HESI EXIT RN EXAM 2026/2027 – EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALE | 2027 Q&A | INSTANT DOWNLOAD PDF
1. A nurse is caring for a client who is postoperative and suddenly becomes
restless, tachypneic, and anxious. The oxygen saturation has decreased from
97% to 88%. Which action should the nurse take first?
A. Notify the healthcare provider of the change. B. Administer the prescribed opioid analgesic.
C. Apply supplemental oxygen and assess the client's airway and breathing. D. Obtain a
prescription for a chest radiograph.
Rationale: The immediate priority is airway and breathing because the client has signs of
impaired oxygenation. Supplemental oxygen and rapid respiratory assessment should occur
before notification or diagnostic testing.
2. A client with heart failure is being discharged. Which statement indicates that the
client understands an important measure for detecting worsening fluid retention?
A. "I will weigh myself every morning using the same scale." B. "I will drink extra fluids
whenever I feel tired." C. "I only need to check my weight when my ankles swell." D. "I should
weigh myself immediately after every meal."
Rationale: Daily weights obtained under consistent conditions can identify fluid retention before
significant edema or respiratory symptoms develop. A rapid weight increase should be reported
according to the prescribed plan.
3. A nurse is preparing to administer digoxin to an adult client. The client's apical
pulse is 54 beats/min. What should the nurse do?
A. Administer the medication with food. B. Withhold the dose and notify the healthcare
provider. C. Give the medication and reassess the pulse in 30 minutes. D. Administer an
additional dose if the client reports fatigue.
Rationale: Digoxin can decrease the heart rate. An adult pulse below the facility's prescribed
threshold, commonly 60 beats/min, requires withholding the medication and further evaluation.
4. A client with diabetes mellitus becomes shaky, diaphoretic, and confused before
lunch. The client's blood glucose is 52 mg/dL, and the client is awake and able to
swallow. Which intervention is appropriate?
A. Administer the scheduled insulin. B. Give a high-protein meal immediately. C. Place the
client in a supine position and reassess in 1 hour. D. Provide a rapid-acting source of oral
carbohydrate.
,Rationale: The findings are consistent with hypoglycemia. A conscious client who can swallow
should receive a rapidly absorbed carbohydrate, followed by reassessment of blood glucose.
5. A nurse is caring for a client receiving a blood transfusion. Fifteen minutes after
the transfusion begins, the client develops chills and low back pain. What is the
nurse's priority action?
A. Slow the transfusion rate. B. Administer the prescribed antipyretic. C. Obtain a urine
specimen. D. Stop the transfusion immediately and maintain IV access with appropriate
solution.
Rationale: Chills and back pain can indicate an acute transfusion reaction. The transfusion must
be stopped immediately while IV access is maintained according to transfusion-reaction
protocol.
6. A client with chronic obstructive pulmonary disease is receiving oxygen. Which
finding requires the nurse's most immediate attention?
A. Oxygen saturation of 91% while receiving prescribed oxygen. B. Productive cough with clear
sputum. C. Respiratory rate of 22/min. D. Increasing somnolence and difficulty maintaining
arousal.
Rationale: Increasing somnolence may indicate worsening hypoventilation and carbon dioxide
retention. A change in level of consciousness in a client with respiratory disease requires prompt
assessment.
7. A client is receiving warfarin therapy. Which laboratory test is most important for
evaluating the medication's therapeutic effect?
A. Activated partial thromboplastin time. B. Platelet count. C. International normalized ratio.
D. Serum creatinine.
Rationale: Warfarin therapy is monitored primarily using the INR. The aPTT is generally used
to monitor unfractionated heparin therapy.
8. A client with a new prescription for an angiotensin-converting enzyme inhibitor
reports swelling of the lips and tongue. Which action is the priority?
A. Give the next dose with food. B. Hold the medication and initiate emergency assessment
for airway compromise. C. Reassure the client that this is an expected effect. D. Encourage
increased oral fluid intake.
Rationale: Facial and tongue swelling may represent angioedema, a potentially life-threatening
reaction that can obstruct the airway. Immediate intervention is required.
, 9. A nurse is caring for a client with suspected increased intracranial pressure.
Which assessment finding is most concerning?
A. Mild headache relieved by rest. B. Pupils equal and reactive to light. C. Blood pressure of
118/72 mm Hg. D. Decreasing level of consciousness with a newly irregular respiratory
pattern.
Rationale: A declining level of consciousness and abnormal respiratory pattern can indicate
worsening intracranial pressure and neurologic deterioration. Prompt intervention is required.
10. A client with pneumonia has a temperature of 39.1°C (102.4°F), respiratory rate
of 30/min, heart rate of 118/min, and new confusion. Which action should the
nurse prioritize?
A. Encourage the client to ambulate. B. Offer a high-calorie snack. C. Recognize possible
systemic deterioration and promptly initiate the prescribed sepsis assessment and response.
D. Delay intervention until the next scheduled vital-sign assessment.
Rationale: Fever, tachycardia, tachypnea, and acute mental-status changes may indicate serious
infection with systemic compromise. Early recognition and timely intervention are essential.
11. A client with chronic kidney disease has a serum potassium level of 6.2 mEq/L.
Which finding requires immediate attention?
A. Mild ankle edema. B. Dry skin. C. Fatigue after activity. D. Newly developed cardiac
dysrhythmia.
Rationale: Severe hyperkalemia can cause life-threatening cardiac conduction abnormalities. A
new dysrhythmia in this setting requires immediate intervention.
12. A nurse is teaching a client who takes furosemide daily. Which food choice
demonstrates understanding of dietary teaching related to potassium?
A. White rice. B. Applesauce. C. Baked potato. D. White bread.
Rationale: Furosemide can increase potassium excretion. Potassium-rich foods such as potatoes
may help maintain potassium levels when appropriate for the client's overall condition and
prescribed diet.
13. A postoperative client reports sudden chest pain and difficulty breathing. The
client is tachycardic and anxious. Which complication should the nurse suspect?
A. Atelectasis caused by prolonged bed rest. B. Pulmonary embolism. C. Constipation related
to opioid therapy. D. Urinary retention.
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALE | 2027 Q&A | INSTANT DOWNLOAD PDF
1. A nurse is caring for a client who is postoperative and suddenly becomes
restless, tachypneic, and anxious. The oxygen saturation has decreased from
97% to 88%. Which action should the nurse take first?
A. Notify the healthcare provider of the change. B. Administer the prescribed opioid analgesic.
C. Apply supplemental oxygen and assess the client's airway and breathing. D. Obtain a
prescription for a chest radiograph.
Rationale: The immediate priority is airway and breathing because the client has signs of
impaired oxygenation. Supplemental oxygen and rapid respiratory assessment should occur
before notification or diagnostic testing.
2. A client with heart failure is being discharged. Which statement indicates that the
client understands an important measure for detecting worsening fluid retention?
A. "I will weigh myself every morning using the same scale." B. "I will drink extra fluids
whenever I feel tired." C. "I only need to check my weight when my ankles swell." D. "I should
weigh myself immediately after every meal."
Rationale: Daily weights obtained under consistent conditions can identify fluid retention before
significant edema or respiratory symptoms develop. A rapid weight increase should be reported
according to the prescribed plan.
3. A nurse is preparing to administer digoxin to an adult client. The client's apical
pulse is 54 beats/min. What should the nurse do?
A. Administer the medication with food. B. Withhold the dose and notify the healthcare
provider. C. Give the medication and reassess the pulse in 30 minutes. D. Administer an
additional dose if the client reports fatigue.
Rationale: Digoxin can decrease the heart rate. An adult pulse below the facility's prescribed
threshold, commonly 60 beats/min, requires withholding the medication and further evaluation.
4. A client with diabetes mellitus becomes shaky, diaphoretic, and confused before
lunch. The client's blood glucose is 52 mg/dL, and the client is awake and able to
swallow. Which intervention is appropriate?
A. Administer the scheduled insulin. B. Give a high-protein meal immediately. C. Place the
client in a supine position and reassess in 1 hour. D. Provide a rapid-acting source of oral
carbohydrate.
,Rationale: The findings are consistent with hypoglycemia. A conscious client who can swallow
should receive a rapidly absorbed carbohydrate, followed by reassessment of blood glucose.
5. A nurse is caring for a client receiving a blood transfusion. Fifteen minutes after
the transfusion begins, the client develops chills and low back pain. What is the
nurse's priority action?
A. Slow the transfusion rate. B. Administer the prescribed antipyretic. C. Obtain a urine
specimen. D. Stop the transfusion immediately and maintain IV access with appropriate
solution.
Rationale: Chills and back pain can indicate an acute transfusion reaction. The transfusion must
be stopped immediately while IV access is maintained according to transfusion-reaction
protocol.
6. A client with chronic obstructive pulmonary disease is receiving oxygen. Which
finding requires the nurse's most immediate attention?
A. Oxygen saturation of 91% while receiving prescribed oxygen. B. Productive cough with clear
sputum. C. Respiratory rate of 22/min. D. Increasing somnolence and difficulty maintaining
arousal.
Rationale: Increasing somnolence may indicate worsening hypoventilation and carbon dioxide
retention. A change in level of consciousness in a client with respiratory disease requires prompt
assessment.
7. A client is receiving warfarin therapy. Which laboratory test is most important for
evaluating the medication's therapeutic effect?
A. Activated partial thromboplastin time. B. Platelet count. C. International normalized ratio.
D. Serum creatinine.
Rationale: Warfarin therapy is monitored primarily using the INR. The aPTT is generally used
to monitor unfractionated heparin therapy.
8. A client with a new prescription for an angiotensin-converting enzyme inhibitor
reports swelling of the lips and tongue. Which action is the priority?
A. Give the next dose with food. B. Hold the medication and initiate emergency assessment
for airway compromise. C. Reassure the client that this is an expected effect. D. Encourage
increased oral fluid intake.
Rationale: Facial and tongue swelling may represent angioedema, a potentially life-threatening
reaction that can obstruct the airway. Immediate intervention is required.
, 9. A nurse is caring for a client with suspected increased intracranial pressure.
Which assessment finding is most concerning?
A. Mild headache relieved by rest. B. Pupils equal and reactive to light. C. Blood pressure of
118/72 mm Hg. D. Decreasing level of consciousness with a newly irregular respiratory
pattern.
Rationale: A declining level of consciousness and abnormal respiratory pattern can indicate
worsening intracranial pressure and neurologic deterioration. Prompt intervention is required.
10. A client with pneumonia has a temperature of 39.1°C (102.4°F), respiratory rate
of 30/min, heart rate of 118/min, and new confusion. Which action should the
nurse prioritize?
A. Encourage the client to ambulate. B. Offer a high-calorie snack. C. Recognize possible
systemic deterioration and promptly initiate the prescribed sepsis assessment and response.
D. Delay intervention until the next scheduled vital-sign assessment.
Rationale: Fever, tachycardia, tachypnea, and acute mental-status changes may indicate serious
infection with systemic compromise. Early recognition and timely intervention are essential.
11. A client with chronic kidney disease has a serum potassium level of 6.2 mEq/L.
Which finding requires immediate attention?
A. Mild ankle edema. B. Dry skin. C. Fatigue after activity. D. Newly developed cardiac
dysrhythmia.
Rationale: Severe hyperkalemia can cause life-threatening cardiac conduction abnormalities. A
new dysrhythmia in this setting requires immediate intervention.
12. A nurse is teaching a client who takes furosemide daily. Which food choice
demonstrates understanding of dietary teaching related to potassium?
A. White rice. B. Applesauce. C. Baked potato. D. White bread.
Rationale: Furosemide can increase potassium excretion. Potassium-rich foods such as potatoes
may help maintain potassium levels when appropriate for the client's overall condition and
prescribed diet.
13. A postoperative client reports sudden chest pain and difficulty breathing. The
client is tachycardic and anxious. Which complication should the nurse suspect?
A. Atelectasis caused by prolonged bed rest. B. Pulmonary embolism. C. Constipation related
to opioid therapy. D. Urinary retention.
