HESI Final Exam Questions and
Answers 2026
An older client is admitted with a diagnosis of bacterial pneumonia. Which symptom should the
nurse report to the HCP after assessing the client?
A)Leukocytosis and febrile.
B) Polycythemia and crackles.
C) Pharyngitis and sputum production.
D) Confusion and tachycardia. - AnswerD.
The onset of Pneumonia in the older client may be signaled by general deterioration, confusion,
increased HR, and/or increased respirations. A, B, and C are often absent in the older client with
bacterial pneumonia.
The nurse is reviewing routine medications taken by a client with chronic angle closure glaucoma.
Which medication prescription should the nurse question?
A) Antianginal with a therapeutic effect of vasodilation.
B) Anticholinergic with a side effect of pupillary dilation.
C) Antihistamine with a side effect of sedation.
D) Corticosteroid with a side effect of hyperglycemia. - AnswerB.
Clients with angle-closure glaucoma should not take medications that dilate the pupil because they
can precipitate acute and severely increased IOP. A, C, and D do not cause increased IOP, which is the
primary concern with angle-closure glaucoma.
The nurse is caring for a critically ill client with cirrhosis of the liver who has a NG tube draining bright
red blood. The nurse notes that the client's serum hemoglobin and hematocrit levels are decreased.
Which additional change in laboratory data should the nurse expect?
A) Increased serum albumin level.
B) Decreased serum creatinine.
C) Decreased serum ammonia level.
D) Increased liver function test results. - AnswerC.
The breakdown of glutamine in the intestine and the increased activity of colonic bacteria from the
digestion of proteins increase ammonia levels in clients with advanced liver disease, so removal of
,blood, a protein source, from the intestine results in a reduced level of ammonia. A, B, and D will not
be significantly affected by the removal of blood.
A resident in a long-term care facility is diagnosed with Hep B. Which intervention should the nurse
implement with the staff caring for this client?
A) Determine if all employees have had the Hep B vaccine series.
B) Explain that this type of hepatitis can be transmitted when feeding the client.
C) Assure the employees that they cannot contract Hep B when providing direct care.
D) Tell the employees that wearing gloves and a gown are required when providing care. - AnswerA.
Hep B vaccine should be administered to all health care providers. Hep A (not Hep B) can be
transmitted by fecal-oral contamination. There is a chance that staff could contract Hep B if exposed
to the client's blood and/or body fluids, therefore C is incorrect. There is no need to wear gloves and
gowns except with blood or body fluid contact.
A client with HTN has been receiving ramipril (altace), 5mg, PO, daily for 2 weeks and is scheduled to
receive a dose at 0900. At 0830, the client's blood pressure is 120/70. Which action should the nurse
take?
A) Administer the prescribed dose at the scheduled time.
B) Hold the dose and contact the HCP.
C) Hold the dose and recheck the BP in 1 hour.
D) Check with the HCP's prescription to clarify dose. - AnswerA.
The client's BP is within normal limits, indicating that the ramipril, an antihypertensive, is having the
desired effect and should be administered. B and C would be appropriate if the client's BP was
excessively low (<100 systolic) or if the client were exhibiting signs of hypotension such as dizziness.
The nurse assesses a client who has been prescribed furosemide (Lasix) for cardiac disease. Which
ECG change would be a concern for a client taking a diuretic?
A) Tall, spiked T waves.
B) A prolonged QT interval.
C) A widening QRS complex.
D) Presence of a U wave. - AnswerD.
, A U wave is a positive deflection following the T wave and is often present with hypokalemia. A, B
and C are all signs of hyperkalemia.
A client diagnosed with chronic kidney disease (CKD) 2 years ago is regularly treated at a community
hemodialysis facility. Before his scheduled dialysis treatment, which electrolyte imbalance should the
nurse anticipate?
A) Hypophosphatemia.
B) Hypocalcemia.
C) Hyponatremia.
D) Hypokalemia - AnswerB.
Hypocalcemia develops in CKD because of chronic hyperphosphatemia. Increased phosphate levels
cause the peripheral deposition of calcium and resistance to vitamin D absorption needed for
calcium absorption. Prior to dialysis, the nurse would expect to find the client hypernatremic and
hyperkalemic, not with C or D.
The home health nurse is assessing a male client being treated for Parkinson's disease with Sinemet.
The nurse observes that he does not demonstrate any apparent emotion when speaking and rarely
blinks. Which intervention should the nurse implement?
A) Perform a complete cranial nerve assessment.
B) Instruct the client that he may be experiencing medication toxicity.
C) Document the presence of these assessment findings.
D) Advise the client to seek immediate medical evaluation. - AnswerC.
A masklike expression and infrequent blinking are common clinical features of parkinsonism. The
nurse should document these expected findings. Signs of toxicity of Sinemet include dyskinesia,
hallucinations, and psychosis.
A client with CHF and Afib develops ventricular ectopy with a pattern of 8 ectopic beats/min. Which
action should the nurse take based on this observation?
A) Assess for bilateral jugular vein distention.
B) Increase oxygen flow via nasal cannula.
C) Administer PRN Lasix.
D) Auscultate for a pleural friction rub. - AnswerB.
Answers 2026
An older client is admitted with a diagnosis of bacterial pneumonia. Which symptom should the
nurse report to the HCP after assessing the client?
A)Leukocytosis and febrile.
B) Polycythemia and crackles.
C) Pharyngitis and sputum production.
D) Confusion and tachycardia. - AnswerD.
The onset of Pneumonia in the older client may be signaled by general deterioration, confusion,
increased HR, and/or increased respirations. A, B, and C are often absent in the older client with
bacterial pneumonia.
The nurse is reviewing routine medications taken by a client with chronic angle closure glaucoma.
Which medication prescription should the nurse question?
A) Antianginal with a therapeutic effect of vasodilation.
B) Anticholinergic with a side effect of pupillary dilation.
C) Antihistamine with a side effect of sedation.
D) Corticosteroid with a side effect of hyperglycemia. - AnswerB.
Clients with angle-closure glaucoma should not take medications that dilate the pupil because they
can precipitate acute and severely increased IOP. A, C, and D do not cause increased IOP, which is the
primary concern with angle-closure glaucoma.
The nurse is caring for a critically ill client with cirrhosis of the liver who has a NG tube draining bright
red blood. The nurse notes that the client's serum hemoglobin and hematocrit levels are decreased.
Which additional change in laboratory data should the nurse expect?
A) Increased serum albumin level.
B) Decreased serum creatinine.
C) Decreased serum ammonia level.
D) Increased liver function test results. - AnswerC.
The breakdown of glutamine in the intestine and the increased activity of colonic bacteria from the
digestion of proteins increase ammonia levels in clients with advanced liver disease, so removal of
,blood, a protein source, from the intestine results in a reduced level of ammonia. A, B, and D will not
be significantly affected by the removal of blood.
A resident in a long-term care facility is diagnosed with Hep B. Which intervention should the nurse
implement with the staff caring for this client?
A) Determine if all employees have had the Hep B vaccine series.
B) Explain that this type of hepatitis can be transmitted when feeding the client.
C) Assure the employees that they cannot contract Hep B when providing direct care.
D) Tell the employees that wearing gloves and a gown are required when providing care. - AnswerA.
Hep B vaccine should be administered to all health care providers. Hep A (not Hep B) can be
transmitted by fecal-oral contamination. There is a chance that staff could contract Hep B if exposed
to the client's blood and/or body fluids, therefore C is incorrect. There is no need to wear gloves and
gowns except with blood or body fluid contact.
A client with HTN has been receiving ramipril (altace), 5mg, PO, daily for 2 weeks and is scheduled to
receive a dose at 0900. At 0830, the client's blood pressure is 120/70. Which action should the nurse
take?
A) Administer the prescribed dose at the scheduled time.
B) Hold the dose and contact the HCP.
C) Hold the dose and recheck the BP in 1 hour.
D) Check with the HCP's prescription to clarify dose. - AnswerA.
The client's BP is within normal limits, indicating that the ramipril, an antihypertensive, is having the
desired effect and should be administered. B and C would be appropriate if the client's BP was
excessively low (<100 systolic) or if the client were exhibiting signs of hypotension such as dizziness.
The nurse assesses a client who has been prescribed furosemide (Lasix) for cardiac disease. Which
ECG change would be a concern for a client taking a diuretic?
A) Tall, spiked T waves.
B) A prolonged QT interval.
C) A widening QRS complex.
D) Presence of a U wave. - AnswerD.
, A U wave is a positive deflection following the T wave and is often present with hypokalemia. A, B
and C are all signs of hyperkalemia.
A client diagnosed with chronic kidney disease (CKD) 2 years ago is regularly treated at a community
hemodialysis facility. Before his scheduled dialysis treatment, which electrolyte imbalance should the
nurse anticipate?
A) Hypophosphatemia.
B) Hypocalcemia.
C) Hyponatremia.
D) Hypokalemia - AnswerB.
Hypocalcemia develops in CKD because of chronic hyperphosphatemia. Increased phosphate levels
cause the peripheral deposition of calcium and resistance to vitamin D absorption needed for
calcium absorption. Prior to dialysis, the nurse would expect to find the client hypernatremic and
hyperkalemic, not with C or D.
The home health nurse is assessing a male client being treated for Parkinson's disease with Sinemet.
The nurse observes that he does not demonstrate any apparent emotion when speaking and rarely
blinks. Which intervention should the nurse implement?
A) Perform a complete cranial nerve assessment.
B) Instruct the client that he may be experiencing medication toxicity.
C) Document the presence of these assessment findings.
D) Advise the client to seek immediate medical evaluation. - AnswerC.
A masklike expression and infrequent blinking are common clinical features of parkinsonism. The
nurse should document these expected findings. Signs of toxicity of Sinemet include dyskinesia,
hallucinations, and psychosis.
A client with CHF and Afib develops ventricular ectopy with a pattern of 8 ectopic beats/min. Which
action should the nurse take based on this observation?
A) Assess for bilateral jugular vein distention.
B) Increase oxygen flow via nasal cannula.
C) Administer PRN Lasix.
D) Auscultate for a pleural friction rub. - AnswerB.
