HESI RN Exit Exam/RN EXIT HESI REAL EXAM LATEST
2026-2027 QUESTION AND CORRECT ANSWERS RATED
A GRADE.
QUESTION
A male client with stomach cancer returns to the unit following a total gastrectomy. He
has a nasogastric tube to suction and is receiving Lactated Ringer's solution at 75
mL/hour IV. One hour after admission to the unit, the nurse notes 300 mL of blood in
the suction canister, the client's heart rate is 155 beats/minute, and his blood pressure is
78/48 mmHg. In addition to reporting the finding to the surgeon, which action should
the nurse implement first?
a. Administer a bolus of packed red blood cells.
b. Place the client in a high Fowler's position.
c. Prepare the client for a return to surgery.
d. Increase the infusion rate of Lactated Ringer's solution.
CORRECT ANS: d. Increase the infusion rate of Lactated Ringer's solution.
EXPERT RATIONALE
The client is exhibiting classic signs of hypovolemic shock due to postoperative
hemorrhage (tachycardia, hypotension, and significant blood loss in the suction
canister). The priority intervention is to restore intravascular volume to maintain tissue
perfusion. Increasing the IV fluid rate is the immediate, independent nursing action that
can be implemented while waiting for blood products. The nurse should also notify the
surgeon (as stated in the question), but the first action is to increase the fluid infusion
rate.
QUESTION
An adult male who fell 20 feet from the roof of his home has multiple injuries, including
a right pneumothorax. Chest tubes were inserted in the emergency department prior to
his transfer to the intensive care unit (ICU). The nurse notes that the suction control
chamber is bubbling at the -10 cm H2O mark, with fluctuation in the water seal, and
over the past hour 75 ml of bright red blood is measured in the collection chamber.
Which intervention should the nurse implement?
,a. Add sterile water to the suction control chamber.
b. Increase the wall suction to maintain a constant gentle bubbling.
c. Milk the chest tube to ensure patency.
d. Prepare for a chest tube replacement.
CORRECT ANS: a. Add sterile water to the suction control chamber.
EXPERT RATIONALE
The suction control chamber should be filled with sterile water to the prescribed level (in
this case, -10 cm H2O) to regulate the amount of suction applied. Bubbling at the
prescribed level indicates the suction is functioning correctly. Fluctuation in the water
seal chamber (tidaling) is a normal finding and indicates that the chest tube is patent. 75
mL of bright red blood over an hour is a significant amount but may be expected
initially; the nurse should continue to monitor the rate. The nurse should not increase
wall suction (b), milk the tube (c), or prepare for replacement (d) without specific orders
or indications of a problem.
QUESTION
A client who received hemodialysis yesterday is experiencing a blood pressure of
200/100 mmHg, heart rate 110 beats/minute, and respiratory rate 36 breaths/minute.
The client is manifesting shortness of breath, bilateral 2+ pedal edema, and an oxygen
saturation on room air of 89%. Which action should the nurse take first?
a. Administer a PRN dose of an antihypertensive medication.
b. Assess the client's lung sounds.
c. Begin supplemental oxygen.
d. Elevate the head of the bed to a high Fowler's position.
CORRECT ANS: c. Begin supplemental oxygen.
EXPERT RATIONALE
The client is exhibiting signs of fluid overload (hypertension, tachycardia, tachypnea,
shortness of breath, and edema) with hypoxia (SpO2 of 89%). The priority is to address
the hypoxia by administering supplemental oxygen. This is the most immediate life-
threatening concern. While the other actions are important, oxygenation takes
precedence.
,QUESTION
A client with Addison's crisis is admitted for treatment with adrenal cortical
supplementation. Based on the client's admitting diagnosis, which findings require
immediate action by the nurse? (Select all that apply)
a. Headache and tremors.
b. Irregular heart rate, pallor, and diaphoresis.
c. Hypertension and bradycardia.
d. Hypoglycemia and hyperkalemia.
CORRECT ANS: a, b, d
EXPERT RATIONALE
Addison's crisis is an acute adrenal insufficiency characterized by severe hypotension,
hypoglycemia, hyperkalemia, and shock. Headache and tremors (a) can be signs of
hypoglycemia or electrolyte imbalance. Irregular heart rate, pallor, and diaphoresis (b)
are signs of cardiovascular instability and shock. Hypoglycemia and hyperkalemia (d) are
hallmark metabolic findings of adrenal crisis. Hypertension and bradycardia (c) are not
typical findings; hypotension and tachycardia are expected.
QUESTION
An older client is admitted with fluid volume deficit and dehydration. Which assessment
finding is the best indicator of hydration that the nurse should report to the healthcare
provider?
a. The client's mucous membranes are dry.
b. The client's urine is dark amber and concentrated.
c. The client's weight has decreased by 2 pounds since yesterday.
d. Skin tenting occurs when the client's forearm is pinched.
CORRECT ANS: d. Skin tenting occurs when the client's forearm is pinched.
EXPERT RATIONALE
Skin tenting (poor skin turgor) is a classic and reliable sign of dehydration. When the
skin is pinched, it fails to return to its normal position immediately. While dry mucous
membranes (a), concentrated urine (b), and weight loss (c) are also signs of dehydration,
skin turgor is a more direct and immediate clinical indicator of fluid volume status.
, QUESTION
After an inservice about electronic health record (EHR) security and safeguarding client
information, the nurse observes a colleague going home with printed copies of client
information in a uniform pocket. Which action should the nurse take?
a. File a detailed incident report with the specific hiring facility.
b. Confront the colleague and request an explanation for the behavior.
c. Report the colleague to the state board of nursing.
d. Remind the colleague of the facility's policy regarding client information.
CORRECT ANS: a. File a detailed incident report with the specific hiring facility.
EXPERT RATIONALE
Taking printed client information home is a serious breach of confidentiality and violates
HIPAA regulations. The nurse has a duty to report this breach through the proper
channels. Filing an incident report with the facility documents the event and initiates the
appropriate investigation.
QUESTION
The nurse is evaluating a tertiary prevention program for clients with cardiovascular
disease implemented in a rural health clinic. Which outcome indicates the program is
effective?
a. Clients with cardiovascular disease identified risk factors.
b. Clients with cardiovascular disease attended the program.
c. Clients who incurred disease complications promptly received rehabilitation.
d. Clients reported an understanding of their disease process.
CORRECT ANS: c. Clients who incurred disease complications promptly received
rehabilitation.
EXPERT RATIONALE
Tertiary prevention focuses on reducing the impact of an existing disease and
preventing complications. The goal is to optimize function and quality of life. Prompt
rehabilitation after a complication is a direct measure of tertiary prevention
2026-2027 QUESTION AND CORRECT ANSWERS RATED
A GRADE.
QUESTION
A male client with stomach cancer returns to the unit following a total gastrectomy. He
has a nasogastric tube to suction and is receiving Lactated Ringer's solution at 75
mL/hour IV. One hour after admission to the unit, the nurse notes 300 mL of blood in
the suction canister, the client's heart rate is 155 beats/minute, and his blood pressure is
78/48 mmHg. In addition to reporting the finding to the surgeon, which action should
the nurse implement first?
a. Administer a bolus of packed red blood cells.
b. Place the client in a high Fowler's position.
c. Prepare the client for a return to surgery.
d. Increase the infusion rate of Lactated Ringer's solution.
CORRECT ANS: d. Increase the infusion rate of Lactated Ringer's solution.
EXPERT RATIONALE
The client is exhibiting classic signs of hypovolemic shock due to postoperative
hemorrhage (tachycardia, hypotension, and significant blood loss in the suction
canister). The priority intervention is to restore intravascular volume to maintain tissue
perfusion. Increasing the IV fluid rate is the immediate, independent nursing action that
can be implemented while waiting for blood products. The nurse should also notify the
surgeon (as stated in the question), but the first action is to increase the fluid infusion
rate.
QUESTION
An adult male who fell 20 feet from the roof of his home has multiple injuries, including
a right pneumothorax. Chest tubes were inserted in the emergency department prior to
his transfer to the intensive care unit (ICU). The nurse notes that the suction control
chamber is bubbling at the -10 cm H2O mark, with fluctuation in the water seal, and
over the past hour 75 ml of bright red blood is measured in the collection chamber.
Which intervention should the nurse implement?
,a. Add sterile water to the suction control chamber.
b. Increase the wall suction to maintain a constant gentle bubbling.
c. Milk the chest tube to ensure patency.
d. Prepare for a chest tube replacement.
CORRECT ANS: a. Add sterile water to the suction control chamber.
EXPERT RATIONALE
The suction control chamber should be filled with sterile water to the prescribed level (in
this case, -10 cm H2O) to regulate the amount of suction applied. Bubbling at the
prescribed level indicates the suction is functioning correctly. Fluctuation in the water
seal chamber (tidaling) is a normal finding and indicates that the chest tube is patent. 75
mL of bright red blood over an hour is a significant amount but may be expected
initially; the nurse should continue to monitor the rate. The nurse should not increase
wall suction (b), milk the tube (c), or prepare for replacement (d) without specific orders
or indications of a problem.
QUESTION
A client who received hemodialysis yesterday is experiencing a blood pressure of
200/100 mmHg, heart rate 110 beats/minute, and respiratory rate 36 breaths/minute.
The client is manifesting shortness of breath, bilateral 2+ pedal edema, and an oxygen
saturation on room air of 89%. Which action should the nurse take first?
a. Administer a PRN dose of an antihypertensive medication.
b. Assess the client's lung sounds.
c. Begin supplemental oxygen.
d. Elevate the head of the bed to a high Fowler's position.
CORRECT ANS: c. Begin supplemental oxygen.
EXPERT RATIONALE
The client is exhibiting signs of fluid overload (hypertension, tachycardia, tachypnea,
shortness of breath, and edema) with hypoxia (SpO2 of 89%). The priority is to address
the hypoxia by administering supplemental oxygen. This is the most immediate life-
threatening concern. While the other actions are important, oxygenation takes
precedence.
,QUESTION
A client with Addison's crisis is admitted for treatment with adrenal cortical
supplementation. Based on the client's admitting diagnosis, which findings require
immediate action by the nurse? (Select all that apply)
a. Headache and tremors.
b. Irregular heart rate, pallor, and diaphoresis.
c. Hypertension and bradycardia.
d. Hypoglycemia and hyperkalemia.
CORRECT ANS: a, b, d
EXPERT RATIONALE
Addison's crisis is an acute adrenal insufficiency characterized by severe hypotension,
hypoglycemia, hyperkalemia, and shock. Headache and tremors (a) can be signs of
hypoglycemia or electrolyte imbalance. Irregular heart rate, pallor, and diaphoresis (b)
are signs of cardiovascular instability and shock. Hypoglycemia and hyperkalemia (d) are
hallmark metabolic findings of adrenal crisis. Hypertension and bradycardia (c) are not
typical findings; hypotension and tachycardia are expected.
QUESTION
An older client is admitted with fluid volume deficit and dehydration. Which assessment
finding is the best indicator of hydration that the nurse should report to the healthcare
provider?
a. The client's mucous membranes are dry.
b. The client's urine is dark amber and concentrated.
c. The client's weight has decreased by 2 pounds since yesterday.
d. Skin tenting occurs when the client's forearm is pinched.
CORRECT ANS: d. Skin tenting occurs when the client's forearm is pinched.
EXPERT RATIONALE
Skin tenting (poor skin turgor) is a classic and reliable sign of dehydration. When the
skin is pinched, it fails to return to its normal position immediately. While dry mucous
membranes (a), concentrated urine (b), and weight loss (c) are also signs of dehydration,
skin turgor is a more direct and immediate clinical indicator of fluid volume status.
, QUESTION
After an inservice about electronic health record (EHR) security and safeguarding client
information, the nurse observes a colleague going home with printed copies of client
information in a uniform pocket. Which action should the nurse take?
a. File a detailed incident report with the specific hiring facility.
b. Confront the colleague and request an explanation for the behavior.
c. Report the colleague to the state board of nursing.
d. Remind the colleague of the facility's policy regarding client information.
CORRECT ANS: a. File a detailed incident report with the specific hiring facility.
EXPERT RATIONALE
Taking printed client information home is a serious breach of confidentiality and violates
HIPAA regulations. The nurse has a duty to report this breach through the proper
channels. Filing an incident report with the facility documents the event and initiates the
appropriate investigation.
QUESTION
The nurse is evaluating a tertiary prevention program for clients with cardiovascular
disease implemented in a rural health clinic. Which outcome indicates the program is
effective?
a. Clients with cardiovascular disease identified risk factors.
b. Clients with cardiovascular disease attended the program.
c. Clients who incurred disease complications promptly received rehabilitation.
d. Clients reported an understanding of their disease process.
CORRECT ANS: c. Clients who incurred disease complications promptly received
rehabilitation.
EXPERT RATIONALE
Tertiary prevention focuses on reducing the impact of an existing disease and
preventing complications. The goal is to optimize function and quality of life. Prompt
rehabilitation after a complication is a direct measure of tertiary prevention
