HESI Comprehensive Review for the NCLEX-
RN Exam 2025: Practice Questions,
Rationales & Test-Taking Strategies
What types of procedures should be assigned to professional nurses? - answers -
:Sterile or invasive procedures.
Negligence is measured by reasonableness. What question might the nurse ask when
determining such reasonableness? - answers -:Would a reasonable and prudent nurse
act in the same manner under the same circumstances?
1. Compare the signs and symptoms of acute glomerulonephritis (AGN) with those of
nephrosis. - answers -:1. AGN: gross hematuria, recent strep infection, hypertension,
and mild edema; nephrosis: severe edema, massive proteinuria, frothy-appearing urine,
anorexia
2. What antecedent event occurs with AGN? - answers -:2. Beta-hemolytic
streptococcal infection
3. Compare the dietary interventions for AGN and nephrosis. - answers -:3. AGN: low-
sodium diet with no added salt; nephrosis: high-protein, low-salt diet
4. What is the physiologic reason for the lab finding of hypoproteinemia in nephrosis? -
answers -:4. Hypoproteinemia occurs because the glomeruli are permeable to serum
proteins.
5. Describe safe monitoring of prednisone administration and withdrawal. - answers -
:5. Long-term prednisone should be given every other day. Signs of edema, mood
,changes, and GI distress should be noted and reported. The drug should be tapered, not
discontinued suddenly.
6. What interventions can be taught to prevent urinary tract infections in children? -
answers -:6. Avoid bubble baths; void frequently; drink adequate fluids, especially
acidic fluids such as apple or cranberry juice; and clean
genital area from front to back.
7. Describe the pathophysiology of vesicoureteral reflux. - answers -:7. A malfunction
of the valves at the end of the ureters, allowing urine to reflux out of the bladder into the
ureters and possibly into the kidneys
8. What are the priorities for a client with a Wilms tumor? - answers -:8. Protect the
child from injury to the encapsulated tumor. Prepare the family and child for surgery.
9. Explain why hypospadias correction is performed before the child reaches preschool
age. - answers -:9. Preschoolers fear castration, achieving sexual identity, and
acquiring independent toileting skills.
1. Describe feeding techniques for a child with cleft lip or palate. - answers -:1. Use
lamb's nipple or prosthesis. Feed child upright, with frequent bubbling.
2. List the signs and symptoms of esophageal atresia with TEF. - answers -:2. Choking,
coughing, cyanosis, and excess salivation
3. What nursing actions are initiated for the newborn with suspected esophageal atresia
with TEF? - answers -:3. Maintain NPO immediately, and suction secretions.
4. Describe the postoperative nursing care for an infant with pyloric stenosis. -
answers -:4. Maintain IV hydration, and provide small, frequent oral feedings of
glucose or electrolyte solutions or both within 4 to 6 hours.
,Gradually increase to full-strength formula. Position infant on right side in semi-Fowler
position after feeding.
5. Describe why a barium enema is used to treat intussusception. - answers -:5. A
barium enema reduces the telescoping of the intestine through hydrostatic pressure
without surgical intervention.
6. Describe the preoperative nursing care for a child with Hirschsprung disease. -
answers -:6. Check vital signs and take axillary temperatures. Provide bowel cleansing
program, and teach about colostomy. Observe for
bowel perforation; measure abdominal girth.
7. What care is needed for a child with a temporary colostomy? - answers -:7. Family
needs education about skin care and appliances. Referral to an enterostomal therapist is
appropriate.
8. What are the signs of anorectal malformation? - answers -:8. A newborn who does
not pass meconium within 24 hours; meconium appearing through a fistula or in the
urine; an unusual-appearing anal dimple.
9. What are the priorities for a child undergoing abdominal surgery? - answers -:9.
Maintain fluid balance (I&O, nasogastric suction, monitor electrolytes); monitor vital
signs; care for drains, if present; assess bowel function; prevent infection of incisional
area and other postoperative complications; and support child and family with
appropriate teaching.
1. Describe the information families should be given when a child is receiving oral iron
preparations. - answers -:1. Give oral iron on an empty stomach and with vitamin C.
Use straws to avoid discoloring teeth.Tarry stools are normal. Increase dietary sources
of iron.
2. List dietary sources of iron. - answers -:2. Meat, green leafy vegetables, fish, liver,
whole grains, legumes
, 3. What is the genetic transmission pattern of hemophilia? - answers -:3. It is an X-
linked recessive chromosomal disorder transmitted by the mother and expressed in
male children.
4. Describe the sequence of events in a vaso-occlusive crisis in sickle cell anemia. -
answers -:4. A vaso-occlusive crisis is caused by the clumping of red blood cells, which
blocks small blood vessels; therefore, the cells
cannot get through the capillaries, causing pain and tissue and organ ischemia. Lowered
oxygen tension affects HgbS, which causes sickling of the cells.
5. Explain why hydration is a priority in treating sickle cell disease. - answers -:5.
Hydration promotes hemodilution and circulation of the red cells through the blood
vessels.
6. What should families and clients do to avoid triggering sickling episodes? - answers
-:6. Keep child well hydrated.Avoid known sources of infections.Avoid high
altitudes.Avoid strenuous exercise.
7. Nursing interventions and medical treatments for a child with leukemia are based on
what three physiologic problems? - answers -:7. Anemia (decreased erythrocytes);
infection (neutropenia); bleeding thrombocytopenia (decreased platelets)
1. How is congenital hypothyroidism diagnosed? - answers -:1. Newborn screening
revealing a low T4 and a high TSH
2. What are the symptoms of congenital hypothyroidism in early infancy? - answers -
:2. Large, protruding tongue; coarse hair; lethargy; sleepiness; and constipation
3. What are the outcomes of untreated congenital hypothyroidism? - answers -:3.
Mental retardation and growth failure
RN Exam 2025: Practice Questions,
Rationales & Test-Taking Strategies
What types of procedures should be assigned to professional nurses? - answers -
:Sterile or invasive procedures.
Negligence is measured by reasonableness. What question might the nurse ask when
determining such reasonableness? - answers -:Would a reasonable and prudent nurse
act in the same manner under the same circumstances?
1. Compare the signs and symptoms of acute glomerulonephritis (AGN) with those of
nephrosis. - answers -:1. AGN: gross hematuria, recent strep infection, hypertension,
and mild edema; nephrosis: severe edema, massive proteinuria, frothy-appearing urine,
anorexia
2. What antecedent event occurs with AGN? - answers -:2. Beta-hemolytic
streptococcal infection
3. Compare the dietary interventions for AGN and nephrosis. - answers -:3. AGN: low-
sodium diet with no added salt; nephrosis: high-protein, low-salt diet
4. What is the physiologic reason for the lab finding of hypoproteinemia in nephrosis? -
answers -:4. Hypoproteinemia occurs because the glomeruli are permeable to serum
proteins.
5. Describe safe monitoring of prednisone administration and withdrawal. - answers -
:5. Long-term prednisone should be given every other day. Signs of edema, mood
,changes, and GI distress should be noted and reported. The drug should be tapered, not
discontinued suddenly.
6. What interventions can be taught to prevent urinary tract infections in children? -
answers -:6. Avoid bubble baths; void frequently; drink adequate fluids, especially
acidic fluids such as apple or cranberry juice; and clean
genital area from front to back.
7. Describe the pathophysiology of vesicoureteral reflux. - answers -:7. A malfunction
of the valves at the end of the ureters, allowing urine to reflux out of the bladder into the
ureters and possibly into the kidneys
8. What are the priorities for a client with a Wilms tumor? - answers -:8. Protect the
child from injury to the encapsulated tumor. Prepare the family and child for surgery.
9. Explain why hypospadias correction is performed before the child reaches preschool
age. - answers -:9. Preschoolers fear castration, achieving sexual identity, and
acquiring independent toileting skills.
1. Describe feeding techniques for a child with cleft lip or palate. - answers -:1. Use
lamb's nipple or prosthesis. Feed child upright, with frequent bubbling.
2. List the signs and symptoms of esophageal atresia with TEF. - answers -:2. Choking,
coughing, cyanosis, and excess salivation
3. What nursing actions are initiated for the newborn with suspected esophageal atresia
with TEF? - answers -:3. Maintain NPO immediately, and suction secretions.
4. Describe the postoperative nursing care for an infant with pyloric stenosis. -
answers -:4. Maintain IV hydration, and provide small, frequent oral feedings of
glucose or electrolyte solutions or both within 4 to 6 hours.
,Gradually increase to full-strength formula. Position infant on right side in semi-Fowler
position after feeding.
5. Describe why a barium enema is used to treat intussusception. - answers -:5. A
barium enema reduces the telescoping of the intestine through hydrostatic pressure
without surgical intervention.
6. Describe the preoperative nursing care for a child with Hirschsprung disease. -
answers -:6. Check vital signs and take axillary temperatures. Provide bowel cleansing
program, and teach about colostomy. Observe for
bowel perforation; measure abdominal girth.
7. What care is needed for a child with a temporary colostomy? - answers -:7. Family
needs education about skin care and appliances. Referral to an enterostomal therapist is
appropriate.
8. What are the signs of anorectal malformation? - answers -:8. A newborn who does
not pass meconium within 24 hours; meconium appearing through a fistula or in the
urine; an unusual-appearing anal dimple.
9. What are the priorities for a child undergoing abdominal surgery? - answers -:9.
Maintain fluid balance (I&O, nasogastric suction, monitor electrolytes); monitor vital
signs; care for drains, if present; assess bowel function; prevent infection of incisional
area and other postoperative complications; and support child and family with
appropriate teaching.
1. Describe the information families should be given when a child is receiving oral iron
preparations. - answers -:1. Give oral iron on an empty stomach and with vitamin C.
Use straws to avoid discoloring teeth.Tarry stools are normal. Increase dietary sources
of iron.
2. List dietary sources of iron. - answers -:2. Meat, green leafy vegetables, fish, liver,
whole grains, legumes
, 3. What is the genetic transmission pattern of hemophilia? - answers -:3. It is an X-
linked recessive chromosomal disorder transmitted by the mother and expressed in
male children.
4. Describe the sequence of events in a vaso-occlusive crisis in sickle cell anemia. -
answers -:4. A vaso-occlusive crisis is caused by the clumping of red blood cells, which
blocks small blood vessels; therefore, the cells
cannot get through the capillaries, causing pain and tissue and organ ischemia. Lowered
oxygen tension affects HgbS, which causes sickling of the cells.
5. Explain why hydration is a priority in treating sickle cell disease. - answers -:5.
Hydration promotes hemodilution and circulation of the red cells through the blood
vessels.
6. What should families and clients do to avoid triggering sickling episodes? - answers
-:6. Keep child well hydrated.Avoid known sources of infections.Avoid high
altitudes.Avoid strenuous exercise.
7. Nursing interventions and medical treatments for a child with leukemia are based on
what three physiologic problems? - answers -:7. Anemia (decreased erythrocytes);
infection (neutropenia); bleeding thrombocytopenia (decreased platelets)
1. How is congenital hypothyroidism diagnosed? - answers -:1. Newborn screening
revealing a low T4 and a high TSH
2. What are the symptoms of congenital hypothyroidism in early infancy? - answers -
:2. Large, protruding tongue; coarse hair; lethargy; sleepiness; and constipation
3. What are the outcomes of untreated congenital hypothyroidism? - answers -:3.
Mental retardation and growth failure
