EXIT HESI COMPREHENSIVE B EVOLVE PRACTICE
QUESTIONS/EXIT HESI COMPREHENSIVE B EVOLVE
PRACTICE QUESTIONS AND ANSWERS LATEST
2026/2027 UPDATE
Course
EXIT HESI
1. A client with heart failure suddenly develops severe dyspnea, bilateral crackles, and pink,
frothy sputum. Which intervention should the nurse implement first?
A. Administer the prescribed IV furosemide
B. Place the client in high-Fowler's position
C. Obtain a 12-lead ECG
D. Restrict the client's oral fluid intake
Correct Answer: B. Place the client in high-Fowler's position
Rationale: Acute pulmonary edema is an emergency. High-Fowler's positioning improves lung
expansion and decreases venous return to the heart, helping reduce pulmonary congestion and
improve oxygenation. Furosemide is important but should follow immediate stabilization
measures.
2. The nurse is caring for a client receiving a heparin infusion. The client's aPTT is markedly
elevated and the client develops bleeding from the gums. What should the nurse do first?
A. Administer protamine sulfate immediately
B. Stop the heparin infusion
C. Increase the IV fluid infusion
D. Apply pressure to the client's gums and continue the infusion
Correct Answer: B. Stop the heparin infusion
Rationale: The client is demonstrating excessive anticoagulation with active bleeding. The first
action is to stop the source of anticoagulation. Protamine sulfate may subsequently be
prescribed to reverse heparin.
3. A client with diabetes mellitus is awake and has a blood glucose level of 54 mg/dL. Which
action should the nurse take?
,A. Administer regular insulin
B. Give 15 g of rapid-acting carbohydrate
C. Administer glucagon intramuscularly
D. Provide a high-protein meal
Correct Answer: B. Give 15 g of rapid-acting carbohydrate
Rationale: A conscious client who can swallow should receive approximately 15 g of rapidly
absorbed carbohydrate. Blood glucose should then be reassessed according to the
hypoglycemia protocol. Insulin would worsen hypoglycemia. Glucagon is generally used when
the client cannot safely take oral carbohydrates.
4. A client receiving digoxin has an apical pulse of 52 beats/min. Which action should the
nurse take?
A. Administer the medication as prescribed
B. Hold the digoxin and notify the healthcare provider
C. Give the medication with food
D. Administer an additional dose later
Correct Answer: B. Hold the digoxin and notify the healthcare provider
Rationale: Digoxin can decrease heart rate. Bradycardia is a significant finding requiring the
medication to be withheld and the client evaluated before another dose is administered.
5. A client receiving magnesium sulfate for severe preeclampsia has a respiratory rate of
9/min and absent patellar reflexes. What is the priority nursing action?
A. Increase the magnesium sulfate infusion
B. Stop the magnesium sulfate infusion
C. Place the client in a supine position
D. Encourage oral fluids
Correct Answer: B. Stop the magnesium sulfate infusion
Rationale: Respiratory depression and absent deep tendon reflexes are signs of magnesium
toxicity. The infusion should be stopped immediately. Calcium gluconate may be prescribed as
the antidote.
,6. A client with SIADH has a sodium level of 119 mEq/L and is confused. Which intervention
has the highest priority?
A. Encourage increased water intake
B. Institute seizure precautions
C. Encourage ambulation
D. Administer potassium supplements
Correct Answer: B. Institute seizure precautions
Rationale: Severe hyponatremia can cause cerebral edema, altered mental status, seizures, and
potentially coma. Seizure precautions are therefore essential. Fluid restriction is commonly part
of SIADH management; increasing water intake can worsen hyponatremia.
7. The nurse receives report on four clients. Which client should be assessed first?
A. Client with chronic arthritis reporting pain of 6/10
B. Client with COPD whose oxygen saturation is 90% on prescribed oxygen
C. Postoperative client with new confusion and respiratory rate of 32/min
D. Client with diabetes requesting a bedtime snack
Correct Answer: C. Postoperative client with new confusion and respiratory rate of 32/min
Rationale: New confusion combined with tachypnea suggests acute deterioration, potentially
related to impaired oxygenation. The client requires immediate assessment. The other clients
are comparatively stable.
8. A client receiving morphine becomes difficult to arouse and has a respiratory rate of 6/min.
Which medication should the nurse anticipate?
A. Naloxone
B. Flumazenil
C. Protamine sulfate
D. Vitamin K
Correct Answer: A. Naloxone
Rationale: Naloxone is an opioid antagonist that reverses opioid-induced respiratory
depression. Flumazenil reverses benzodiazepines, protamine reverses heparin, and vitamin K is
used to reverse warfarin effects.
, 9. A client with hyperkalemia develops peaked T waves. Which medication should the nurse
anticipate administering to stabilize the myocardium?
A. IV calcium gluconate
B. Oral potassium chloride
C. IV magnesium sulfate
D. Sodium chloride tablets
Correct Answer: A. IV calcium gluconate
Rationale: IV calcium gluconate stabilizes the cardiac membrane during significant hyperkalemia
with ECG changes. It does not remove potassium from the body but reduces the immediate risk
of lethal dysrhythmias.
10. A client with suspected bacterial meningitis is admitted. Which isolation precaution
should the nurse initiate?
A. Contact
B. Airborne
C. Droplet
D. Protective
Correct Answer: C. Droplet
Rationale: Suspected bacterial meningitis requires droplet precautions because organisms may
be transmitted through respiratory secretions. Standard precautions are also maintained.
11. A postpartum client has heavy vaginal bleeding and a boggy uterus. Which intervention
should the nurse perform first?
A. Prepare the client for surgery
B. Massage the uterine fundus
C. Encourage ambulation
D. Apply an abdominal heating pad
Correct Answer: B. Massage the uterine fundus
Rationale: A boggy uterus indicates uterine atony, a common cause of postpartum hemorrhage.
Fundal massage promotes uterine contraction and is an immediate nursing intervention.
QUESTIONS/EXIT HESI COMPREHENSIVE B EVOLVE
PRACTICE QUESTIONS AND ANSWERS LATEST
2026/2027 UPDATE
Course
EXIT HESI
1. A client with heart failure suddenly develops severe dyspnea, bilateral crackles, and pink,
frothy sputum. Which intervention should the nurse implement first?
A. Administer the prescribed IV furosemide
B. Place the client in high-Fowler's position
C. Obtain a 12-lead ECG
D. Restrict the client's oral fluid intake
Correct Answer: B. Place the client in high-Fowler's position
Rationale: Acute pulmonary edema is an emergency. High-Fowler's positioning improves lung
expansion and decreases venous return to the heart, helping reduce pulmonary congestion and
improve oxygenation. Furosemide is important but should follow immediate stabilization
measures.
2. The nurse is caring for a client receiving a heparin infusion. The client's aPTT is markedly
elevated and the client develops bleeding from the gums. What should the nurse do first?
A. Administer protamine sulfate immediately
B. Stop the heparin infusion
C. Increase the IV fluid infusion
D. Apply pressure to the client's gums and continue the infusion
Correct Answer: B. Stop the heparin infusion
Rationale: The client is demonstrating excessive anticoagulation with active bleeding. The first
action is to stop the source of anticoagulation. Protamine sulfate may subsequently be
prescribed to reverse heparin.
3. A client with diabetes mellitus is awake and has a blood glucose level of 54 mg/dL. Which
action should the nurse take?
,A. Administer regular insulin
B. Give 15 g of rapid-acting carbohydrate
C. Administer glucagon intramuscularly
D. Provide a high-protein meal
Correct Answer: B. Give 15 g of rapid-acting carbohydrate
Rationale: A conscious client who can swallow should receive approximately 15 g of rapidly
absorbed carbohydrate. Blood glucose should then be reassessed according to the
hypoglycemia protocol. Insulin would worsen hypoglycemia. Glucagon is generally used when
the client cannot safely take oral carbohydrates.
4. A client receiving digoxin has an apical pulse of 52 beats/min. Which action should the
nurse take?
A. Administer the medication as prescribed
B. Hold the digoxin and notify the healthcare provider
C. Give the medication with food
D. Administer an additional dose later
Correct Answer: B. Hold the digoxin and notify the healthcare provider
Rationale: Digoxin can decrease heart rate. Bradycardia is a significant finding requiring the
medication to be withheld and the client evaluated before another dose is administered.
5. A client receiving magnesium sulfate for severe preeclampsia has a respiratory rate of
9/min and absent patellar reflexes. What is the priority nursing action?
A. Increase the magnesium sulfate infusion
B. Stop the magnesium sulfate infusion
C. Place the client in a supine position
D. Encourage oral fluids
Correct Answer: B. Stop the magnesium sulfate infusion
Rationale: Respiratory depression and absent deep tendon reflexes are signs of magnesium
toxicity. The infusion should be stopped immediately. Calcium gluconate may be prescribed as
the antidote.
,6. A client with SIADH has a sodium level of 119 mEq/L and is confused. Which intervention
has the highest priority?
A. Encourage increased water intake
B. Institute seizure precautions
C. Encourage ambulation
D. Administer potassium supplements
Correct Answer: B. Institute seizure precautions
Rationale: Severe hyponatremia can cause cerebral edema, altered mental status, seizures, and
potentially coma. Seizure precautions are therefore essential. Fluid restriction is commonly part
of SIADH management; increasing water intake can worsen hyponatremia.
7. The nurse receives report on four clients. Which client should be assessed first?
A. Client with chronic arthritis reporting pain of 6/10
B. Client with COPD whose oxygen saturation is 90% on prescribed oxygen
C. Postoperative client with new confusion and respiratory rate of 32/min
D. Client with diabetes requesting a bedtime snack
Correct Answer: C. Postoperative client with new confusion and respiratory rate of 32/min
Rationale: New confusion combined with tachypnea suggests acute deterioration, potentially
related to impaired oxygenation. The client requires immediate assessment. The other clients
are comparatively stable.
8. A client receiving morphine becomes difficult to arouse and has a respiratory rate of 6/min.
Which medication should the nurse anticipate?
A. Naloxone
B. Flumazenil
C. Protamine sulfate
D. Vitamin K
Correct Answer: A. Naloxone
Rationale: Naloxone is an opioid antagonist that reverses opioid-induced respiratory
depression. Flumazenil reverses benzodiazepines, protamine reverses heparin, and vitamin K is
used to reverse warfarin effects.
, 9. A client with hyperkalemia develops peaked T waves. Which medication should the nurse
anticipate administering to stabilize the myocardium?
A. IV calcium gluconate
B. Oral potassium chloride
C. IV magnesium sulfate
D. Sodium chloride tablets
Correct Answer: A. IV calcium gluconate
Rationale: IV calcium gluconate stabilizes the cardiac membrane during significant hyperkalemia
with ECG changes. It does not remove potassium from the body but reduces the immediate risk
of lethal dysrhythmias.
10. A client with suspected bacterial meningitis is admitted. Which isolation precaution
should the nurse initiate?
A. Contact
B. Airborne
C. Droplet
D. Protective
Correct Answer: C. Droplet
Rationale: Suspected bacterial meningitis requires droplet precautions because organisms may
be transmitted through respiratory secretions. Standard precautions are also maintained.
11. A postpartum client has heavy vaginal bleeding and a boggy uterus. Which intervention
should the nurse perform first?
A. Prepare the client for surgery
B. Massage the uterine fundus
C. Encourage ambulation
D. Apply an abdominal heating pad
Correct Answer: B. Massage the uterine fundus
Rationale: A boggy uterus indicates uterine atony, a common cause of postpartum hemorrhage.
Fundal massage promotes uterine contraction and is an immediate nursing intervention.
