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2025 HESI EXIT EXAM FOR NIGHTINGALE COLLEGE WITH
ACCURATE AND VERIFIED QUESTIONS COVERING
COMPREHENSIVE NURSING CONCEPTS, CLINICAL JUDGMENT,
NCLEX READINESS, AND PATIENT CARE MANAGEMENT.
An adolescent who was diagnosed with diabetes mellitus Type 1 at the age of 9, is admitted to
the hospital in diabetic ketoacidosis. Which occurrence is the most likely cause of the
ketoacidosis?
A. Ate an extra peanut butter sandwich before gym class
B. incorrectly administered too much insulin
C. Had a cold and ear infection for the past two days
D. Skipped eating lunch - ANSWER-C. Had a cold and ear infection for the past two days
A client with a prescription for "do not resuscitate" (DNR) begins to manifest signs of impending
death. After notifying the family of the client's status, what priority action should the nurse
implement?
A. The impending signs of death should be documented
B. The client's status should be conveyed to the chaplain
C. The client's need for pain medication should be determined
D. The nurse manager should be updated on the client's status - ANSWER-C. The client's need
for pain medication should be determined
Which self care measure is most important for the nurse to include in the plan of care of a client
recently diagnosed with type 2 diabetes mellitus?
A. Self-injection techniques
B. Blood glucose monitoring
C. Diabetic diet meal planning
D. A realistic exercise plan - ANSWER-B. Blood glucose monitoring
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A client who gave birth 48 hours ago has decided to bottle feed the infant. During the
assessment, the nurse observes that both breasts are swollen, warm, and tender on palpation.
Which instruction should the nurse provide?
A. Apply ice to the breasts for comfort
B. Wear a loose-fitting bra during the day to prevent nipple irritation
C. Run warm water over breasts
D. Express small amounts of milk from the breasts to relieve pressure - ANSWER-A. Apply ice to
the breasts for comfort
The nurse is preparing a client who had a below-the-knee (BKA) amputation for discharge to
home. Which recommendations should the nurse provide this client? (Select all that apply)
A. Avoid range of motion exercises
B. Use a residual limb shrinker
C. Apply alcohol to the stump after bathing
D. Inspect skin for redness
E. Wash the stump with soap and water - ANSWER-B. Use a residual limb shrinker
D. Inspect skin for redness
E. Wash the stump with soap and water
A toddler presenting with a history of intermittent skin rashes, hives, abdominal pain, and
vomiting that occurs after ingesting of milk products arrives to the clinic accompanied by the
parents. Which type of testing should the nurse provide education to the toddler's family
about?
A. Serum immunoglobulin E (IgE)
B. Intradermal test
C. Atopy patch test
D. Placebo-controlled food challenge - ANSWER-A. Serum immunoglobulin E (IgE)
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A client who is scheduled for a bronchoscopy in the morning is anxious and asking the nurse
numerous questions about the procedure. In preparing the client for the procedure, which
intervention has the highest priority?
A. Allow client to gargle with warm salt water
B. Administer a sedative to alleviate anxiety
C. Instruct client to write down the questions
D. Deny client's request for a midnight snack - ANSWER-C. Instruct client to write down the
questions
The nurse assesses a client one hour after starting a transfusion of packed red blood cells and
determines that there are no indications of a transfusion reaction. What instruction should the
nurse provide the unlicensed assistive personnel (UAP) who is working with the nurse?
A. Notify the nurse when the transfusion has finished, so further client assessment can be done
B. Continue to measure the client's vital signs every thirty minutes until the transfusion is
complete
C. Monitor the client carefully for the next three hours and report the onset of a reaction
immediately
D. Since a reaction did not occur, the priority is to maintain client comfort during the transfusion
- ANSWER-B. Continue to measure the client's vital signs every thirty minutes until the
transfusion is complete
The healthcare provider prescribes a sepsis protocol for a client with multi-organ failure caused
by a ruptured appendix. Which intervention is most important for the nurse to include in the
plan of care?
A. Assess warmth of extremities
B. Keep head of bed raised 45 degrees
C. Monitor blood glucose level
D. Maintain strict intake and output - ANSWER-D. Maintain strict intake and output
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A client presses the call bell and requests pain medication for a severe headache. To assess the
quality of the client's pain, which approach should the nurse use?
A. Ask the client to describe the pain
B. Observe body language and movement
C. Identify effective pain relief measures
D. Provide a numeric pain scale - ANSWER-A. Ask the client to describe the pain
A client presents to the labor and delivery unit with a report of leaking fluid that is greenish-
brown vaginal discharge. Which action should the nurse take first?
A. Start an intravenous infusion
B. Administer oxygen via facemask
C. Perform a vaginal exam
D. Begin continuous fetal monitoring - ANSWER-D. Begin continuous fetal monitoring
A client asks the nurse for information about how to reduce risk factors for benign prostatic
hyperplasia (BPH). Which information should the nurse provide?
A. Consume a high protein diet
B. Increase physical activity
C. Take vitamin supplements
D. Obtain a prostate-specific antigen blood level test - ANSWER-B. Increase physical activity
The healthcare provider prescribes a fluid challenge of 0.9% sodium chloride 1,000 mL to be
infused intravenously over 4 hours. The IV administration set delivers 10gtt/mL. How many
gtt/minute should the nurse regulate the infusion? (Round to the nearest whole number) -
ANSWER-42 gtt/min
2025 HESI EXIT EXAM FOR NIGHTINGALE COLLEGE WITH
ACCURATE AND VERIFIED QUESTIONS COVERING
COMPREHENSIVE NURSING CONCEPTS, CLINICAL JUDGMENT,
NCLEX READINESS, AND PATIENT CARE MANAGEMENT.
An adolescent who was diagnosed with diabetes mellitus Type 1 at the age of 9, is admitted to
the hospital in diabetic ketoacidosis. Which occurrence is the most likely cause of the
ketoacidosis?
A. Ate an extra peanut butter sandwich before gym class
B. incorrectly administered too much insulin
C. Had a cold and ear infection for the past two days
D. Skipped eating lunch - ANSWER-C. Had a cold and ear infection for the past two days
A client with a prescription for "do not resuscitate" (DNR) begins to manifest signs of impending
death. After notifying the family of the client's status, what priority action should the nurse
implement?
A. The impending signs of death should be documented
B. The client's status should be conveyed to the chaplain
C. The client's need for pain medication should be determined
D. The nurse manager should be updated on the client's status - ANSWER-C. The client's need
for pain medication should be determined
Which self care measure is most important for the nurse to include in the plan of care of a client
recently diagnosed with type 2 diabetes mellitus?
A. Self-injection techniques
B. Blood glucose monitoring
C. Diabetic diet meal planning
D. A realistic exercise plan - ANSWER-B. Blood glucose monitoring
,2|Page
A client who gave birth 48 hours ago has decided to bottle feed the infant. During the
assessment, the nurse observes that both breasts are swollen, warm, and tender on palpation.
Which instruction should the nurse provide?
A. Apply ice to the breasts for comfort
B. Wear a loose-fitting bra during the day to prevent nipple irritation
C. Run warm water over breasts
D. Express small amounts of milk from the breasts to relieve pressure - ANSWER-A. Apply ice to
the breasts for comfort
The nurse is preparing a client who had a below-the-knee (BKA) amputation for discharge to
home. Which recommendations should the nurse provide this client? (Select all that apply)
A. Avoid range of motion exercises
B. Use a residual limb shrinker
C. Apply alcohol to the stump after bathing
D. Inspect skin for redness
E. Wash the stump with soap and water - ANSWER-B. Use a residual limb shrinker
D. Inspect skin for redness
E. Wash the stump with soap and water
A toddler presenting with a history of intermittent skin rashes, hives, abdominal pain, and
vomiting that occurs after ingesting of milk products arrives to the clinic accompanied by the
parents. Which type of testing should the nurse provide education to the toddler's family
about?
A. Serum immunoglobulin E (IgE)
B. Intradermal test
C. Atopy patch test
D. Placebo-controlled food challenge - ANSWER-A. Serum immunoglobulin E (IgE)
,3|Page
A client who is scheduled for a bronchoscopy in the morning is anxious and asking the nurse
numerous questions about the procedure. In preparing the client for the procedure, which
intervention has the highest priority?
A. Allow client to gargle with warm salt water
B. Administer a sedative to alleviate anxiety
C. Instruct client to write down the questions
D. Deny client's request for a midnight snack - ANSWER-C. Instruct client to write down the
questions
The nurse assesses a client one hour after starting a transfusion of packed red blood cells and
determines that there are no indications of a transfusion reaction. What instruction should the
nurse provide the unlicensed assistive personnel (UAP) who is working with the nurse?
A. Notify the nurse when the transfusion has finished, so further client assessment can be done
B. Continue to measure the client's vital signs every thirty minutes until the transfusion is
complete
C. Monitor the client carefully for the next three hours and report the onset of a reaction
immediately
D. Since a reaction did not occur, the priority is to maintain client comfort during the transfusion
- ANSWER-B. Continue to measure the client's vital signs every thirty minutes until the
transfusion is complete
The healthcare provider prescribes a sepsis protocol for a client with multi-organ failure caused
by a ruptured appendix. Which intervention is most important for the nurse to include in the
plan of care?
A. Assess warmth of extremities
B. Keep head of bed raised 45 degrees
C. Monitor blood glucose level
D. Maintain strict intake and output - ANSWER-D. Maintain strict intake and output
, 4|Page
A client presses the call bell and requests pain medication for a severe headache. To assess the
quality of the client's pain, which approach should the nurse use?
A. Ask the client to describe the pain
B. Observe body language and movement
C. Identify effective pain relief measures
D. Provide a numeric pain scale - ANSWER-A. Ask the client to describe the pain
A client presents to the labor and delivery unit with a report of leaking fluid that is greenish-
brown vaginal discharge. Which action should the nurse take first?
A. Start an intravenous infusion
B. Administer oxygen via facemask
C. Perform a vaginal exam
D. Begin continuous fetal monitoring - ANSWER-D. Begin continuous fetal monitoring
A client asks the nurse for information about how to reduce risk factors for benign prostatic
hyperplasia (BPH). Which information should the nurse provide?
A. Consume a high protein diet
B. Increase physical activity
C. Take vitamin supplements
D. Obtain a prostate-specific antigen blood level test - ANSWER-B. Increase physical activity
The healthcare provider prescribes a fluid challenge of 0.9% sodium chloride 1,000 mL to be
infused intravenously over 4 hours. The IV administration set delivers 10gtt/mL. How many
gtt/minute should the nurse regulate the infusion? (Round to the nearest whole number) -
ANSWER-42 gtt/min
