1
Page | 1
HESI RN Exit Exam 2025/2026 – 100
Practice Questions with Correct
Answers & Detailed Rationales
, 2
Page | 2
1. A patient with COPD is receiving oxygen therapy. Which assessment finding should
the nurse report immediately?
A) Respiratory rate of 24 breaths/min
B) PaO2 of 88 mm Hg
C) Decreased level of consciousness
D) Use of accessory muscles for breathing
✔ Correct Answer > C) Decreased level of consciousness
Rationale: A sudden change in LOC may indicate CO₂ retention or hypoventilation — this is
a priority concern in COPD patients receiving oxygen.
2. What is the priority nursing intervention when caring for a patient with a serum
potassium level of 2.8 mEq/L?
A) Encourage increased fluid intake
B) Administer prescribed potassium supplement
C) Monitor for signs of hyperkalemia
D) Withhold cardiac medications
✔ Correct Answer > B) Administer prescribed potassium supplement
Rationale: Potassium levels below 3.5 can cause cardiac dysrhythmias; replacement is the
priority.
, 3
3. A nurse is assessing a patient with type 1 diabetes mellitus who is confused, sweating,
Page | 3
and has a rapid pulse. What is the nurse’s initial action?
A) Notify the health care provider
B) Administer insulin as prescribed
C) Give 15 grams of simple carbohydrates
D) Place the patient in a supine position
✔ Correct Answer > C) Give 15 grams of simple carbohydrates
Rationale: These are classic signs of hypoglycemia. The immediate treatment is fast-acting
carbs.
4. Which client is most at risk for developing a pressure injury?
A) A young adult in skeletal traction for a femur fracture
B) An older adult on bed rest with limited mobility
C) A pregnant woman on bed rest for preterm labor
D) A toddler admitted for pneumonia
✔ Correct Answer > B) An older adult on bed rest with limited mobility
Rationale: Elderly patients with immobility are at greatest risk for pressure injuries due to
reduced skin integrity and circulation.
5. A nurse is caring for a client who has a chest tube following a pneumothorax. Which
finding should be reported to the provider?
A) Continuous bubbling in the water seal chamber
, 4
B) Intermittent bubbling during inhalation
C) Drainage of 60 mL in the past hour
D) Occlusive dressing at insertion site
Page | 4
✔ Correct Answer > A) Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling suggests an air leak and must be reported.
6. A client with heart failure has gained 5 pounds in 3 days. What is the priority action?
A) Educate the client on low-sodium diet
B) Notify the healthcare provider
C) Recheck the client’s weight later in the day
D) Encourage increased activity
✔ Correct Answer > B) Notify the healthcare provider
Rationale: Rapid weight gain in HF may indicate fluid overload — a potential sign of
decompensation.
7. A nurse is reviewing lab results for a client with chronic kidney disease. Which result
should be reported?
A) BUN of 18 mg/dL
B) Hemoglobin of 9 g/dL
C) Potassium of 5.0 mEq/L
D) Creatinine of 1.2 mg/dL
✔ Correct Answer > B) Hemoglobin of 9 g/dL
Page | 1
HESI RN Exit Exam 2025/2026 – 100
Practice Questions with Correct
Answers & Detailed Rationales
, 2
Page | 2
1. A patient with COPD is receiving oxygen therapy. Which assessment finding should
the nurse report immediately?
A) Respiratory rate of 24 breaths/min
B) PaO2 of 88 mm Hg
C) Decreased level of consciousness
D) Use of accessory muscles for breathing
✔ Correct Answer > C) Decreased level of consciousness
Rationale: A sudden change in LOC may indicate CO₂ retention or hypoventilation — this is
a priority concern in COPD patients receiving oxygen.
2. What is the priority nursing intervention when caring for a patient with a serum
potassium level of 2.8 mEq/L?
A) Encourage increased fluid intake
B) Administer prescribed potassium supplement
C) Monitor for signs of hyperkalemia
D) Withhold cardiac medications
✔ Correct Answer > B) Administer prescribed potassium supplement
Rationale: Potassium levels below 3.5 can cause cardiac dysrhythmias; replacement is the
priority.
, 3
3. A nurse is assessing a patient with type 1 diabetes mellitus who is confused, sweating,
Page | 3
and has a rapid pulse. What is the nurse’s initial action?
A) Notify the health care provider
B) Administer insulin as prescribed
C) Give 15 grams of simple carbohydrates
D) Place the patient in a supine position
✔ Correct Answer > C) Give 15 grams of simple carbohydrates
Rationale: These are classic signs of hypoglycemia. The immediate treatment is fast-acting
carbs.
4. Which client is most at risk for developing a pressure injury?
A) A young adult in skeletal traction for a femur fracture
B) An older adult on bed rest with limited mobility
C) A pregnant woman on bed rest for preterm labor
D) A toddler admitted for pneumonia
✔ Correct Answer > B) An older adult on bed rest with limited mobility
Rationale: Elderly patients with immobility are at greatest risk for pressure injuries due to
reduced skin integrity and circulation.
5. A nurse is caring for a client who has a chest tube following a pneumothorax. Which
finding should be reported to the provider?
A) Continuous bubbling in the water seal chamber
, 4
B) Intermittent bubbling during inhalation
C) Drainage of 60 mL in the past hour
D) Occlusive dressing at insertion site
Page | 4
✔ Correct Answer > A) Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling suggests an air leak and must be reported.
6. A client with heart failure has gained 5 pounds in 3 days. What is the priority action?
A) Educate the client on low-sodium diet
B) Notify the healthcare provider
C) Recheck the client’s weight later in the day
D) Encourage increased activity
✔ Correct Answer > B) Notify the healthcare provider
Rationale: Rapid weight gain in HF may indicate fluid overload — a potential sign of
decompensation.
7. A nurse is reviewing lab results for a client with chronic kidney disease. Which result
should be reported?
A) BUN of 18 mg/dL
B) Hemoglobin of 9 g/dL
C) Potassium of 5.0 mEq/L
D) Creatinine of 1.2 mg/dL
✔ Correct Answer > B) Hemoglobin of 9 g/dL
