Duke university school of nursing 2025 HESI
Practice Test Questions | More Than 70 Complete
Prep with Answer Keys, Study Strategies, and
High-Scoring Exam Tips
1. Asthma Client Receiving Antihypertensive Medication
Question:
A client with asthma receives a prescription for high blood pressure during a clinic visit.
Which antihypertensive medication should the nurse anticipate being least likely to
exacerbate asthma symptoms?
A. Pindolol
B. Carteolol
C. Metoprolol Tartrate
D. Propranolol
Correct Answer: C. Metoprolol Tartrate
Rationale:
Metoprolol is a cardioselective beta-blocker that primarily blocks β1 receptors in the
heart rather than β2 receptors in the lungs. This makes it less likely to cause
bronchoconstriction and safer for clients with asthma. In contrast, pindolol, carteolol,
and propranolol are nonselective beta-blockers that can exacerbate bronchospasm.
2. Discontinuing Propranolol
Question:
A client who has been taking propranolol for 18 months tells the nurse that the
healthcare provider discontinued it because their blood pressure has been stable for 3
months. What should the nurse recommend?
A. Stop taking the medication immediately
B. Take the last dose today
C. Ask the healthcare provider about tapering the dose
D. Continue taking the drug for another 3 months
Correct Answer: C. Ask the healthcare provider about tapering the dose
Rationale:
Propranolol should not be stopped abruptly because it may lead to rebound
,hypertension, tachycardia, or dysrhythmias. Gradual tapering over 1–2 weeks helps
prevent these effects.
3. Drowsiness with Clonidine
Question:
A client taking clonidine reports experiencing drowsiness. What should the nurse
assess further?
A. How long the client has been taking the medication
B. The client's fluid intake
C. The client's dietary habits
D. Whether the client is using herbal supplements
Correct Answer: A. How long the client has been taking the medication
Rationale:
Drowsiness is a common early side effect of clonidine, which often decreases over
time. Determining the duration of use helps guide patient education and expectations.
4. Purpose of Atropine Before Surgery
Question:
A client scheduled for surgery is prescribed atropine preoperatively. The client asks why
they need this medication. What is the best response by the nurse?
A. Reduce nausea and vomiting
B. Decrease the risk of bradycardia during surgery
C. Control blood pressure during surgery
D. Relieve muscle spasms
Correct Answer: B. Decrease the risk of bradycardia during surgery
Rationale:
Atropine is an anticholinergic that prevents vagal-induced bradycardia during surgery by
increasing the firing of the sinoatrial node.
5. Urinary Retention Risk in Older Client
Question:
An elderly client receives morphine sulfate for postoperative pain. Which concomitant
medication should the nurse question due to the risk of urinary retention?
,A. Acetaminophen
B. Ibuprofen
C. Tricyclic antidepressants
D. Beta-blockers
Correct Answer: C. Tricyclic antidepressants
Rationale:
Tricyclic antidepressants have anticholinergic effects that, combined with opioids like
morphine, increase the risk of urinary retention, particularly in elderly clients.
6. Verapamil Administration
Question:
A client with atrial flutter has a heart rate of 92 bpm and blood pressure of 110/76
mmHg. They are scheduled for a dose of verapamil. What action should the nurse take?
A. Administer the medication as prescribed
B. Hold the medication and notify the provider
C. Recheck vitals in 30 minutes
D. Delay the dose for an hour
Correct Answer: A. Administer the medication as prescribed
Rationale:
Verapamil is used to slow AV node conduction and manage atrial arrhythmias. The
current heart rate and blood pressure are within a safe range for administration.
7. Postpartum Breastfeeding
Question:
Following an emergency C-section, a nurse encourages the new mother to breastfeed.
The mother asks why it's important to breastfeed immediately. What is the best
response?
A. Prevents infection
B. Promotes colostrum production
C. Stimulates contraction of the uterus
D. Enhances mother-infant bonding
Correct Answer: C. Stimulates contraction of the uterus
, Rationale:
Breastfeeding triggers oxytocin release, which causes uterine contractions that help
reduce postpartum bleeding and aid in uterine involution.
8. Nutrition Goal for Mentally Impaired Client
Question:
A nurse identifies "Imbalanced nutrition: Less than body requirements" in a client with
mental impairment and weight loss. What is the best short-term goal?
A. Nurse will monitor weight daily
B. Gain 10 pounds within two days
C. Eat 100% of all meals by tomorrow
D. Eat 50% of six small meals each day by the end of the week
Correct Answer: D. Eat 50% of six small meals each day by the end of the week
Rationale:
Short-term goals should be specific, measurable, realistic, and achievable within a
short time frame. Eating 50% of meals is realistic for a client with confusion.
9. Evaluating Fluid Intake Goal
Question:
A care plan includes a goal for a client to ingest at least 1000 mL of fluids between 7:00
AM and 3:30 PM. Which client behavior indicates a successful outcome?
A. Client reports drinking adequate fluids
B. Client voids three times during the shift
C. Client requests more water in the afternoon
D. Client drinks 240 mL of fluid five times during the shift
Correct Answer: D. Client drinks 240 mL of fluid five times during the shift
Rationale:
Drinking 240 mL five times equals 1200 mL, which exceeds the fluid intake goal and
shows a measurable outcome aligned with the plan of care.
10. Priority for Active Tuberculosis Client
Question:
A client with active tuberculosis is admitted to the medical unit. What is the nurse's
priority action?
Practice Test Questions | More Than 70 Complete
Prep with Answer Keys, Study Strategies, and
High-Scoring Exam Tips
1. Asthma Client Receiving Antihypertensive Medication
Question:
A client with asthma receives a prescription for high blood pressure during a clinic visit.
Which antihypertensive medication should the nurse anticipate being least likely to
exacerbate asthma symptoms?
A. Pindolol
B. Carteolol
C. Metoprolol Tartrate
D. Propranolol
Correct Answer: C. Metoprolol Tartrate
Rationale:
Metoprolol is a cardioselective beta-blocker that primarily blocks β1 receptors in the
heart rather than β2 receptors in the lungs. This makes it less likely to cause
bronchoconstriction and safer for clients with asthma. In contrast, pindolol, carteolol,
and propranolol are nonselective beta-blockers that can exacerbate bronchospasm.
2. Discontinuing Propranolol
Question:
A client who has been taking propranolol for 18 months tells the nurse that the
healthcare provider discontinued it because their blood pressure has been stable for 3
months. What should the nurse recommend?
A. Stop taking the medication immediately
B. Take the last dose today
C. Ask the healthcare provider about tapering the dose
D. Continue taking the drug for another 3 months
Correct Answer: C. Ask the healthcare provider about tapering the dose
Rationale:
Propranolol should not be stopped abruptly because it may lead to rebound
,hypertension, tachycardia, or dysrhythmias. Gradual tapering over 1–2 weeks helps
prevent these effects.
3. Drowsiness with Clonidine
Question:
A client taking clonidine reports experiencing drowsiness. What should the nurse
assess further?
A. How long the client has been taking the medication
B. The client's fluid intake
C. The client's dietary habits
D. Whether the client is using herbal supplements
Correct Answer: A. How long the client has been taking the medication
Rationale:
Drowsiness is a common early side effect of clonidine, which often decreases over
time. Determining the duration of use helps guide patient education and expectations.
4. Purpose of Atropine Before Surgery
Question:
A client scheduled for surgery is prescribed atropine preoperatively. The client asks why
they need this medication. What is the best response by the nurse?
A. Reduce nausea and vomiting
B. Decrease the risk of bradycardia during surgery
C. Control blood pressure during surgery
D. Relieve muscle spasms
Correct Answer: B. Decrease the risk of bradycardia during surgery
Rationale:
Atropine is an anticholinergic that prevents vagal-induced bradycardia during surgery by
increasing the firing of the sinoatrial node.
5. Urinary Retention Risk in Older Client
Question:
An elderly client receives morphine sulfate for postoperative pain. Which concomitant
medication should the nurse question due to the risk of urinary retention?
,A. Acetaminophen
B. Ibuprofen
C. Tricyclic antidepressants
D. Beta-blockers
Correct Answer: C. Tricyclic antidepressants
Rationale:
Tricyclic antidepressants have anticholinergic effects that, combined with opioids like
morphine, increase the risk of urinary retention, particularly in elderly clients.
6. Verapamil Administration
Question:
A client with atrial flutter has a heart rate of 92 bpm and blood pressure of 110/76
mmHg. They are scheduled for a dose of verapamil. What action should the nurse take?
A. Administer the medication as prescribed
B. Hold the medication and notify the provider
C. Recheck vitals in 30 minutes
D. Delay the dose for an hour
Correct Answer: A. Administer the medication as prescribed
Rationale:
Verapamil is used to slow AV node conduction and manage atrial arrhythmias. The
current heart rate and blood pressure are within a safe range for administration.
7. Postpartum Breastfeeding
Question:
Following an emergency C-section, a nurse encourages the new mother to breastfeed.
The mother asks why it's important to breastfeed immediately. What is the best
response?
A. Prevents infection
B. Promotes colostrum production
C. Stimulates contraction of the uterus
D. Enhances mother-infant bonding
Correct Answer: C. Stimulates contraction of the uterus
, Rationale:
Breastfeeding triggers oxytocin release, which causes uterine contractions that help
reduce postpartum bleeding and aid in uterine involution.
8. Nutrition Goal for Mentally Impaired Client
Question:
A nurse identifies "Imbalanced nutrition: Less than body requirements" in a client with
mental impairment and weight loss. What is the best short-term goal?
A. Nurse will monitor weight daily
B. Gain 10 pounds within two days
C. Eat 100% of all meals by tomorrow
D. Eat 50% of six small meals each day by the end of the week
Correct Answer: D. Eat 50% of six small meals each day by the end of the week
Rationale:
Short-term goals should be specific, measurable, realistic, and achievable within a
short time frame. Eating 50% of meals is realistic for a client with confusion.
9. Evaluating Fluid Intake Goal
Question:
A care plan includes a goal for a client to ingest at least 1000 mL of fluids between 7:00
AM and 3:30 PM. Which client behavior indicates a successful outcome?
A. Client reports drinking adequate fluids
B. Client voids three times during the shift
C. Client requests more water in the afternoon
D. Client drinks 240 mL of fluid five times during the shift
Correct Answer: D. Client drinks 240 mL of fluid five times during the shift
Rationale:
Drinking 240 mL five times equals 1200 mL, which exceeds the fluid intake goal and
shows a measurable outcome aligned with the plan of care.
10. Priority for Active Tuberculosis Client
Question:
A client with active tuberculosis is admitted to the medical unit. What is the nurse's
priority action?
