HESI EXIT RN EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Adult Medical-Surgical Nursing*
*- Pharmacology and Medication Management*
*- Maternal-Newborn Nursing*
*- Pediatrics and Infant Care*
*- Mental Health and Psychiatric Nursing*
*- Nursing Fundamentals and Safety*
*- Critical Care and Emergency Nursing*
*- Ethics, Legal Compliance, and Professional Standards*
Introduction
This comprehensive assessment is designed to evaluate your readiness for the HESI Exit RN Exam and your
mastery of essential nursing competencies. The exam assesses critical clinical judgment skills, professional
knowledge application, regulatory compliance understanding, and ethical decision-making capabilities
required for safe, effective nursing practice. Through multiple-choice and scenario-based questions, this
assessment emphasizes real-world application of nursing principles, prioritization strategies, and evidence-
based decision-making in diverse patient care situations. Success on this exam demonstrates your ability to
integrate foundational theory with applied professional knowledge across all major nursing domains,
preparing you for successful transition to clinical practice and NCLEX-RN readiness.
SECTION ONE: QUESTIONS 1–100
,Question 1
A 65-year-old male patient with chronic heart failure presents with increased shortness of breath, weight gain of
4 pounds in 2 days, and bilateral leg edema. Which intervention should the nurse prioritize first?
A. Administer prescribed furosemide 40 mg IV
B. Obtain vital signs including oxygen saturation
C. Place the patient in high-Fowler's position
D. Assess lung sounds for crackles
🟢 Correct answer: C
🔴 RATIONALE: Placing the patient in high-Fowler's position immediately improves breathing by reducing
venous return and decreasing pulmonary congestion. This is the fastest non-invasive intervention to address
acute shortness of breath. Medication administration (A) requires preparation time, vital signs (B) and lung
assessment (D) are important but do not immediately relieve the respiratory distress.
Question 2
A nurse is administering packed red blood cells to a patient with severe anemia. At 15 minutes into the
transfusion, the patient develops flushing, tachycardia, and back pain. What is the nurse's first action?
A. Stop the transfusion immediately
B. Notify the healthcare provider
C. Administer acetaminophen for fever
D. Slow the transfusion rate
🟢 Correct answer: A
,🔴 RATIONALE: These signs indicate a hemolytic transfusion reaction, which is life-threatening. Stopping the
transfusion immediately prevents further introduction of incompatible blood. The provider should be notified
(B) after stopping, acetaminophen (C) treats febrile reactions not hemolytic, and slowing the rate (D) worsens
the reaction.
Question 3
Which nursing action best demonstrates adherence to the ethical principle of autonomy?
A. Administering pain medication before a procedure
B. Providing information about treatment options to a conscious adult patient
C. Calling a family member to speak with the healthcare team
D. Documenting care accurately in the medical record
🟢 Correct answer: B
🔴 RATIONALE: Autonomy refers to the patient's right to make informed decisions about their care. Providing
information about treatment options enables the patient to exercise this right. Pain medication (A) relates to
beneficence, calling family (C) may support communication but doesn't directly address autonomy, and
documentation (D) relates to professional standards.
Question 4
A 28-year-old pregnant woman at 32 weeks gestation presents with sudden, painless, bright red vaginal
bleeding. Her vital signs are stable. Which condition is most likely?
, A. Placenta previa
B. Placental abruption
C. Ectopic pregnancy
D. Vasa previa
🟢 Correct answer: A
🔴 RATIONALE: Placenta previa presents with sudden, painless, bright red bleeding in the third trimester with
stable maternal vital signs. Placental abruption (B) typically involves painful bleeding with uterine tenderness.
Ectopic pregnancy (C) occurs in the first trimester. Vasa previa (D) involves fetal bleeding and is less common.
Question 5
A patient with diabetes mellitus has a blood glucose of 45 mg/dL. The patient is conscious but confused and
diaphoretic. What is the most appropriate nursing intervention?
A. Administer 1 unit regular insulin subcutaneously
B. Give 15 grams of fast-acting carbohydrate
C. Administer 50 mL of 50% dextrose IV
D. Monitor blood glucose every 4 hours
🟢 Correct answer: B
🔴 RATIONALE: For a conscious patient with hypoglycemia (blood glucose <70 mg/dL), the standard
treatment is 15 grams of fast-acting carbohydrate (e.g., 4 oz juice, 3-4 glucose tablets). Insulin (A) would worsen
hypoglycemia. IV dextrose (C) is for unconscious patients. Monitoring (D) without treatment is dangerous.
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Adult Medical-Surgical Nursing*
*- Pharmacology and Medication Management*
*- Maternal-Newborn Nursing*
*- Pediatrics and Infant Care*
*- Mental Health and Psychiatric Nursing*
*- Nursing Fundamentals and Safety*
*- Critical Care and Emergency Nursing*
*- Ethics, Legal Compliance, and Professional Standards*
Introduction
This comprehensive assessment is designed to evaluate your readiness for the HESI Exit RN Exam and your
mastery of essential nursing competencies. The exam assesses critical clinical judgment skills, professional
knowledge application, regulatory compliance understanding, and ethical decision-making capabilities
required for safe, effective nursing practice. Through multiple-choice and scenario-based questions, this
assessment emphasizes real-world application of nursing principles, prioritization strategies, and evidence-
based decision-making in diverse patient care situations. Success on this exam demonstrates your ability to
integrate foundational theory with applied professional knowledge across all major nursing domains,
preparing you for successful transition to clinical practice and NCLEX-RN readiness.
SECTION ONE: QUESTIONS 1–100
,Question 1
A 65-year-old male patient with chronic heart failure presents with increased shortness of breath, weight gain of
4 pounds in 2 days, and bilateral leg edema. Which intervention should the nurse prioritize first?
A. Administer prescribed furosemide 40 mg IV
B. Obtain vital signs including oxygen saturation
C. Place the patient in high-Fowler's position
D. Assess lung sounds for crackles
🟢 Correct answer: C
🔴 RATIONALE: Placing the patient in high-Fowler's position immediately improves breathing by reducing
venous return and decreasing pulmonary congestion. This is the fastest non-invasive intervention to address
acute shortness of breath. Medication administration (A) requires preparation time, vital signs (B) and lung
assessment (D) are important but do not immediately relieve the respiratory distress.
Question 2
A nurse is administering packed red blood cells to a patient with severe anemia. At 15 minutes into the
transfusion, the patient develops flushing, tachycardia, and back pain. What is the nurse's first action?
A. Stop the transfusion immediately
B. Notify the healthcare provider
C. Administer acetaminophen for fever
D. Slow the transfusion rate
🟢 Correct answer: A
,🔴 RATIONALE: These signs indicate a hemolytic transfusion reaction, which is life-threatening. Stopping the
transfusion immediately prevents further introduction of incompatible blood. The provider should be notified
(B) after stopping, acetaminophen (C) treats febrile reactions not hemolytic, and slowing the rate (D) worsens
the reaction.
Question 3
Which nursing action best demonstrates adherence to the ethical principle of autonomy?
A. Administering pain medication before a procedure
B. Providing information about treatment options to a conscious adult patient
C. Calling a family member to speak with the healthcare team
D. Documenting care accurately in the medical record
🟢 Correct answer: B
🔴 RATIONALE: Autonomy refers to the patient's right to make informed decisions about their care. Providing
information about treatment options enables the patient to exercise this right. Pain medication (A) relates to
beneficence, calling family (C) may support communication but doesn't directly address autonomy, and
documentation (D) relates to professional standards.
Question 4
A 28-year-old pregnant woman at 32 weeks gestation presents with sudden, painless, bright red vaginal
bleeding. Her vital signs are stable. Which condition is most likely?
, A. Placenta previa
B. Placental abruption
C. Ectopic pregnancy
D. Vasa previa
🟢 Correct answer: A
🔴 RATIONALE: Placenta previa presents with sudden, painless, bright red bleeding in the third trimester with
stable maternal vital signs. Placental abruption (B) typically involves painful bleeding with uterine tenderness.
Ectopic pregnancy (C) occurs in the first trimester. Vasa previa (D) involves fetal bleeding and is less common.
Question 5
A patient with diabetes mellitus has a blood glucose of 45 mg/dL. The patient is conscious but confused and
diaphoretic. What is the most appropriate nursing intervention?
A. Administer 1 unit regular insulin subcutaneously
B. Give 15 grams of fast-acting carbohydrate
C. Administer 50 mL of 50% dextrose IV
D. Monitor blood glucose every 4 hours
🟢 Correct answer: B
🔴 RATIONALE: For a conscious patient with hypoglycemia (blood glucose <70 mg/dL), the standard
treatment is 15 grams of fast-acting carbohydrate (e.g., 4 oz juice, 3-4 glucose tablets). Insulin (A) would worsen
hypoglycemia. IV dextrose (C) is for unconscious patients. Monitoring (D) without treatment is dangerous.
