HESI RN Exit Exam 2025 – Actual Test Bank with 100% Verified Questions, Correct Answers & Rationales | Real NGN Case Studies Included | Graded A+

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HESI RN Exit Exam 2025 – Actual
Test Bank with 100% Verified
Questions, Correct Answers &
Rationales | Real NGN Case Studies
Included | Graded A+

Case Study 1: Acute Myocardial Infarction
Patient Profile: A 58-year-old male presents to the ED with chest pain for 2 hours, described as
heavy and radiating to the left arm. Vital signs: BP 150/90 mm Hg, HR 100 beats/min, RR 20
breaths/min, SpO2 94%, Temp 98.6°F (37°C). ECG shows ST elevation in leads II, III, and aVF.

Question 1 (Select All That Apply)

Which interventions should the nurse initiate immediately for this patient?
A. Administer aspirin 325 mg orally
B. Apply oxygen at 2 L/min via nasal cannula
C. Obtain a 12-lead ECG
D. Administer nitroglycerin sublingually
E. Prepare for thrombolytic therapy
F. Encourage ambulation

Correct Answer: A, B, D, E
Rationale: Aspirin (A) reduces platelet aggregation, oxygen (B) addresses potential hypoxemia,
nitroglycerin (D) relieves ischemic pain, and thrombolytic therapy (E) may be indicated for ST-
elevation MI. An ECG (C) is already obtained, and ambulation (F) is contraindicated due to
cardiac risk, per HESI RN cardiovascular standards.



Question 2 (Hot Spot)

What is the priority nursing action for this patient?
A. Administer aspirin
B. Monitor cardiac rhythm
C. Administer nitroglycerin
D. Obtain vital signs

, 2


Correct Answer: B. Monitor cardiac rhythm
Rationale: ST-elevation MI increases the risk of life-threatening arrhythmias, making
continuous cardiac monitoring the priority to ensure timely intervention, per HESI RN critical
care standards.



Question 3 (Cloze)

The nurse administers nitroglycerin sublingually. Complete the sentence:
The nurse should monitor for ________ and ________ after administration.
Options:
A. Hypotension
B. Pain relief
C. Hyperglycemia
D. Tachycardia
E. Fever

Correct Answer: A. Hypotension, B. Pain relief
Rationale: Nitroglycerin causes vasodilation, which may lead to hypotension (A), and pain relief
(B) is the expected therapeutic effect. Hyperglycemia (C), tachycardia (D), and fever (E) are not
primary concerns, per HESI RN pharmacology standards.



Question 4 (Matrix)

Match the MI interventions with their purposes:

Intervention Purpose
A. Aspirin 1. Reduce platelet aggregation
B. Nitroglycerin 2. Relieve ischemic pain
C. Oxygen 3. Improve myocardial oxygenation
D. Beta-blockers 4. Decrease myocardial oxygen demand

Correct Answer: A-1, B-2, C-3, D-4
Rationale: Aspirin prevents clot progression (1), nitroglycerin reduces pain (2), oxygen
improves oxygenation (3), and beta-blockers lower heart rate and workload (4), per HESI RN
cardiovascular standards.



Question 5 (Bowtie)

, 3


Develop a care plan for this patient. Drag and drop the actions, potential complications, and
parameters to monitor.
Actions: Administer aspirin, Apply oxygen, Monitor ECG
Complications: Arrhythmias, Cardiogenic shock
Parameters: Blood pressure, Chest pain

Correct Answer:

• Actions: Administer aspirin, Apply oxygen, Monitor ECG
• Complications: Arrhythmias, Cardiogenic shock
• Parameters: Blood pressure, Chest pain

Rationale: Aspirin and oxygen address acute MI, while ECG monitoring detects arrhythmias.
Arrhythmias and cardiogenic shock are key risks, and blood pressure and chest pain are critical
parameters, per HESI RN standards.




Case Study 2: Pediatric Diabetic Ketoacidosis
Patient Profile: A 10-year-old female presents with vomiting, lethargy, and fruity breath odor.
She has a history of type 1 diabetes mellitus. Vital signs: BP 100/60 mm Hg, HR 120 beats/min,
RR 30 breaths/min, SpO2 96%, Temp 99°F (37.2°C). Labs: Blood glucose 450 mg/dL, pH 7.20,
bicarbonate 15 mEq/L.

Question 6 (Extended Drag and Drop)

Place the steps for managing this patient in the correct order:
A. Administer IV normal saline
B. Obtain blood glucose level
C. Administer regular insulin IV
D. Monitor potassium levels
E. Assess mental status

Correct Answer: B, A, C, D, E
Rationale: Checking blood glucose (B) confirms hyperglycemia, IV saline (A) corrects
dehydration, insulin (C) reduces glucose, potassium (D) monitoring prevents hypokalemia, and
mental status (E) assesses response, per HESI RN pediatric standards.



Question 7 (Highlight)

The nurse documents the patient’s assessment. Highlight the findings indicating diabetic
ketoacidosis (DKA).

, 4


Text: The child presents with vomiting, lethargy, fruity breath odor, blood glucose 450 mg/dL,
pH 7.20, and bicarbonate 15 mEq/L.

Correct Answer: vomiting, lethargy, fruity breath odor, blood glucose 450 mg/dL, pH 7.20,
bicarbonate 15 mEq/L
Rationale: These findings indicate DKA, reflecting hyperglycemia, acidosis, and ketosis. All are
critical for diagnosis, per HESI RN endocrine standards.



Question 8 (Multiple Response)

Which interventions should the nurse include in the care plan?
A. Administer IV normal saline
B. Encourage oral glucose intake
C. Monitor arterial blood gases
D. Administer regular insulin IV
E. Restrict fluid intake

Correct Answer: A, C, D
Rationale: IV saline (A) corrects dehydration, ABGs (C) monitor acidosis, and insulin (D)
reduces hyperglycemia. Oral glucose (B) worsens DKA, and fluid restriction (E) is
contraindicated, per HESI RN pediatric standards.



Question 9 (Matrix)

Match the DKA interventions with their purposes:

Intervention Purpose
A. IV normal saline 1. Restore fluid volume
B. Regular insulin 2. Reduce blood glucose
C. Potassium replacement 3. Prevent hypokalemia

Correct Answer: A-1, B-2, C-3
Rationale: Saline restores volume (1), insulin lowers glucose (2), and potassium prevents
hypokalemia (3) due to insulin therapy, per HESI RN endocrine standards.



Question 10 (Trend)

The nurse reviews the child’s labs over 6 hours: