HESI RN Exit Practice Exam Test Bank | Complete
Actual Exam Questions with Verified Correct
Answers and Detailed Rationales | Latest Update
(New 2026/2027 Edition) | Already Graded A+
Question 1
A client presents at the ED complaining of a raspy voice, cold intolerance, and fatigue. Lab
tests indicate an elevated TSH and low T3 and T4 levels. After the client is admitted to the
telemetry unit, which intervention is most important for the nurse to implement?
A. Assess for presence of non-pitting edema.
B. Administer the prescribed dose of levothyroxine.
C. Offer additional blankets and a warm drink.
D. Note client's most recent hemoglobin levels.
Answer: B
Rationale: In hypothyroidism, low thyroid hormone levels stimulate TSH production, but
the thyroid gland does not respond with adequate T3/T4 production. Administering
supplementary thyroid hormone is the priority to avert possible myxedema coma. Non-
pitting edema (A) is seen in chronic hypothyroidism but is not the top priority. Providing
warmth (C) is beneficial but of less priority. Anemia is common, but (D) is lower priority
than initiating treatment.
Question 2
The nurse suspects that a client might be hemorrhaging internally. Which findings of an
orthostatic tilt test are a most likely indication of a major bleed (>1000 ml)?
A. A decrease in the systolic BP of 10 mmHg with a corresponding increase in the HR of
20.
B. A decrease in the systolic BP of 10 mmHg with a corresponding decrease in the HR of
20.
C. A decrease in the systolic BP of 20 mmHg with a corresponding decrease in the HR of
10.
D. A decrease in the systolic BP of 20 mmHg with a corresponding increase in the HR of
10.
Answer: A
Rationale: Loss of circulatory volume results in a 10 mmHg drop in systolic pressure,
while the HR increases by 20% above normal as a compensatory response to low pressure.
1
,Question 3
When conducting diet teaching for a client who is on a postoperative full liquid diet, which
foods should the nurse encourage the client to eat? (Select all that apply)
A. Canned fruit cocktail
B. Creamy peanut butter
C. Vegetable juice
D. Vanilla frozen yogurt
E. Clear beef broth
Answer: C, D, E
Rationale: A full liquid diet includes all liquids that are not clear such as vegetable juice
and frozen yogurt, as well as clear liquids. Pieces of fruit and peanut butter are not
considered liquids.
Question 4
A client is receiving ophthalmic drops preoperatively for a cataract extraction and asks the
nurse why he is prescribed all these medications. (Select all that apply)
A. One of the medications is used to anesthetize the corneal surface.
B. The iris must be paralyzed during the surgery to prevent it from reacting to light.
C. Medication is used to induce sleep during the procedure.
D. Pupillary dilation is necessary to access the eye chamber for lens removal.
E. These meds assist in obstructing the client's vision during the surgery.
Answer: A, B, D
Rationale: Cataract surgery requires anesthetizing the corneal surface (A), paralyzing the
ciliary body (B), and providing pupil dilation (D) to facilitate access to the lens behind the
iris. A sedative may reduce anxiety but is not used to induce sleep (C). Cloudy vision may
be a side effect, but the client will still be able to see (E).
Question 5
When assessing an IV site that is used for fluid replacement and medication administration,
the client complains of tenderness when the arm is touched above the site. Which additional
assessment warrants immediate intervention by the nurse?
A. Sluggish blood return
B. Client uses the arm cautiously
C. Spot of dried blood at the insertion site
D. Red streak tracking the vein
Answer: D
Rationale: A red streak (D) indicates vein irritation and necessitates discontinuing the IV at
2
,the present site. A, B, and C are indications for relocating the IV site or other immediate
intervention.
Question 6
A client with a liver abscess develops septic shock. A sepsis resuscitation bundle protocol is
initiated and the client receives a bolus of IV fluids. Which parameter should the nurse
monitor to assess effectiveness of the fluid bolus?
A. Blood cultures
B. Oxygen saturation
C. White blood count
D. Mean arterial pressure (MAP)
Answer: D
Rationale: The cornerstone of initial sepsis resuscitation is fluid volume administration to
restore and then maintain MAP of at least 65 mmHg.
Question 7
When attempting to establish risk reduction strategies in a community, the nurse notes that
regional studies indicate a high number of persons with growth stunting and irreversible
mental deficiencies (cretinism) caused by hypothyroidism. The nurse should seek funding
to implement which screening measure?
A. T4 levels in newborns.
B. TSH levels in women over 45.
C. T3 levels in school-aged children.
D. Iodine levels in all persons over 60.
Answer: A
Rationale: Screening for low T4 levels in newborns with follow-up treatment can reduce
the risk for irreversible growth stunting and mental deficiencies caused by congenital
hypothyroidism.
Question 8
For the past 24 hours, an antidiarrheal agent, diphenoxylate, has been administered to a
bedridden, older client with infectious gastroenteritis. Which finding requires the nurse to
take further action?
A. Loss of appetite
B. Serum K+ 4.0 mEq/L
C. Loose, runny stools
D. Tented skin turgor
3
, Answer: D
Rationale: Tented skin turgor indicates dehydration, a serious complication following
prolonged diarrhea that requires further intervention by the nurse.
Question 9
A male client with ulcerative colitis received an Rx for a corticosteroid last month but
because of side effects, he stopped taking the medications 6 days ago. Which finding
warrants immediate intervention by the nurse?
A. Fluid retention
B. Hypotension and fever
C. Anxiety and restlessness
D. Increased blood glucose
Answer: B
Rationale: Sudden withdrawal from a corticosteroid can cause decreased adrenal function
resulting in low serum sodium, high potassium, and low blood pressure which can lead to
shock and possible death. Hypotension and fever are the first signs of precipitous
withdrawal.
Question 10
The nurse working in the ED is obtaining evidence for a rape kit from a woman who reports
that she was raped. Which intervention is most important for the nurse to implement?
A. Do not allow client to shower until all evidence is obtained.
B. Report incident to the university's security department.
C. Listen attentively to the client's description of the event.
D. Determine the client's personal reaction to the reported rape.
Answer: A
Rationale: It is most important to gather evidence and a shower distorts such evidence. The
client should not be allowed to shower until all the evidence is collected.
Question 11
The nurse is preparing to gavage feed a premature infant through an orogastric tube. During
insertion of the tube, the infant's HR drops to 60 bpm. Which action should the nurse take?
A. Continue the insertion since this is a typical response.
B. Insert the feeding tube into the infant's nasal passage.
C. Pause and monitor for a continued drop of the HR.
D. Postpone the feeding until the infant's vital signs are stable.
4
Actual Exam Questions with Verified Correct
Answers and Detailed Rationales | Latest Update
(New 2026/2027 Edition) | Already Graded A+
Question 1
A client presents at the ED complaining of a raspy voice, cold intolerance, and fatigue. Lab
tests indicate an elevated TSH and low T3 and T4 levels. After the client is admitted to the
telemetry unit, which intervention is most important for the nurse to implement?
A. Assess for presence of non-pitting edema.
B. Administer the prescribed dose of levothyroxine.
C. Offer additional blankets and a warm drink.
D. Note client's most recent hemoglobin levels.
Answer: B
Rationale: In hypothyroidism, low thyroid hormone levels stimulate TSH production, but
the thyroid gland does not respond with adequate T3/T4 production. Administering
supplementary thyroid hormone is the priority to avert possible myxedema coma. Non-
pitting edema (A) is seen in chronic hypothyroidism but is not the top priority. Providing
warmth (C) is beneficial but of less priority. Anemia is common, but (D) is lower priority
than initiating treatment.
Question 2
The nurse suspects that a client might be hemorrhaging internally. Which findings of an
orthostatic tilt test are a most likely indication of a major bleed (>1000 ml)?
A. A decrease in the systolic BP of 10 mmHg with a corresponding increase in the HR of
20.
B. A decrease in the systolic BP of 10 mmHg with a corresponding decrease in the HR of
20.
C. A decrease in the systolic BP of 20 mmHg with a corresponding decrease in the HR of
10.
D. A decrease in the systolic BP of 20 mmHg with a corresponding increase in the HR of
10.
Answer: A
Rationale: Loss of circulatory volume results in a 10 mmHg drop in systolic pressure,
while the HR increases by 20% above normal as a compensatory response to low pressure.
1
,Question 3
When conducting diet teaching for a client who is on a postoperative full liquid diet, which
foods should the nurse encourage the client to eat? (Select all that apply)
A. Canned fruit cocktail
B. Creamy peanut butter
C. Vegetable juice
D. Vanilla frozen yogurt
E. Clear beef broth
Answer: C, D, E
Rationale: A full liquid diet includes all liquids that are not clear such as vegetable juice
and frozen yogurt, as well as clear liquids. Pieces of fruit and peanut butter are not
considered liquids.
Question 4
A client is receiving ophthalmic drops preoperatively for a cataract extraction and asks the
nurse why he is prescribed all these medications. (Select all that apply)
A. One of the medications is used to anesthetize the corneal surface.
B. The iris must be paralyzed during the surgery to prevent it from reacting to light.
C. Medication is used to induce sleep during the procedure.
D. Pupillary dilation is necessary to access the eye chamber for lens removal.
E. These meds assist in obstructing the client's vision during the surgery.
Answer: A, B, D
Rationale: Cataract surgery requires anesthetizing the corneal surface (A), paralyzing the
ciliary body (B), and providing pupil dilation (D) to facilitate access to the lens behind the
iris. A sedative may reduce anxiety but is not used to induce sleep (C). Cloudy vision may
be a side effect, but the client will still be able to see (E).
Question 5
When assessing an IV site that is used for fluid replacement and medication administration,
the client complains of tenderness when the arm is touched above the site. Which additional
assessment warrants immediate intervention by the nurse?
A. Sluggish blood return
B. Client uses the arm cautiously
C. Spot of dried blood at the insertion site
D. Red streak tracking the vein
Answer: D
Rationale: A red streak (D) indicates vein irritation and necessitates discontinuing the IV at
2
,the present site. A, B, and C are indications for relocating the IV site or other immediate
intervention.
Question 6
A client with a liver abscess develops septic shock. A sepsis resuscitation bundle protocol is
initiated and the client receives a bolus of IV fluids. Which parameter should the nurse
monitor to assess effectiveness of the fluid bolus?
A. Blood cultures
B. Oxygen saturation
C. White blood count
D. Mean arterial pressure (MAP)
Answer: D
Rationale: The cornerstone of initial sepsis resuscitation is fluid volume administration to
restore and then maintain MAP of at least 65 mmHg.
Question 7
When attempting to establish risk reduction strategies in a community, the nurse notes that
regional studies indicate a high number of persons with growth stunting and irreversible
mental deficiencies (cretinism) caused by hypothyroidism. The nurse should seek funding
to implement which screening measure?
A. T4 levels in newborns.
B. TSH levels in women over 45.
C. T3 levels in school-aged children.
D. Iodine levels in all persons over 60.
Answer: A
Rationale: Screening for low T4 levels in newborns with follow-up treatment can reduce
the risk for irreversible growth stunting and mental deficiencies caused by congenital
hypothyroidism.
Question 8
For the past 24 hours, an antidiarrheal agent, diphenoxylate, has been administered to a
bedridden, older client with infectious gastroenteritis. Which finding requires the nurse to
take further action?
A. Loss of appetite
B. Serum K+ 4.0 mEq/L
C. Loose, runny stools
D. Tented skin turgor
3
, Answer: D
Rationale: Tented skin turgor indicates dehydration, a serious complication following
prolonged diarrhea that requires further intervention by the nurse.
Question 9
A male client with ulcerative colitis received an Rx for a corticosteroid last month but
because of side effects, he stopped taking the medications 6 days ago. Which finding
warrants immediate intervention by the nurse?
A. Fluid retention
B. Hypotension and fever
C. Anxiety and restlessness
D. Increased blood glucose
Answer: B
Rationale: Sudden withdrawal from a corticosteroid can cause decreased adrenal function
resulting in low serum sodium, high potassium, and low blood pressure which can lead to
shock and possible death. Hypotension and fever are the first signs of precipitous
withdrawal.
Question 10
The nurse working in the ED is obtaining evidence for a rape kit from a woman who reports
that she was raped. Which intervention is most important for the nurse to implement?
A. Do not allow client to shower until all evidence is obtained.
B. Report incident to the university's security department.
C. Listen attentively to the client's description of the event.
D. Determine the client's personal reaction to the reported rape.
Answer: A
Rationale: It is most important to gather evidence and a shower distorts such evidence. The
client should not be allowed to shower until all the evidence is collected.
Question 11
The nurse is preparing to gavage feed a premature infant through an orogastric tube. During
insertion of the tube, the infant's HR drops to 60 bpm. Which action should the nurse take?
A. Continue the insertion since this is a typical response.
B. Insert the feeding tube into the infant's nasal passage.
C. Pause and monitor for a continued drop of the HR.
D. Postpone the feeding until the infant's vital signs are stable.
4
