HESI EXIT EXAM REVIEW
(NIGHTINGALE COLLEGE) LATEST
2026 ACTUAL QUESTIONS AND
CORRECT DETAILED ANSWERS
1. A client who is 24 hours post-thyroidectomy develops tingling in the fingertips and around
the mouth. Which assessment should the nurse perform first?
A. Assess for Chvostek’s sign by tapping the facial nerve
B. Check the client’s temperature for signs of infection
C. Measure the client’s blood pressure in both arms
D. Evaluate the client’s ability to swallow clear liquids
Answer: A
Conceptual Explanation: Tingling around the mouth and in the fingertips (paresthesia)
after a thyroidectomy suggests hypocalcemia due to accidental parathyroid gland removal.
Chvostek’s sign is a classic test for hypocalcemia.
2. A client with chronic kidney disease has a serum potassium level of 6.8 mEq/L. Which
medication should the nurse anticipate administering immediately to protect the heart?
A. Sodium polystyrene sulfonate
B. Furosemide
,C. Calcium gluconate
D. Epoetin alfa
Answer: C
Conceptual Explanation: Calcium gluconate does not lower potassium but antagonizes
the membrane effect of hyperkalemia on the heart, preventing lethal arrhythmias. Sodium
polystyrene sulfonate is used to lower potassium but takes longer to act.
3. The nurse is caring for a client with preeclampsia receiving intravenous Magnesium Sulfate.
The nurse notes deep tendon reflexes are absent and respirations are 10 breaths/minute.
What is the priority action?
A. Increase the infusion rate to prevent seizures
B. Notify the provider to request a STAT chest X-ray
C. Stop the infusion and prepare to administer Calcium Gluconate
D. Place the client in a Trendelenburg position
Answer: C
Conceptual Explanation: Absent reflexes and respiratory depression are signs of
magnesium toxicity. The immediate action is to stop the magnesium and prepare the
antidote, calcium gluconate.
, 4. Which clinical manifestation is most characteristic of a client experiencing a systemic lupus
erythematosus (SLE) flare-up?
A. Butterfly-shaped rash across the bridge of the nose and cheeks
B. Intense pain and swelling in the great toe
C. Weight gain and increased appetite
D. Decreased erythrocyte sedimentation rate (ESR)
Answer: A
Conceptual Explanation: The malar (butterfly) rash is a classic systemic sign of SLE. Other
signs include photosensitivity and joint pain. ESR is usually increased, not decreased,
during a flare.
5. A client is admitted with suspected bacterial meningitis. Which type of precautions should
the nurse implement?
A. Standard precautions only
B. Airborne precautions
C. Droplet precautions
D. Contact precautions
Answer: C
(NIGHTINGALE COLLEGE) LATEST
2026 ACTUAL QUESTIONS AND
CORRECT DETAILED ANSWERS
1. A client who is 24 hours post-thyroidectomy develops tingling in the fingertips and around
the mouth. Which assessment should the nurse perform first?
A. Assess for Chvostek’s sign by tapping the facial nerve
B. Check the client’s temperature for signs of infection
C. Measure the client’s blood pressure in both arms
D. Evaluate the client’s ability to swallow clear liquids
Answer: A
Conceptual Explanation: Tingling around the mouth and in the fingertips (paresthesia)
after a thyroidectomy suggests hypocalcemia due to accidental parathyroid gland removal.
Chvostek’s sign is a classic test for hypocalcemia.
2. A client with chronic kidney disease has a serum potassium level of 6.8 mEq/L. Which
medication should the nurse anticipate administering immediately to protect the heart?
A. Sodium polystyrene sulfonate
B. Furosemide
,C. Calcium gluconate
D. Epoetin alfa
Answer: C
Conceptual Explanation: Calcium gluconate does not lower potassium but antagonizes
the membrane effect of hyperkalemia on the heart, preventing lethal arrhythmias. Sodium
polystyrene sulfonate is used to lower potassium but takes longer to act.
3. The nurse is caring for a client with preeclampsia receiving intravenous Magnesium Sulfate.
The nurse notes deep tendon reflexes are absent and respirations are 10 breaths/minute.
What is the priority action?
A. Increase the infusion rate to prevent seizures
B. Notify the provider to request a STAT chest X-ray
C. Stop the infusion and prepare to administer Calcium Gluconate
D. Place the client in a Trendelenburg position
Answer: C
Conceptual Explanation: Absent reflexes and respiratory depression are signs of
magnesium toxicity. The immediate action is to stop the magnesium and prepare the
antidote, calcium gluconate.
, 4. Which clinical manifestation is most characteristic of a client experiencing a systemic lupus
erythematosus (SLE) flare-up?
A. Butterfly-shaped rash across the bridge of the nose and cheeks
B. Intense pain and swelling in the great toe
C. Weight gain and increased appetite
D. Decreased erythrocyte sedimentation rate (ESR)
Answer: A
Conceptual Explanation: The malar (butterfly) rash is a classic systemic sign of SLE. Other
signs include photosensitivity and joint pain. ESR is usually increased, not decreased,
during a flare.
5. A client is admitted with suspected bacterial meningitis. Which type of precautions should
the nurse implement?
A. Standard precautions only
B. Airborne precautions
C. Droplet precautions
D. Contact precautions
Answer: C
