HESI Exit Exam V8 | 2026 Latest Questions & Correct Answers
- 249 Questions
This exam assesses mastery of core nursing fundamentals including evidence-based practice, patient safety,
infection control, pharmacology, and clinical reasoning at an advanced undergraduate level. Questions require
synthesis of concepts and application to complex clinical scenarios. It contains 249 multiple-choice questions,
each with four distractors and a fully worked rationale that explains why the keyed answer is correct. Content is
organized into 10 focused sections: Fundamentals of Nursing, Medical-Surgical Nursing, Maternal-Newborn
Nursing, Pediatric Nursing, Psychiatric/Mental Health Nursing, Pharmacology, Leadership and Management,
Community Health, Critical Care, Emergency Nursing. Targeted learning outcomes include: Apply nursing
process to prioritize care in complex situations.; Evaluate evidence-based interventions for infection prevention
and safety.; Analyze pharmacological principles and calculate dosages accurately.; Demonstrate ethical and
legal decision-making in nursing practice.. Every item has been reviewed for clinical accuracy, current
guidelines, and clarity so that students can study with confidence and self-correct as they work through the bank.
Use it as a high-yield review immediately before the exam, or as a structured practice tool during the unit - the
rationales double as concise teaching notes. The recommended writing time is 3 hours, with a passing score of
90%. Aligned with Aligns with AACN Essentials and NCLEX-RN test plan standards for top-tier US nursing
programs. standards and reflects the question style commonly seen on accredited program examinations. Students
Section 1: Fundamentals of Nursing (Questions 1-25)
1 A nurse is assessing a patient who has been on strict bed rest for 72 hours.
Which finding indicates the highest risk for developing a pressure injury?
A) Capillary refill time of 2 seconds
B) Non-blanchable erythema over the sacrum
C) Skin temperature slightly cooler than surrounding areas
D) Patient reports intermittent tingling in lower extremities
Answer: B
Rationale: Non-blanchable erythema indicates stage 1 pressure injury, which is
the earliest sign of tissue damage. Capillary refill of 2 seconds is normal.
Cooler skin may indicate poor perfusion but is not as specific. Tingling is
neurological, not a direct pressure injury sign.
2 A nurse is preparing to administer a blood transfusion. Which action is most
critical to prevent a transfusion reaction?
A) Verify patient identification with two identifiers before transfusion
B) Prime the blood tubing with normal saline solution
C) Obtain baseline vital signs 15 minutes before starting
D) Use a 22-gauge IV catheter for administration
Answer: A
,Rationale: Wrong patient identification is the leading cause of fatal transfusion
reactions. Two-patient identifiers (e.g., name and date of birth) must be verified
per facility protocol. Priming with saline and vital signs are important but
secondary to correct ID. Gauge size affects flow but not safety.
3 A nurse is evaluating a patient's ability to use an incentive spirometer. Which
observation indicates correct technique?
A) Patient exhales forcefully into the mouthpiece
B) Patient performs sustained inhalation with the spirometer indicator rising
C) Patient coughs immediately after using the spirometer
D) Patient holds the spirometer upright and inhales rapidly
Answer: B
Rationale: Incentive spirometry requires a slow, deep inhalation to keep the
indicator within the target range, promoting lung expansion. Exhaling
forcefully or rapid inhalation does not achieve the goal. Coughing is separate
and not part of the technique.
4 A nurse is caring for a patient with a nasogastric tube set to low intermittent
suction. The nurse notes a decrease in output and the patient reports nausea.
What should the nurse do first?
A) Irrigate the tube with 30 mL of normal saline
B) Reposition the patient onto their left side
C) Check tube placement by aspirating gastric contents
D) Increase suction pressure to medium
Answer: C
Rationale: Decreased output with nausea may indicate tube displacement or
obstruction. Checking placement is the priority to ensure safety before any
intervention. Irrigating without verification could cause harm if the tube is
misplaced. Repositioning may help, but placement must be confirmed first.
5 A nurse is assessing a patient who has a chest tube connected to a water seal
drainage system. Which finding requires immediate intervention?
A) Intermittent bubbling in the water seal chamber
B) Constant bubbling in the water seal chamber
C) Fluctuations in the water seal chamber with respirations
D) Drainage of 50 mL of serosanguinous fluid in the first hour
,Answer: B
Rationale: Constant bubbling in the water seal chamber indicates an air leak,
which can compromise the pleural seal and lead to pneumothorax. Intermittent
bubbling is normal with exhalation. Fluctuations (tidaling) are expected. 50 mL
drainage in first hour may be acceptable but should be monitored.
6 A nurse is calculating the intake for a patient receiving IV fluids at 125
mL/hr via infusion pump. The patient also consumed 240 mL of water and
120 mL of ice chips (melted). What is the total intake in mL over 8 hours?
A) 1360 mL
B) 1440 mL
C) 1480 mL
D) 1560 mL
Answer: A
Rationale: IV intake: 125 mL/hr × 8 hr = 1000 mL. Oral water: 240 mL. Ice
chips: 120 mL (melted volume counts fully). Total = 1000 + 240 + 120 = 1360
mL. The other options miscalculate either the IV rate or ice chips.
7 A nurse is preparing to administer a medication via a nasogastric tube.
Which action is most appropriate to ensure accurate dosing?
A) Crush the tablet and mix with 30 mL of warm water
B) Administer each medication separately with a 15 mL water flush between
them
C) Open the capsule and mix the contents with applesauce
D) Flush the tube with 60 mL of water after all medications
Answer: B
Rationale: Administering each medication separately with a flush prevents
drug-drug interactions and ensures full delivery. Crushing tablets may alter
absorption; mixing with applesauce is for oral, not NG. Flushing after all
medications is insufficient; flushes between are needed.
8 A nurse is evaluating a patient's understanding of a low-sodium diet. Which
meal selection indicates the patient needs further teaching?
A) Grilled chicken breast with steamed rice and fresh green beans
B) Baked salmon with a side of canned vegetable soup
C) Turkey sandwich on whole wheat bread with lettuce and tomato
, D) Omelet made with egg whites, spinach, and mushrooms
Answer: B
Rationale: Canned vegetable soup is typically high in sodium. Fresh or frozen
vegetables without added salt are acceptable. The other options are low in
sodium. The patient selecting canned soup indicates misunderstanding of
hidden sodium sources.
9 A nurse is caring for a patient with a peripheral IV that is infiltrated. Which
action should the nurse take first?
A) Apply a warm compress to the site
B) Discontinue the IV and restart at another site
C) Elevate the extremity above the heart
D) Slow the infusion rate and monitor the site
Answer: B
Rationale: Infiltration requires immediate removal of the IV to prevent further
tissue damage. Restarting at a different site is the correct action. Warm
compresses and elevation are secondary interventions after removal. Slowing
the infusion is inappropriate as the catheter is already compromised.
10 A nurse is assessing a patient who has a fecal impaction. Which finding is
most consistent with this condition?
A) Frequent small, liquid stools
B) Hard, dry stools every 3 days
C) Abdominal distension with hyperactive bowel sounds
D) Rectal pain with bright red blood
Answer: A
Rationale: Fecal impaction often presents with paradoxical diarrhea: liquid
stool seeps around the impacted mass. Hard stools every 3 days may indicate
constipation but not necessarily impaction. Abdominal distension and
hyperactive sounds can occur but are less specific. Rectal pain with blood
suggests fissure or hemorrhoids.
11 A nurse is assessing a patient who has been on bed rest for 3 days. Which
finding indicates the need to modify the plan of care to prevent venous
thromboembolism?
A) Bilateral calf circumference increase of 1 cm compared to admission
- 249 Questions
This exam assesses mastery of core nursing fundamentals including evidence-based practice, patient safety,
infection control, pharmacology, and clinical reasoning at an advanced undergraduate level. Questions require
synthesis of concepts and application to complex clinical scenarios. It contains 249 multiple-choice questions,
each with four distractors and a fully worked rationale that explains why the keyed answer is correct. Content is
organized into 10 focused sections: Fundamentals of Nursing, Medical-Surgical Nursing, Maternal-Newborn
Nursing, Pediatric Nursing, Psychiatric/Mental Health Nursing, Pharmacology, Leadership and Management,
Community Health, Critical Care, Emergency Nursing. Targeted learning outcomes include: Apply nursing
process to prioritize care in complex situations.; Evaluate evidence-based interventions for infection prevention
and safety.; Analyze pharmacological principles and calculate dosages accurately.; Demonstrate ethical and
legal decision-making in nursing practice.. Every item has been reviewed for clinical accuracy, current
guidelines, and clarity so that students can study with confidence and self-correct as they work through the bank.
Use it as a high-yield review immediately before the exam, or as a structured practice tool during the unit - the
rationales double as concise teaching notes. The recommended writing time is 3 hours, with a passing score of
90%. Aligned with Aligns with AACN Essentials and NCLEX-RN test plan standards for top-tier US nursing
programs. standards and reflects the question style commonly seen on accredited program examinations. Students
Section 1: Fundamentals of Nursing (Questions 1-25)
1 A nurse is assessing a patient who has been on strict bed rest for 72 hours.
Which finding indicates the highest risk for developing a pressure injury?
A) Capillary refill time of 2 seconds
B) Non-blanchable erythema over the sacrum
C) Skin temperature slightly cooler than surrounding areas
D) Patient reports intermittent tingling in lower extremities
Answer: B
Rationale: Non-blanchable erythema indicates stage 1 pressure injury, which is
the earliest sign of tissue damage. Capillary refill of 2 seconds is normal.
Cooler skin may indicate poor perfusion but is not as specific. Tingling is
neurological, not a direct pressure injury sign.
2 A nurse is preparing to administer a blood transfusion. Which action is most
critical to prevent a transfusion reaction?
A) Verify patient identification with two identifiers before transfusion
B) Prime the blood tubing with normal saline solution
C) Obtain baseline vital signs 15 minutes before starting
D) Use a 22-gauge IV catheter for administration
Answer: A
,Rationale: Wrong patient identification is the leading cause of fatal transfusion
reactions. Two-patient identifiers (e.g., name and date of birth) must be verified
per facility protocol. Priming with saline and vital signs are important but
secondary to correct ID. Gauge size affects flow but not safety.
3 A nurse is evaluating a patient's ability to use an incentive spirometer. Which
observation indicates correct technique?
A) Patient exhales forcefully into the mouthpiece
B) Patient performs sustained inhalation with the spirometer indicator rising
C) Patient coughs immediately after using the spirometer
D) Patient holds the spirometer upright and inhales rapidly
Answer: B
Rationale: Incentive spirometry requires a slow, deep inhalation to keep the
indicator within the target range, promoting lung expansion. Exhaling
forcefully or rapid inhalation does not achieve the goal. Coughing is separate
and not part of the technique.
4 A nurse is caring for a patient with a nasogastric tube set to low intermittent
suction. The nurse notes a decrease in output and the patient reports nausea.
What should the nurse do first?
A) Irrigate the tube with 30 mL of normal saline
B) Reposition the patient onto their left side
C) Check tube placement by aspirating gastric contents
D) Increase suction pressure to medium
Answer: C
Rationale: Decreased output with nausea may indicate tube displacement or
obstruction. Checking placement is the priority to ensure safety before any
intervention. Irrigating without verification could cause harm if the tube is
misplaced. Repositioning may help, but placement must be confirmed first.
5 A nurse is assessing a patient who has a chest tube connected to a water seal
drainage system. Which finding requires immediate intervention?
A) Intermittent bubbling in the water seal chamber
B) Constant bubbling in the water seal chamber
C) Fluctuations in the water seal chamber with respirations
D) Drainage of 50 mL of serosanguinous fluid in the first hour
,Answer: B
Rationale: Constant bubbling in the water seal chamber indicates an air leak,
which can compromise the pleural seal and lead to pneumothorax. Intermittent
bubbling is normal with exhalation. Fluctuations (tidaling) are expected. 50 mL
drainage in first hour may be acceptable but should be monitored.
6 A nurse is calculating the intake for a patient receiving IV fluids at 125
mL/hr via infusion pump. The patient also consumed 240 mL of water and
120 mL of ice chips (melted). What is the total intake in mL over 8 hours?
A) 1360 mL
B) 1440 mL
C) 1480 mL
D) 1560 mL
Answer: A
Rationale: IV intake: 125 mL/hr × 8 hr = 1000 mL. Oral water: 240 mL. Ice
chips: 120 mL (melted volume counts fully). Total = 1000 + 240 + 120 = 1360
mL. The other options miscalculate either the IV rate or ice chips.
7 A nurse is preparing to administer a medication via a nasogastric tube.
Which action is most appropriate to ensure accurate dosing?
A) Crush the tablet and mix with 30 mL of warm water
B) Administer each medication separately with a 15 mL water flush between
them
C) Open the capsule and mix the contents with applesauce
D) Flush the tube with 60 mL of water after all medications
Answer: B
Rationale: Administering each medication separately with a flush prevents
drug-drug interactions and ensures full delivery. Crushing tablets may alter
absorption; mixing with applesauce is for oral, not NG. Flushing after all
medications is insufficient; flushes between are needed.
8 A nurse is evaluating a patient's understanding of a low-sodium diet. Which
meal selection indicates the patient needs further teaching?
A) Grilled chicken breast with steamed rice and fresh green beans
B) Baked salmon with a side of canned vegetable soup
C) Turkey sandwich on whole wheat bread with lettuce and tomato
, D) Omelet made with egg whites, spinach, and mushrooms
Answer: B
Rationale: Canned vegetable soup is typically high in sodium. Fresh or frozen
vegetables without added salt are acceptable. The other options are low in
sodium. The patient selecting canned soup indicates misunderstanding of
hidden sodium sources.
9 A nurse is caring for a patient with a peripheral IV that is infiltrated. Which
action should the nurse take first?
A) Apply a warm compress to the site
B) Discontinue the IV and restart at another site
C) Elevate the extremity above the heart
D) Slow the infusion rate and monitor the site
Answer: B
Rationale: Infiltration requires immediate removal of the IV to prevent further
tissue damage. Restarting at a different site is the correct action. Warm
compresses and elevation are secondary interventions after removal. Slowing
the infusion is inappropriate as the catheter is already compromised.
10 A nurse is assessing a patient who has a fecal impaction. Which finding is
most consistent with this condition?
A) Frequent small, liquid stools
B) Hard, dry stools every 3 days
C) Abdominal distension with hyperactive bowel sounds
D) Rectal pain with bright red blood
Answer: A
Rationale: Fecal impaction often presents with paradoxical diarrhea: liquid
stool seeps around the impacted mass. Hard stools every 3 days may indicate
constipation but not necessarily impaction. Abdominal distension and
hyperactive sounds can occur but are less specific. Rectal pain with blood
suggests fissure or hemorrhoids.
11 A nurse is assessing a patient who has been on bed rest for 3 days. Which
finding indicates the need to modify the plan of care to prevent venous
thromboembolism?
A) Bilateral calf circumference increase of 1 cm compared to admission
