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BSN 246 HESI Exam 2026–2027 – Complete Questions and Fully Worked Solutions for Nursing Assessment and Clinical Decision-Making

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This document contains comprehensive HESI-style exam questions for BSN 246, covering core nursing concepts tested during the 2026–2027 academic year. It includes complete, step-by-step solutions with rationales to support exam preparation, critical thinking, and clinical judgment development.

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BSN 246 HESI EXAM 2026-2027
QUESTIONS WITH COMPLETE
SOLUTIONS
Which action can be assigned to the unlicensed assistive personnel (UAP)? - CORRECT ANSWER-Measure
the client's urinary output.



What is the best initial response by the nurse? - CORRECT ANSWER-Describe the location and type of
pain you are having



Based on the nurse's assessment, which assessment data supports the decision to administer pain
medication as the first intervention? (Select all that apply. One, some, or all options may be correct.) -
CORRECT ANSWER-Pain rating of 6/10 - Heart rate of 102 beats/minute - Blood pressure of 132/76
mmHg



Which action should the nurse implement first? - CORRECT ANSWER-Administer an analgesic.



Which interventions are important to include in the client's plan of care while receiving multiple
immunosuppressants? (Select all that apply. One, some, or all options may be correct.) - CORRECT
ANSWER-Instruct client to wear a mask when walking in the halls. - Instruct visitors that fresh flowers
should not be taken into the room. - Monitor immunosuppression drug levels regularly.



Which intervention should the nurse ensure is included in the plan of care during the immediate
postoperative period?

a. Monitor Judy's urinary output hourly using an urimeter.

b. Assess Judy's surgical incision every shift.

c. Monitor Judy's nasogastric tube every 4 hours.

d. Encourage Judy to use the incentive spirometer daily. - CORRECT ANSWER-a



Which is the priority nursing assessment during the first 24-hour postoperative period? - CORRECT
ANSWER-Vital signs



BSN 246 HESI EXAM 2024-2025 QUESTIONS WITH COMPLETE SOLUTIONS

,The nurse is teaching the patient about fluid management between dialysis treatments. Which
instruction by the nurse is the most accurate? - CORRECT ANSWER-Limit fluids in between treatments to
minimize the amount of fluid that needs to be removed during dialysis.



Which expected outcome should be included in the nurse's teaching plan? - CORRECT ANSWER-Client
will avoid canned and processed foods.



The nurse assesses the dialysis graft. Which assessment should be reported to the healthcare provider
(HCP) immediately? (Select all that apply. One, some, or all options may be correct.) - CORRECT
ANSWER-Yellow, purulent drainage from graft incision site. - Absence of a thrill over the graft site. -
Capillary refill >10 seconds in the hand where the graft is placed.



Which intervention should the nurse ensure has been include in the client's plan of care? (Select all that
apply. One, some, or all options may be correct.)

A. Instruct lab personnel to obtain blood specimens from the dual-lumen catheter.

B. Perform sterile dressing changes at the dual-lumen catheter site.

C. Empty and record the drainage from the graft tubing regularly.

D. Regularly rotate IV insertion sites above and below the graft site.

E. Assess Judy's distal pulses and circulation in the arm with the access - CORRECT ANSWER-B. Perform
sterile dressing changes at the dual lumen catheter site - E. Assess the client's distal pulses and
circulation in the arm with the access.



The nurse documents the assessment of the arteriovenous (AV) graft. Which documentation best
describes a properly functioning AV graft? - CORRECT ANSWER-Thrill present and palpated



The client asks the nurse to clarify what palliative care involves. Which explanation provides the client
the best education regarding palliative care? (Select all that apply. One, some, or all options may be
correct.) - CORRECT ANSWER-Palliative care provides relief from symptoms including pain. - Palliative
care supports holistic care and improves quality of life. -



What complication would the client be most concerned about if choosing peritoneal dialysis? - CORRECT
ANSWER-Abdominal infection/Peritonitis




BSN 246 HESI EXAM 2024-2025 QUESTIONS WITH COMPLETE SOLUTIONS

,The nurse prepares and instructs the client for hemodialysis. Which statements by the client indicate the
need for further education? (Select all that apply. One, some, or all options may be correct.) - CORRECT
ANSWER-Hemodialysis will help restore kidney function back to a normal level. - Bowel or bladder
perforation may occur with hemodialysis catheter placement.



What action should the nurse take based on the response from the healthcare provider (HCP) phone
call? (Select all that apply. One, some, or all options may be correct.) - CORRECT ANSWER-Document
both phone calls and the HCP's prescriptions. - Notify the charge nurse and activate the chain of
command - Hold the potassium chloride



Which intervention should the nurse implement? - CORRECT ANSWER-Call and speak directly with the
healthcare provider (HCP).



Which intervention is most important for the nurse to implement? - CORRECT ANSWER-Hold the dose of
potassium chloride and contact the HCP to report the serum potassium level.



Based on these problems, which nursing intervention should be included in the client's plan of care? -
CORRECT ANSWER-Encourage the client to ask questions and discuss fears about diagnosis



Which assessment data indicates to the nurse that the desired outcome of the epoetin alfa has been
achieved? - CORRECT ANSWER-Conjunctival sac returns to a reddish pink color



Which assessment should the nurse perform to determine if the desired outcome of the losartan has
been achieved? - CORRECT ANSWER-Blood pressure



Which assessment finding indicates to the nurse that the desired outcome of the calcium acetate has
been achieved? - CORRECT ANSWER-Serum phosphorous of 4.0 mg/dL (1.29 mmol/L)5



After the nurse completes the assessment, what findings are most important to report to the healthcare
provider (HCP) ? (Select all that apply. One, some, or all options may be correct.) - CORRECT ANSWER-
Blood pressure of 178/92 mmHg - Respiratory rate of 28 breaths per minute- Bibasilar crackles - Edema



The client's hemoglobin level is 7.8 g/dL (78 g/L). What action should the nurse take? - CORRECT
ANSWER-Obtain an order to start an erythropoietin stimulating agent (ESA)


BSN 246 HESI EXAM 2024-2025 QUESTIONS WITH COMPLETE SOLUTIONS

, What assessment data supports the diagnosis of acute organ rejection? (Select all that apply. One,
some, or all options may be correct.) - CORRECT ANSWER-- Blood pressure of 178/96 mm Hg.

- Sub therapeutic immunosuppression levels

- Acute pain rated 6/10

- Temperature of 100.6 F(38.1 C).

- BUN of 56 mg/dL (19.99 mmol/L)

- Creatinine of 1.9 mg/dL (167.96 mcmol/L



What is the correct interpretation of these ABG's? - CORRECT ANSWER-Metabolic acidosis
(compensated)



Which lab value would the nurse be MOST concerned about? - CORRECT ANSWER-Glomerular filtration
rate (GFR) of 9mL/min/1.73m2.



The nurse is teaching the client about progression of chronic kidney disease (CKD). Which evaluation
statement documented by the nurse indicates the client's understanding of the disease process? -
CORRECT ANSWER-The client acknowledges that renal replacement therapy will need to be initiated
immediately to rid the body of waste and maintain fluid balance.



Based on the client's symptoms, what should the nurse suspect? - CORRECT ANSWER-The client has
uremia and may need to start dialysis.



Which additional symptoms should the nurse ask about? (Select all that apply. One, some, or all options
may be correct.) - CORRECT ANSWER-- Nausea - Decreased attention span - Itching



The nurse reviews the client's medical history. What part of the medical history should the nurse
consider relevant to the client's current history? (Select all that apply. One, some, or all options may be
correct.) - CORRECT ANSWER-- Hypertension - Polycystic kidney disease - Diabetes Mellitus-



The nurse palpates a weak pedal pulse in the client's right foot. Which assessment findings should the
RN document that are consistent with diminished peripheral circulation? (Select all that apply.)

Diminished hair on legs

BSN 246 HESI EXAM 2024-2025 QUESTIONS WITH COMPLETE SOLUTIONS

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