HESI RN COMPREHENSIVE EXIT
PRACTICE EXAM QUESTIONS WITH
VERIFIED ANSWERS AND RATIONALES
FOR GUARANTEED PASS | LATEST
UPDATE 2025
1. A nurse is caring for a patient who has a new prescription for enoxaparin
(Lovenox) after knee surgery. Which of the following instructions should the
nurse provide?
A) Take the medication orally with food.
B) Avoid aspirin and NSAIDs during therapy.
C) Stop the medication if bruising occurs.
D) Massage the injection site after administration.
Answer: B) Avoid aspirin and NSAIDs during therapy.
Rationale: Enoxaparin is an anticoagulant that increases bleeding risk; concurrent
use with aspirin or NSAIDs further increases this risk. It is given by subcutaneous
,injection and massaging the site is contraindicated as it can cause bleeding or
bruising. Bruising is common and does not always require stopping therapy.
2. Which of the following actions is the priority when a nurse finds a patient
unresponsive and not breathing?
A) Call for help.
B) Start chest compressions.
C) Open the airway.
D) Assess the pulse.
Answer: A) Call for help.
Rationale: The first action should be to activate emergency response to ensure
help is on the way. Next, open the airway, check for pulse, and begin chest
compressions if needed.
3. A patient with congestive heart failure reports gaining 4 pounds in 2 days.
Which nursing intervention is most appropriate?
A) Restrict fluid intake to 500 mL per day.
B) Notify the healthcare provider immediately.
C) Assess lung sounds and edema.
D) Encourage increased physical activity.
Answer: C) Assess lung sounds and edema.
Rationale: Sudden weight gain can indicate fluid retention. The nurse should
assess respiratory status and edema to evaluate for worsening heart failure
before notifying the provider.
,4. Which finding indicates that a client with type 1 diabetes mellitus is
experiencing diabetic ketoacidosis?
A) Blood glucose 120 mg/dL and fruity breath odor
B) Blood glucose 250 mg/dL and increased urination
C) Blood glucose 500 mg/dL and Kussmaul respirations
D) Blood glucose 80 mg/dL and diaphoresis
Answer: C) Blood glucose 500 mg/dL and Kussmaul respirations.
Rationale: High blood glucose with deep, rapid respirations (Kussmaul) and fruity
breath odor are classic signs of diabetic ketoacidosis (DKA).
5. A nurse is preparing to administer ceftriaxone 1 gram IV to a client who is
allergic to penicillin. What is the best action?
A) Administer the medication as ordered.
B) Withhold the medication and notify the provider.
C) Administer a test dose to assess for reaction.
D) Premedicate with diphenhydramine and administer.
Answer: B) Withhold the medication and notify the provider.
Rationale: Ceftriaxone is a cephalosporin, which can cross-react with penicillin
allergies. The nurse should withhold and clarify the order.
6. What is the appropriate way to communicate a patient’s pain assessment
during a handoff report?
, A) “The patient rates pain as a 7 on a 0-10 scale.”
B) “The patient appears to be in moderate pain.”
C) “The patient denies pain currently.”
D) “The patient’s pain is well controlled.”
Answer: A) “The patient rates pain as a 7 on a 0-10 scale.”
Rationale: Pain is subjective; using the patient’s own rating is the most accurate
and objective information for communication.
7. A nurse is caring for a client in labor. The nurse notes late decelerations on
the fetal monitor. What is the best immediate action?
A) Increase oxytocin infusion.
B) Reposition the client to left side.
C) Administer oxygen via nasal cannula.
D) Prepare for immediate delivery.
Answer: B) Reposition the client to left side.
Rationale: Late decelerations indicate uteroplacental insufficiency. Repositioning
improves placental perfusion. Administering oxygen and notifying the provider
come next.
8. Which of the following foods should a nurse recommend for a patient with
iron-deficiency anemia?
A) Milk and cheese
B) Spinach and red meat
PRACTICE EXAM QUESTIONS WITH
VERIFIED ANSWERS AND RATIONALES
FOR GUARANTEED PASS | LATEST
UPDATE 2025
1. A nurse is caring for a patient who has a new prescription for enoxaparin
(Lovenox) after knee surgery. Which of the following instructions should the
nurse provide?
A) Take the medication orally with food.
B) Avoid aspirin and NSAIDs during therapy.
C) Stop the medication if bruising occurs.
D) Massage the injection site after administration.
Answer: B) Avoid aspirin and NSAIDs during therapy.
Rationale: Enoxaparin is an anticoagulant that increases bleeding risk; concurrent
use with aspirin or NSAIDs further increases this risk. It is given by subcutaneous
,injection and massaging the site is contraindicated as it can cause bleeding or
bruising. Bruising is common and does not always require stopping therapy.
2. Which of the following actions is the priority when a nurse finds a patient
unresponsive and not breathing?
A) Call for help.
B) Start chest compressions.
C) Open the airway.
D) Assess the pulse.
Answer: A) Call for help.
Rationale: The first action should be to activate emergency response to ensure
help is on the way. Next, open the airway, check for pulse, and begin chest
compressions if needed.
3. A patient with congestive heart failure reports gaining 4 pounds in 2 days.
Which nursing intervention is most appropriate?
A) Restrict fluid intake to 500 mL per day.
B) Notify the healthcare provider immediately.
C) Assess lung sounds and edema.
D) Encourage increased physical activity.
Answer: C) Assess lung sounds and edema.
Rationale: Sudden weight gain can indicate fluid retention. The nurse should
assess respiratory status and edema to evaluate for worsening heart failure
before notifying the provider.
,4. Which finding indicates that a client with type 1 diabetes mellitus is
experiencing diabetic ketoacidosis?
A) Blood glucose 120 mg/dL and fruity breath odor
B) Blood glucose 250 mg/dL and increased urination
C) Blood glucose 500 mg/dL and Kussmaul respirations
D) Blood glucose 80 mg/dL and diaphoresis
Answer: C) Blood glucose 500 mg/dL and Kussmaul respirations.
Rationale: High blood glucose with deep, rapid respirations (Kussmaul) and fruity
breath odor are classic signs of diabetic ketoacidosis (DKA).
5. A nurse is preparing to administer ceftriaxone 1 gram IV to a client who is
allergic to penicillin. What is the best action?
A) Administer the medication as ordered.
B) Withhold the medication and notify the provider.
C) Administer a test dose to assess for reaction.
D) Premedicate with diphenhydramine and administer.
Answer: B) Withhold the medication and notify the provider.
Rationale: Ceftriaxone is a cephalosporin, which can cross-react with penicillin
allergies. The nurse should withhold and clarify the order.
6. What is the appropriate way to communicate a patient’s pain assessment
during a handoff report?
, A) “The patient rates pain as a 7 on a 0-10 scale.”
B) “The patient appears to be in moderate pain.”
C) “The patient denies pain currently.”
D) “The patient’s pain is well controlled.”
Answer: A) “The patient rates pain as a 7 on a 0-10 scale.”
Rationale: Pain is subjective; using the patient’s own rating is the most accurate
and objective information for communication.
7. A nurse is caring for a client in labor. The nurse notes late decelerations on
the fetal monitor. What is the best immediate action?
A) Increase oxytocin infusion.
B) Reposition the client to left side.
C) Administer oxygen via nasal cannula.
D) Prepare for immediate delivery.
Answer: B) Reposition the client to left side.
Rationale: Late decelerations indicate uteroplacental insufficiency. Repositioning
improves placental perfusion. Administering oxygen and notifying the provider
come next.
8. Which of the following foods should a nurse recommend for a patient with
iron-deficiency anemia?
A) Milk and cheese
B) Spinach and red meat
