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HESI EXIT EXAM / NGN HESI RN EXIT EXAM ACTUAL TEST BANK
2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE ACCURATE EXAM
COMPLETE REAL QUESTIONS AND CORRECT VERIFIED ANSWERS.
QUESTION 1
A 68-year-old client with a history of chronic heart failure is admitted with
increasing dyspnea, bilateral crackles, 3+ dependent edema, and an oxygen
saturation of 88% on room air. The client is anxious and reports that the shortness
of breath became significantly worse overnight. Which intervention should the
nurse implement first?
A. Administer the prescribed oral diuretic and reassess the client in 30 minutes.
B. Place the client in high-Fowler position and apply supplemental oxygen as
prescribed.
C. Encourage the client to increase oral fluid intake to improve renal perfusion.
D. Obtain the client's daily weight before initiating any other intervention.
Answer: B
QUESTION 2
A client with type 1 diabetes mellitus is admitted with nausea, vomiting,
abdominal pain, polyuria, and deep, rapid respirations. Laboratory results reveal a
markedly elevated blood glucose level, metabolic acidosis, and positive serum
ketones. Which prescription should the nurse anticipate implementing as a
priority?
A. Begin intravenous regular insulin therapy according to the prescribed protocol.
B. Administer long-acting subcutaneous insulin and restrict intravenous fluids.
C. Give sodium bicarbonate routinely regardless of the client's arterial pH.
D. Administer oral glucose to prevent further metabolic deterioration.
Answer: A
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QUESTION 3
A postoperative client suddenly develops severe dyspnea, pleuritic chest pain,
tachycardia, and an oxygen saturation of 84%. The client appears frightened and
restless. Which action should the nurse take first?
A. Encourage the client to ambulate to improve pulmonary circulation.
B. Place the client in a supine position and reassess after 15 minutes.
C. Apply supplemental oxygen and rapidly assess the client's respiratory status.
D. Administer the prescribed opioid analgesic before notifying the healthcare
provider.
Answer: C
QUESTION 4
A client receiving a continuous intravenous heparin infusion develops bleeding
from the gums and reports new severe headache. The nurse notes several large
areas of ecchymosis. Which action is most appropriate?
A. Increase the infusion rate because the client may have inadequate
anticoagulation.
B. Hold the heparin infusion and immediately notify the healthcare provider.
C. Administer the next scheduled dose of aspirin to prevent thrombosis.
D. Encourage vigorous oral hygiene to reduce the gingival bleeding.
Answer: B
QUESTION 5
A client with chronic obstructive pulmonary disease is receiving oxygen therapy
and becomes increasingly drowsy. The respiratory rate decreases from 20 to 10
breaths/minute, and the client is difficult to arouse. Which assessment finding
requires the most immediate intervention?
,3
A. The client reports decreased appetite during the previous day.
B. The client's respiratory effort has become shallow with increasing somnolence.
C. The client has a productive cough containing small amounts of clear sputum.
D. The client reports mild fatigue after walking to the bathroom.
Answer: B
QUESTION 6
A client with a newly diagnosed myocardial infarction reports crushing substernal
chest pain that radiates to the left arm and jaw. The client is pale, diaphoretic, and
nauseated. Which nursing action has the highest priority?
A. Place the client on cardiac monitoring and assess vital signs while initiating
prescribed emergency measures.
B. Encourage the client to walk slowly around the room to reduce anxiety.
C. Provide a large meal because nausea may be caused by hypoglycemia.
D. Delay assessment until the healthcare provider arrives on the unit.
Answer: A
QUESTION 7
A client with chronic kidney disease has a serum potassium level of 6.7 mEq/L and
reports muscle weakness and palpitations. The cardiac monitor shows peaked T
waves. Which intervention should the nurse anticipate?
A. Administer potassium supplementation with the prescribed maintenance fluids.
B. Encourage foods containing bananas, oranges, and dried fruits.
C. Prepare to administer prescribed medications that rapidly stabilize the
myocardium and lower serum potassium.
D. Reassure the client that the electrocardiographic changes are expected with
kidney disease.
Answer: C
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QUESTION 8
A client with pneumonia is receiving intravenous antibiotics. Four hours later, the
client develops a temperature of 39.4°C, blood pressure of 82/48 mm Hg, heart
rate of 126/minute, respiratory rate of 30/minute, and altered mental status.
Which condition should the nurse suspect?
A. Stable chronic respiratory failure.
B. Septic shock requiring immediate intervention.
C. Mild dehydration requiring oral fluids only.
D. Expected response to intravenous antibiotic therapy.
Answer: B
QUESTION 9
A client receiving chemotherapy has an absolute neutrophil count of 400/mm³.
Which nursing intervention is most important?
A. Encourage visitors with recent respiratory infections to spend time with the
client.
B. Place fresh flowers in the client's room to improve the environment.
C. Monitor closely for infection and use appropriate infection-prevention
measures.
D. Encourage the client to consume raw fruits and vegetables without washing
them.
Answer: C
QUESTION 10
A client with a history of stroke has difficulty swallowing and begins coughing
repeatedly while attempting to drink water. Which action should the nurse take?
HESI EXIT EXAM / NGN HESI RN EXIT EXAM ACTUAL TEST BANK
2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE ACCURATE EXAM
COMPLETE REAL QUESTIONS AND CORRECT VERIFIED ANSWERS.
QUESTION 1
A 68-year-old client with a history of chronic heart failure is admitted with
increasing dyspnea, bilateral crackles, 3+ dependent edema, and an oxygen
saturation of 88% on room air. The client is anxious and reports that the shortness
of breath became significantly worse overnight. Which intervention should the
nurse implement first?
A. Administer the prescribed oral diuretic and reassess the client in 30 minutes.
B. Place the client in high-Fowler position and apply supplemental oxygen as
prescribed.
C. Encourage the client to increase oral fluid intake to improve renal perfusion.
D. Obtain the client's daily weight before initiating any other intervention.
Answer: B
QUESTION 2
A client with type 1 diabetes mellitus is admitted with nausea, vomiting,
abdominal pain, polyuria, and deep, rapid respirations. Laboratory results reveal a
markedly elevated blood glucose level, metabolic acidosis, and positive serum
ketones. Which prescription should the nurse anticipate implementing as a
priority?
A. Begin intravenous regular insulin therapy according to the prescribed protocol.
B. Administer long-acting subcutaneous insulin and restrict intravenous fluids.
C. Give sodium bicarbonate routinely regardless of the client's arterial pH.
D. Administer oral glucose to prevent further metabolic deterioration.
Answer: A
,2
QUESTION 3
A postoperative client suddenly develops severe dyspnea, pleuritic chest pain,
tachycardia, and an oxygen saturation of 84%. The client appears frightened and
restless. Which action should the nurse take first?
A. Encourage the client to ambulate to improve pulmonary circulation.
B. Place the client in a supine position and reassess after 15 minutes.
C. Apply supplemental oxygen and rapidly assess the client's respiratory status.
D. Administer the prescribed opioid analgesic before notifying the healthcare
provider.
Answer: C
QUESTION 4
A client receiving a continuous intravenous heparin infusion develops bleeding
from the gums and reports new severe headache. The nurse notes several large
areas of ecchymosis. Which action is most appropriate?
A. Increase the infusion rate because the client may have inadequate
anticoagulation.
B. Hold the heparin infusion and immediately notify the healthcare provider.
C. Administer the next scheduled dose of aspirin to prevent thrombosis.
D. Encourage vigorous oral hygiene to reduce the gingival bleeding.
Answer: B
QUESTION 5
A client with chronic obstructive pulmonary disease is receiving oxygen therapy
and becomes increasingly drowsy. The respiratory rate decreases from 20 to 10
breaths/minute, and the client is difficult to arouse. Which assessment finding
requires the most immediate intervention?
,3
A. The client reports decreased appetite during the previous day.
B. The client's respiratory effort has become shallow with increasing somnolence.
C. The client has a productive cough containing small amounts of clear sputum.
D. The client reports mild fatigue after walking to the bathroom.
Answer: B
QUESTION 6
A client with a newly diagnosed myocardial infarction reports crushing substernal
chest pain that radiates to the left arm and jaw. The client is pale, diaphoretic, and
nauseated. Which nursing action has the highest priority?
A. Place the client on cardiac monitoring and assess vital signs while initiating
prescribed emergency measures.
B. Encourage the client to walk slowly around the room to reduce anxiety.
C. Provide a large meal because nausea may be caused by hypoglycemia.
D. Delay assessment until the healthcare provider arrives on the unit.
Answer: A
QUESTION 7
A client with chronic kidney disease has a serum potassium level of 6.7 mEq/L and
reports muscle weakness and palpitations. The cardiac monitor shows peaked T
waves. Which intervention should the nurse anticipate?
A. Administer potassium supplementation with the prescribed maintenance fluids.
B. Encourage foods containing bananas, oranges, and dried fruits.
C. Prepare to administer prescribed medications that rapidly stabilize the
myocardium and lower serum potassium.
D. Reassure the client that the electrocardiographic changes are expected with
kidney disease.
Answer: C
, 4
QUESTION 8
A client with pneumonia is receiving intravenous antibiotics. Four hours later, the
client develops a temperature of 39.4°C, blood pressure of 82/48 mm Hg, heart
rate of 126/minute, respiratory rate of 30/minute, and altered mental status.
Which condition should the nurse suspect?
A. Stable chronic respiratory failure.
B. Septic shock requiring immediate intervention.
C. Mild dehydration requiring oral fluids only.
D. Expected response to intravenous antibiotic therapy.
Answer: B
QUESTION 9
A client receiving chemotherapy has an absolute neutrophil count of 400/mm³.
Which nursing intervention is most important?
A. Encourage visitors with recent respiratory infections to spend time with the
client.
B. Place fresh flowers in the client's room to improve the environment.
C. Monitor closely for infection and use appropriate infection-prevention
measures.
D. Encourage the client to consume raw fruits and vegetables without washing
them.
Answer: C
QUESTION 10
A client with a history of stroke has difficulty swallowing and begins coughing
repeatedly while attempting to drink water. Which action should the nurse take?
