HESI RN Fundamentals Exit Exam
2025/2026 – 70 Actual Questions with
Verified Correct Answers
1. A client with cholecystitis is being taught about dietary modifications. Which meal
choice is most appropriate for this client?
A. Grilled steak, baked beans, and a green salad
B. Broiled fish, green beans, and an apple
C. Pork chops, macaroni and cheese, and grapes
D. Avocado salad, milk, and angel food cake
Answer: B
Rationale: Clients with cholecystitis should follow a low-fat diet to reduce
gallbladder stimulation. Broiled fish, green beans, and an apple are low in fat,
making this the best choice. Options A, C, and D contain high-fat foods, which can
exacerbate symptoms.
2. A nurse observes a 65-year-old client in a wheelchair with redness in the sacral area.
What is the most important instruction to provide?
A. Take a daily vitamin supplement
B. Change positions in the chair frequently
C. Increase daily water intake
D. Apply a heating pad to the area
Answer: B
Rationale: Frequent position changes relieve pressure on the sacral area, preventing
pressure ulcers. Vitamin supplements and water intake are important but not
specific to preventing pressure ulcers. A heating pad may worsen the condition by
increasing tissue damage.
3. A postoperative client’s antihypertensive medication is not listed in the new orders. What
should the nurse do?
A. Consult the pharmacist about continuing the medication
B. Administer the preoperative dose
C. Withhold the medication until the client is alert
D. Contact the healthcare provider to renew the prescription
Answer: D
Rationale: Medications prescribed preoperatively must be renewed postoperatively.
Contacting the healthcare provider ensures continuity of care. The pharmacist
cannot prescribe, and administering without a current order is unsafe. Withholding
without clarification delays treatment.
4. A client with a history of hypertension reports a persistent dry cough after starting
lisinopril. What is the best nursing action?
A. Encourage increased fluid intake
B. Discontinue the medication immediately
, C. Notify the healthcare provider for an alternative
D. Instruct the client to take the medication at bedtime
Answer: C
Rationale: A dry cough is a common side effect of ACE inhibitors like lisinopril.
Notifying the healthcare provider allows for consideration of an alternative
medication. Increasing fluids or changing administration time does not address the
side effect, and discontinuing without an order is inappropriate.
5. A nurse is assessing a pregnant client at 34 weeks with painless bright red vaginal
bleeding. What is the most likely diagnosis?
A. Placental abruption
B. Placenta previa
C. Preterm labor
D. Uterine rupture
Answer: B
Rationale: Placenta previa presents with painless bright red vaginal bleeding in the
third trimester. Placental abruption causes painful bleeding, preterm labor involves
contractions, and uterine rupture is rare and associated with severe pain and fetal
distress.
6. A client with diabetes is scheduled for a fasting blood glucose test at 8 AM. When should
the nurse instruct the client to stop eating?
A. 12 AM (midnight)
B. 6 AM
C. 10 PM the previous night
D. No restrictions are needed
Answer: A
Rationale: A fasting blood glucose test requires 8–12 hours of fasting. Stopping
eating at midnight ensures at least 8 hours of fasting by 8 AM. Earlier or later times
do not meet the fasting requirement, and restrictions are necessary.
7. A client with pneumonia is confused, has a fever of 103°F, and a respiratory rate of 32.
What is the priority nursing action?
A. Apply oxygen
B. Administer acetaminophen
C. Encourage fluid intake
D. Obtain a sputum culture
Answer: A
Rationale: Confusion and a respiratory rate of 32 suggest hypoxia, making oxygen
therapy the priority to improve oxygenation. Acetaminophen addresses fever but
not hypoxia, fluid intake is secondary, and a sputum culture does not address the
immediate need.
8. A client with Cushing’s syndrome is being assessed. Which finding is most
characteristic?
A. Moon face and buffalo hump
B. Weight loss and dehydration
C. Hyperpigmentation
D. Bradycardia
Answer: A
, Rationale: Cushing’s syndrome causes fat redistribution, leading to a moon face and
buffalo hump due to excess cortisol. Weight loss and dehydration are seen in
Addison’s disease, hyperpigmentation is also associated with Addison’s, and
bradycardia is not typical.
9. A nurse is caring for a client with a chest tube. Which finding requires immediate
intervention?
A. Continuous bubbling in the water seal chamber
B. 40 mL of drainage in the past hour
C. The chest tube is below chest level
D. The client reports mild pain at the insertion site
Answer: A
Rationale: Continuous bubbling in the water seal chamber indicates an air leak,
which requires immediate intervention to prevent complications. Moderate
drainage, proper tube positioning, and mild pain are expected or less urgent.
10. A client presses the call bell and requests pain medication for a severe headache. How
should the nurse assess the pain?
A. Ask the client to describe the pain
B. Measure the client’s vital signs
C. Check the medication administration record
D. Observe the client’s facial expressions
Answer: A
Rationale: Asking the client to describe the pain provides the most direct assessment
of its quality, intensity, and characteristics, guiding appropriate intervention. Vital
signs, medication records, and observations are secondary.
11. A client with a suspected MRSA infection has wound drainage. Why is it important to
send this for culture and sensitivity?
A. To monitor the client’s immune response
B. To confirm the presence of MRSA and guide antibiotic therapy
C. To assess the wound’s healing progress
D. To determine the client’s pain level
Answer: B
Rationale: Culture and sensitivity testing identifies the specific organism (e.g.,
MRSA) and determines effective antibiotics, guiding treatment. It does not assess
immune response, healing, or pain.
12. A client with heart failure is prescribed furosemide IV. What therapeutic response should
the nurse expect?
A. Increased cardiac contractility
B. Reduced preload
C. Relaxed vascular tone
D. Decreased afterload
Answer: B
Rationale: Furosemide reduces fluid volume, decreasing preload (the initial
stretching of the cardiac ventricles) in heart failure, which alleviates symptoms. It
does not directly affect contractility, vascular tone, or afterload.
13. A nurse is teaching a client with diabetes about foot care. Which instruction is most
important?
2025/2026 – 70 Actual Questions with
Verified Correct Answers
1. A client with cholecystitis is being taught about dietary modifications. Which meal
choice is most appropriate for this client?
A. Grilled steak, baked beans, and a green salad
B. Broiled fish, green beans, and an apple
C. Pork chops, macaroni and cheese, and grapes
D. Avocado salad, milk, and angel food cake
Answer: B
Rationale: Clients with cholecystitis should follow a low-fat diet to reduce
gallbladder stimulation. Broiled fish, green beans, and an apple are low in fat,
making this the best choice. Options A, C, and D contain high-fat foods, which can
exacerbate symptoms.
2. A nurse observes a 65-year-old client in a wheelchair with redness in the sacral area.
What is the most important instruction to provide?
A. Take a daily vitamin supplement
B. Change positions in the chair frequently
C. Increase daily water intake
D. Apply a heating pad to the area
Answer: B
Rationale: Frequent position changes relieve pressure on the sacral area, preventing
pressure ulcers. Vitamin supplements and water intake are important but not
specific to preventing pressure ulcers. A heating pad may worsen the condition by
increasing tissue damage.
3. A postoperative client’s antihypertensive medication is not listed in the new orders. What
should the nurse do?
A. Consult the pharmacist about continuing the medication
B. Administer the preoperative dose
C. Withhold the medication until the client is alert
D. Contact the healthcare provider to renew the prescription
Answer: D
Rationale: Medications prescribed preoperatively must be renewed postoperatively.
Contacting the healthcare provider ensures continuity of care. The pharmacist
cannot prescribe, and administering without a current order is unsafe. Withholding
without clarification delays treatment.
4. A client with a history of hypertension reports a persistent dry cough after starting
lisinopril. What is the best nursing action?
A. Encourage increased fluid intake
B. Discontinue the medication immediately
, C. Notify the healthcare provider for an alternative
D. Instruct the client to take the medication at bedtime
Answer: C
Rationale: A dry cough is a common side effect of ACE inhibitors like lisinopril.
Notifying the healthcare provider allows for consideration of an alternative
medication. Increasing fluids or changing administration time does not address the
side effect, and discontinuing without an order is inappropriate.
5. A nurse is assessing a pregnant client at 34 weeks with painless bright red vaginal
bleeding. What is the most likely diagnosis?
A. Placental abruption
B. Placenta previa
C. Preterm labor
D. Uterine rupture
Answer: B
Rationale: Placenta previa presents with painless bright red vaginal bleeding in the
third trimester. Placental abruption causes painful bleeding, preterm labor involves
contractions, and uterine rupture is rare and associated with severe pain and fetal
distress.
6. A client with diabetes is scheduled for a fasting blood glucose test at 8 AM. When should
the nurse instruct the client to stop eating?
A. 12 AM (midnight)
B. 6 AM
C. 10 PM the previous night
D. No restrictions are needed
Answer: A
Rationale: A fasting blood glucose test requires 8–12 hours of fasting. Stopping
eating at midnight ensures at least 8 hours of fasting by 8 AM. Earlier or later times
do not meet the fasting requirement, and restrictions are necessary.
7. A client with pneumonia is confused, has a fever of 103°F, and a respiratory rate of 32.
What is the priority nursing action?
A. Apply oxygen
B. Administer acetaminophen
C. Encourage fluid intake
D. Obtain a sputum culture
Answer: A
Rationale: Confusion and a respiratory rate of 32 suggest hypoxia, making oxygen
therapy the priority to improve oxygenation. Acetaminophen addresses fever but
not hypoxia, fluid intake is secondary, and a sputum culture does not address the
immediate need.
8. A client with Cushing’s syndrome is being assessed. Which finding is most
characteristic?
A. Moon face and buffalo hump
B. Weight loss and dehydration
C. Hyperpigmentation
D. Bradycardia
Answer: A
, Rationale: Cushing’s syndrome causes fat redistribution, leading to a moon face and
buffalo hump due to excess cortisol. Weight loss and dehydration are seen in
Addison’s disease, hyperpigmentation is also associated with Addison’s, and
bradycardia is not typical.
9. A nurse is caring for a client with a chest tube. Which finding requires immediate
intervention?
A. Continuous bubbling in the water seal chamber
B. 40 mL of drainage in the past hour
C. The chest tube is below chest level
D. The client reports mild pain at the insertion site
Answer: A
Rationale: Continuous bubbling in the water seal chamber indicates an air leak,
which requires immediate intervention to prevent complications. Moderate
drainage, proper tube positioning, and mild pain are expected or less urgent.
10. A client presses the call bell and requests pain medication for a severe headache. How
should the nurse assess the pain?
A. Ask the client to describe the pain
B. Measure the client’s vital signs
C. Check the medication administration record
D. Observe the client’s facial expressions
Answer: A
Rationale: Asking the client to describe the pain provides the most direct assessment
of its quality, intensity, and characteristics, guiding appropriate intervention. Vital
signs, medication records, and observations are secondary.
11. A client with a suspected MRSA infection has wound drainage. Why is it important to
send this for culture and sensitivity?
A. To monitor the client’s immune response
B. To confirm the presence of MRSA and guide antibiotic therapy
C. To assess the wound’s healing progress
D. To determine the client’s pain level
Answer: B
Rationale: Culture and sensitivity testing identifies the specific organism (e.g.,
MRSA) and determines effective antibiotics, guiding treatment. It does not assess
immune response, healing, or pain.
12. A client with heart failure is prescribed furosemide IV. What therapeutic response should
the nurse expect?
A. Increased cardiac contractility
B. Reduced preload
C. Relaxed vascular tone
D. Decreased afterload
Answer: B
Rationale: Furosemide reduces fluid volume, decreasing preload (the initial
stretching of the cardiac ventricles) in heart failure, which alleviates symptoms. It
does not directly affect contractility, vascular tone, or afterload.
13. A nurse is teaching a client with diabetes about foot care. Which instruction is most
important?
