2023 NGN RN HESI Exit Exam — Questions, Answer Key
& Source Rationales, Questions with Answers
Introduction
This document contains 150 core RN HESI Exit Exam questions
covering medical-surgical nursing, pediatrics, maternity,
pharmacology, mental health, prioritization, delegation, infection
control, and calculations. It also includes 7 bonus hot spot questions, a
3-question pharmacology mini-exam, the complete answer key, and
detailed source rationales.
Exam Questions and Answers
Contents
Part I — Core RN Questions 1–85
Part II — Core RN Questions 86–150
Part III — Bonus Hot Spot Questions 1–7
Part IV — Pharmacology Mini-Exam 1–3
Part V — Core RN Answer Key 1–150
Part VI — Detailed Core RN Rationales 1–150
Part VII — Bonus Hot Spot Answers & Rationales
Part VIII — Pharmacology Answers & Rationales
1
,Part I — Core RN Questions 1–85
Select the best answer unless the question states “Select all that
apply” or is a calculation/sequence item.
1. The nurse is reviewing medical prescriptions for newly admitted
clients. It would be a priority for the nurse to follow up with the
physician if a client with
a. a potassium level of 4.5mEq/L has Kayexalate (sodium
polystyrene) prescribed
b. a Dilantin (phenytoin) level of 8 mcg/ml is placed on seizure
precautions
c. sensitivity to Aspirin (acetylsalicylic acid) is prescribed Tylenol
(acetaminophen)
d. sensitivity to Penicillin is prescribed Zithromax (azithromycin)
2. The nurse from the postpartum unit has been temporarily assigned
to the medical surgical unit. It would be most appropriate to assign
this nurse to the client who*
a. has returned from right total hip replacement surgery four hours
ago
b. is being observed for increased intracranial pressure
c. had surgery two hours ago to remove the appendix
d. is two weeks post partum being maintained on a mechanical
ventilator for respiratory failure
3. The nurse should intervene if the nurse notes a staff member
a. obtaining a clients consent prior to their operative procedure
after receiving Ativan (lorazepam)
b. placing a client on the affected side following surgical repair of a
retinal detachment
c. handling a wet cast with the palms of the hands
2
, d. using a broad base of support while transferring a client
4. The community health nurse is caring for the following clients. It
would be a priority for the nurse to initiate a multidisciplinary
conference for the client who is
a. 12 years old with Autism who is starting a new school and
recently had a URI (upper respiratory tract infection)
b. 16 years old, has type 1 Diabetes Mellitus, is unemployed and had
a recent Hemoglobin A1c of 13%
c. 52 years old, with Myasthenia Gravis, recently prescribed
Mestinon (pyridostigmine) and employed as a mail carrier
d. 70 years old, has schizophrenia, lives alone and reports hearing
non threatening voices.
5. The nurse in a well baby clinic has assessed several children today.
It would be a priority for the nurse to suggest follow up for the child
who is
a. 2 months old with a positive babinski reflex
b. 5 months old and does not hold their own bottle
c. 10 months old who cries around strangers
d. 18 months old who needs support while ambulating
6. The nurse is caring for a mechanically ventilated client who was
declared brain dead. An Advance Directive is not documented on the
medical record. It would be most appropriate to obtain consent for
organ donation from the
a. client’s primary care provider
b. client’s nurse manager
c. closest living family member
d. hospital‘s ethics committee
3
, 7. The nurse has received report on four clients. The nurse should first
assess the client who has*
a. Chronic Obstructive Pulmonary Disease (COPD) with a pulse
oximetry reading of 90%
b. Parkinson‘s Disease and is demanding to leave the hospital
against medical advice (AMA)
c. been admitted with suspected Guillian-Barre´ Syndrome and has
begun plasmapheresis therapy
d. Congestive Heart Failure (CHF) whose pitting edema has
increased to 2(+)
8. It would be appropriate to assign which of these tasks to the CNA?
a. Feeding a client who is experiencing dysphagia
b. One-on-one client observation for safety
c. Removal of an indwelling catheter
d. Performing a simple dressing change
9. The nurse should intervene if a staff member is observed
a. discussing a client’s diagnosis with visiting family members
b. collaborating with another nurse to review a prescription for
blood transfusion
c. interrupting other staff members discussing a client in the
cafeteria
d. reviewing a clients lab values with the nutritionist
10. The nurse is preparing a staff presentation on legal and ethical
issues in nursing. The nurse would be correct to include which of the
following examples?
a. Putting a client in a geriatric chair with the lap tray in front of
the client in the day room to watch television is false imprisonment
4
& Source Rationales, Questions with Answers
Introduction
This document contains 150 core RN HESI Exit Exam questions
covering medical-surgical nursing, pediatrics, maternity,
pharmacology, mental health, prioritization, delegation, infection
control, and calculations. It also includes 7 bonus hot spot questions, a
3-question pharmacology mini-exam, the complete answer key, and
detailed source rationales.
Exam Questions and Answers
Contents
Part I — Core RN Questions 1–85
Part II — Core RN Questions 86–150
Part III — Bonus Hot Spot Questions 1–7
Part IV — Pharmacology Mini-Exam 1–3
Part V — Core RN Answer Key 1–150
Part VI — Detailed Core RN Rationales 1–150
Part VII — Bonus Hot Spot Answers & Rationales
Part VIII — Pharmacology Answers & Rationales
1
,Part I — Core RN Questions 1–85
Select the best answer unless the question states “Select all that
apply” or is a calculation/sequence item.
1. The nurse is reviewing medical prescriptions for newly admitted
clients. It would be a priority for the nurse to follow up with the
physician if a client with
a. a potassium level of 4.5mEq/L has Kayexalate (sodium
polystyrene) prescribed
b. a Dilantin (phenytoin) level of 8 mcg/ml is placed on seizure
precautions
c. sensitivity to Aspirin (acetylsalicylic acid) is prescribed Tylenol
(acetaminophen)
d. sensitivity to Penicillin is prescribed Zithromax (azithromycin)
2. The nurse from the postpartum unit has been temporarily assigned
to the medical surgical unit. It would be most appropriate to assign
this nurse to the client who*
a. has returned from right total hip replacement surgery four hours
ago
b. is being observed for increased intracranial pressure
c. had surgery two hours ago to remove the appendix
d. is two weeks post partum being maintained on a mechanical
ventilator for respiratory failure
3. The nurse should intervene if the nurse notes a staff member
a. obtaining a clients consent prior to their operative procedure
after receiving Ativan (lorazepam)
b. placing a client on the affected side following surgical repair of a
retinal detachment
c. handling a wet cast with the palms of the hands
2
, d. using a broad base of support while transferring a client
4. The community health nurse is caring for the following clients. It
would be a priority for the nurse to initiate a multidisciplinary
conference for the client who is
a. 12 years old with Autism who is starting a new school and
recently had a URI (upper respiratory tract infection)
b. 16 years old, has type 1 Diabetes Mellitus, is unemployed and had
a recent Hemoglobin A1c of 13%
c. 52 years old, with Myasthenia Gravis, recently prescribed
Mestinon (pyridostigmine) and employed as a mail carrier
d. 70 years old, has schizophrenia, lives alone and reports hearing
non threatening voices.
5. The nurse in a well baby clinic has assessed several children today.
It would be a priority for the nurse to suggest follow up for the child
who is
a. 2 months old with a positive babinski reflex
b. 5 months old and does not hold their own bottle
c. 10 months old who cries around strangers
d. 18 months old who needs support while ambulating
6. The nurse is caring for a mechanically ventilated client who was
declared brain dead. An Advance Directive is not documented on the
medical record. It would be most appropriate to obtain consent for
organ donation from the
a. client’s primary care provider
b. client’s nurse manager
c. closest living family member
d. hospital‘s ethics committee
3
, 7. The nurse has received report on four clients. The nurse should first
assess the client who has*
a. Chronic Obstructive Pulmonary Disease (COPD) with a pulse
oximetry reading of 90%
b. Parkinson‘s Disease and is demanding to leave the hospital
against medical advice (AMA)
c. been admitted with suspected Guillian-Barre´ Syndrome and has
begun plasmapheresis therapy
d. Congestive Heart Failure (CHF) whose pitting edema has
increased to 2(+)
8. It would be appropriate to assign which of these tasks to the CNA?
a. Feeding a client who is experiencing dysphagia
b. One-on-one client observation for safety
c. Removal of an indwelling catheter
d. Performing a simple dressing change
9. The nurse should intervene if a staff member is observed
a. discussing a client’s diagnosis with visiting family members
b. collaborating with another nurse to review a prescription for
blood transfusion
c. interrupting other staff members discussing a client in the
cafeteria
d. reviewing a clients lab values with the nutritionist
10. The nurse is preparing a staff presentation on legal and ethical
issues in nursing. The nurse would be correct to include which of the
following examples?
a. Putting a client in a geriatric chair with the lap tray in front of
the client in the day room to watch television is false imprisonment
4
