HESI Case Study Exam Practice
Questions And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A
Instant Download Pdf
1. A nurse is caring for a client who reports sudden shortness of breath and chest
pain. Which assessment finding requires the nurse's immediate attention?
A. Respiratory rate of 20/min
B. Oxygen saturation of 88%
C. Temperature of 37.2°C (99°F)
D. Blood pressure of 128/76 mm Hg
Answer: B. Oxygen saturation of 88%
Rationale: An oxygen saturation of 88% indicates hypoxemia and requires
immediate assessment and intervention.
2. A client with diabetes mellitus has a blood glucose level of 54 mg/dL and is
awake and able to swallow. Which intervention should the nurse implement first?
A. Administer regular insulin
B. Give 15 g of rapid-acting carbohydrate
C. Start an IV infusion of normal saline
D. Encourage the client to exercise
Answer: B. Give 15 g of rapid-acting carbohydrate
,Rationale: A conscious client with symptomatic hypoglycemia who can swallow
should receive approximately 15 g of rapid-acting carbohydrate, followed by
reassessment.
3. A client with heart failure reports increasing shortness of breath and difficulty
sleeping while lying flat. Which finding most strongly supports worsening heart
failure?
A. Weight gain of 2 kg in 3 days
B. Heart rate of 72/min
C. Temperature of 36.8°C (98.2°F)
D. Increased appetite
Answer: A. Weight gain of 2 kg in 3 days
Rationale: Rapid weight gain indicates fluid retention and is an important sign
of worsening heart failure.
4. A client with pneumonia has a productive cough and fever. Which nursing
intervention is most appropriate?
A. Restrict fluids
B. Encourage coughing and deep breathing
C. Keep the client completely flat
D. Discourage mobility
Answer: B. Encourage coughing and deep breathing
Rationale: Coughing and deep breathing help mobilize respiratory secretions
and improve ventilation.
5. A client receiving a blood transfusion develops chills, fever, and back pain 15
minutes after the transfusion begins. What should the nurse do first?
,A. Increase the transfusion rate
B. Stop the transfusion
C. Administer the next prescribed medication
D. Document the findings after completion
Answer: B. Stop the transfusion
Rationale: These findings may indicate an acute transfusion reaction. The
transfusion must be stopped immediately, and the IV line should be maintained
with appropriate compatible fluid according to protocol.
6. A client with chronic kidney disease has a potassium level of 6.2 mEq/L. Which
assessment finding is the priority?
A. Muscle weakness
B. Dry skin
C. Increased appetite
D. Mild headache
Answer: A. Muscle weakness
Rationale: Hyperkalemia can cause muscle weakness and life-threatening
cardiac dysrhythmias. Cardiac monitoring and prompt intervention are
priorities.
7. A client is admitted with suspected stroke. Which assessment finding is most
consistent with an acute stroke?
A. Gradual improvement in coordination
B. Sudden unilateral weakness
C. Increased appetite
D. Bilateral ankle edema
Answer: B. Sudden unilateral weakness
, Rationale: Sudden unilateral weakness is a classic manifestation of acute stroke
and requires immediate evaluation.
8. A client with a suspected stroke has difficulty swallowing. What is the nurse's
priority action before giving oral medications?
A. Offer water
B. Perform or obtain a swallowing assessment
C. Place food at the bedside
D. Encourage the client to eat quickly
Answer: B. Perform or obtain a swallowing assessment
Rationale: Dysphagia increases the risk for aspiration. Oral intake should be
withheld until swallowing ability is evaluated.
9. A client with asthma develops wheezing and increasing respiratory distress.
Which medication should the nurse expect to administer for rapid
bronchodilation?
A. Albuterol
B. Warfarin
C. Furosemide
D. Levothyroxine
Answer: A. Albuterol
Rationale: Albuterol is a short-acting beta2-adrenergic agonist used for rapid
relief of bronchospasm.
10. A client with chronic obstructive pulmonary disease is receiving oxygen
therapy. Which finding indicates improvement?
Questions And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A
Instant Download Pdf
1. A nurse is caring for a client who reports sudden shortness of breath and chest
pain. Which assessment finding requires the nurse's immediate attention?
A. Respiratory rate of 20/min
B. Oxygen saturation of 88%
C. Temperature of 37.2°C (99°F)
D. Blood pressure of 128/76 mm Hg
Answer: B. Oxygen saturation of 88%
Rationale: An oxygen saturation of 88% indicates hypoxemia and requires
immediate assessment and intervention.
2. A client with diabetes mellitus has a blood glucose level of 54 mg/dL and is
awake and able to swallow. Which intervention should the nurse implement first?
A. Administer regular insulin
B. Give 15 g of rapid-acting carbohydrate
C. Start an IV infusion of normal saline
D. Encourage the client to exercise
Answer: B. Give 15 g of rapid-acting carbohydrate
,Rationale: A conscious client with symptomatic hypoglycemia who can swallow
should receive approximately 15 g of rapid-acting carbohydrate, followed by
reassessment.
3. A client with heart failure reports increasing shortness of breath and difficulty
sleeping while lying flat. Which finding most strongly supports worsening heart
failure?
A. Weight gain of 2 kg in 3 days
B. Heart rate of 72/min
C. Temperature of 36.8°C (98.2°F)
D. Increased appetite
Answer: A. Weight gain of 2 kg in 3 days
Rationale: Rapid weight gain indicates fluid retention and is an important sign
of worsening heart failure.
4. A client with pneumonia has a productive cough and fever. Which nursing
intervention is most appropriate?
A. Restrict fluids
B. Encourage coughing and deep breathing
C. Keep the client completely flat
D. Discourage mobility
Answer: B. Encourage coughing and deep breathing
Rationale: Coughing and deep breathing help mobilize respiratory secretions
and improve ventilation.
5. A client receiving a blood transfusion develops chills, fever, and back pain 15
minutes after the transfusion begins. What should the nurse do first?
,A. Increase the transfusion rate
B. Stop the transfusion
C. Administer the next prescribed medication
D. Document the findings after completion
Answer: B. Stop the transfusion
Rationale: These findings may indicate an acute transfusion reaction. The
transfusion must be stopped immediately, and the IV line should be maintained
with appropriate compatible fluid according to protocol.
6. A client with chronic kidney disease has a potassium level of 6.2 mEq/L. Which
assessment finding is the priority?
A. Muscle weakness
B. Dry skin
C. Increased appetite
D. Mild headache
Answer: A. Muscle weakness
Rationale: Hyperkalemia can cause muscle weakness and life-threatening
cardiac dysrhythmias. Cardiac monitoring and prompt intervention are
priorities.
7. A client is admitted with suspected stroke. Which assessment finding is most
consistent with an acute stroke?
A. Gradual improvement in coordination
B. Sudden unilateral weakness
C. Increased appetite
D. Bilateral ankle edema
Answer: B. Sudden unilateral weakness
, Rationale: Sudden unilateral weakness is a classic manifestation of acute stroke
and requires immediate evaluation.
8. A client with a suspected stroke has difficulty swallowing. What is the nurse's
priority action before giving oral medications?
A. Offer water
B. Perform or obtain a swallowing assessment
C. Place food at the bedside
D. Encourage the client to eat quickly
Answer: B. Perform or obtain a swallowing assessment
Rationale: Dysphagia increases the risk for aspiration. Oral intake should be
withheld until swallowing ability is evaluated.
9. A client with asthma develops wheezing and increasing respiratory distress.
Which medication should the nurse expect to administer for rapid
bronchodilation?
A. Albuterol
B. Warfarin
C. Furosemide
D. Levothyroxine
Answer: A. Albuterol
Rationale: Albuterol is a short-acting beta2-adrenergic agonist used for rapid
relief of bronchospasm.
10. A client with chronic obstructive pulmonary disease is receiving oxygen
therapy. Which finding indicates improvement?
