2026/2027
2026/2027 HESI RN Exit Exam V3
The Definitive Study and Exam Prep
Guide: Comprehensive Topic Review,
Realistic Practice Questions,
Complete Test Bank Mastery, and
Advanced Preparation Manual
1. A healthcare provider prescribes 1,000 mL of 0.9% sodium chloride to infuse
intravenously over 4 hours. The IV administration set has a drop factor of 10
gtt/mL. Which infusion rate should the nurse regulate to deliver the prescribed
fluid volume accurately?
A. 32 gtt/min
B. 38 gtt/min
C. 42 gtt/min
D. 50 gtt/min
Correct Answer: C. 42 gtt/min
Rationale: 1,000 mL × 10 gtt/mL ÷ 240 minutes = 41.67 gtt/min, which rounds to 42
gtt/min.
2. A client receives prasugrel following coronary artery stent placement. Which
assessment finding is most important for the nurse to monitor to identify a
potential adverse effect of this medication?
A. Urine color
B. Body temperature
C. Skin turgor
D. Pedal edema
Correct Answer: A. Urine color
Rationale: Prasugrel increases the risk for bleeding, and hematuria may be an early sign
of occult bleeding.
,2026/2027
3. A client falls in the bathroom after being left unattended by an unlicensed
assistive personnel. Which documentation entry by the nurse best reflects
appropriate charting principles?
A. The UAP left to assist another client.
B. The last time the client was assisted to the bathroom.
C. The unit was understaffed at the time.
D. The client fell and sustained a fracture to the left hip.
Correct Answer: D. The client fell and sustained a fracture to the left hip.
Rationale: Documentation should be objective, factual, and free of blame or speculation.
4. A client with a positive skin test is being evaluated for tuberculosis. Which
reported symptom most strongly supports the diagnosis?
A. Barking cough and vomiting
B. Mucopurulent cough and night sweats
C. Dry cough and chest tightness
D. Chronic cough and fatty stools
Correct Answer: B. Mucopurulent cough and night sweats
Rationale: Tuberculosis commonly presents with a chronic productive cough and night
sweats.
5. A client with type 1 diabetes develops deep, rapid respirations and
increasing lethargy. Which assessment should the nurse perform immediately?
A. Temperature
B. Breath sounds
C. Blood glucose level
D. White blood cell count
Correct Answer: C. Blood glucose level
Rationale: These findings suggest diabetic ketoacidosis, and confirming blood glucose is
the highest priority.
6. A nurse receives report on a client who is 4 hours post–total abdominal
hysterectomy. The client’s perineal pad has been saturated repeatedly, and
urinary output has decreased. What is the nurse’s priority action?
A. Change the perineal pad
B. Evaluate skin turgor
C. Assess for weakness or dizziness
D. Measure urinary output
,2026/2027
Correct Answer: C. Assess for weakness or dizziness
Rationale: Persistent bleeding and decreased output suggest possible hypovolemia or
hemorrhage.
7. A client with heart failure and pulmonary edema presents with pink, frothy
sputum. After initiating oxygen and positioning, which intervention should the
nurse perform next?
A. Obtain sputum sample
B. Document degree of edema
C. Measure hourly urine output
D. Administer IV diuretics
Correct Answer: A. Obtain sputum sample
Rationale: Pink, frothy sputum is a classic sign of pulmonary edema and should be
evaluated promptly.
8. A client with suspected myxedema coma requires assessment. In what order
should the nurse perform the following assessments?
1. Observe breathing patterns
2. Assess blood pressure
3. Measure body temperature
4. Palpate for pedal edema
A. 1 → 2 → 3 → 4
B. 2 → 1 → 4 → 3
C. 3 → 2 → 1 → 4
D. 1 → 3 → 2 → 4
Correct Answer: A. 1 → 2 → 3 → 4
Rationale: Airway and breathing are the priority, followed by blood pressure and
temperature.
9. A client with type 2 diabetes reports weakness and palpitations. Which
finding suggests a potentially urgent metabolic imbalance?
A. Potassium 3.5 mEq/L
B. Fingertips feel numb
C. Sodium 135 mEq/L
D. Cervical spine stiffness
Correct Answer: B. Fingertips feel numb
Rationale: Numbness may indicate neurologic effects of hypoglycemia and needs prompt
evaluation.
, 2026/2027
10. An older adult with sudden confusion after a fall is being reported using
SBAR communication. Which information should the nurse prioritize in the
“Situation” section?
A. Current medications
B. Healthcare power of attorney
C. Increasing confusion
D. Fall at home
Correct Answer: C. Increasing confusion
Rationale: The Situation section should focus on the most immediate and concerning
clinical issue.
11. A client with full-thickness burns has a 2 kg weight gain in 24 hours and
elevated central venous pressure. Which intervention is most appropriate?
A. Auscultate for irregular heart rate
B. Review arterial blood gases
C. Measure ankle circumference
D. Document abdominal girth
Correct Answer: A. Auscultate for irregular heart rate
Rationale: Rapid weight gain and elevated CVP indicate fluid overload and possible
cardiac strain.
12. Which nursing tasks can be safely delegated to a practical nurse (PN)?
(Select all that apply.)
A. Sliding-scale insulin administration
B. Initiating blood transfusion
C. PCA pump initiation
D. Surgical dressing change
E. Postoperative vital signs (day 1)
Correct Answers: A, D, E
Rationale: PNs may administer routine medications, perform sterile dressing changes in
stable clients, and obtain routine postoperative vital signs.
13. A nurse is teaching a group about osteoporosis prevention. Which exercise
is most beneficial?
A. Core strengthening
B. Aerobic exercise
2026/2027 HESI RN Exit Exam V3
The Definitive Study and Exam Prep
Guide: Comprehensive Topic Review,
Realistic Practice Questions,
Complete Test Bank Mastery, and
Advanced Preparation Manual
1. A healthcare provider prescribes 1,000 mL of 0.9% sodium chloride to infuse
intravenously over 4 hours. The IV administration set has a drop factor of 10
gtt/mL. Which infusion rate should the nurse regulate to deliver the prescribed
fluid volume accurately?
A. 32 gtt/min
B. 38 gtt/min
C. 42 gtt/min
D. 50 gtt/min
Correct Answer: C. 42 gtt/min
Rationale: 1,000 mL × 10 gtt/mL ÷ 240 minutes = 41.67 gtt/min, which rounds to 42
gtt/min.
2. A client receives prasugrel following coronary artery stent placement. Which
assessment finding is most important for the nurse to monitor to identify a
potential adverse effect of this medication?
A. Urine color
B. Body temperature
C. Skin turgor
D. Pedal edema
Correct Answer: A. Urine color
Rationale: Prasugrel increases the risk for bleeding, and hematuria may be an early sign
of occult bleeding.
,2026/2027
3. A client falls in the bathroom after being left unattended by an unlicensed
assistive personnel. Which documentation entry by the nurse best reflects
appropriate charting principles?
A. The UAP left to assist another client.
B. The last time the client was assisted to the bathroom.
C. The unit was understaffed at the time.
D. The client fell and sustained a fracture to the left hip.
Correct Answer: D. The client fell and sustained a fracture to the left hip.
Rationale: Documentation should be objective, factual, and free of blame or speculation.
4. A client with a positive skin test is being evaluated for tuberculosis. Which
reported symptom most strongly supports the diagnosis?
A. Barking cough and vomiting
B. Mucopurulent cough and night sweats
C. Dry cough and chest tightness
D. Chronic cough and fatty stools
Correct Answer: B. Mucopurulent cough and night sweats
Rationale: Tuberculosis commonly presents with a chronic productive cough and night
sweats.
5. A client with type 1 diabetes develops deep, rapid respirations and
increasing lethargy. Which assessment should the nurse perform immediately?
A. Temperature
B. Breath sounds
C. Blood glucose level
D. White blood cell count
Correct Answer: C. Blood glucose level
Rationale: These findings suggest diabetic ketoacidosis, and confirming blood glucose is
the highest priority.
6. A nurse receives report on a client who is 4 hours post–total abdominal
hysterectomy. The client’s perineal pad has been saturated repeatedly, and
urinary output has decreased. What is the nurse’s priority action?
A. Change the perineal pad
B. Evaluate skin turgor
C. Assess for weakness or dizziness
D. Measure urinary output
,2026/2027
Correct Answer: C. Assess for weakness or dizziness
Rationale: Persistent bleeding and decreased output suggest possible hypovolemia or
hemorrhage.
7. A client with heart failure and pulmonary edema presents with pink, frothy
sputum. After initiating oxygen and positioning, which intervention should the
nurse perform next?
A. Obtain sputum sample
B. Document degree of edema
C. Measure hourly urine output
D. Administer IV diuretics
Correct Answer: A. Obtain sputum sample
Rationale: Pink, frothy sputum is a classic sign of pulmonary edema and should be
evaluated promptly.
8. A client with suspected myxedema coma requires assessment. In what order
should the nurse perform the following assessments?
1. Observe breathing patterns
2. Assess blood pressure
3. Measure body temperature
4. Palpate for pedal edema
A. 1 → 2 → 3 → 4
B. 2 → 1 → 4 → 3
C. 3 → 2 → 1 → 4
D. 1 → 3 → 2 → 4
Correct Answer: A. 1 → 2 → 3 → 4
Rationale: Airway and breathing are the priority, followed by blood pressure and
temperature.
9. A client with type 2 diabetes reports weakness and palpitations. Which
finding suggests a potentially urgent metabolic imbalance?
A. Potassium 3.5 mEq/L
B. Fingertips feel numb
C. Sodium 135 mEq/L
D. Cervical spine stiffness
Correct Answer: B. Fingertips feel numb
Rationale: Numbness may indicate neurologic effects of hypoglycemia and needs prompt
evaluation.
, 2026/2027
10. An older adult with sudden confusion after a fall is being reported using
SBAR communication. Which information should the nurse prioritize in the
“Situation” section?
A. Current medications
B. Healthcare power of attorney
C. Increasing confusion
D. Fall at home
Correct Answer: C. Increasing confusion
Rationale: The Situation section should focus on the most immediate and concerning
clinical issue.
11. A client with full-thickness burns has a 2 kg weight gain in 24 hours and
elevated central venous pressure. Which intervention is most appropriate?
A. Auscultate for irregular heart rate
B. Review arterial blood gases
C. Measure ankle circumference
D. Document abdominal girth
Correct Answer: A. Auscultate for irregular heart rate
Rationale: Rapid weight gain and elevated CVP indicate fluid overload and possible
cardiac strain.
12. Which nursing tasks can be safely delegated to a practical nurse (PN)?
(Select all that apply.)
A. Sliding-scale insulin administration
B. Initiating blood transfusion
C. PCA pump initiation
D. Surgical dressing change
E. Postoperative vital signs (day 1)
Correct Answers: A, D, E
Rationale: PNs may administer routine medications, perform sterile dressing changes in
stable clients, and obtain routine postoperative vital signs.
13. A nurse is teaching a group about osteoporosis prevention. Which exercise
is most beneficial?
A. Core strengthening
B. Aerobic exercise
