) An adolescent with multiple contusions due to a fall 2 days ago.
CORRECT ANSWER: C
Rationale: A client expressing suicidal ideation requires a comprehensive mental health
,3|Page
assessment, development of a safety plan, and ongoing evaluation—complex nursing
judgments that fall within the scope of an RN, not a PN.
4. NGN - Infant of a Diabetic Mother (IDM): For each finding, indicate if it is associated
with IDM or is a normal newborn presentation.
• Soft Fontanelles: Normal Presentation.
• Blood Glucose 35 mg/dL: Diabetic Finding.
• Axillary Temp 96°F: Diabetic Finding.
• Acrocyanosis: Normal Presentation.
• Ballard Maturity Rating 37 weeks: Diabetic Finding.
CORRECT ANSWERS:
Rationale: Infants of diabetic mothers (IDMs) are at risk for hypoglycemia (BG <40
mg/dL), hypothermia, and may be large-for-gestational-age but have immature
Ballard scores. Acrocyanosis and soft fontanelles are normal findings in a healthy
newborn.
5. NGN - IDM Risks: The nurse recognizes the infant is at risk for:
CORRECT ANSWER: Hyperbilirubinemia, Respiratory Distress Syndrome (RDS), and
Cardiomyopathy.
Rationale: IDMs are at increased risk for hyperbilirubinemia due to polycythemia and
, 4|Page
bruising, RDS due to delayed lung maturity, and hypertrophic cardiomyopathy due to
fetal hyperinsulinemia.
6. NGN - IDM Priority Orders: Which 6 orders take priority?
A) Feed Immediately.
B) Monitor for respiratory distress.
D) Keep in warmer with bilirubin lights.
E) Monitor temp every 30 min.
G) Contact RT for ABG and oxygen therapy.
J) Blood glucose level.
CORRECT ANSWERS: A, B, D, E, G, J
Rationale: Priorities for an IDM are: 1) Thermoregulation (D, E), 2) Glucose
Stabilization (A, J), and 3) Respiratory Support/Monitoring (B, G). These address the
immediate, life-threatening risks of hypothermia, hypoglycemia, and respiratory
distress.
7. NGN - IDM Appropriate Actions: Select all that apply.
A) Keep infant in warmer with bili lights to maintain temp of 97.6°F.
E) Explain to the mother that the baby's RR needs to be below 60.
F) Inform the mother that the baby is stable enough to take out of the warmer.
G) Observe for signs of respiratory distress and monitor O2 with pulse ox.
