HESI RN EXIT EXAM FINAL REVIEW QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Medical-Surgical Nursing
Pharmacology and Medication Administration
Maternal-Newborn Nursing
Pediatric Nursing
Mental Health and Psychiatric Nursing
Fundamentals of Nursing Care
Leadership, Management, and Delegation
Safety and Infection Control
Health Promotion and Maintenance
Physiological Integrity and Adaptation
,Introduction
This comprehensive assessment is designed to evaluate nursing students' readiness for professional practice
and transition to the RN role. The exam assesses critical clinical knowledge, decision-making skills, and the
ability to apply nursing principles in real-world healthcare scenarios. Through multiple-choice and scenario-
based questions, this test measures competency across essential nursing domains including patient assessment,
pharmacological interventions, care prioritization, therapeutic communication, and safety protocols. The
questions emphasize clinical judgment, priority setting, and evidence-based practice to ensure graduates can
deliver safe, effective patient care while demonstrating professional accountability and ethical standards
required for successful nursing practice.
Section One: Questions 1–100
Question 1
A nurse is caring for a patient with acute myocardial infarction who develops sudden shortness of breath and
chest pain. Which action should the nurse take first?
A. Administer oxygen at 2 L/min via nasal cannula
B. Obtain a 12-lead electrocardiogram
C. Notify the healthcare provider immediately
D. Assess vital signs and oxygen saturation
🟢 D. Assess vital signs and nurse should first assess before intervening to gather baseline data
🔴 RATIONALE: Assessment is the first step in the nursing process. Before administering oxygen, obtaining
tests, or notifying the provider, the nurse must assess vital signs and oxygen saturation to determine the
patient's current status and guide subsequent interventions. This follows the ADPIE (Assessment, Diagnosis,
Planning, Implementation, Evaluation) framework.
,Question 2
Which medication classification is most appropriate for a patient experiencing status epilepticus?
A. Beta-blockers
B. Benzodiazepines
C. Anticoagulants
D. Nonsteroidal anti-inflammatory drugs
🟢 B. Benzodiazepines
🔴 RATIONALE: Benzodiazepines (particularly lorazepam and diazepam) are the first-line treatment for status
epilepticus because they rapidly suppress neuronal activity and stop seizure activity. Beta-blockers treat
cardiovascular conditions, anticoagulants prevent clotting, and NSAIDs manage pain/inflammation but do not
terminate seizures.
Question 3
A postpartum patient reports heavy vaginal bleeding with a saturated peripad in 15 minutes. The fundus is
boggy. What is the nurse's priority intervention?
A. Administer prescribed methylergonovine
B. Perform moderate fundal massage
C. Insert a large-bore IV catheter
D. Document findings and continue monitoring
🟢 B. Perform moderate fundal massage
, 🔴 RATIONALE: Fundal massage is the immediate first-line intervention for postpartum hemorrhage with a
boggy fundus to stimulate uterine contraction and reduce bleeding. Medication administration and IV insertion
are important but occur after initial massage. Documentation without intervention is inappropriate for active
hemorrhage.
Question 4
Which laboratory value requires immediate notification of the healthcare provider?
A. Sodium 138 mEq/L
B. Potassium 5.8 mEq/L
C. Glucose 110 mg/dL
D. Creatinine 0.9 mg/dL
🟢 B. Potassium 5.8 mEq/L
🔴 RATIONALE: Potassium levels above 5.0 mEq/L indicate hyperkalemia, which can cause life-threatening
cardiac arrhythmias. Normal potassium is 3.5-5.0 mEq/L. The other values are within normal ranges: sodium
135-145 mEq/L, glucose 70-110 mg/dL (fasting), and creatinine 0.6-1.2 mg/dL.
Question 5
A child with asthma presents with wheezing, decreased breath sounds, and oxygen saturation of 88%. Which
medication should the nurse administer first?
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Medical-Surgical Nursing
Pharmacology and Medication Administration
Maternal-Newborn Nursing
Pediatric Nursing
Mental Health and Psychiatric Nursing
Fundamentals of Nursing Care
Leadership, Management, and Delegation
Safety and Infection Control
Health Promotion and Maintenance
Physiological Integrity and Adaptation
,Introduction
This comprehensive assessment is designed to evaluate nursing students' readiness for professional practice
and transition to the RN role. The exam assesses critical clinical knowledge, decision-making skills, and the
ability to apply nursing principles in real-world healthcare scenarios. Through multiple-choice and scenario-
based questions, this test measures competency across essential nursing domains including patient assessment,
pharmacological interventions, care prioritization, therapeutic communication, and safety protocols. The
questions emphasize clinical judgment, priority setting, and evidence-based practice to ensure graduates can
deliver safe, effective patient care while demonstrating professional accountability and ethical standards
required for successful nursing practice.
Section One: Questions 1–100
Question 1
A nurse is caring for a patient with acute myocardial infarction who develops sudden shortness of breath and
chest pain. Which action should the nurse take first?
A. Administer oxygen at 2 L/min via nasal cannula
B. Obtain a 12-lead electrocardiogram
C. Notify the healthcare provider immediately
D. Assess vital signs and oxygen saturation
🟢 D. Assess vital signs and nurse should first assess before intervening to gather baseline data
🔴 RATIONALE: Assessment is the first step in the nursing process. Before administering oxygen, obtaining
tests, or notifying the provider, the nurse must assess vital signs and oxygen saturation to determine the
patient's current status and guide subsequent interventions. This follows the ADPIE (Assessment, Diagnosis,
Planning, Implementation, Evaluation) framework.
,Question 2
Which medication classification is most appropriate for a patient experiencing status epilepticus?
A. Beta-blockers
B. Benzodiazepines
C. Anticoagulants
D. Nonsteroidal anti-inflammatory drugs
🟢 B. Benzodiazepines
🔴 RATIONALE: Benzodiazepines (particularly lorazepam and diazepam) are the first-line treatment for status
epilepticus because they rapidly suppress neuronal activity and stop seizure activity. Beta-blockers treat
cardiovascular conditions, anticoagulants prevent clotting, and NSAIDs manage pain/inflammation but do not
terminate seizures.
Question 3
A postpartum patient reports heavy vaginal bleeding with a saturated peripad in 15 minutes. The fundus is
boggy. What is the nurse's priority intervention?
A. Administer prescribed methylergonovine
B. Perform moderate fundal massage
C. Insert a large-bore IV catheter
D. Document findings and continue monitoring
🟢 B. Perform moderate fundal massage
, 🔴 RATIONALE: Fundal massage is the immediate first-line intervention for postpartum hemorrhage with a
boggy fundus to stimulate uterine contraction and reduce bleeding. Medication administration and IV insertion
are important but occur after initial massage. Documentation without intervention is inappropriate for active
hemorrhage.
Question 4
Which laboratory value requires immediate notification of the healthcare provider?
A. Sodium 138 mEq/L
B. Potassium 5.8 mEq/L
C. Glucose 110 mg/dL
D. Creatinine 0.9 mg/dL
🟢 B. Potassium 5.8 mEq/L
🔴 RATIONALE: Potassium levels above 5.0 mEq/L indicate hyperkalemia, which can cause life-threatening
cardiac arrhythmias. Normal potassium is 3.5-5.0 mEq/L. The other values are within normal ranges: sodium
135-145 mEq/L, glucose 70-110 mg/dL (fasting), and creatinine 0.6-1.2 mg/dL.
Question 5
A child with asthma presents with wheezing, decreased breath sounds, and oxygen saturation of 88%. Which
medication should the nurse administer first?
