2026 Hesi Rn Exit V3 160
Questions And Answers(Exam)
Course2026 HESI RN EXIT V3
1. The nurse is caring for a client who has a potassium level of 6.8 mEq/L and peaked T waves
on the ECG. Which intervention should the nurse implement first?
A. Administer oral potassium
B. Administer IV calcium gluconate as prescribed
C. Encourage foods high in potassium
D. Administer a potassium-sparing diuretic
Correct Answer: B. Administer IV calcium gluconate as prescribed
Rationale: Severe hyperkalemia with ECG changes can cause life-threatening dysrhythmias. IV
calcium stabilizes the cardiac membrane while other therapies are used to lower serum
potassium.
2. A client with heart failure is prescribed furosemide. Which finding best indicates that the
medication is effective?
A. Increased peripheral edema
B. Increased crackles
C. Decreased dyspnea and increased urine output
D. Weight gain of 2 kg
Correct Answer: C. Decreased dyspnea and increased urine output
Rationale: Furosemide promotes diuresis, reducing excess fluid volume. Improved urine output
and decreased pulmonary congestion indicate therapeutic effectiveness.
3. A client with suspected bacterial meningitis is admitted to the emergency department. Which
intervention is the priority?
A. Initiate appropriate isolation precautions
B. Encourage ambulation
C. Provide a high-protein meal
D. Place the client in a brightly lit room
Correct Answer: A. Initiate appropriate isolation precautions
Rationale: Suspected bacterial meningitis requires prompt infection-control measures, commonly
including droplet precautions during the initial period of treatment.
4. A client receiving a heparin infusion develops a sudden platelet decrease and a new deep vein
thrombosis. Which complication should the nurse suspect?
,A. Hemophilia
B. Heparin-induced thrombocytopenia
C. Iron-deficiency anemia
D. Thrombocytosis
Correct Answer: B. Heparin-induced thrombocytopenia
Rationale: HIT is characterized by a significant platelet decrease after heparin exposure and an
increased risk of thrombosis.
5. A client with diabetic ketoacidosis is receiving an IV insulin infusion. Which laboratory value
requires close monitoring?
A. Potassium
B. Hemoglobin
C. Platelets
D. Albumin
Correct Answer: A. Potassium
Rationale: Insulin drives potassium into cells and may cause dangerous hypokalemia during
DKA treatment. Frequent potassium monitoring is essential.
6. A client reports crushing substernal chest pain radiating to the left arm and becomes
diaphoretic. What should the nurse do first?
A. Obtain an ECG promptly
B. Encourage the client to walk
C. Give oral fluids
D. Place the client in Trendelenburg position
Correct Answer: A. Obtain an ECG promptly
Rationale: Acute coronary syndrome must be rapidly evaluated. A 12-lead ECG is a priority
diagnostic assessment in a client with suspected myocardial ischemia.
7. A client with COPD is receiving oxygen therapy. Which finding requires immediate
intervention?
A. Respiratory rate of 18/min
B. Increasing somnolence and shallow respirations
C. Mild productive cough
D. Oxygen saturation of 91% with stable breathing
Correct Answer: B. Increasing somnolence and shallow respirations
Rationale: Increasing somnolence and decreasing respiratory effort can indicate worsening
hypercapnia and respiratory failure.
,8. A client taking warfarin has an INR of 6.2 and reports black, tarry stools. Which action is the
priority?
A. Administer the next warfarin dose
B. Assess for significant bleeding and notify the provider
C. Encourage foods high in potassium
D. Encourage vigorous exercise
Correct Answer: B. Assess for significant bleeding and notify the provider
Rationale: A markedly elevated INR combined with melena suggests significant anticoagulant-
associated bleeding and requires immediate evaluation.
9. A client suddenly develops facial drooping, right-sided weakness, and difficulty speaking.
Which information is most important to obtain?
A. Last-known-well time
B. Favorite food
C. Sleep schedule
D. Childhood vaccination history
Correct Answer: A. Last-known-well time
Rationale: The exact time the client was last known to be neurologically normal is critical for
determining eligibility for time-sensitive stroke therapies.
10. A client with acute pulmonary edema is severely dyspneic and has bilateral crackles. Which
position should the nurse use?
A. Supine
B. High-Fowler's
C. Trendelenburg
D. Prone with the head flat
Correct Answer: B. High-Fowler's
Rationale: High-Fowler's positioning improves lung expansion and can reduce venous return,
helping relieve pulmonary congestion.
11. A postoperative client suddenly develops dyspnea, tachycardia, and pleuritic chest pain.
Which complication should the nurse suspect?
A. Pulmonary embolism
B. Constipation
C. Hypoglycemia
D. Urinary retention
Correct Answer: A. Pulmonary embolism
, Rationale: Sudden dyspnea, tachycardia, and pleuritic chest pain after surgery are classic
warning signs of pulmonary embolism.
12. A client receiving morphine becomes difficult to arouse and has a respiratory rate of 6/min.
Which medication should the nurse anticipate?
A. Naloxone
B. Furosemide
C. Protamine
D. Vitamin K
Correct Answer: A. Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse opioid-induced respiratory
depression. Airway and ventilatory support are also priorities.
13. A client with septic shock remains hypotensive after adequate fluid resuscitation. Which
medication does the nurse anticipate?
A. Norepinephrine
B. Metoprolol
C. Furosemide
D. Digoxin
Correct Answer: A. Norepinephrine
Rationale: Norepinephrine is commonly the first-line vasopressor for persistent hypotension in
septic shock following appropriate fluid resuscitation.
14. A client with increased intracranial pressure has a sudden decrease in level of consciousness.
Which intervention is the priority?
A. Maintain airway and oxygenation
B. Encourage coughing
C. Place the client flat
D. Encourage oral fluids
Correct Answer: A. Maintain airway and oxygenation
Rationale: Declining consciousness can compromise airway protection. Hypoxemia can worsen
secondary brain injury, making airway and oxygenation priorities.
15. A client with severe asthma suddenly has minimal wheezing but increasing respiratory
fatigue. How should the nurse interpret this finding?
A. The client's condition is improving
B. Airflow may be critically reduced
C. Bronchodilator therapy is no longer necessary
D. The client is adequately ventilating
Questions And Answers(Exam)
Course2026 HESI RN EXIT V3
1. The nurse is caring for a client who has a potassium level of 6.8 mEq/L and peaked T waves
on the ECG. Which intervention should the nurse implement first?
A. Administer oral potassium
B. Administer IV calcium gluconate as prescribed
C. Encourage foods high in potassium
D. Administer a potassium-sparing diuretic
Correct Answer: B. Administer IV calcium gluconate as prescribed
Rationale: Severe hyperkalemia with ECG changes can cause life-threatening dysrhythmias. IV
calcium stabilizes the cardiac membrane while other therapies are used to lower serum
potassium.
2. A client with heart failure is prescribed furosemide. Which finding best indicates that the
medication is effective?
A. Increased peripheral edema
B. Increased crackles
C. Decreased dyspnea and increased urine output
D. Weight gain of 2 kg
Correct Answer: C. Decreased dyspnea and increased urine output
Rationale: Furosemide promotes diuresis, reducing excess fluid volume. Improved urine output
and decreased pulmonary congestion indicate therapeutic effectiveness.
3. A client with suspected bacterial meningitis is admitted to the emergency department. Which
intervention is the priority?
A. Initiate appropriate isolation precautions
B. Encourage ambulation
C. Provide a high-protein meal
D. Place the client in a brightly lit room
Correct Answer: A. Initiate appropriate isolation precautions
Rationale: Suspected bacterial meningitis requires prompt infection-control measures, commonly
including droplet precautions during the initial period of treatment.
4. A client receiving a heparin infusion develops a sudden platelet decrease and a new deep vein
thrombosis. Which complication should the nurse suspect?
,A. Hemophilia
B. Heparin-induced thrombocytopenia
C. Iron-deficiency anemia
D. Thrombocytosis
Correct Answer: B. Heparin-induced thrombocytopenia
Rationale: HIT is characterized by a significant platelet decrease after heparin exposure and an
increased risk of thrombosis.
5. A client with diabetic ketoacidosis is receiving an IV insulin infusion. Which laboratory value
requires close monitoring?
A. Potassium
B. Hemoglobin
C. Platelets
D. Albumin
Correct Answer: A. Potassium
Rationale: Insulin drives potassium into cells and may cause dangerous hypokalemia during
DKA treatment. Frequent potassium monitoring is essential.
6. A client reports crushing substernal chest pain radiating to the left arm and becomes
diaphoretic. What should the nurse do first?
A. Obtain an ECG promptly
B. Encourage the client to walk
C. Give oral fluids
D. Place the client in Trendelenburg position
Correct Answer: A. Obtain an ECG promptly
Rationale: Acute coronary syndrome must be rapidly evaluated. A 12-lead ECG is a priority
diagnostic assessment in a client with suspected myocardial ischemia.
7. A client with COPD is receiving oxygen therapy. Which finding requires immediate
intervention?
A. Respiratory rate of 18/min
B. Increasing somnolence and shallow respirations
C. Mild productive cough
D. Oxygen saturation of 91% with stable breathing
Correct Answer: B. Increasing somnolence and shallow respirations
Rationale: Increasing somnolence and decreasing respiratory effort can indicate worsening
hypercapnia and respiratory failure.
,8. A client taking warfarin has an INR of 6.2 and reports black, tarry stools. Which action is the
priority?
A. Administer the next warfarin dose
B. Assess for significant bleeding and notify the provider
C. Encourage foods high in potassium
D. Encourage vigorous exercise
Correct Answer: B. Assess for significant bleeding and notify the provider
Rationale: A markedly elevated INR combined with melena suggests significant anticoagulant-
associated bleeding and requires immediate evaluation.
9. A client suddenly develops facial drooping, right-sided weakness, and difficulty speaking.
Which information is most important to obtain?
A. Last-known-well time
B. Favorite food
C. Sleep schedule
D. Childhood vaccination history
Correct Answer: A. Last-known-well time
Rationale: The exact time the client was last known to be neurologically normal is critical for
determining eligibility for time-sensitive stroke therapies.
10. A client with acute pulmonary edema is severely dyspneic and has bilateral crackles. Which
position should the nurse use?
A. Supine
B. High-Fowler's
C. Trendelenburg
D. Prone with the head flat
Correct Answer: B. High-Fowler's
Rationale: High-Fowler's positioning improves lung expansion and can reduce venous return,
helping relieve pulmonary congestion.
11. A postoperative client suddenly develops dyspnea, tachycardia, and pleuritic chest pain.
Which complication should the nurse suspect?
A. Pulmonary embolism
B. Constipation
C. Hypoglycemia
D. Urinary retention
Correct Answer: A. Pulmonary embolism
, Rationale: Sudden dyspnea, tachycardia, and pleuritic chest pain after surgery are classic
warning signs of pulmonary embolism.
12. A client receiving morphine becomes difficult to arouse and has a respiratory rate of 6/min.
Which medication should the nurse anticipate?
A. Naloxone
B. Furosemide
C. Protamine
D. Vitamin K
Correct Answer: A. Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse opioid-induced respiratory
depression. Airway and ventilatory support are also priorities.
13. A client with septic shock remains hypotensive after adequate fluid resuscitation. Which
medication does the nurse anticipate?
A. Norepinephrine
B. Metoprolol
C. Furosemide
D. Digoxin
Correct Answer: A. Norepinephrine
Rationale: Norepinephrine is commonly the first-line vasopressor for persistent hypotension in
septic shock following appropriate fluid resuscitation.
14. A client with increased intracranial pressure has a sudden decrease in level of consciousness.
Which intervention is the priority?
A. Maintain airway and oxygenation
B. Encourage coughing
C. Place the client flat
D. Encourage oral fluids
Correct Answer: A. Maintain airway and oxygenation
Rationale: Declining consciousness can compromise airway protection. Hypoxemia can worsen
secondary brain injury, making airway and oxygenation priorities.
15. A client with severe asthma suddenly has minimal wheezing but increasing respiratory
fatigue. How should the nurse interpret this finding?
A. The client's condition is improving
B. Airflow may be critically reduced
C. Bronchodilator therapy is no longer necessary
D. The client is adequately ventilating
