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HESI Comprehensive Exam 2026 (500+ Q&A) – HESI Exit Exam – RN Program – Med-Surg, OB, Pediatrics & Pharmacology Review

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This document contains over 500 fully solved HESI Comprehensive Exam 2026 questions and answers designed to prepare nursing students for the HESI Exit Exam and final RN program assessment . The material is presented in a structured multiple-choice format with detailed rationales for each answer, reinforcing clinical judgment, prioritization, pharmacology safety, and NCLEX-style critical thinking across all major nursing specialties. The content spans medical-surgical nursing, maternal-newborn, pediatric nursing, mental health, pharmacology, renal disorders, cardiovascular emergencies, respiratory conditions, oncology, endocrine disorders, and emergency care. Topics include ACE inhibitors such as enalapril and blood pressure prioritization, management of myocardial infarction and dysrhythmias, lithium toxicity monitoring, MAOI dietary restrictions, antipsychotic adverse effects (tardive dyskinesia), Parkinson’s medications, COPD dietary modifications, chronic kidney disease fluid distribution calculations, dialysis dietary restrictions, gout management, autoimmune disorders such as SLE and rheumatoid arthritis, and electrolyte imbalance interventions. Maternal-child content includes preeclampsia management and magnesium sulfate antidote (calcium gluconate), placenta previa assessment findings, oxytocin-induced uterine hypertonicity interventions, fetal heart rate interpretation (accelerations), amniocentesis for fetal lung maturity, terbutaline adverse reactions, sickle-cell disease in pregnancy prioritization, and postpartum complications. Pediatric and community health elements are integrated alongside psychosocial assessments, therapeutic communication techniques, crisis intervention, and client education strategies. Pharmacology review is extensive, covering IV medication administration timing (lorazepam), opioid dosage calculations, cisplatin ototoxicity monitoring, tricyclic antidepressant therapeutic ranges, anticholinergic effects, beta-agonist adverse reactions, NSAID gastrointestinal management, neostigmine therapeutic response, and MAOI hypertensive crisis warning signs. Clinical decision-making scenarios emphasize prioritization, delegation, legal-ethical responsibilities, and safe medication administration practices. The document is highly relevant for senior nursing students preparing for the HESI Exit Exam, ADN and BSN candidates completing capstone courses, accelerated nursing students, repeat test takers, and RN students preparing for comprehensive final exams prior to NCLEX-RN eligibility. It is also suitable for nursing remediation programs, faculty-led review courses, and structured independent exam preparation. Due to its broad specialty integration, emphasis on prioritization and safety, detailed rationales, and alignment with HESI blueprint competencies, this document serves as a comprehensive final exam review bank and high-yield RN exit preparation resource. Keywords: HESI comprehensive exam 2026, HESI exit exam RN review, nursing capstone exam questions, medical surgical nursing prioritization, pharmacology adverse effects monitoring, lithium toxicity signs symptoms, magnesium sulfate calcium gluconate antidote, placenta previa painless bleeding, oxytocin uterine hypertonicity intervention, MAOI tyramine diet restriction, tardive dyskinesia tongue protrusion, COPD high calorie high protein diet, chronic kidney disease fluid restriction 40 percent evening, cisplatin ototoxicity hearing loss, terbutaline maternal tachycardia 110 bpm, ACE inhibitor enalapril blood pressure check, systemic lupus erythematosus manifestations, rheumatoid arthritis early symptoms fatigue, dialysis sodium potassium restriction education

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HESI Comprehensive Exam 2026
Exam Questions and Answers |
100% Solved


Enalapril maleate is prescribed for a hospitalized client. Which assessment

does the nurse perform as a priority before administering the medication?




Checking the client's blood pressure

Checking the client's peripheral pulses

Checking the most recent potassium level

,Checking the client's intake-and-output record for the last 24 hours - 🧠

ANSWER ✔✔Checking the client's blood pressure




Rationale: Enalapril maleate is an angiotensin-converting enzyme (ACE)

inhibitor used to treat hypertension. One common side effect is postural

hypotension. Therefore the nurse would check the client's blood pressure

immediately before administering each dose. Checking the client's

peripheral pulses, the results of the most recent potassium level, and the

intake and output for the previous 24 hours are not specifically associated

with this mediation.

A client is scheduled to undergo an upper gastrointestinal (GI) series, and

the nurse provides instructions to the client about the test. Which statement

by the client indicates a need for further instruction?




"The test will take about 30 minutes."

"I need to fast for 8 hours before the test."

"I need to drink citrate of magnesia the night before the test and give

myself a Fleet enema on the morning of the test."

,"I need to take a laxative after the test is completed, because the liquid that

I'll have to drink for the test can be constipating." - 🧠 ANSWER ✔✔"I need

to drink citrate of magnesia the night before the test and give myself a Fleet

enema on the morning of the test."




Rationale: No special preparation is necessary before a GI series, except

that NPO (nothing by mouth) status must be maintained for 8 hours before

the test. An upper GI series involves visualization of the esophagus,

duodenum, and upper jejunum by means of the use of a contrast medium.

It involves swallowing a contrast medium (usually barium), which is

administered in a flavored milkshake. Films are taken at intervals during the

test, which takes about 30 minutes. After an upper GI series, the client is

prescribed a laxative to hasten elimination of the barium. Barium that

remains in the colon may become hard and difficult to expel, leading to

fecal impaction.

A nurse on the evening shift checks a primary health care provider's

prescriptions and notes that the dose of a prescribed medication is higher

than the normal dose. The nurse calls the primary health care provider's

answering service and is told that the primary health care provider is off for


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, the night and will be available in the morning. What should the nurse do

next?




Call the nursing supervisor

Ask the answering service to contact the on-call primary health care

provider

Withhold the medication until the primary health care provider can be

reached in the morning

Administer the medication but consult the primary health care provider

when he becomes available - 🧠 ANSWER ✔✔Ask the answering service to

contact the on-call primary health care provider




Rationale: The nurse has a duty to protect the client from harm. A nurse

who believes that a primary health care provider's prescription may be in

error is responsible for clarifying the prescription before carrying it out.

Therefore the nurse would not administer the medication; instead, the

nurse would withhold the medication until the dose can be clarified. The

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