HESI RN Exit Exam 2026 V6–V8 Verified Examplify
Pack – Complete Actual Exam Questions
Practice Exam – Version 1 (Questions 1–75)
1. A nurse is caring for a client who is 2 days postoperative following a total abdominal hysterectomy. The
client reports sudden shortness of breath and chest pain. Vital signs: HR 122, BP 98/60, RR 28, SpO₂ 88% on
room air. Which action should the nurse take first?
A. Administer prescribed morphine sulfate for pain
B. Apply oxygen and raise the head of the bed
C. Obtain a 12-lead ECG
D. Notify the surgeon
Correct Answer: B
Rationale: The client is demonstrating signs of a pulmonary embolism (sudden dyspnea, chest pain,
tachycardia, hypoxemia following pelvic surgery). The priority nursing action is to apply oxygen and position
the client upright to improve ventilation and oxygenation. While ECG and notification are important,
oxygenation is the immediate physiological need. Morphine is not the first action and could mask
symptoms.
2. A nurse is reviewing lab results for a client with chronic kidney disease. Which finding requires immediate
intervention?
A. Potassium 6.8 mEq/L
B. Hemoglobin 9.2 g/dL
C. Calcium 8.8 mg/dL
D. Phosphorus 5.0 mg/dL
Correct Answer: A
Rationale: A potassium level of 6.8 mEq/L is critically elevated and places the client at risk for life-
threatening cardiac dysrhythmias. Normal potassium is 3.5–5.0 mEq/L. The other values are expected or
only mildly abnormal in CKD. Immediate intervention (ECG, calcium gluconate, insulin/glucose, kayexalate)
is required.
3. A nurse is teaching a client newly diagnosed with type 1 diabetes about insulin administration. Which
statement by the client indicates correct understanding?
A. "I will inject my insulin into the same spot every time."
B. "I should rotate injection sites to prevent tissue damage."
,C. "I can skip my insulin if I'm not eating."
D. "I will store my unopened insulin in the freezer."
Correct Answer: B
Rationale: Rotating injection sites prevents lipohypertrophy and ensures consistent insulin absorption.
Injecting the same site causes tissue damage. Insulin should never be skipped in type 1 diabetes (risk of
DKA). Unopened insulin is stored in the refrigerator, not the freezer.
4. A nurse is assessing a client with suspected meningitis. Which finding should the nurse expect?
A. Positive Brudzinski's sign
B. Positive Homans' sign
C. Positive Babinski sign in an adult
D. Positive Trousseau's sign
Correct Answer: A
Rationale: Brudzinski's sign (involuntary flexion of hips and knees when the neck is flexed) is a classic
meningeal irritation sign associated with meningitis. Homans' sign is associated with DVT. Babinski in
adults indicates upper motor neuron damage. Trousseau's sign is associated with hypocalcemia.
5. A nurse is caring for a client receiving a blood transfusion. Ten minutes into the transfusion, the client
develops fever, chills, and flank pain. Which action should the nurse take first?
A. Slow the transfusion rate
B. Administer acetaminophen
C. Stop the transfusion immediately
D. Obtain a urine specimen
Correct Answer: C
Rationale: Fever, chills, and flank pain suggest an acute hemolytic transfusion reaction. The first action is to
stop the transfusion immediately to prevent further hemolysis. Then maintain IV access with normal saline,
notify the provider, and obtain specimens per protocol.
6. A nurse is providing discharge teaching to a client with heart failure. Which instruction should be
included?
A. "Weigh yourself weekly."
B. "Limit sodium to 4 grams per day."
C. "Report a weight gain of 2–3 pounds in one day."
D. "Drink at least 3 liters of fluid daily."
Correct Answer: C
, Rationale: Daily weight monitoring is essential in heart failure. A gain of 2–3 pounds in one day or 5 pounds
in one week indicates fluid retention and should be reported. Sodium should be limited to 2–3 g/day, daily
(not weekly) weights are recommended, and fluid restriction may be necessary.
7. A nurse is assessing a client with a suspected peptic ulcer. Which symptom is most characteristic?
A. Pain relieved by vomiting
B. Burning epigastric pain relieved by food
C. Right lower quadrant pain
D. Pain that radiates to the left shoulder
Correct Answer: B
Rationale: Duodenal ulcer pain is typically burning epigastric pain that is relieved by food. Gastric ulcer pain
may worsen with food. Right lower quadrant pain suggests appendicitis. Left shoulder pain suggests
splenic or diaphragmatic irritation.
8. A nurse is caring for a client in labor. The fetal heart rate tracing shows late decelerations. Which action
should the nurse take first?
A. Increase the oxytocin rate
B. Turn the client to the left side
C. Prepare for immediate delivery
D. Administer a bolus of IV fluids
Correct Answer: B
Rationale: Late decelerations indicate uteroplacental insufficiency. The first nursing action is to reposition
the client to the left side to improve uterine perfusion. Other measures include stopping oxytocin,
administering oxygen, and IV fluids. Immediate delivery is considered if decelerations persist.
9. A nurse is reviewing medications for a client with asthma. Which medication is a long-term controller?
A. Albuterol
B. Levalbuterol
C. Inhaled corticosteroid
D. Ipratropium
Correct Answer: C
Rationale: Inhaled corticosteroids (e.g., fluticasone, budesonide) are long-term controllers used to reduce
airway inflammation. Albuterol, levalbuterol, and ipratropium are rescue/quick-relief medications.
10. A nurse is assessing a client with cirrhosis. Which finding indicates worsening hepatic encephalopathy?
Pack – Complete Actual Exam Questions
Practice Exam – Version 1 (Questions 1–75)
1. A nurse is caring for a client who is 2 days postoperative following a total abdominal hysterectomy. The
client reports sudden shortness of breath and chest pain. Vital signs: HR 122, BP 98/60, RR 28, SpO₂ 88% on
room air. Which action should the nurse take first?
A. Administer prescribed morphine sulfate for pain
B. Apply oxygen and raise the head of the bed
C. Obtain a 12-lead ECG
D. Notify the surgeon
Correct Answer: B
Rationale: The client is demonstrating signs of a pulmonary embolism (sudden dyspnea, chest pain,
tachycardia, hypoxemia following pelvic surgery). The priority nursing action is to apply oxygen and position
the client upright to improve ventilation and oxygenation. While ECG and notification are important,
oxygenation is the immediate physiological need. Morphine is not the first action and could mask
symptoms.
2. A nurse is reviewing lab results for a client with chronic kidney disease. Which finding requires immediate
intervention?
A. Potassium 6.8 mEq/L
B. Hemoglobin 9.2 g/dL
C. Calcium 8.8 mg/dL
D. Phosphorus 5.0 mg/dL
Correct Answer: A
Rationale: A potassium level of 6.8 mEq/L is critically elevated and places the client at risk for life-
threatening cardiac dysrhythmias. Normal potassium is 3.5–5.0 mEq/L. The other values are expected or
only mildly abnormal in CKD. Immediate intervention (ECG, calcium gluconate, insulin/glucose, kayexalate)
is required.
3. A nurse is teaching a client newly diagnosed with type 1 diabetes about insulin administration. Which
statement by the client indicates correct understanding?
A. "I will inject my insulin into the same spot every time."
B. "I should rotate injection sites to prevent tissue damage."
,C. "I can skip my insulin if I'm not eating."
D. "I will store my unopened insulin in the freezer."
Correct Answer: B
Rationale: Rotating injection sites prevents lipohypertrophy and ensures consistent insulin absorption.
Injecting the same site causes tissue damage. Insulin should never be skipped in type 1 diabetes (risk of
DKA). Unopened insulin is stored in the refrigerator, not the freezer.
4. A nurse is assessing a client with suspected meningitis. Which finding should the nurse expect?
A. Positive Brudzinski's sign
B. Positive Homans' sign
C. Positive Babinski sign in an adult
D. Positive Trousseau's sign
Correct Answer: A
Rationale: Brudzinski's sign (involuntary flexion of hips and knees when the neck is flexed) is a classic
meningeal irritation sign associated with meningitis. Homans' sign is associated with DVT. Babinski in
adults indicates upper motor neuron damage. Trousseau's sign is associated with hypocalcemia.
5. A nurse is caring for a client receiving a blood transfusion. Ten minutes into the transfusion, the client
develops fever, chills, and flank pain. Which action should the nurse take first?
A. Slow the transfusion rate
B. Administer acetaminophen
C. Stop the transfusion immediately
D. Obtain a urine specimen
Correct Answer: C
Rationale: Fever, chills, and flank pain suggest an acute hemolytic transfusion reaction. The first action is to
stop the transfusion immediately to prevent further hemolysis. Then maintain IV access with normal saline,
notify the provider, and obtain specimens per protocol.
6. A nurse is providing discharge teaching to a client with heart failure. Which instruction should be
included?
A. "Weigh yourself weekly."
B. "Limit sodium to 4 grams per day."
C. "Report a weight gain of 2–3 pounds in one day."
D. "Drink at least 3 liters of fluid daily."
Correct Answer: C
, Rationale: Daily weight monitoring is essential in heart failure. A gain of 2–3 pounds in one day or 5 pounds
in one week indicates fluid retention and should be reported. Sodium should be limited to 2–3 g/day, daily
(not weekly) weights are recommended, and fluid restriction may be necessary.
7. A nurse is assessing a client with a suspected peptic ulcer. Which symptom is most characteristic?
A. Pain relieved by vomiting
B. Burning epigastric pain relieved by food
C. Right lower quadrant pain
D. Pain that radiates to the left shoulder
Correct Answer: B
Rationale: Duodenal ulcer pain is typically burning epigastric pain that is relieved by food. Gastric ulcer pain
may worsen with food. Right lower quadrant pain suggests appendicitis. Left shoulder pain suggests
splenic or diaphragmatic irritation.
8. A nurse is caring for a client in labor. The fetal heart rate tracing shows late decelerations. Which action
should the nurse take first?
A. Increase the oxytocin rate
B. Turn the client to the left side
C. Prepare for immediate delivery
D. Administer a bolus of IV fluids
Correct Answer: B
Rationale: Late decelerations indicate uteroplacental insufficiency. The first nursing action is to reposition
the client to the left side to improve uterine perfusion. Other measures include stopping oxytocin,
administering oxygen, and IV fluids. Immediate delivery is considered if decelerations persist.
9. A nurse is reviewing medications for a client with asthma. Which medication is a long-term controller?
A. Albuterol
B. Levalbuterol
C. Inhaled corticosteroid
D. Ipratropium
Correct Answer: C
Rationale: Inhaled corticosteroids (e.g., fluticasone, budesonide) are long-term controllers used to reduce
airway inflammation. Albuterol, levalbuterol, and ipratropium are rescue/quick-relief medications.
10. A nurse is assessing a client with cirrhosis. Which finding indicates worsening hepatic encephalopathy?
