2026 HESI RN Exit Exam (V1) Actual Qs &
Ans to Pass the Exam, 100% Verified -
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Section 1: Medical-Surgical Nursing (Cardiovascular & Respiratory)
1. A nurse is assessing a client with left-sided heart failure. Which finding is most
consistent with this diagnosis?
A. Jugular vein distention
B. Peripheral edema
C. Hepatomegaly
D. Crackles in the lung bases
Correct answer D. Crackles in the lung bases
Rationale: Left-sided heart failure leads to pulmonary congestion due to the
inability of the left ventricle to pump blood forward, causing fluid backup into the
lungs (crackles). The other options are signs of right-sided heart failure .
2. A client with heart failure is prescribed furosemide 40 mg IV. Which laboratory
value should the nurse monitor most closely?
A. Sodium
B. Potassium
C. Hemoglobin
D. Platelets
Correct answer B. Potassium
,Rationale: Loop diuretics like furosemide cause potassium loss in the urine.
Hypokalemia can lead to life-threatening arrhythmias, especially if the patient is
also on Digoxin .
3. A client is admitted with acute myocardial infarction (MI). Which lab value is
the most specific indicator of myocardial damage?
A. Creatine Kinase-MB (CK-MB)
B. Troponin I
C. Myoglobin
D. C-reactive protein (CRP)
Correct answer B. Troponin I
Rationale: Troponin I and T are the most specific cardiac markers for myocardial
necrosis. Troponin remains elevated for days, making it the gold standard for MI
diagnosis .
4. A nurse is caring for a client with pneumonia who is receiving IV antibiotics.
Which finding requires the nurse’s immediate intervention?
A. Productive cough with thick sputum
B. Temperature of 100.8°F (38.2°C)
C. Oxygen saturation of 84% on room air
D. White blood cell count of 12,000/mm³
Correct answer C. Oxygen saturation of 84% on room air
Rationale: An O₂ sat of 84% indicates severe hypoxemia requiring immediate
intervention (oxygen therapy). The other findings are expected in pneumonia .
,5. A client with COPD has an arterial blood gas (ABG): pH 7.32, PaCO2 58, HCO3
26. The nurse interprets this as:
A. Metabolic alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Respiratory alkalosis
Correct answer B. Respiratory acidosis
Rationale: The pH is low (acidosis), PaCO2 is high (respiratory), and HCO3 is
normal (no compensation yet). COPD patients retain CO2 .
6. A client with tuberculosis is admitted to the unit. What action is most
important for the nurse to implement?
A. Place an isolation cart in the hallway.
B. Fit the client with a respirator mask.
C. Assign the client to a negative pressure room.
D. Wear an N95 mask when in the room.
Correct answer C. Assign the client to a negative pressure room.
Rationale: Airborne precautions are required for TB. While wearing an N95 and
placing a cart are correct, the priority is ensuring the room has negative pressure
airflow to prevent spread to others .
7. The nurse is caring for a client on a mechanical ventilator. The high-pressure
alarm sounds. What should the nurse check first?
, A. Assess the client for a disconnection.
B. Suction the client for secretions.
C. Notify the respiratory therapist.
D. Check the tubing for kinks or biting.
Correct answer D. Check the tubing for kinks or biting.
Rationale: A high-pressure alarm usually indicates an obstruction (kinks, mucus
plug, patient biting the tube). A disconnection triggers the low-pressure alarm .
8. A client with peripheral artery disease (PAD) reports leg pain that starts when
walking and stops with rest. The nurse documents this as:
A. Rest pain
B. Intermittent claudication
C. Venous stasis
D. Neuropathy
Correct answer B. Intermittent claudication
Rationale: This is the hallmark symptom of PAD, caused by ischemic muscle pain
induced by exercise and relieved by rest .
9. A nurse is administering nitroglycerin intravenously to a client with unstable
angina. What is the priority assessment?
A. Monitoring for headache
B. Monitoring blood pressure continuously
C. Assessing urinary output
D. Checking for flushing
Ans to Pass the Exam, 100% Verified -
Section 1: Medical-Surgical Nursing (Cardiovascular & Respiratory)
1. A nurse is assessing a client with left-sided heart failure. Which finding is most
consistent with this diagnosis?
A. Jugular vein distention
B. Peripheral edema
C. Hepatomegaly
D. Crackles in the lung bases
Correct answer D. Crackles in the lung bases
Rationale: Left-sided heart failure leads to pulmonary congestion due to the
inability of the left ventricle to pump blood forward, causing fluid backup into the
lungs (crackles). The other options are signs of right-sided heart failure .
2. A client with heart failure is prescribed furosemide 40 mg IV. Which laboratory
value should the nurse monitor most closely?
A. Sodium
B. Potassium
C. Hemoglobin
D. Platelets
Correct answer B. Potassium
,Rationale: Loop diuretics like furosemide cause potassium loss in the urine.
Hypokalemia can lead to life-threatening arrhythmias, especially if the patient is
also on Digoxin .
3. A client is admitted with acute myocardial infarction (MI). Which lab value is
the most specific indicator of myocardial damage?
A. Creatine Kinase-MB (CK-MB)
B. Troponin I
C. Myoglobin
D. C-reactive protein (CRP)
Correct answer B. Troponin I
Rationale: Troponin I and T are the most specific cardiac markers for myocardial
necrosis. Troponin remains elevated for days, making it the gold standard for MI
diagnosis .
4. A nurse is caring for a client with pneumonia who is receiving IV antibiotics.
Which finding requires the nurse’s immediate intervention?
A. Productive cough with thick sputum
B. Temperature of 100.8°F (38.2°C)
C. Oxygen saturation of 84% on room air
D. White blood cell count of 12,000/mm³
Correct answer C. Oxygen saturation of 84% on room air
Rationale: An O₂ sat of 84% indicates severe hypoxemia requiring immediate
intervention (oxygen therapy). The other findings are expected in pneumonia .
,5. A client with COPD has an arterial blood gas (ABG): pH 7.32, PaCO2 58, HCO3
26. The nurse interprets this as:
A. Metabolic alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Respiratory alkalosis
Correct answer B. Respiratory acidosis
Rationale: The pH is low (acidosis), PaCO2 is high (respiratory), and HCO3 is
normal (no compensation yet). COPD patients retain CO2 .
6. A client with tuberculosis is admitted to the unit. What action is most
important for the nurse to implement?
A. Place an isolation cart in the hallway.
B. Fit the client with a respirator mask.
C. Assign the client to a negative pressure room.
D. Wear an N95 mask when in the room.
Correct answer C. Assign the client to a negative pressure room.
Rationale: Airborne precautions are required for TB. While wearing an N95 and
placing a cart are correct, the priority is ensuring the room has negative pressure
airflow to prevent spread to others .
7. The nurse is caring for a client on a mechanical ventilator. The high-pressure
alarm sounds. What should the nurse check first?
, A. Assess the client for a disconnection.
B. Suction the client for secretions.
C. Notify the respiratory therapist.
D. Check the tubing for kinks or biting.
Correct answer D. Check the tubing for kinks or biting.
Rationale: A high-pressure alarm usually indicates an obstruction (kinks, mucus
plug, patient biting the tube). A disconnection triggers the low-pressure alarm .
8. A client with peripheral artery disease (PAD) reports leg pain that starts when
walking and stops with rest. The nurse documents this as:
A. Rest pain
B. Intermittent claudication
C. Venous stasis
D. Neuropathy
Correct answer B. Intermittent claudication
Rationale: This is the hallmark symptom of PAD, caused by ischemic muscle pain
induced by exercise and relieved by rest .
9. A nurse is administering nitroglycerin intravenously to a client with unstable
angina. What is the priority assessment?
A. Monitoring for headache
B. Monitoring blood pressure continuously
C. Assessing urinary output
D. Checking for flushing
