HESI RN Exit Exam 2026 | Actual Exam Questions
& Verified Answers | Complete NCLEX-RN®
Predictor Exam | Evolve Testing| Latest version
Q001: A 68-year-old client recovering from a total hip replacement is receiving morphine
via patient-controlled analgesia (PCA). During your 0800 assessment, the client is
difficult to arouse, with a respiratory rate of 6 breaths/min and an oxygen saturation of
88%. Which action should the nurse take first?
Options:
A. Apply oxygen via nasal cannula at 2 L/min
B. Discontinue the PCA pump and notify the provider
C. Administer naloxone 0.4 mg IV as prescribed - CORRECT
D. Increase the PCA dose interval in the pump settings
(Correct Answer: C)
Q002: The nurse is caring for a client with heart failure who is prescribed digoxin 0.25
mg PO daily. The client reports nausea, blurred vision, and a heart rate of 52 beats/min.
Which laboratory value should the nurse review first?
Options:
A. Serum potassium
B. Serum digoxin level - CORRECT
C. Serum creatinine
D. Serum sodium
(Correct Answer: B)
Q003: A 34-year-old client with asthma is prescribed albuterol and fluticasone inhalers.
The nurse observes the client use the inhalers during a home visit. Which client
statement indicates a need for further teaching?
Options:
A. “I shake the albuterol inhaler before each puff.”
B. “I rinse my mouth after using the fluticasone.”
C. “I use the fluticasone inhaler during acute wheezing.” - CORRECT
,D. “I wait 1 minute between puffs of albuterol.”
(Correct Answer: C)
Q004: A 55-year-old client with diabetes mellitus is scheduled for a coronary angiogram.
The client received metformin 1000 mg PO this morning. Which action should the nurse
prioritize?
Options:
A. Hold the next dose of metformin and document the missed dose
B. Notify the radiology team and document metformin administration - CORRECT
C. Administer a reduced dose of metformin after the procedure
D. Encourage adequate hydration and continue metformin as scheduled
(Correct Answer: B)
Q005: A client with chronic kidney disease (CKD) stage 4 is receiving epoetin alvia
subcutaneously. Which laboratory result best indicates the effectiveness of this
therapy?
Options:
A. Hemoglobin level of 10.8 g/dL - CORRECT
B. White blood cell count of 12,000/mm³
C. Platelet count of 450,000/mm³
D. Serum creatinine of 3.0 mg/dL
(Correct Answer: A)
Q006: The nurse is assessing a client with major depressive disorder who started
sertraline 3 days ago. The client states, “I feel worse and still can’t sleep.” Which
response by the nurse is most appropriate?
Options:
A. “You should stop the medication and call your provider.”
B. “Antidepressants can take 1–2 weeks to show effect.” - CORRECT
C. “Insomnia is unrelated to depression.”
D. “Your dosage needs to be doubled immediately.”
(Correct Answer: B)
Q007: A client with a pulmonary embolism is receiving a heparin infusion at 18
units/kg/hr. The partial thromboplastin time (PTT) is 90 seconds (control 30 seconds).
Which action should the nurse take?
Options:
A. Decrease the heparin infusion rate - CORRECT
,B. Increase the heparin infusion rate
C. Continue the current rate and recheck in 6 hours
D. Discontinue the heparin and start warfarin
(Correct Answer: A)
Q008: A 78-year-old client with dementia becomes agitated and attempts to remove the
IV line. Which intervention is most appropriate?
Options:
A. Apply soft wrist restraints - CORRECT
B. Assign a sitter and use distraction techniques
C. Administer PRN haloperidol 5 mg IM
D. Discontinue the IV and switch to PO medications
(Correct Answer: B)
Q009: A client in labor receives an epidural block. The nurse notes a sudden drop in fetal
heart rate to 90 beats/min with loss of variability. Which maternal position should the
nurse initiate first?
Options:
A. Supine with left tilt
B. Left lateral recumbent - CORRECT
C. Trendelenburg
D. Right lateral recumbent
(Correct Answer: B)
Q010: A client with type 1 diabetes is receiving an insulin drip with blood glucose
checked q1h. At 0700, the glucose is 140 mg/dL. According to the protocol, the insulin
rate should decrease when glucose is:
Options:
A. <150 mg/dL
B. <110 mg/dL - CORRECT
C. <180 mg/dL
D. <200 mg/dL
(Correct Answer: B)
Q011: A client with acute pancreatitis is receiving morphine for pain. Which assessment
finding indicates the medication is effective?
Options:
A. Pain rating decreased from 8 to 4 on a 0–10 scale - CORRECT
, B. Respiratory rate of 8 breaths/min
C. Oxygen saturation of 85%
D. Client appears sedated and drowsy
(Correct Answer: A)
Q012: A client with a chest tube has no fluctuation in the water-seal chamber. The client
denies dyspnea and breath sounds are clear. Which action should the nurse take?
Options:
A. Check for kinks in the tubing - CORRECT
B. Encourage deep breathing and coughing
C. Clamp the chest tube immediately
D. Notify the provider of a possible air leak
(Correct Answer: A)
Q013: A client with cirrhosis develops ascites and is prescribed spironolactone. Which
laboratory value should the nurse monitor for effectiveness?
Options:
A. Serum potassium 5.2 mEq/L
B. Serum sodium 128 mEq/L
C. Decreased ascitic fluid volume on ultrasound - CORRECT
D. Serum albumin 2.8 g/dL
(Correct Answer: C)
Q014: A client with a traumatic brain injury is receiving mannitol IV. Which assessment
finding requires immediate intervention?
Options:
A. Urine output 200 mL/hr for 2 hours - CORRECT
B. Serum osmolality 310 mOsm/kg
C. BP 140/80 mmHg
D. Heart rate 88 beats/min
(Correct Answer: A)
Q015: A client with sepsis is receiving a norepinephrine infusion. The nurse notes the IV
site is pale and cool with delayed capillary refill. Which action should the nurse take
first?
Options:
A. Stop the infusion and start a new IV line - CORRECT
B. Apply warm compresses to the site
& Verified Answers | Complete NCLEX-RN®
Predictor Exam | Evolve Testing| Latest version
Q001: A 68-year-old client recovering from a total hip replacement is receiving morphine
via patient-controlled analgesia (PCA). During your 0800 assessment, the client is
difficult to arouse, with a respiratory rate of 6 breaths/min and an oxygen saturation of
88%. Which action should the nurse take first?
Options:
A. Apply oxygen via nasal cannula at 2 L/min
B. Discontinue the PCA pump and notify the provider
C. Administer naloxone 0.4 mg IV as prescribed - CORRECT
D. Increase the PCA dose interval in the pump settings
(Correct Answer: C)
Q002: The nurse is caring for a client with heart failure who is prescribed digoxin 0.25
mg PO daily. The client reports nausea, blurred vision, and a heart rate of 52 beats/min.
Which laboratory value should the nurse review first?
Options:
A. Serum potassium
B. Serum digoxin level - CORRECT
C. Serum creatinine
D. Serum sodium
(Correct Answer: B)
Q003: A 34-year-old client with asthma is prescribed albuterol and fluticasone inhalers.
The nurse observes the client use the inhalers during a home visit. Which client
statement indicates a need for further teaching?
Options:
A. “I shake the albuterol inhaler before each puff.”
B. “I rinse my mouth after using the fluticasone.”
C. “I use the fluticasone inhaler during acute wheezing.” - CORRECT
,D. “I wait 1 minute between puffs of albuterol.”
(Correct Answer: C)
Q004: A 55-year-old client with diabetes mellitus is scheduled for a coronary angiogram.
The client received metformin 1000 mg PO this morning. Which action should the nurse
prioritize?
Options:
A. Hold the next dose of metformin and document the missed dose
B. Notify the radiology team and document metformin administration - CORRECT
C. Administer a reduced dose of metformin after the procedure
D. Encourage adequate hydration and continue metformin as scheduled
(Correct Answer: B)
Q005: A client with chronic kidney disease (CKD) stage 4 is receiving epoetin alvia
subcutaneously. Which laboratory result best indicates the effectiveness of this
therapy?
Options:
A. Hemoglobin level of 10.8 g/dL - CORRECT
B. White blood cell count of 12,000/mm³
C. Platelet count of 450,000/mm³
D. Serum creatinine of 3.0 mg/dL
(Correct Answer: A)
Q006: The nurse is assessing a client with major depressive disorder who started
sertraline 3 days ago. The client states, “I feel worse and still can’t sleep.” Which
response by the nurse is most appropriate?
Options:
A. “You should stop the medication and call your provider.”
B. “Antidepressants can take 1–2 weeks to show effect.” - CORRECT
C. “Insomnia is unrelated to depression.”
D. “Your dosage needs to be doubled immediately.”
(Correct Answer: B)
Q007: A client with a pulmonary embolism is receiving a heparin infusion at 18
units/kg/hr. The partial thromboplastin time (PTT) is 90 seconds (control 30 seconds).
Which action should the nurse take?
Options:
A. Decrease the heparin infusion rate - CORRECT
,B. Increase the heparin infusion rate
C. Continue the current rate and recheck in 6 hours
D. Discontinue the heparin and start warfarin
(Correct Answer: A)
Q008: A 78-year-old client with dementia becomes agitated and attempts to remove the
IV line. Which intervention is most appropriate?
Options:
A. Apply soft wrist restraints - CORRECT
B. Assign a sitter and use distraction techniques
C. Administer PRN haloperidol 5 mg IM
D. Discontinue the IV and switch to PO medications
(Correct Answer: B)
Q009: A client in labor receives an epidural block. The nurse notes a sudden drop in fetal
heart rate to 90 beats/min with loss of variability. Which maternal position should the
nurse initiate first?
Options:
A. Supine with left tilt
B. Left lateral recumbent - CORRECT
C. Trendelenburg
D. Right lateral recumbent
(Correct Answer: B)
Q010: A client with type 1 diabetes is receiving an insulin drip with blood glucose
checked q1h. At 0700, the glucose is 140 mg/dL. According to the protocol, the insulin
rate should decrease when glucose is:
Options:
A. <150 mg/dL
B. <110 mg/dL - CORRECT
C. <180 mg/dL
D. <200 mg/dL
(Correct Answer: B)
Q011: A client with acute pancreatitis is receiving morphine for pain. Which assessment
finding indicates the medication is effective?
Options:
A. Pain rating decreased from 8 to 4 on a 0–10 scale - CORRECT
, B. Respiratory rate of 8 breaths/min
C. Oxygen saturation of 85%
D. Client appears sedated and drowsy
(Correct Answer: A)
Q012: A client with a chest tube has no fluctuation in the water-seal chamber. The client
denies dyspnea and breath sounds are clear. Which action should the nurse take?
Options:
A. Check for kinks in the tubing - CORRECT
B. Encourage deep breathing and coughing
C. Clamp the chest tube immediately
D. Notify the provider of a possible air leak
(Correct Answer: A)
Q013: A client with cirrhosis develops ascites and is prescribed spironolactone. Which
laboratory value should the nurse monitor for effectiveness?
Options:
A. Serum potassium 5.2 mEq/L
B. Serum sodium 128 mEq/L
C. Decreased ascitic fluid volume on ultrasound - CORRECT
D. Serum albumin 2.8 g/dL
(Correct Answer: C)
Q014: A client with a traumatic brain injury is receiving mannitol IV. Which assessment
finding requires immediate intervention?
Options:
A. Urine output 200 mL/hr for 2 hours - CORRECT
B. Serum osmolality 310 mOsm/kg
C. BP 140/80 mmHg
D. Heart rate 88 beats/min
(Correct Answer: A)
Q015: A client with sepsis is receiving a norepinephrine infusion. The nurse notes the IV
site is pale and cool with delayed capillary refill. Which action should the nurse take
first?
Options:
A. Stop the infusion and start a new IV line - CORRECT
B. Apply warm compresses to the site
