HESI EXIT EXAM 2026 NGN
PRACTICE EXAM|||questions and
answers with rationales/graded
A+/2026 update/100% correct
/instant download
Student Name: _________________________
Date: _________________________
Total Questions: 85
Time Limit: 3 hours
Instructions: Select the best answer for each question. Correct answers
are highlighted in bold red. Rationales are provided.
SECTION A: Multiple Choice (Stand-Alone)
1. A nurse is assessing a client with heart failure who has been taking digoxin
daily. Which finding indicates digoxin toxicity?
a) Heart rate of 62 bpm
b) Serum potassium of 4.0 mEq/L
c) Yellow-tinged vision
d) Blood pressure 132/86 mmHg
Rationale: Yellow-tinged (xanthopsia) or blurred vision is a classic sign of digoxin
toxicity. Bradycardia can occur but is not specific; normal K+ is 3.5-5.0; BP is
normal.
2. A client post-op day 2 after abdominal surgery reports sudden chest pain
and dyspnea. The nurse notes O2 saturation 88% on room air. What is the
priority action?
a) Administer PRN morphine
b) Apply oxygen and notify provider
, c) Encourage deep breathing
d) Ambulate the client
Rationale: Sudden chest pain + desaturation post-op suggests pulmonary
embolism. Priority is oxygenation and immediate provider notification.
3. A nurse is teaching a client with type 1 diabetes about sick day
management. Which statement indicates understanding?
a) “I will stop my insulin if I cannot eat.”
b) “I will check my blood glucose every 4 hours.”
c) “I will drink sugar-free liquids and check ketones.”
d) “I will take half my usual long-acting insulin.”
Rationale: Sick days increase glucose; never stop insulin. Check glucose q2-4h,
hydrate, and check ketones; may need extra insulin.
4. A client with cirrhosis has ascites and jaundice. Which lab value is most
concerning?
a) Albumin 3.2 g/dL
b) Ammonia 85 mcg/dL
c) Bilirubin 2.1 mg/dL
d) INR 1.2
Rationale: Ammonia > 50 mcg/dL indicates hepatic encephalopathy risk. Normal
< 35; high ammonia is a medical emergency.
5. A nurse is caring for a client with major depressive disorder who started
sertraline 2 weeks ago. Which finding requires immediate action?
a) Drowsiness
b) Dry mouth
c) Sudden energy surge and talk of suicide
d) Nausea
Rationale: SSRIs can cause activation syndrome; sudden energy + suicidal
ideation is a high risk for acting on thoughts.
PRACTICE EXAM|||questions and
answers with rationales/graded
A+/2026 update/100% correct
/instant download
Student Name: _________________________
Date: _________________________
Total Questions: 85
Time Limit: 3 hours
Instructions: Select the best answer for each question. Correct answers
are highlighted in bold red. Rationales are provided.
SECTION A: Multiple Choice (Stand-Alone)
1. A nurse is assessing a client with heart failure who has been taking digoxin
daily. Which finding indicates digoxin toxicity?
a) Heart rate of 62 bpm
b) Serum potassium of 4.0 mEq/L
c) Yellow-tinged vision
d) Blood pressure 132/86 mmHg
Rationale: Yellow-tinged (xanthopsia) or blurred vision is a classic sign of digoxin
toxicity. Bradycardia can occur but is not specific; normal K+ is 3.5-5.0; BP is
normal.
2. A client post-op day 2 after abdominal surgery reports sudden chest pain
and dyspnea. The nurse notes O2 saturation 88% on room air. What is the
priority action?
a) Administer PRN morphine
b) Apply oxygen and notify provider
, c) Encourage deep breathing
d) Ambulate the client
Rationale: Sudden chest pain + desaturation post-op suggests pulmonary
embolism. Priority is oxygenation and immediate provider notification.
3. A nurse is teaching a client with type 1 diabetes about sick day
management. Which statement indicates understanding?
a) “I will stop my insulin if I cannot eat.”
b) “I will check my blood glucose every 4 hours.”
c) “I will drink sugar-free liquids and check ketones.”
d) “I will take half my usual long-acting insulin.”
Rationale: Sick days increase glucose; never stop insulin. Check glucose q2-4h,
hydrate, and check ketones; may need extra insulin.
4. A client with cirrhosis has ascites and jaundice. Which lab value is most
concerning?
a) Albumin 3.2 g/dL
b) Ammonia 85 mcg/dL
c) Bilirubin 2.1 mg/dL
d) INR 1.2
Rationale: Ammonia > 50 mcg/dL indicates hepatic encephalopathy risk. Normal
< 35; high ammonia is a medical emergency.
5. A nurse is caring for a client with major depressive disorder who started
sertraline 2 weeks ago. Which finding requires immediate action?
a) Drowsiness
b) Dry mouth
c) Sudden energy surge and talk of suicide
d) Nausea
Rationale: SSRIs can cause activation syndrome; sudden energy + suicidal
ideation is a high risk for acting on thoughts.
