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2025–2026 HESI RN Exit Exam (V1–V7) | 7 Sets × 100
Verified NCLEX-Style Qs with Rationales | 700 A+ Practice
Questions for Guaranteed Success
1. A 62-year-old female patient with a history of type 2 diabetes mellitus and chronic kidney
disease is admitted with shortness of breath, confusion, and decreased urine output. The nurse
notes crackles upon auscultation, peripheral edema, and an elevated serum potassium level of 6.5
mEq/L. The provider prescribes sodium polystyrene sulfonate (Kayexalate), loop diuretics, and
telemetry monitoring. Which action should the nurse prioritize to ensure patient safety?
A. Educate the patient on low-potassium dietary choices.
B. Administer sodium polystyrene sulfonate orally with 240 mL of water.
C. Place the patient on continuous cardiac monitoring.
D. Notify the provider about the patient’s diabetic history before giving any treatment.
✔️
Correct Answer: C. Place the patient on continuous cardiac monitoring.
Rationale: This patient is exhibiting signs of hyperkalemia, which can cause life-threatening
cardiac arrhythmias. Continuous cardiac monitoring is the priority to detect and intervene if
dysrhythmias occur. While Kayexalate and diuretics will lower potassium, and education is
,2
important, these are not the immediate life-saving interventions. Notifying the provider is
unnecessary at this point, as orders have already been given.
📘 Source: Saunders 10th Ed., p. 413; HESI Comp Review 6th Ed., p. 132
2. A nurse in the labor and delivery unit is caring for a 25-year-old G1P0 patient at 40 weeks
gestation. The patient is receiving oxytocin (Pitocin) to augment labor. The nurse observes
uterine contractions lasting 90 seconds and occurring every 90 seconds. The fetal heart rate
(FHR) shows late decelerations. What is the priority nursing action?
A. Stop the oxytocin infusion immediately.
B. Reposition the client to the left side.
C. Administer oxygen via non-rebreather mask at 10 L/min.
D. Notify the healthcare provider of the abnormal FHR.
✔️
Correct Answer: A. Stop the oxytocin infusion immediately.
Rationale: The presence of late decelerations with excessive uterine activity (tachysystole)
indicates uteroplacental insufficiency. The first priority is to discontinue the oxytocin, which
is likely contributing to uterine hyperstimulation. Repositioning and oxygen administration are
also important, but removing the causative agent is the immediate action.
📘 Source: HESI Comp Review, p. 253; Lippincott Q&A, p. 415
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3. A 76-year-old patient with a history of chronic obstructive pulmonary disease (COPD) is
admitted with dyspnea and productive cough. His arterial blood gas (ABG) results are: pH 7.31,
PaCO₂ 58 mmHg, HCO₃⁻ 26 mEq/L, and PaO₂ 68 mmHg on room air. Which of the following
best describes the acid-base imbalance?
A. Metabolic acidosis with partial compensation
B. Respiratory acidosis without compensation
C. Respiratory acidosis with no compensation
D. Respiratory acidosis with partial compensation
✔️
Correct Answer: D. Respiratory acidosis with partial compensation.
Rationale: The pH is low (acidosis), PaCO₂ is high (indicative of respiratory acidosis), and
HCO₃⁻ is slightly elevated, indicating the kidneys have begun to partially compensate. This is
typical in chronic COPD exacerbation.
📘 Source: Saunders 10th Ed., p. 499; HESI Review 6th Ed., p. 119
4. A 60-year-old male patient receiving chemotherapy for colorectal cancer has a WBC count of
2,300/mm³ and a temperature of 100.9°F (38.3°C). He reports feeling "a little off" and has a
productive cough. What is the most appropriate action by the nurse?
, 4
A. Encourage increased fluid intake and monitor vital signs.
B. Place the patient in protective isolation.
C. Administer acetaminophen and reassess in 1 hour.
D. Call the provider to obtain an antibiotic order.
✔️
Correct Answer: B. Place the patient in protective isolation.
Rationale: A WBC count below 4,000/mm³ with signs of infection and elevated temperature
signals neutropenic fever, which can quickly become fatal. Protective (reverse) isolation is
crucial to prevent patient exposure to outside pathogens. Antibiotics will be necessary but
must be preceded by protective measures.
📘 Source: LaCharity 5th Ed., Case 7; Saunders 10th Ed., p. 231
5. A nurse is teaching a client with newly diagnosed heart failure about home care and
medication management. The client is prescribed furosemide, lisinopril, and potassium chloride.
Which statement by the client indicates the need for further teaching?
A. “I will weigh myself every morning before eating.”
B. “I should rise slowly when getting out of bed to prevent dizziness.”
C. “I will take my potassium supplement even when I eat a banana.”
D. “I’ll stop taking my diuretic if I feel better for a few days.”
✔️
Correct Answer: D. “I’ll stop taking my diuretic if I feel better for a few days.”
Rationale: Patients with heart failure must understand that diuretics are maintenance
2025–2026 HESI RN Exit Exam (V1–V7) | 7 Sets × 100
Verified NCLEX-Style Qs with Rationales | 700 A+ Practice
Questions for Guaranteed Success
1. A 62-year-old female patient with a history of type 2 diabetes mellitus and chronic kidney
disease is admitted with shortness of breath, confusion, and decreased urine output. The nurse
notes crackles upon auscultation, peripheral edema, and an elevated serum potassium level of 6.5
mEq/L. The provider prescribes sodium polystyrene sulfonate (Kayexalate), loop diuretics, and
telemetry monitoring. Which action should the nurse prioritize to ensure patient safety?
A. Educate the patient on low-potassium dietary choices.
B. Administer sodium polystyrene sulfonate orally with 240 mL of water.
C. Place the patient on continuous cardiac monitoring.
D. Notify the provider about the patient’s diabetic history before giving any treatment.
✔️
Correct Answer: C. Place the patient on continuous cardiac monitoring.
Rationale: This patient is exhibiting signs of hyperkalemia, which can cause life-threatening
cardiac arrhythmias. Continuous cardiac monitoring is the priority to detect and intervene if
dysrhythmias occur. While Kayexalate and diuretics will lower potassium, and education is
,2
important, these are not the immediate life-saving interventions. Notifying the provider is
unnecessary at this point, as orders have already been given.
📘 Source: Saunders 10th Ed., p. 413; HESI Comp Review 6th Ed., p. 132
2. A nurse in the labor and delivery unit is caring for a 25-year-old G1P0 patient at 40 weeks
gestation. The patient is receiving oxytocin (Pitocin) to augment labor. The nurse observes
uterine contractions lasting 90 seconds and occurring every 90 seconds. The fetal heart rate
(FHR) shows late decelerations. What is the priority nursing action?
A. Stop the oxytocin infusion immediately.
B. Reposition the client to the left side.
C. Administer oxygen via non-rebreather mask at 10 L/min.
D. Notify the healthcare provider of the abnormal FHR.
✔️
Correct Answer: A. Stop the oxytocin infusion immediately.
Rationale: The presence of late decelerations with excessive uterine activity (tachysystole)
indicates uteroplacental insufficiency. The first priority is to discontinue the oxytocin, which
is likely contributing to uterine hyperstimulation. Repositioning and oxygen administration are
also important, but removing the causative agent is the immediate action.
📘 Source: HESI Comp Review, p. 253; Lippincott Q&A, p. 415
,3
3. A 76-year-old patient with a history of chronic obstructive pulmonary disease (COPD) is
admitted with dyspnea and productive cough. His arterial blood gas (ABG) results are: pH 7.31,
PaCO₂ 58 mmHg, HCO₃⁻ 26 mEq/L, and PaO₂ 68 mmHg on room air. Which of the following
best describes the acid-base imbalance?
A. Metabolic acidosis with partial compensation
B. Respiratory acidosis without compensation
C. Respiratory acidosis with no compensation
D. Respiratory acidosis with partial compensation
✔️
Correct Answer: D. Respiratory acidosis with partial compensation.
Rationale: The pH is low (acidosis), PaCO₂ is high (indicative of respiratory acidosis), and
HCO₃⁻ is slightly elevated, indicating the kidneys have begun to partially compensate. This is
typical in chronic COPD exacerbation.
📘 Source: Saunders 10th Ed., p. 499; HESI Review 6th Ed., p. 119
4. A 60-year-old male patient receiving chemotherapy for colorectal cancer has a WBC count of
2,300/mm³ and a temperature of 100.9°F (38.3°C). He reports feeling "a little off" and has a
productive cough. What is the most appropriate action by the nurse?
, 4
A. Encourage increased fluid intake and monitor vital signs.
B. Place the patient in protective isolation.
C. Administer acetaminophen and reassess in 1 hour.
D. Call the provider to obtain an antibiotic order.
✔️
Correct Answer: B. Place the patient in protective isolation.
Rationale: A WBC count below 4,000/mm³ with signs of infection and elevated temperature
signals neutropenic fever, which can quickly become fatal. Protective (reverse) isolation is
crucial to prevent patient exposure to outside pathogens. Antibiotics will be necessary but
must be preceded by protective measures.
📘 Source: LaCharity 5th Ed., Case 7; Saunders 10th Ed., p. 231
5. A nurse is teaching a client with newly diagnosed heart failure about home care and
medication management. The client is prescribed furosemide, lisinopril, and potassium chloride.
Which statement by the client indicates the need for further teaching?
A. “I will weigh myself every morning before eating.”
B. “I should rise slowly when getting out of bed to prevent dizziness.”
C. “I will take my potassium supplement even when I eat a banana.”
D. “I’ll stop taking my diuretic if I feel better for a few days.”
✔️
Correct Answer: D. “I’ll stop taking my diuretic if I feel better for a few days.”
Rationale: Patients with heart failure must understand that diuretics are maintenance
