1
2025/2026 HESI RN Exit Actual Exam
– 160 Real Questions with Highlighted
Correct Answers and Verified Expert
Rationales
Medical-Surgical Nursing (64 Questions)
1. A client with heart failure is admitted with dyspnea and leg edema. Which intervention
should the nurse prioritize?
A. Administering antibiotics
B. Administering diuretics as prescribed
C. Encouraging high-sodium diet
D. Restricting fluid intake to 500 mL/day
B. Administering diuretics as prescribed
Rationale: Diuretics reduce fluid overload, alleviating dyspnea and edema in heart
failure.
2. A client with type 1 diabetes reports nausea and sweating. The blood glucose is 50
mg/dL. What is the nurse’s priority action?
A. Administer insulin
B. Provide a fast-acting carbohydrate
C. Encourage fluid restriction
D. Monitor blood pressure
B. Provide a fast-acting carbohydrate
Rationale: Hypoglycemia (blood glucose <70 mg/dL) requires immediate carbohydrate
administration.
3. A client with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of
88%. What should the nurse do?
A. Increase oxygen to 6 L/min
B. Administer a bronchodilator as prescribed
C. Place the client in a supine position
D. Encourage deep breathing exercises
B. Administer a bronchodilator as prescribed
Rationale: Bronchodilators improve airflow in COPD; oxygen saturation of 88% is
typical for COPD clients.
, 2
4. A client with a suspected myocardial infarction reports chest pain. Which diagnostic test
should the nurse anticipate?
A. Complete blood count (CBC)
B. Troponin levels
C. Urinalysis
D. Blood glucose
B. Troponin levels
Rationale: Troponin is a specific marker for myocardial injury.
5. A client with pneumonia has a fever of 101.5°F. What is the nurse’s priority
intervention?
A. Administer antipyretics as prescribed
B. Apply a heating pad
C. Restrict fluids
D. Encourage bed rest only
A. Administer antipyretics as prescribed
Rationale: Antipyretics reduce fever and improve client comfort in pneumonia.
6. A client with a new colostomy reports leakage around the stoma. What should the nurse
do first?
A. Change the appliance immediately
B. Assess the stoma and skin barrier fit
C. Administer an antidiarrheal
D. Restrict oral intake
B. Assess the stoma and skin barrier fit
Rationale: Proper assessment ensures the correct appliance size to prevent leakage.
7. A client with hypertension is prescribed lisinopril. Which side effect should the nurse
monitor?
A. Hyperglycemia
B. Persistent cough
C. Weight gain
D. Increased heart rate
B. Persistent cough
Rationale: Lisinopril, an ACE inhibitor, commonly causes a dry cough.
8. A client with acute kidney injury has a potassium level of 6.2 mEq/L. What should the
nurse anticipate?
A. Administering potassium supplements
B. Preparing for dialysis
C. Encouraging a high-potassium diet
D. Monitoring blood glucose
, 3
B. Preparing for dialysis
Rationale: Hyperkalemia (potassium >5.0 mEq/L) may require dialysis in acute kidney
injury.
9. A client with a deep vein thrombosis (DVT) is prescribed heparin. What should the nurse
monitor?
A. Platelet count
B. Blood glucose
C. Serum creatinine
D. Oxygen saturation
A. Platelet count
Rationale: Heparin can cause thrombocytopenia, requiring platelet monitoring.
10. A client with cirrhosis reports abdominal distension. What is the nurse’s priority action?
A. Administer an antacid
B. Assess for ascites
C. Encourage a high-protein diet
D. Restrict physical activity
B. Assess for ascites
Rationale: Abdominal distension in cirrhosis is often due to ascites, requiring assessment.
11. A client with a fractured femur is in traction. What should the nurse assess regularly?
A. Skin integrity under traction
B. Blood glucose levels
C. Respiratory rate
D. Fluid intake
A. Skin integrity under traction
Rationale: Traction can cause skin breakdown, requiring regular assessment.
12. A client with rheumatoid arthritis reports morning stiffness. What should the nurse
recommend?
A. Cold packs to joints
B. Gentle range-of-motion exercises
C. High-impact aerobics
D. Complete bed rest
B. Gentle range-of-motion exercises
Rationale: Gentle exercises reduce stiffness and improve joint mobility.
13. A client with a seizure disorder is prescribed phenytoin. What should the nurse teach the
client?
A. Avoid oral hygiene
B. Monitor for gingival hyperplasia
, 4
C. Increase sodium intake
D. Restrict fluid intake
B. Monitor for gingival hyperplasia
Rationale: Phenytoin commonly causes gingival hyperplasia as a side effect.
14. A client with a burn injury is at risk for infection. What should the nurse prioritize?
A. Administering analgesics
B. Maintaining sterile technique
C. Encouraging high-calorie meals
D. Restricting visitors
B. Maintaining sterile technique
Rationale: Sterile technique prevents infection in burn injuries.
15. A client with a peptic ulcer reports epigastric pain. What should the nurse assess?
A. Bowel sounds
B. Pain characteristics and triggers
C. Respiratory rate
D. Blood pressure
B. Pain characteristics and triggers
Rationale: Assessing pain helps identify ulcer triggers like food or stress.
16. A client with asthma reports wheezing. What should the nurse administer first?
A. Long-acting inhaler
B. Short-acting beta-agonist inhaler
C. Oral corticosteroids
D. Antihistamine
B. Short-acting beta-agonist inhaler
Rationale: Short-acting beta-agonists provide rapid relief for acute asthma symptoms.
17. A client with a stroke has dysphagia. What should the nurse do?
A. Offer thin liquids
B. Consult a speech therapist
C. Encourage solid foods
D. Restrict oral intake
B. Consult a speech therapist
Rationale: Speech therapists assess and manage dysphagia to prevent aspiration.
18. A client with diabetic ketoacidosis (DKA) has a pH of 7.25. What should the nurse
anticipate?
A. Administering sodium bicarbonate
B. Administering insulin as prescribed
2025/2026 HESI RN Exit Actual Exam
– 160 Real Questions with Highlighted
Correct Answers and Verified Expert
Rationales
Medical-Surgical Nursing (64 Questions)
1. A client with heart failure is admitted with dyspnea and leg edema. Which intervention
should the nurse prioritize?
A. Administering antibiotics
B. Administering diuretics as prescribed
C. Encouraging high-sodium diet
D. Restricting fluid intake to 500 mL/day
B. Administering diuretics as prescribed
Rationale: Diuretics reduce fluid overload, alleviating dyspnea and edema in heart
failure.
2. A client with type 1 diabetes reports nausea and sweating. The blood glucose is 50
mg/dL. What is the nurse’s priority action?
A. Administer insulin
B. Provide a fast-acting carbohydrate
C. Encourage fluid restriction
D. Monitor blood pressure
B. Provide a fast-acting carbohydrate
Rationale: Hypoglycemia (blood glucose <70 mg/dL) requires immediate carbohydrate
administration.
3. A client with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of
88%. What should the nurse do?
A. Increase oxygen to 6 L/min
B. Administer a bronchodilator as prescribed
C. Place the client in a supine position
D. Encourage deep breathing exercises
B. Administer a bronchodilator as prescribed
Rationale: Bronchodilators improve airflow in COPD; oxygen saturation of 88% is
typical for COPD clients.
, 2
4. A client with a suspected myocardial infarction reports chest pain. Which diagnostic test
should the nurse anticipate?
A. Complete blood count (CBC)
B. Troponin levels
C. Urinalysis
D. Blood glucose
B. Troponin levels
Rationale: Troponin is a specific marker for myocardial injury.
5. A client with pneumonia has a fever of 101.5°F. What is the nurse’s priority
intervention?
A. Administer antipyretics as prescribed
B. Apply a heating pad
C. Restrict fluids
D. Encourage bed rest only
A. Administer antipyretics as prescribed
Rationale: Antipyretics reduce fever and improve client comfort in pneumonia.
6. A client with a new colostomy reports leakage around the stoma. What should the nurse
do first?
A. Change the appliance immediately
B. Assess the stoma and skin barrier fit
C. Administer an antidiarrheal
D. Restrict oral intake
B. Assess the stoma and skin barrier fit
Rationale: Proper assessment ensures the correct appliance size to prevent leakage.
7. A client with hypertension is prescribed lisinopril. Which side effect should the nurse
monitor?
A. Hyperglycemia
B. Persistent cough
C. Weight gain
D. Increased heart rate
B. Persistent cough
Rationale: Lisinopril, an ACE inhibitor, commonly causes a dry cough.
8. A client with acute kidney injury has a potassium level of 6.2 mEq/L. What should the
nurse anticipate?
A. Administering potassium supplements
B. Preparing for dialysis
C. Encouraging a high-potassium diet
D. Monitoring blood glucose
, 3
B. Preparing for dialysis
Rationale: Hyperkalemia (potassium >5.0 mEq/L) may require dialysis in acute kidney
injury.
9. A client with a deep vein thrombosis (DVT) is prescribed heparin. What should the nurse
monitor?
A. Platelet count
B. Blood glucose
C. Serum creatinine
D. Oxygen saturation
A. Platelet count
Rationale: Heparin can cause thrombocytopenia, requiring platelet monitoring.
10. A client with cirrhosis reports abdominal distension. What is the nurse’s priority action?
A. Administer an antacid
B. Assess for ascites
C. Encourage a high-protein diet
D. Restrict physical activity
B. Assess for ascites
Rationale: Abdominal distension in cirrhosis is often due to ascites, requiring assessment.
11. A client with a fractured femur is in traction. What should the nurse assess regularly?
A. Skin integrity under traction
B. Blood glucose levels
C. Respiratory rate
D. Fluid intake
A. Skin integrity under traction
Rationale: Traction can cause skin breakdown, requiring regular assessment.
12. A client with rheumatoid arthritis reports morning stiffness. What should the nurse
recommend?
A. Cold packs to joints
B. Gentle range-of-motion exercises
C. High-impact aerobics
D. Complete bed rest
B. Gentle range-of-motion exercises
Rationale: Gentle exercises reduce stiffness and improve joint mobility.
13. A client with a seizure disorder is prescribed phenytoin. What should the nurse teach the
client?
A. Avoid oral hygiene
B. Monitor for gingival hyperplasia
, 4
C. Increase sodium intake
D. Restrict fluid intake
B. Monitor for gingival hyperplasia
Rationale: Phenytoin commonly causes gingival hyperplasia as a side effect.
14. A client with a burn injury is at risk for infection. What should the nurse prioritize?
A. Administering analgesics
B. Maintaining sterile technique
C. Encouraging high-calorie meals
D. Restricting visitors
B. Maintaining sterile technique
Rationale: Sterile technique prevents infection in burn injuries.
15. A client with a peptic ulcer reports epigastric pain. What should the nurse assess?
A. Bowel sounds
B. Pain characteristics and triggers
C. Respiratory rate
D. Blood pressure
B. Pain characteristics and triggers
Rationale: Assessing pain helps identify ulcer triggers like food or stress.
16. A client with asthma reports wheezing. What should the nurse administer first?
A. Long-acting inhaler
B. Short-acting beta-agonist inhaler
C. Oral corticosteroids
D. Antihistamine
B. Short-acting beta-agonist inhaler
Rationale: Short-acting beta-agonists provide rapid relief for acute asthma symptoms.
17. A client with a stroke has dysphagia. What should the nurse do?
A. Offer thin liquids
B. Consult a speech therapist
C. Encourage solid foods
D. Restrict oral intake
B. Consult a speech therapist
Rationale: Speech therapists assess and manage dysphagia to prevent aspiration.
18. A client with diabetic ketoacidosis (DKA) has a pH of 7.25. What should the nurse
anticipate?
A. Administering sodium bicarbonate
B. Administering insulin as prescribed
