HESI RN Comprehensive Exit Exam Test
Bank | Complete Study Guide with 300+
Actual Exam Questions with Verified Correct
Answers and Detailed Rationales || Latest
Editon- Updated 2026/2027
Question 1
While assessing a radial artery catheter, the client complains of numbness and pain
distal to the insertion site. What interventions should the nurse implement?
Answer: Promptly remove the arterial catheter from the radial artery. ✔✔
Rationale: Numbness and pain distal to an arterial catheter insertion site indicate
compromised circulation or nerve damage. Prompt removal of the catheter is necessary
to prevent further ischemia or injury to the hand.
Question 2
A client is admitted with an epidural hematoma that resulted from a skateboarding
accident. To differentiate the vascular source of the intracranial bleeding, which finding
should the nurse monitor?
Answer: Rapid onset of decreased level of consciousness. ✔✔
Rationale: Epidural hematomas are typically arterial bleeds (often from the middle
meningeal artery) that cause a rapid decrease in level of consciousness due to expanding
hematoma and increased intracranial pressure.
Question 3
When preparing a client for discharge from the hospital following a cystectomy and a
urinary diversion to treat bladder cancer, which instruction is most important for the
nurse to include in the client's discharge teaching plan?
Answer: Report any signs of cloudy urine output. ✔✔
Rationale: Cloudy urine output may indicate a urinary tract infection, which is a
common complication following urinary diversion surgery. Early detection and
treatment are essential.
pg. 1
,Question 4
After repositioning an immobile client, the nurse observes an area of hyperemia. To
assess for blanching, what action should the nurse take?
Answer: Apply light pressure over the area. ✔✔
Rationale: Applying light pressure over the hyperemic area helps determine if the
redness blanches. Non-blanching redness indicates tissue damage and a pressure ulcer.
Question 5
The nurse enters a client's room and observes the client's wrist restraint secured as seen
in the picture. What action should the nurse take?
Answer: Reposition the restraint tie onto the bedframe. ✔✔
Rationale: Restraints should be secured to the bedframe, not the side rails, to prevent
injury from side rail movement.
Question 6
A female client with acute respiratory distress syndrome (ARDS) is chemically paralyzed
and sedated while she is on an assist-control ventilator using 50% FIO2. Which
assessment finding warrants immediate intervention by the nurse?
Answer: Diminished left lower lobe sounds. ✔✔
Rationale: Diminished lobe sounds indicate collapsed alveoli or tension
pneumothorax, which required immediate chest tube insertion to re-inflate the lung.
Question 7
The development of atherosclerosis is a process of sequential events. Arrange the
pathophysiological events in order of occurrence. (Place the first event on top and the
last on the bottom)
Answer:
1. Arterial endothelium injury causes inflammation
2. Macrophages consume low density lipoprotein (LDL), creating foam cells
3. Foam cells release growth factors for smooth muscle cells
4. Smooth muscle grows over fatty streaks creating fibrous plaques
pg. 2
, 5. Vessel narrowing results in ischemia ✔✔
Rationale: Atherosclerosis begins with endothelial injury, followed by LDL
accumulation, foam cell formation, smooth muscle proliferation, fibrous plaque
development, and eventual vessel narrowing leading to ischemia.
Question 8
Following a motor vehicle collision, an adult female with a ruptured spleen and a blood
pressure of 70/44, had an emergency splenectomy. Twelve hours after the surgery, her
urine output is 25 ml/hour for the last two hours. What pathophysiological reason
supports the nurse's decision to report this finding to the healthcare provider?
Answer: Oliguria signals tubular necrosis related to hypoperfusion. ✔✔
Rationale: Oliguria (less than 30 ml/hour) following hemorrhagic shock indicates
acute tubular necrosis due to renal hypoperfusion, which requires immediate
intervention.
Question 9
A nurse-manager is preparing the curricula for a class for charge nurses. A staffing
formula based on what data ensures quality client care and is most cost-effective?
Answer: Skills of staff and client acuity. ✔✔
Rationale: Staffing based on staff skills and client acuity ensures that the right staff are
assigned to clients with appropriate care needs, promoting quality care and cost-
effectiveness.
Question 10
When performing postural drainage on a client with Chronic Obstructive Pulmonary
Disease (COPD), which approach should the nurse use?
Answer: Explain that the client may be placed in five positions. ✔✔
Rationale: Postural drainage uses five positions to drain different lung segments. The
nurse should explain this to the client before beginning the procedure.
Question 11
A client presents in the emergency room with right-sided facial asymmetry. The nurse
asks the client to perform a series of movements that require use of the facial muscles.
What symptoms suggest that the client has most likely experienced a Bell's palsy rather
pg. 3
, than a stroke?
Answer: Inability to close the affected eye, raise brow, or smile. ✔✔
Rationale: Bell's palsy affects all facial muscles on one side, including the forehead.
Stroke typically spares the forehead. Inability to close the eye, raise the brow, or smile
indicates peripheral nerve involvement (Bell's palsy).
Question 12
The nurse is teaching a client how to perform colostomy irrigations. When observing the
client's return demonstration, which action indicated that the client understood the
teaching?
Answer: Keeps the irrigating container less than 18 inches above the stoma. ✔✔
Rationale: The irrigating container should be held no more than 18 inches above the
stoma to prevent injury to the bowel mucosa from excessive pressure.
Question 13
The nurse should teach the client to observe which precaution while taking
dronedarone?
Answer: Avoid grapefruits and its juice. ✔✔
Rationale: Grapefruit juice increases dronedarone levels by inhibiting hepatic
metabolism, increasing the risk of toxicity and QT prolongation.
Question 14
A client who sustained a head injury following an automobile collision is admitted to the
hospital. The nurse includes the client's risk for developing increased intracranial
pressure (ICP) in the plan of care. Which signs indicate to the nurse that ICP has
increased?
Answer: Confusion and papilledema. ✔✔
Rationale: Papilledema is always an indicator of increased ICP, and confusion is
usually the first sign of increased ICP. Other options do not necessarily reflect increased
ICP.
Question 15
The nurse is caring for a client receiving continuous IV fluids through a single lumen
central venous catheter (CVC). Based on the CVC care bundle, which action should be
pg. 4
Bank | Complete Study Guide with 300+
Actual Exam Questions with Verified Correct
Answers and Detailed Rationales || Latest
Editon- Updated 2026/2027
Question 1
While assessing a radial artery catheter, the client complains of numbness and pain
distal to the insertion site. What interventions should the nurse implement?
Answer: Promptly remove the arterial catheter from the radial artery. ✔✔
Rationale: Numbness and pain distal to an arterial catheter insertion site indicate
compromised circulation or nerve damage. Prompt removal of the catheter is necessary
to prevent further ischemia or injury to the hand.
Question 2
A client is admitted with an epidural hematoma that resulted from a skateboarding
accident. To differentiate the vascular source of the intracranial bleeding, which finding
should the nurse monitor?
Answer: Rapid onset of decreased level of consciousness. ✔✔
Rationale: Epidural hematomas are typically arterial bleeds (often from the middle
meningeal artery) that cause a rapid decrease in level of consciousness due to expanding
hematoma and increased intracranial pressure.
Question 3
When preparing a client for discharge from the hospital following a cystectomy and a
urinary diversion to treat bladder cancer, which instruction is most important for the
nurse to include in the client's discharge teaching plan?
Answer: Report any signs of cloudy urine output. ✔✔
Rationale: Cloudy urine output may indicate a urinary tract infection, which is a
common complication following urinary diversion surgery. Early detection and
treatment are essential.
pg. 1
,Question 4
After repositioning an immobile client, the nurse observes an area of hyperemia. To
assess for blanching, what action should the nurse take?
Answer: Apply light pressure over the area. ✔✔
Rationale: Applying light pressure over the hyperemic area helps determine if the
redness blanches. Non-blanching redness indicates tissue damage and a pressure ulcer.
Question 5
The nurse enters a client's room and observes the client's wrist restraint secured as seen
in the picture. What action should the nurse take?
Answer: Reposition the restraint tie onto the bedframe. ✔✔
Rationale: Restraints should be secured to the bedframe, not the side rails, to prevent
injury from side rail movement.
Question 6
A female client with acute respiratory distress syndrome (ARDS) is chemically paralyzed
and sedated while she is on an assist-control ventilator using 50% FIO2. Which
assessment finding warrants immediate intervention by the nurse?
Answer: Diminished left lower lobe sounds. ✔✔
Rationale: Diminished lobe sounds indicate collapsed alveoli or tension
pneumothorax, which required immediate chest tube insertion to re-inflate the lung.
Question 7
The development of atherosclerosis is a process of sequential events. Arrange the
pathophysiological events in order of occurrence. (Place the first event on top and the
last on the bottom)
Answer:
1. Arterial endothelium injury causes inflammation
2. Macrophages consume low density lipoprotein (LDL), creating foam cells
3. Foam cells release growth factors for smooth muscle cells
4. Smooth muscle grows over fatty streaks creating fibrous plaques
pg. 2
, 5. Vessel narrowing results in ischemia ✔✔
Rationale: Atherosclerosis begins with endothelial injury, followed by LDL
accumulation, foam cell formation, smooth muscle proliferation, fibrous plaque
development, and eventual vessel narrowing leading to ischemia.
Question 8
Following a motor vehicle collision, an adult female with a ruptured spleen and a blood
pressure of 70/44, had an emergency splenectomy. Twelve hours after the surgery, her
urine output is 25 ml/hour for the last two hours. What pathophysiological reason
supports the nurse's decision to report this finding to the healthcare provider?
Answer: Oliguria signals tubular necrosis related to hypoperfusion. ✔✔
Rationale: Oliguria (less than 30 ml/hour) following hemorrhagic shock indicates
acute tubular necrosis due to renal hypoperfusion, which requires immediate
intervention.
Question 9
A nurse-manager is preparing the curricula for a class for charge nurses. A staffing
formula based on what data ensures quality client care and is most cost-effective?
Answer: Skills of staff and client acuity. ✔✔
Rationale: Staffing based on staff skills and client acuity ensures that the right staff are
assigned to clients with appropriate care needs, promoting quality care and cost-
effectiveness.
Question 10
When performing postural drainage on a client with Chronic Obstructive Pulmonary
Disease (COPD), which approach should the nurse use?
Answer: Explain that the client may be placed in five positions. ✔✔
Rationale: Postural drainage uses five positions to drain different lung segments. The
nurse should explain this to the client before beginning the procedure.
Question 11
A client presents in the emergency room with right-sided facial asymmetry. The nurse
asks the client to perform a series of movements that require use of the facial muscles.
What symptoms suggest that the client has most likely experienced a Bell's palsy rather
pg. 3
, than a stroke?
Answer: Inability to close the affected eye, raise brow, or smile. ✔✔
Rationale: Bell's palsy affects all facial muscles on one side, including the forehead.
Stroke typically spares the forehead. Inability to close the eye, raise the brow, or smile
indicates peripheral nerve involvement (Bell's palsy).
Question 12
The nurse is teaching a client how to perform colostomy irrigations. When observing the
client's return demonstration, which action indicated that the client understood the
teaching?
Answer: Keeps the irrigating container less than 18 inches above the stoma. ✔✔
Rationale: The irrigating container should be held no more than 18 inches above the
stoma to prevent injury to the bowel mucosa from excessive pressure.
Question 13
The nurse should teach the client to observe which precaution while taking
dronedarone?
Answer: Avoid grapefruits and its juice. ✔✔
Rationale: Grapefruit juice increases dronedarone levels by inhibiting hepatic
metabolism, increasing the risk of toxicity and QT prolongation.
Question 14
A client who sustained a head injury following an automobile collision is admitted to the
hospital. The nurse includes the client's risk for developing increased intracranial
pressure (ICP) in the plan of care. Which signs indicate to the nurse that ICP has
increased?
Answer: Confusion and papilledema. ✔✔
Rationale: Papilledema is always an indicator of increased ICP, and confusion is
usually the first sign of increased ICP. Other options do not necessarily reflect increased
ICP.
Question 15
The nurse is caring for a client receiving continuous IV fluids through a single lumen
central venous catheter (CVC). Based on the CVC care bundle, which action should be
pg. 4
