HESI Comprehensive Review · NCLEX-
RN · 300 Q&A · 7th Ed · 2025/2026
Sandra L. Upchurch & HESI – First-Attempt Success
Instant PDF Download
300 exam-style questions · Full rationales · Why wrong explanations · 2025/2026 updated
Written by HESIprepPro, RN, MSN, CNE – 15 years Nursing Education & HESI Exam
Specialist
HESI Comprehensive Review: 99% | Verified: 2025/2026 Academic Year
Description
This comprehensive HESI Comprehensive Review for the NCLEX-RN® Examination, 7th Edition study guide contains
300 practice questions that mirror the HESI exam in content, difficulty, and structure. Each question is paired with a
verified correct answer, a detailed rationale, and a "Why Wrong" breakdown for every incorrect option. Updated for
the 2025/2026 academic year and based on Sandra L. Upchurch & HESI's 7th Edition, this guide covers all core
nursing content areas including Medical-Surgical, Pharmacology, Mental Health, Maternal-Newborn, Pediatrics,
Fundamentals, and Leadership.
Key Features
300 exam-style questions with verified correct answers
Detailed rationales and nursing implications for each question
"Why Wrong" sections for every incorrect option (A, B, C, D)
Covers all HESI Comprehensive Review content areas with accurate weight distribution
Includes Medical-Surgical, Pharmacology, Mental Health, Maternal-Newborn, Pediatrics, Fundamentals, and
Leadership
Based on Sandra L. Upchurch & HESI's 7th Edition
High-yield content for nursing students and healthcare professionals
Latest Updates
Updated for the 2025/2026 HESI Comprehensive Review testing cycle
Reflects current clinical guidelines and evidence-based practice
Includes new questions on emerging healthcare topics and NGN-style case studies
Aligns with the latest NCLEX-RN test plan and HESI exam blueprint
Keywords
, HESI Comprehensive Review, NCLEX-RN, HESI exam, Sandra Upchurch, medical-surgical nursing, pharmacology,
mental health nursing, maternal-newborn nursing, pediatric nursing, fundamentals of nursing, leadership nursing,
nursing exam, nursing study guide, 2025/2026 nursing exam, verified answers, graded A+.
Answer Format
Each question includes four answer choices (A, B, C, D)
Correct answer is clearly marked and highlighted
Rationale explains the clinical reasoning behind the correct answer
"Why Wrong" section provides a targeted explanation for each incorrect option
References are included for each question to support evidence-based practice
Section Questions Weight
Medical-Surgical Nursing 55 18%
Pharmacology 45 15%
Mental Health Nursing 40 13%
Maternal-Newborn / OB 35 12%
Pediatric Nursing 35 12%
Fundamentals & Leadership 50 17%
NGN Case Studies & Prioritization 40 13%
Medical-Surgical Nursing (287 questions)
,Q1. A patient with heart failure is receiving furosemide. Which finding indicates a
therapeutic response?
A Weight loss of 2 kg in 24 hours
B BP 160/90
C Jugular vein distension
D Bilateral crackles
Correct answer: A. Weight loss of 2 kg in 24 hours
Rationale: Furosemide reduces fluid overload; weight loss indicates diuresis. JVD and
crackles are signs of fluid overload.
Why wrong:
B: BP elevation indicates poor response to diuretic therapy.
C: JVD indicates fluid overload, not therapeutic response.
D: Crackles indicate pulmonary congestion, not improvement.
Reference: HESI Comprehensive Review for the NCLEX-RN® Examination, 7th Edition · Sandra L.
Upchurch & HESI · Saunders Comprehensive Review.
Q2. A client with COPD has an SpO₂ of 88%. Which action should the nurse take first?
A Apply oxygen at 2 L/min
B Encourage coughing
C Position in high-Fowler’s
D Notify provider
Correct answer: C. Position in high-Fowler’s
Rationale: High-Fowler’s improves lung expansion and oxygenation. Oxygen is needed but
positioning is immediate.
Why wrong:
A: Oxygen is indicated but positioning first improves ventilation.
B: Coughing is secondary to positioning.
D: Notify provider after intervention.
Reference: HESI Comprehensive Review for the NCLEX-RN® Examination, 7th Edition · Sandra L.
Upchurch & HESI · Saunders Comprehensive Review.
, Q3. Which lab value is most critical to monitor in a patient receiving heparin therapy?
A aPTT
B INR
C Platelet count
D PTT
Correct answer: A. aPTT
Rationale: aPTT monitors heparin effectiveness. INR is for warfarin. Platelets are for HIT.
Why wrong:
B: INR is for warfarin monitoring.
C: Platelet count is for HIT, not routine monitoring.
D: PTT is an older, less specific test.
Reference: HESI Comprehensive Review for the NCLEX-RN® Examination, 7th Edition · Sandra L.
Upchurch & HESI · Saunders Comprehensive Review.
Q4. A patient with diabetes has a blood glucose of 58 mg/dL and is confused. What
should the nurse administer?
A Orange juice 4 oz
B Glucagon 1 mg IM
C IV dextrose 50%
D Crackers with peanut butter
Correct answer: C. IV dextrose 50%
Rationale: IV dextrose is the fastest way to raise glucose in a confused patient. Juice and
crackers require ability to swallow.
Why wrong:
A: Juice is not safe with confusion and risk of aspiration.
B: Glucagon is for severe hypoglycemia without IV access.
D: Crackers are too slow and require swallowing.
Reference: HESI Comprehensive Review for the NCLEX-RN® Examination, 7th Edition · Sandra L.
Upchurch & HESI · Saunders Comprehensive Review.
RN · 300 Q&A · 7th Ed · 2025/2026
Sandra L. Upchurch & HESI – First-Attempt Success
Instant PDF Download
300 exam-style questions · Full rationales · Why wrong explanations · 2025/2026 updated
Written by HESIprepPro, RN, MSN, CNE – 15 years Nursing Education & HESI Exam
Specialist
HESI Comprehensive Review: 99% | Verified: 2025/2026 Academic Year
Description
This comprehensive HESI Comprehensive Review for the NCLEX-RN® Examination, 7th Edition study guide contains
300 practice questions that mirror the HESI exam in content, difficulty, and structure. Each question is paired with a
verified correct answer, a detailed rationale, and a "Why Wrong" breakdown for every incorrect option. Updated for
the 2025/2026 academic year and based on Sandra L. Upchurch & HESI's 7th Edition, this guide covers all core
nursing content areas including Medical-Surgical, Pharmacology, Mental Health, Maternal-Newborn, Pediatrics,
Fundamentals, and Leadership.
Key Features
300 exam-style questions with verified correct answers
Detailed rationales and nursing implications for each question
"Why Wrong" sections for every incorrect option (A, B, C, D)
Covers all HESI Comprehensive Review content areas with accurate weight distribution
Includes Medical-Surgical, Pharmacology, Mental Health, Maternal-Newborn, Pediatrics, Fundamentals, and
Leadership
Based on Sandra L. Upchurch & HESI's 7th Edition
High-yield content for nursing students and healthcare professionals
Latest Updates
Updated for the 2025/2026 HESI Comprehensive Review testing cycle
Reflects current clinical guidelines and evidence-based practice
Includes new questions on emerging healthcare topics and NGN-style case studies
Aligns with the latest NCLEX-RN test plan and HESI exam blueprint
Keywords
, HESI Comprehensive Review, NCLEX-RN, HESI exam, Sandra Upchurch, medical-surgical nursing, pharmacology,
mental health nursing, maternal-newborn nursing, pediatric nursing, fundamentals of nursing, leadership nursing,
nursing exam, nursing study guide, 2025/2026 nursing exam, verified answers, graded A+.
Answer Format
Each question includes four answer choices (A, B, C, D)
Correct answer is clearly marked and highlighted
Rationale explains the clinical reasoning behind the correct answer
"Why Wrong" section provides a targeted explanation for each incorrect option
References are included for each question to support evidence-based practice
Section Questions Weight
Medical-Surgical Nursing 55 18%
Pharmacology 45 15%
Mental Health Nursing 40 13%
Maternal-Newborn / OB 35 12%
Pediatric Nursing 35 12%
Fundamentals & Leadership 50 17%
NGN Case Studies & Prioritization 40 13%
Medical-Surgical Nursing (287 questions)
,Q1. A patient with heart failure is receiving furosemide. Which finding indicates a
therapeutic response?
A Weight loss of 2 kg in 24 hours
B BP 160/90
C Jugular vein distension
D Bilateral crackles
Correct answer: A. Weight loss of 2 kg in 24 hours
Rationale: Furosemide reduces fluid overload; weight loss indicates diuresis. JVD and
crackles are signs of fluid overload.
Why wrong:
B: BP elevation indicates poor response to diuretic therapy.
C: JVD indicates fluid overload, not therapeutic response.
D: Crackles indicate pulmonary congestion, not improvement.
Reference: HESI Comprehensive Review for the NCLEX-RN® Examination, 7th Edition · Sandra L.
Upchurch & HESI · Saunders Comprehensive Review.
Q2. A client with COPD has an SpO₂ of 88%. Which action should the nurse take first?
A Apply oxygen at 2 L/min
B Encourage coughing
C Position in high-Fowler’s
D Notify provider
Correct answer: C. Position in high-Fowler’s
Rationale: High-Fowler’s improves lung expansion and oxygenation. Oxygen is needed but
positioning is immediate.
Why wrong:
A: Oxygen is indicated but positioning first improves ventilation.
B: Coughing is secondary to positioning.
D: Notify provider after intervention.
Reference: HESI Comprehensive Review for the NCLEX-RN® Examination, 7th Edition · Sandra L.
Upchurch & HESI · Saunders Comprehensive Review.
, Q3. Which lab value is most critical to monitor in a patient receiving heparin therapy?
A aPTT
B INR
C Platelet count
D PTT
Correct answer: A. aPTT
Rationale: aPTT monitors heparin effectiveness. INR is for warfarin. Platelets are for HIT.
Why wrong:
B: INR is for warfarin monitoring.
C: Platelet count is for HIT, not routine monitoring.
D: PTT is an older, less specific test.
Reference: HESI Comprehensive Review for the NCLEX-RN® Examination, 7th Edition · Sandra L.
Upchurch & HESI · Saunders Comprehensive Review.
Q4. A patient with diabetes has a blood glucose of 58 mg/dL and is confused. What
should the nurse administer?
A Orange juice 4 oz
B Glucagon 1 mg IM
C IV dextrose 50%
D Crackers with peanut butter
Correct answer: C. IV dextrose 50%
Rationale: IV dextrose is the fastest way to raise glucose in a confused patient. Juice and
crackers require ability to swallow.
Why wrong:
A: Juice is not safe with confusion and risk of aspiration.
B: Glucagon is for severe hypoglycemia without IV access.
D: Crackers are too slow and require swallowing.
Reference: HESI Comprehensive Review for the NCLEX-RN® Examination, 7th Edition · Sandra L.
Upchurch & HESI · Saunders Comprehensive Review.
