RN HESI EXIT EXAM VERSION 1 - All questions + answers – EXAM-STYLE
QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS
RATIONALES | GUARANTEED PASS | 2026/27 LATEST UPDATE | EXAM PREP |
STUDY GUIDE | PRACTICE TEST
Section One: Questions 1–50
1. A nurse is providing discharge teaching to a client with a new diagnosis of
heart failure. Which statement by the client indicates a need for further
teaching?
A. "I will weigh myself every morning before breakfast."
B. "I should limit my fluid intake to 2 liters per day."
C. "I can stop taking my diuretic if I feel dizzy."
D. "I will notify my provider if I gain 2 pounds in one day."
Correct Answer: C. I can stop taking my diuretic if I feel dizzy.
*Rationale: The client should not stop taking a prescribed diuretic without
consulting the healthcare provider, as this can lead to fluid overload and worsening
heart failure. Dizziness may indicate hypotension or electrolyte imbalance and
should be reported, but the medication should not be discontinued independently.
Weighing daily, limiting fluids, and reporting rapid weight gain are all appropriate
self-management strategies.
2. A nurse is caring for a client who is post-operative day one following a total
hip arthroplasty. Which intervention is most important to prevent dislocation
of the new joint?
,A. Maintain the client in a high-Fowler's position.
B. Keep a pillow between the client's legs when turning.
C. Position the client on the operative side.
D. Encourage the client to cross their legs at the ankles.
Correct Answer: B. Keep a pillow between the client's legs when turning.
*Rationale: Maintaining abduction of the hip by keeping a pillow between the legs
prevents adduction, which is a primary risk factor for dislocation after a hip
arthroplasty. High-Fowler's positioning, positioning on the operative side, and
crossing the legs are all contraindicated post-operatively due to the risk of
dislocation.
3. A client with a history of chronic obstructive pulmonary disease (COPD) is
admitted with pneumonia. The nurse notes a respiratory rate of 28 breaths per
minute and an oxygen saturation of 88% on room air. Which action should the
nurse take first?
A. Administer the prescribed bronchodilator.
B. Apply a nasal cannula at 2 L/min.
C. Position the client in a prone position.
D. Obtain an order for arterial blood gases.
Correct Answer: B. Apply a nasal cannula at 2 L/min.
*Rationale: The client is in acute respiratory distress with hypoxemia. The priority is
to correct the hypoxia by administering supplemental oxygen. While administering
a bronchodilator and obtaining ABGs are important interventions, they are not the
immediate priority. Prone positioning is not the first-line intervention for a client
with COPD and pneumonia.
,4. A nurse is preparing to administer a blood transfusion to a client. Which
action is essential to prevent a transfusion reaction?
A. Verify client identification and blood product using a two-nurse verification
process.
B. Administer the blood transfusion over 4 hours per unit.
C. Infuse the blood product with a solution containing 5% dextrose.
D. Pre-medicate the client with an antihistamine.
Correct Answer: A. Verify client identification and blood product using a two-
nurse verification process.
*Rationale: The most critical action to prevent a transfusion reaction is the accurate
verification of the client's identity and the blood product, typically performed by two
licensed professionals. Administering the transfusion too slowly is not a preventative
measure, and blood should only be infused with normal saline, not dextrose
solutions. Pre-medication with antihistamines is not routine and is not the primary
preventative measure.
5. A client has a new prescription for enoxaparin. Which statement indicates
the client understands the discharge teaching regarding this medication?
A. "I will need to have my blood drawn weekly to check my levels."
B. "I should massage the injection site to help the medication absorb."
C. "I will inject the medication into the fatty tissue of my abdomen."
D. "I can take aspirin with this medication for my headache."
Correct Answer: C. I will inject the medication into the fatty tissue of my
abdomen.
, *Rationale: Enoxaparin is a low-molecular-weight heparin administered
subcutaneously in the abdomen. It does not require routine monitoring of
coagulation levels like unfractionated heparin. Aspirin and massage at the injection
site should be avoided to reduce the risk of bleeding and hematoma formation.
6. A nurse is performing a medication reconciliation for a client who is being
admitted to a medical-surgical unit. The client's home medications include
digoxin, furosemide, and enalapril. The nurse should monitor for which
potential adverse effect related to this medication combination?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: B. Hypokalemia
*Rationale: Furosemide is a loop diuretic that can cause significant potassium loss.
Hypokalemia predisposes the client to digoxin toxicity, as digoxin competes with
potassium for binding sites on the sodium-potassium pump. This combination of
medications requires careful monitoring of serum potassium levels.
7. A client is exhibiting signs of acute alcohol withdrawal, including tremors,
diaphoresis, and confusion. Which medication should the nurse anticipate
administering to prevent the progression to delirium tremens?
A. Lorazepam
B. Naloxone
C. Disulfiram
D. Acamprosate
QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS
RATIONALES | GUARANTEED PASS | 2026/27 LATEST UPDATE | EXAM PREP |
STUDY GUIDE | PRACTICE TEST
Section One: Questions 1–50
1. A nurse is providing discharge teaching to a client with a new diagnosis of
heart failure. Which statement by the client indicates a need for further
teaching?
A. "I will weigh myself every morning before breakfast."
B. "I should limit my fluid intake to 2 liters per day."
C. "I can stop taking my diuretic if I feel dizzy."
D. "I will notify my provider if I gain 2 pounds in one day."
Correct Answer: C. I can stop taking my diuretic if I feel dizzy.
*Rationale: The client should not stop taking a prescribed diuretic without
consulting the healthcare provider, as this can lead to fluid overload and worsening
heart failure. Dizziness may indicate hypotension or electrolyte imbalance and
should be reported, but the medication should not be discontinued independently.
Weighing daily, limiting fluids, and reporting rapid weight gain are all appropriate
self-management strategies.
2. A nurse is caring for a client who is post-operative day one following a total
hip arthroplasty. Which intervention is most important to prevent dislocation
of the new joint?
,A. Maintain the client in a high-Fowler's position.
B. Keep a pillow between the client's legs when turning.
C. Position the client on the operative side.
D. Encourage the client to cross their legs at the ankles.
Correct Answer: B. Keep a pillow between the client's legs when turning.
*Rationale: Maintaining abduction of the hip by keeping a pillow between the legs
prevents adduction, which is a primary risk factor for dislocation after a hip
arthroplasty. High-Fowler's positioning, positioning on the operative side, and
crossing the legs are all contraindicated post-operatively due to the risk of
dislocation.
3. A client with a history of chronic obstructive pulmonary disease (COPD) is
admitted with pneumonia. The nurse notes a respiratory rate of 28 breaths per
minute and an oxygen saturation of 88% on room air. Which action should the
nurse take first?
A. Administer the prescribed bronchodilator.
B. Apply a nasal cannula at 2 L/min.
C. Position the client in a prone position.
D. Obtain an order for arterial blood gases.
Correct Answer: B. Apply a nasal cannula at 2 L/min.
*Rationale: The client is in acute respiratory distress with hypoxemia. The priority is
to correct the hypoxia by administering supplemental oxygen. While administering
a bronchodilator and obtaining ABGs are important interventions, they are not the
immediate priority. Prone positioning is not the first-line intervention for a client
with COPD and pneumonia.
,4. A nurse is preparing to administer a blood transfusion to a client. Which
action is essential to prevent a transfusion reaction?
A. Verify client identification and blood product using a two-nurse verification
process.
B. Administer the blood transfusion over 4 hours per unit.
C. Infuse the blood product with a solution containing 5% dextrose.
D. Pre-medicate the client with an antihistamine.
Correct Answer: A. Verify client identification and blood product using a two-
nurse verification process.
*Rationale: The most critical action to prevent a transfusion reaction is the accurate
verification of the client's identity and the blood product, typically performed by two
licensed professionals. Administering the transfusion too slowly is not a preventative
measure, and blood should only be infused with normal saline, not dextrose
solutions. Pre-medication with antihistamines is not routine and is not the primary
preventative measure.
5. A client has a new prescription for enoxaparin. Which statement indicates
the client understands the discharge teaching regarding this medication?
A. "I will need to have my blood drawn weekly to check my levels."
B. "I should massage the injection site to help the medication absorb."
C. "I will inject the medication into the fatty tissue of my abdomen."
D. "I can take aspirin with this medication for my headache."
Correct Answer: C. I will inject the medication into the fatty tissue of my
abdomen.
, *Rationale: Enoxaparin is a low-molecular-weight heparin administered
subcutaneously in the abdomen. It does not require routine monitoring of
coagulation levels like unfractionated heparin. Aspirin and massage at the injection
site should be avoided to reduce the risk of bleeding and hematoma formation.
6. A nurse is performing a medication reconciliation for a client who is being
admitted to a medical-surgical unit. The client's home medications include
digoxin, furosemide, and enalapril. The nurse should monitor for which
potential adverse effect related to this medication combination?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: B. Hypokalemia
*Rationale: Furosemide is a loop diuretic that can cause significant potassium loss.
Hypokalemia predisposes the client to digoxin toxicity, as digoxin competes with
potassium for binding sites on the sodium-potassium pump. This combination of
medications requires careful monitoring of serum potassium levels.
7. A client is exhibiting signs of acute alcohol withdrawal, including tremors,
diaphoresis, and confusion. Which medication should the nurse anticipate
administering to prevent the progression to delirium tremens?
A. Lorazepam
B. Naloxone
C. Disulfiram
D. Acamprosate
