HESI · ELSEVIER
HESI 799 RN Exit Exam
Practice Question Bank
NCLEX-Style Practice Questions with Rationales
Comprehensive Review for RN Licensure
89 Comprehensive Questions with Verified Answers
Edition 1 · August 2026
✓ Institution Verification
VERIFIED This document was independently verified as belonging to HESI (Health
Education Systems, Inc.) · Elsevier. Exam: HESI 799 RN Exit Exam. This comprehensive
review covers medical-surgical nursing, critical care, pharmacology, mental health, pediatrics,
obstetrics, and professional nursing standards.
Table of Contents
,1. Instructions for Use 2
2. Practice Questions with Answers & Rationales 2
3. Appreciation & Review 12
HESI 799 · Elsevier Page 1
,HESI 799 RN EXIT EXAM PRACTICE GUIDE INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem carefully, choose your answer, then review the rationale directly below. Each
correct option is marked, and every wrong option is explained so you understand why it's
wrong — not just that it is. These questions are designed to mirror the HESI Exit Exam format
and clinical reasoning required for RN licensure. All answers have been verified against the
source material.
Category: Medical-Surgical Nursing & Comprehensive Review
1 A male client notifies the nurse that he feels short of breath and has chest pressure
radiating down his left arm. A STAT 12-lead electrocardiogram (ECG) is obtained and
shows ST segment elevation in leads II, III, aVF and V4R. The nurse collects blood
samples and gives a normal saline bolus. What action is most important for the
nurse to implement?
A Obtain the results for STAT serum cardiac biomarkers
B Assess for contraindications for thrombolytic therapy
C Measure ST-segment height and waveform changes
D Transfer for percutaneous coronary intervention (PCI)
Why B is correct: ST segment elevation myocardial infarction (STEMI) usually occurs with
complete occlusion of an epicardial coronary artery which requires early reperfusion
therapy. Screening the client for fibrinolytic therapy is most important to determine PCI
option for rapid reperfusion. If the client is not a candidate for fibrinolytic therapy, then
transfer to a PCI unit or facility is indicated.
A — Reperfusion therapy should not be delayed in STEMI.
C — This is of significant concern in ECG interpretation with ST-segment depression, not
STEMI.
D — Transfer is indicated if the client is not a candidate for fibrinolytic therapy.
, 2 An IV antibiotic is prescribed for a client with a postoperative infection. The
medication is to be administered in 4 divided doses. What schedule is best for
administering this prescription?
A 1000, 1600, 2200, 0400
B 0900, 1300, 1700, 2100
C 0800, 1200, 1600, 2000
D 0700, 1100, 1500, 1900
Why A is correct: 1000, 1600, 2200, 0400 provides equal intervals of 6 hours between each
dose, ensuring consistent therapeutic drug levels throughout the 24-hour period.
B — These intervals are not evenly spaced.
C — These intervals are not evenly spaced.
D — These intervals are not evenly spaced.
3 A client is receiving continuous bladder irrigation via a triple-lumen suprapubic
catheter that was placed during prostatectomy. Which report by the unlicensed
assistive personnel (UAP) requires intervention by the nurse?
A Leakage around catheter insertion site
B Output is pink-tinged
C Client reports bladder spasms
D Irrigation solution is infusing slowly
Why A is correct: Leakage around the catheter insertion site indicates improper catheter
placement or obstruction, which requires immediate nursing intervention to prevent
infection and ensure proper drainage.
B — Pink-tinged output is expected immediately post-prostatectomy.
C — Bladder spasms are common and expected with catheter presence.
D — Slow infusion may require adjustment but is not the priority.
HESI 799 RN Exit Exam
Practice Question Bank
NCLEX-Style Practice Questions with Rationales
Comprehensive Review for RN Licensure
89 Comprehensive Questions with Verified Answers
Edition 1 · August 2026
✓ Institution Verification
VERIFIED This document was independently verified as belonging to HESI (Health
Education Systems, Inc.) · Elsevier. Exam: HESI 799 RN Exit Exam. This comprehensive
review covers medical-surgical nursing, critical care, pharmacology, mental health, pediatrics,
obstetrics, and professional nursing standards.
Table of Contents
,1. Instructions for Use 2
2. Practice Questions with Answers & Rationales 2
3. Appreciation & Review 12
HESI 799 · Elsevier Page 1
,HESI 799 RN EXIT EXAM PRACTICE GUIDE INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem carefully, choose your answer, then review the rationale directly below. Each
correct option is marked, and every wrong option is explained so you understand why it's
wrong — not just that it is. These questions are designed to mirror the HESI Exit Exam format
and clinical reasoning required for RN licensure. All answers have been verified against the
source material.
Category: Medical-Surgical Nursing & Comprehensive Review
1 A male client notifies the nurse that he feels short of breath and has chest pressure
radiating down his left arm. A STAT 12-lead electrocardiogram (ECG) is obtained and
shows ST segment elevation in leads II, III, aVF and V4R. The nurse collects blood
samples and gives a normal saline bolus. What action is most important for the
nurse to implement?
A Obtain the results for STAT serum cardiac biomarkers
B Assess for contraindications for thrombolytic therapy
C Measure ST-segment height and waveform changes
D Transfer for percutaneous coronary intervention (PCI)
Why B is correct: ST segment elevation myocardial infarction (STEMI) usually occurs with
complete occlusion of an epicardial coronary artery which requires early reperfusion
therapy. Screening the client for fibrinolytic therapy is most important to determine PCI
option for rapid reperfusion. If the client is not a candidate for fibrinolytic therapy, then
transfer to a PCI unit or facility is indicated.
A — Reperfusion therapy should not be delayed in STEMI.
C — This is of significant concern in ECG interpretation with ST-segment depression, not
STEMI.
D — Transfer is indicated if the client is not a candidate for fibrinolytic therapy.
, 2 An IV antibiotic is prescribed for a client with a postoperative infection. The
medication is to be administered in 4 divided doses. What schedule is best for
administering this prescription?
A 1000, 1600, 2200, 0400
B 0900, 1300, 1700, 2100
C 0800, 1200, 1600, 2000
D 0700, 1100, 1500, 1900
Why A is correct: 1000, 1600, 2200, 0400 provides equal intervals of 6 hours between each
dose, ensuring consistent therapeutic drug levels throughout the 24-hour period.
B — These intervals are not evenly spaced.
C — These intervals are not evenly spaced.
D — These intervals are not evenly spaced.
3 A client is receiving continuous bladder irrigation via a triple-lumen suprapubic
catheter that was placed during prostatectomy. Which report by the unlicensed
assistive personnel (UAP) requires intervention by the nurse?
A Leakage around catheter insertion site
B Output is pink-tinged
C Client reports bladder spasms
D Irrigation solution is infusing slowly
Why A is correct: Leakage around the catheter insertion site indicates improper catheter
placement or obstruction, which requires immediate nursing intervention to prevent
infection and ensure proper drainage.
B — Pink-tinged output is expected immediately post-prostatectomy.
C — Bladder spasms are common and expected with catheter presence.
D — Slow infusion may require adjustment but is not the priority.
