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HESI 366 BSN Exit Exam 2026/2027
Comprehensive Nursing Review Actual Exam
Questions with Verified Answers and Detailed
Rationales Grade A Study Guide
1. Four hours following surgical repair of a compound fracture of the right ulna, the
nurse is unable to palpate the client's right radial pulse. Which action should the nurse
take first?
A. Elevate the client's right hand on one or two pillows
B. Notify the healthcare provider immediately
C. Administer a prescribed analgesic
D. Check for capillary refill in the right fingers
CORRECT ANSWER: A
Rationale: Elevating the extremity is a priority intervention for suspected compartment
syndrome, which can occur after a fracture. Elevation promotes venous return and can
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help reduce swelling and pressure. This should be done immediately while preparing for
further assessment and notification of the provider.
2. After placing a 36-week-gestation newborn in an isolette and drying the infant with
several blankets, what should the nurse implement next?
A. Administer vitamin K
B. Remove the wet blankets and linen from the isolette
C. Obtain the infant's weight
D. Record the Apgar score
CORRECT ANSWER: B
Rationale: The principle of thermoregulation is critical for newborns. Wet blankets
conduct heat away from the infant, so they must be removed promptly to prevent
evaporative heat loss and maintain a neutral thermal environment.
3. A client in the third trimester of pregnancy complains of frequent nasal stiffness and
occasional nosebleeds. Her chest circumference has increased by 5 cm during the
pregnancy, and she uses thoracic breathing. Her diaphragm is elevated and she has an
increased costal angle. Which intervention should the nurse implement?
A. Instruct the client on using a humidifier at night
B. Record the respiratory findings in the client's chart as normal
C. Auscultate the client's lungs for adventitious sounds
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D. Teach the client pursed-lip breathing techniques
CORRECT ANSWER: B
Rationale: The described findings—increased chest circumference, thoracic breathing,
elevated diaphragm, and increased costal angle—are normal physiological adaptations
of pregnancy due to hormonal influences and upward displacement of the diaphragm by
the enlarging uterus. Nasal stuffiness and epistaxis are also common due to increased
vascularity.
4. A terminally ill male hospice client who is at home is showing decreased awareness of
his surroundings. His appetite is poor and he often refuses oral intake of solids and
liquids. For the past several days he has been unable to get out of bed. Which action
should the hospice nurse implement?
A. Start intravenous fluids for hydration
B. Instruct family to offer client only soft bland foods
C. Initiate enteral tube feedings
D. Discuss the normal dying process with the family
CORRECT ANSWER: D
Rationale: As death approaches, decreased consciousness, anorexia, and decreased
mobility are expected. The nurse's role in hospice is to provide comfort and support, not
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to force nutrition. Educating the family about these normal signs helps alleviate anxiety
and promotes acceptance.
5. A woman was admitted yesterday afternoon with severe abdominal pain. Her
pregnancy test and ultrasound were negative, so an exploratory laparotomy was
completed during the night. When coffee ground material is observed in the drainage
from the nasogastric tube (NGT), which intervention should the nurse implement?
A. Verify correct placement of the nasogastric tube
B. Irrigate the NGT with sterile saline
C. Increase the suction setting
D. Notify the healthcare provider immediately
CORRECT ANSWER: A
Rationale: "Coffee ground" drainage indicates the presence of old, digested blood. The
first nursing action is to confirm the NGT is properly positioned in the stomach, as
malplacement could alter the character of the drainage. Accurate assessment precedes
intervention.
6. The nurse is reviewing the laboratory values for a client with acute pancreatitis who
reports the abdominal pain is not as severe as it was on admission. Which laboratory
test should the nurse review to evaluate the client's clinical recovery?
A. Amylase
HESI 366 BSN Exit Exam 2026/2027
Comprehensive Nursing Review Actual Exam
Questions with Verified Answers and Detailed
Rationales Grade A Study Guide
1. Four hours following surgical repair of a compound fracture of the right ulna, the
nurse is unable to palpate the client's right radial pulse. Which action should the nurse
take first?
A. Elevate the client's right hand on one or two pillows
B. Notify the healthcare provider immediately
C. Administer a prescribed analgesic
D. Check for capillary refill in the right fingers
CORRECT ANSWER: A
Rationale: Elevating the extremity is a priority intervention for suspected compartment
syndrome, which can occur after a fracture. Elevation promotes venous return and can
,2|Page
help reduce swelling and pressure. This should be done immediately while preparing for
further assessment and notification of the provider.
2. After placing a 36-week-gestation newborn in an isolette and drying the infant with
several blankets, what should the nurse implement next?
A. Administer vitamin K
B. Remove the wet blankets and linen from the isolette
C. Obtain the infant's weight
D. Record the Apgar score
CORRECT ANSWER: B
Rationale: The principle of thermoregulation is critical for newborns. Wet blankets
conduct heat away from the infant, so they must be removed promptly to prevent
evaporative heat loss and maintain a neutral thermal environment.
3. A client in the third trimester of pregnancy complains of frequent nasal stiffness and
occasional nosebleeds. Her chest circumference has increased by 5 cm during the
pregnancy, and she uses thoracic breathing. Her diaphragm is elevated and she has an
increased costal angle. Which intervention should the nurse implement?
A. Instruct the client on using a humidifier at night
B. Record the respiratory findings in the client's chart as normal
C. Auscultate the client's lungs for adventitious sounds
,3|Page
D. Teach the client pursed-lip breathing techniques
CORRECT ANSWER: B
Rationale: The described findings—increased chest circumference, thoracic breathing,
elevated diaphragm, and increased costal angle—are normal physiological adaptations
of pregnancy due to hormonal influences and upward displacement of the diaphragm by
the enlarging uterus. Nasal stuffiness and epistaxis are also common due to increased
vascularity.
4. A terminally ill male hospice client who is at home is showing decreased awareness of
his surroundings. His appetite is poor and he often refuses oral intake of solids and
liquids. For the past several days he has been unable to get out of bed. Which action
should the hospice nurse implement?
A. Start intravenous fluids for hydration
B. Instruct family to offer client only soft bland foods
C. Initiate enteral tube feedings
D. Discuss the normal dying process with the family
CORRECT ANSWER: D
Rationale: As death approaches, decreased consciousness, anorexia, and decreased
mobility are expected. The nurse's role in hospice is to provide comfort and support, not
, 4|Page
to force nutrition. Educating the family about these normal signs helps alleviate anxiety
and promotes acceptance.
5. A woman was admitted yesterday afternoon with severe abdominal pain. Her
pregnancy test and ultrasound were negative, so an exploratory laparotomy was
completed during the night. When coffee ground material is observed in the drainage
from the nasogastric tube (NGT), which intervention should the nurse implement?
A. Verify correct placement of the nasogastric tube
B. Irrigate the NGT with sterile saline
C. Increase the suction setting
D. Notify the healthcare provider immediately
CORRECT ANSWER: A
Rationale: "Coffee ground" drainage indicates the presence of old, digested blood. The
first nursing action is to confirm the NGT is properly positioned in the stomach, as
malplacement could alter the character of the drainage. Accurate assessment precedes
intervention.
6. The nurse is reviewing the laboratory values for a client with acute pancreatitis who
reports the abdominal pain is not as severe as it was on admission. Which laboratory
test should the nurse review to evaluate the client's clinical recovery?
A. Amylase
