RN HESI Exit Exam V1 Prep 2026 | 160 Questions &
Answers
Exam
1–20: HESI Exit Exam Style (2026 Focus)
1. A nurse is prioritizing care for four patients. Which patient should be seen
first?
A) Patient with pneumonia, O2 sat 91% on room air
B) Patient with heart failure, 2+ pitting edema in lower legs
C) Patient post-appendectomy, reports pain 6/10
D) Patient with new-onset confusion and BP 90/60
Answer: D
Rationale: New-onset confusion + hypotension may indicate shock, sepsis, or
stroke. ABCs + acute change in mental status takes priority over stable pain, mild
hypoxia, or chronic edema.
2. Which task can the RN delegate to a licensed practical nurse (LPN)?
A) Initial admission assessment
B) Teaching a diabetic patient about insulin injection
C) Administering a tube feeding to a stable patient
D) Evaluating the effectiveness of pain medication
Answer: C
Rationale: LPNs can perform stable, standard procedures like tube feedings,
dressing changes, and medication administration. RN must perform initial
assessment, teaching, and evaluation.
3. A patient with major depressive disorder refuses to get out of bed. What is
the best initial response?
A) “You need to get up now or you’ll get weaker.”
B) “I’ll sit with you for 5 minutes, then let’s walk to the chair.”
,C) “Why don’t you want to get up?”
D) “I’ll come back later when you feel better.”
Answer: B
Rationale: Offering a brief, manageable goal with support is therapeutic (milieu
therapy). Avoid “why” questions (judgmental) or enabling avoidance.
4. A nurse administers IV push morphine to a patient post-op. Five minutes
later, respirations are 8/min. What is the priority action?
A) Administer naloxone
B) Call the rapid response team
C) Stimulate the patient to breathe
D) Recheck respirations in 5 minutes
Answer: A
Rationale: Respiratory depression from opioids is reversed with naloxone. This is
an emergency; waiting or stimulation is insufficient.
5. A patient with chronic kidney disease (CKD) has a potassium level of 6.2
mEq/L. Which assessment finding requires immediate action?
A) Blood pressure 148/90
B) Muscle weakness and peaked T waves on ECG
C) Urine output of 40 mL/hour
D) Ankle edema 1+
Answer: B
Rationale: Peaked T waves and muscle weakness indicate hyperkalemia
progression → risk of cardiac arrest. Urgent treatment (IV calcium,
insulin/glucose, kayexalate) needed.
6. A nurse is teaching a patient with heart failure about a 2-gram sodium diet.
Which food choice indicates understanding?
A) Canned vegetable soup
B) Grilled chicken breast with fresh green beans
,C) Ham sandwich on whole wheat bread
D) Pickles and olives
Answer: B
Rationale: Fresh or frozen unprocessed foods are low sodium. Canned soup, ham,
pickles, and olives are high in sodium.
7. Which patient should be placed in a private room with negative pressure
airflow?
A) MRSA in a wound
B) C. difficile diarrhea
C) Active pulmonary tuberculosis
D) RSV bronchiolitis
Answer: C
Rationale: TB requires airborne precautions (negative pressure, N95 mask). MRSA
= contact; C. diff = contact + bleach wipes; RSV = contact + droplet.
8. A postpartum patient reports a gush of blood and a firm fundus deviated to
the right. What is the priority action?
A) Massage the fundus
B) Have the patient empty her bladder
C) Notify the provider immediately
D) Increase oxytocin infusion
Answer: B
Rationale: A firm, deviated fundus suggests a distended bladder displacing the
uterus. Emptying the bladder often stops bleeding and restores midline
contraction.
9. A nurse is caring for a patient with a chest tube to water seal. Which finding
requires immediate notification of the provider?
A) Tidaling in the water seal chamber
B) Bubbling in the suction control chamber
, C) Continuous bubbling in the water seal chamber
D) Serosanguinous drainage of 30 mL/hour
Answer: C
Rationale: Continuous bubbling in water seal chamber indicates an air leak (likely
at insertion site or tubing). Tidaling is normal; suction chamber bubbling is
expected.
10. Which lab value indicates warfarin (Coumadin) is therapeutic for atrial
fibrillation?
A) aPTT 60 seconds
B) Platelets 150,000
C) INR 2.5
D) PT 12 seconds
Answer: C
Rationale: For atrial fibrillation, target INR is 2–3. aPTT tracks heparin; PT without
INR isn’t standardized.
11. A patient with dementia wanders at night and tries to leave the unit. What
is the best intervention?
A) Place a bed alarm and redirect to a safe area
B) Apply soft wrist restraints
C) Administer lorazepam at bedtime
D) Lock the door to the unit
Answer: A
Rationale: Least restrictive intervention: bed alarm + redirection preserves safety
and dignity. Restraints and chemical sedation increase risk; locking doors is a fire
hazard.
12. A nurse is suctioning a tracheostomy. What is the maximum amount of time
for each suction pass?
A) 5 seconds
Answers
Exam
1–20: HESI Exit Exam Style (2026 Focus)
1. A nurse is prioritizing care for four patients. Which patient should be seen
first?
A) Patient with pneumonia, O2 sat 91% on room air
B) Patient with heart failure, 2+ pitting edema in lower legs
C) Patient post-appendectomy, reports pain 6/10
D) Patient with new-onset confusion and BP 90/60
Answer: D
Rationale: New-onset confusion + hypotension may indicate shock, sepsis, or
stroke. ABCs + acute change in mental status takes priority over stable pain, mild
hypoxia, or chronic edema.
2. Which task can the RN delegate to a licensed practical nurse (LPN)?
A) Initial admission assessment
B) Teaching a diabetic patient about insulin injection
C) Administering a tube feeding to a stable patient
D) Evaluating the effectiveness of pain medication
Answer: C
Rationale: LPNs can perform stable, standard procedures like tube feedings,
dressing changes, and medication administration. RN must perform initial
assessment, teaching, and evaluation.
3. A patient with major depressive disorder refuses to get out of bed. What is
the best initial response?
A) “You need to get up now or you’ll get weaker.”
B) “I’ll sit with you for 5 minutes, then let’s walk to the chair.”
,C) “Why don’t you want to get up?”
D) “I’ll come back later when you feel better.”
Answer: B
Rationale: Offering a brief, manageable goal with support is therapeutic (milieu
therapy). Avoid “why” questions (judgmental) or enabling avoidance.
4. A nurse administers IV push morphine to a patient post-op. Five minutes
later, respirations are 8/min. What is the priority action?
A) Administer naloxone
B) Call the rapid response team
C) Stimulate the patient to breathe
D) Recheck respirations in 5 minutes
Answer: A
Rationale: Respiratory depression from opioids is reversed with naloxone. This is
an emergency; waiting or stimulation is insufficient.
5. A patient with chronic kidney disease (CKD) has a potassium level of 6.2
mEq/L. Which assessment finding requires immediate action?
A) Blood pressure 148/90
B) Muscle weakness and peaked T waves on ECG
C) Urine output of 40 mL/hour
D) Ankle edema 1+
Answer: B
Rationale: Peaked T waves and muscle weakness indicate hyperkalemia
progression → risk of cardiac arrest. Urgent treatment (IV calcium,
insulin/glucose, kayexalate) needed.
6. A nurse is teaching a patient with heart failure about a 2-gram sodium diet.
Which food choice indicates understanding?
A) Canned vegetable soup
B) Grilled chicken breast with fresh green beans
,C) Ham sandwich on whole wheat bread
D) Pickles and olives
Answer: B
Rationale: Fresh or frozen unprocessed foods are low sodium. Canned soup, ham,
pickles, and olives are high in sodium.
7. Which patient should be placed in a private room with negative pressure
airflow?
A) MRSA in a wound
B) C. difficile diarrhea
C) Active pulmonary tuberculosis
D) RSV bronchiolitis
Answer: C
Rationale: TB requires airborne precautions (negative pressure, N95 mask). MRSA
= contact; C. diff = contact + bleach wipes; RSV = contact + droplet.
8. A postpartum patient reports a gush of blood and a firm fundus deviated to
the right. What is the priority action?
A) Massage the fundus
B) Have the patient empty her bladder
C) Notify the provider immediately
D) Increase oxytocin infusion
Answer: B
Rationale: A firm, deviated fundus suggests a distended bladder displacing the
uterus. Emptying the bladder often stops bleeding and restores midline
contraction.
9. A nurse is caring for a patient with a chest tube to water seal. Which finding
requires immediate notification of the provider?
A) Tidaling in the water seal chamber
B) Bubbling in the suction control chamber
, C) Continuous bubbling in the water seal chamber
D) Serosanguinous drainage of 30 mL/hour
Answer: C
Rationale: Continuous bubbling in water seal chamber indicates an air leak (likely
at insertion site or tubing). Tidaling is normal; suction chamber bubbling is
expected.
10. Which lab value indicates warfarin (Coumadin) is therapeutic for atrial
fibrillation?
A) aPTT 60 seconds
B) Platelets 150,000
C) INR 2.5
D) PT 12 seconds
Answer: C
Rationale: For atrial fibrillation, target INR is 2–3. aPTT tracks heparin; PT without
INR isn’t standardized.
11. A patient with dementia wanders at night and tries to leave the unit. What
is the best intervention?
A) Place a bed alarm and redirect to a safe area
B) Apply soft wrist restraints
C) Administer lorazepam at bedtime
D) Lock the door to the unit
Answer: A
Rationale: Least restrictive intervention: bed alarm + redirection preserves safety
and dignity. Restraints and chemical sedation increase risk; locking doors is a fire
hazard.
12. A nurse is suctioning a tracheostomy. What is the maximum amount of time
for each suction pass?
A) 5 seconds
