HESI RN EXIT EXAM REVIEW 2026 | ULTIMATE
NURSING TEST BANK PACK WITH COMPLETE
EXPLANATIONS & HIGH-YIELD NGN CONCEPTS
This comprehensive HESI Exit Exam study guide provides high-
yield, multiple-choice practice questions paired with bolded
rationales and italicized answers to mimic the current testing
style. Designed specifically for nursing students aiming for the
mandatory 850–900 benchmark score, it thoroughly covers critical
clinical scenarios including prioritization, pharmacology, fluid
balance, and emergency nursing interventions. Mastering these
detailed rationales will strengthen your critical thinking and test-
taking endurance to ensure a guaranteed pass on your first
attempt.
1. A nurse is caring for a client who is 24 hours
postoperative following a total hip arthroplasty.
Which of the following actions should the nurse
take?
A. Maintain the client's affected hip in an adducted
position.
B. Keep the client on strict bed rest for the first 48
hours.
C. Place an abduction pillow between the client's
legs when turning.
D. Encourage the client to flex the affected hip past
90 degrees when sitting.
Answer: C. Place an abduction pillow between the
client's legs when turning.
,Rationale: After a total hip arthroplasty, the
nurse must prevent dislocation of the new
prosthesis. An abduction pillow keeps the hip in
alignment and prevents adduction, which could
cause dislocation. Flexion past 90 degrees and
adduction are strictly contraindicated.
2. A nurse is reviewing the laboratory results of a
client who is receiving a continuous intravenous
heparin infusion for a deep vein thrombosis. The
client's aPTT is 110 seconds. Which of the
following actions should the nurse take?
A. Increase the heparin infusion rate by 100 units/hr.
B. Stop the heparin infusion and prepare protamine
sulfate.
C. Administer vitamin K intramuscularly.
D. Continue the infusion at the current rate and
recheck in 4 hours.
Answer: B. Stop the heparin infusion and prepare
protamine sulfate.
Rationale: The therapeutic range for aPTT during
heparin therapy is typically 1.5 to 2.5 times the
normal control value (about 60 to 80 seconds).
An aPTT of 110 seconds is significantly elevated,
placing the client at high risk for hemorrhage.
The infusion must be stopped, and the antidote,
,protamine sulfate, should be readily available.
Vitamin K is the antidote for warfarin, not
heparin.
3. A nurse in the emergency department is
assessing a client who reports a sudden, severe
headache described as "the worst headache of
my life." The nurse should suspect which of the
following conditions?
A. Migraine headache
B. Ruptured intracranial aneurysm
C. Ischemic stroke
D. Transient ischemic attack (TIA)
Answer: B. Ruptured intracranial aneurysm
Rationale: A sudden, catastrophic headache
described as "the worst headache of my life" is
the classic presentation of a subarachnoid
hemorrhage, most commonly caused by a
ruptured intracranial aneurysm. This is a medical
emergency requiring immediate surgical
intervention.
4. A nurse is assessing a client who has a chest
tube connected to a water-seal drainage system.
The nurse notes continuous bubbling in the
water-seal chamber. Which of the following
findings does this indicate?
, A. The system is functioning normally.
B. The client's lung has fully re-expanded.
C. There is an air leak in the drainage system.
D. Suction pressure is set too high.
Answer: C. There is an air leak in the drainage
system.
Rationale: Intermittent bubbling in the water-seal
chamber is normal during exhalation or
coughing, but continuous bubbling indicates an
air leak somewhere in the system or from the
client's lung. The nurse should locate and
resolve the leak immediately.
5. A nurse is preparing to administer digoxin
0.25 mg PO daily to a client with heart failure.
Which of the following assessments is the
priority before administering the medication?
A. Assess the client's apical pulse rate for 1 full
minute.
B. Monitor the client's blood pressure sitting and
standing.
C. Check the client's serum potassium level.
D. Review the client's intake and output record.
Answer: A. Assess the client's apical pulse rate for 1
full minute.
Rationale: Digoxin slows the heart rate. The
NURSING TEST BANK PACK WITH COMPLETE
EXPLANATIONS & HIGH-YIELD NGN CONCEPTS
This comprehensive HESI Exit Exam study guide provides high-
yield, multiple-choice practice questions paired with bolded
rationales and italicized answers to mimic the current testing
style. Designed specifically for nursing students aiming for the
mandatory 850–900 benchmark score, it thoroughly covers critical
clinical scenarios including prioritization, pharmacology, fluid
balance, and emergency nursing interventions. Mastering these
detailed rationales will strengthen your critical thinking and test-
taking endurance to ensure a guaranteed pass on your first
attempt.
1. A nurse is caring for a client who is 24 hours
postoperative following a total hip arthroplasty.
Which of the following actions should the nurse
take?
A. Maintain the client's affected hip in an adducted
position.
B. Keep the client on strict bed rest for the first 48
hours.
C. Place an abduction pillow between the client's
legs when turning.
D. Encourage the client to flex the affected hip past
90 degrees when sitting.
Answer: C. Place an abduction pillow between the
client's legs when turning.
,Rationale: After a total hip arthroplasty, the
nurse must prevent dislocation of the new
prosthesis. An abduction pillow keeps the hip in
alignment and prevents adduction, which could
cause dislocation. Flexion past 90 degrees and
adduction are strictly contraindicated.
2. A nurse is reviewing the laboratory results of a
client who is receiving a continuous intravenous
heparin infusion for a deep vein thrombosis. The
client's aPTT is 110 seconds. Which of the
following actions should the nurse take?
A. Increase the heparin infusion rate by 100 units/hr.
B. Stop the heparin infusion and prepare protamine
sulfate.
C. Administer vitamin K intramuscularly.
D. Continue the infusion at the current rate and
recheck in 4 hours.
Answer: B. Stop the heparin infusion and prepare
protamine sulfate.
Rationale: The therapeutic range for aPTT during
heparin therapy is typically 1.5 to 2.5 times the
normal control value (about 60 to 80 seconds).
An aPTT of 110 seconds is significantly elevated,
placing the client at high risk for hemorrhage.
The infusion must be stopped, and the antidote,
,protamine sulfate, should be readily available.
Vitamin K is the antidote for warfarin, not
heparin.
3. A nurse in the emergency department is
assessing a client who reports a sudden, severe
headache described as "the worst headache of
my life." The nurse should suspect which of the
following conditions?
A. Migraine headache
B. Ruptured intracranial aneurysm
C. Ischemic stroke
D. Transient ischemic attack (TIA)
Answer: B. Ruptured intracranial aneurysm
Rationale: A sudden, catastrophic headache
described as "the worst headache of my life" is
the classic presentation of a subarachnoid
hemorrhage, most commonly caused by a
ruptured intracranial aneurysm. This is a medical
emergency requiring immediate surgical
intervention.
4. A nurse is assessing a client who has a chest
tube connected to a water-seal drainage system.
The nurse notes continuous bubbling in the
water-seal chamber. Which of the following
findings does this indicate?
, A. The system is functioning normally.
B. The client's lung has fully re-expanded.
C. There is an air leak in the drainage system.
D. Suction pressure is set too high.
Answer: C. There is an air leak in the drainage
system.
Rationale: Intermittent bubbling in the water-seal
chamber is normal during exhalation or
coughing, but continuous bubbling indicates an
air leak somewhere in the system or from the
client's lung. The nurse should locate and
resolve the leak immediately.
5. A nurse is preparing to administer digoxin
0.25 mg PO daily to a client with heart failure.
Which of the following assessments is the
priority before administering the medication?
A. Assess the client's apical pulse rate for 1 full
minute.
B. Monitor the client's blood pressure sitting and
standing.
C. Check the client's serum potassium level.
D. Review the client's intake and output record.
Answer: A. Assess the client's apical pulse rate for 1
full minute.
Rationale: Digoxin slows the heart rate. The
