1
HESI EXIT EXAM 2026, 180+ VERIFIED QUESTIONS WITH CORRECT
ANSWERS & RATIONALES FOR NURSING SUCCESS, ALREADY
GRADED A+
1. A 65-year-old patient with chronic heart failure presents with increasing
shortness of breath, edema, and weight gain over the past week. Which medication
adjustment should the nurse anticipate to manage fluid overload effectively?
A. Increase the dose of furosemide
B. Initiate lisinopril
C. Start metoprolol
D. Administer aspirin
Answer: A
Rationale: Furosemide is a loop diuretic used to manage fluid retention in heart
failure. Increasing the dose helps relieve pulmonary congestion and peripheral
edema. ACE inhibitors and beta-blockers improve long-term outcomes but do not
provide rapid diuresis.
2. A patient receiving warfarin for atrial fibrillation reports new bruising and
nosebleeds. Laboratory results show an INR of 5.0. What is the priority nursing
intervention?
A. Hold the next dose and notify the provider
B. Increase the dose of vitamin K
C. Continue the current dose and monitor
D. Administer heparin
Answer: A
Rationale: An INR above the therapeutic range increases bleeding risk. Holding
warfarin and notifying the provider is appropriate. Vitamin K may be used if
significant bleeding occurs. Heparin is not indicated in this context.
3. A 22-year-old female presents with severe dysuria, frequency, and urgency.
Urinalysis shows positive nitrites and leukocyte esterase. Which antibiotic is
considered first-line for uncomplicated urinary tract infection in non-pregnant
adults?
A. Nitrofurantoin
B. Ciprofloxacin
C. Amoxicillin
D. Trimethoprim-sulfamethoxazole
, 2
Answer: A
Rationale: Nitrofurantoin is recommended for uncomplicated UTIs due to efficacy
against common pathogens and low resistance. Fluoroquinolones and amoxicillin
are reserved for specific situations or resistant infections.
4. A patient with type 2 diabetes reports frequent episodes of hypoglycemia despite
following the prescribed insulin regimen. Which factor is most likely contributing
to these episodes?
A. Skipping meals after insulin administration
B. Increasing physical activity moderately
C. Taking metformin with meals
D. Drinking water before bedtime
Answer: A
Rationale: Insulin-induced hypoglycemia often occurs if a patient skips meals or
delays eating. Metformin rarely causes hypoglycemia, and hydration or moderate
exercise alone is unlikely to cause recurrent episodes.
5. A patient presents with acute asthma exacerbation and wheezing. The provider
orders albuterol via nebulizer every 20 minutes for three doses. What is the
primary rationale for this medication regimen?
A. Albuterol is a short-acting beta-agonist that rapidly relieves bronchospasm
B. Albuterol is an anti-inflammatory used for long-term asthma control
C. Albuterol prevents nocturnal asthma symptoms
D. Albuterol is a leukotriene receptor antagonist
Answer: A
Rationale: Short-acting beta-agonists like albuterol provide quick relief of acute
bronchospasm. Anti-inflammatory agents are for maintenance therapy and do not
act immediately.
6. A 55-year-old male with hypertension is prescribed lisinopril. He reports a
persistent dry cough. What is the most appropriate nursing action?
A. Notify the provider to consider switching to an ARB
B. Advise the patient to continue the medication as prescribed
C. Suggest taking the medication with food to reduce cough
D. Prescribe a cough suppressant
Answer: A
Rationale: ACE inhibitors can cause a persistent, dry cough. Switching to an
angiotensin receptor blocker (ARB) often resolves this side effect while
maintaining blood pressure control.
, 3
7. A patient is admitted with community-acquired pneumonia and has an oxygen
saturation of 88% on room air. Which nursing intervention is priority?
A. Administer supplemental oxygen to maintain SpO2 above 92%
B. Begin intravenous antibiotics immediately
C. Encourage coughing and deep breathing exercises
D. Obtain blood cultures before starting antibiotics
Answer: A
Rationale: Oxygen therapy is immediately necessary to prevent hypoxia and organ
damage. While antibiotics and cultures are important, oxygenation is the first
priority in hypoxemic patients.
8. A patient presents with chest pain radiating to the left arm, diaphoresis, and
shortness of breath. Which initial action should the nurse take?
A. Obtain a 12-lead ECG and notify the provider immediately
B. Administer nitroglycerin without assessing vital signs
C. Begin chest compressions immediately
D. Ask the patient to rest and monitor for changes
Answer: A
Rationale: Rapid assessment and ECG are critical for suspected myocardial
infarction. Timely diagnosis guides treatment such as reperfusion therapy.
Immediate CPR is not indicated unless the patient is pulseless.
9. A patient with chronic kidney disease is prescribed gentamicin. Which lab
parameter is most critical to monitor to prevent toxicity?
A. Serum creatinine and BUN
B. Serum potassium
C. Liver function tests
D. Complete blood count
Answer: A
Rationale: Gentamicin is nephrotoxic; renal function tests guide dosing
adjustments to prevent accumulation and kidney damage.
10. A patient receiving chemotherapy reports oral ulcers and pain while
swallowing. Which nursing intervention is most appropriate?
A. Recommend saline or baking soda mouth rinses
B. Encourage acidic foods to reduce microbial growth
C. Administer oral aspirin for pain relief
D. Suggest skipping oral hygiene to prevent irritation
Answer: A
, 4
Rationale: Gentle oral rinses maintain hygiene and reduce irritation. Acidic foods
worsen mucositis, and aspirin may increase bleeding risk.
11. A 70-year-old patient with atrial fibrillation is taking warfarin and reports
black, tarry stools. Which action should the nurse take first?
A. Notify the provider immediately for possible bleeding
B. Advise the patient to continue medication as prescribed
C. Instruct the patient to drink more water
D. Check the patient’s blood pressure only
Answer: A
Rationale: Black, tarry stools indicate gastrointestinal bleeding. Immediate
provider notification is critical; continued warfarin may worsen bleeding.
12. A patient with newly diagnosed type 2 diabetes asks why metformin is
prescribed. Which explanation is most accurate?
A. Metformin decreases hepatic glucose production and improves insulin
sensitivity
B. Metformin increases insulin secretion from the pancreas
C. Metformin promotes rapid weight gain to improve energy
D. Metformin blocks glucose absorption in the kidneys
Answer: A
Rationale: Metformin reduces hepatic gluconeogenesis and enhances peripheral
insulin sensitivity. It does not stimulate insulin secretion directly.
13. A patient receiving vancomycin reports flushing and itching after an infusion.
What is the likely cause and appropriate nursing action?
A. Red man syndrome; slow the infusion rate and notify the provider
B. Anaphylaxis; discontinue the drug immediately and administer epinephrine
C. Allergic reaction; continue infusion with antihistamines
D. Nephrotoxicity; increase the infusion rate
Answer: A
Rationale: Red man syndrome is an infusion-related reaction. Slowing the rate and
premedicating with antihistamines reduces symptoms.
14. A patient is prescribed a short-acting beta-agonist inhaler for asthma. How
should the nurse instruct the patient regarding its use?
A. Use the inhaler as needed for acute symptoms only
B. Use the inhaler twice daily for long-term control
C. Take it every morning regardless of symptoms
D. Avoid using it before exercise
HESI EXIT EXAM 2026, 180+ VERIFIED QUESTIONS WITH CORRECT
ANSWERS & RATIONALES FOR NURSING SUCCESS, ALREADY
GRADED A+
1. A 65-year-old patient with chronic heart failure presents with increasing
shortness of breath, edema, and weight gain over the past week. Which medication
adjustment should the nurse anticipate to manage fluid overload effectively?
A. Increase the dose of furosemide
B. Initiate lisinopril
C. Start metoprolol
D. Administer aspirin
Answer: A
Rationale: Furosemide is a loop diuretic used to manage fluid retention in heart
failure. Increasing the dose helps relieve pulmonary congestion and peripheral
edema. ACE inhibitors and beta-blockers improve long-term outcomes but do not
provide rapid diuresis.
2. A patient receiving warfarin for atrial fibrillation reports new bruising and
nosebleeds. Laboratory results show an INR of 5.0. What is the priority nursing
intervention?
A. Hold the next dose and notify the provider
B. Increase the dose of vitamin K
C. Continue the current dose and monitor
D. Administer heparin
Answer: A
Rationale: An INR above the therapeutic range increases bleeding risk. Holding
warfarin and notifying the provider is appropriate. Vitamin K may be used if
significant bleeding occurs. Heparin is not indicated in this context.
3. A 22-year-old female presents with severe dysuria, frequency, and urgency.
Urinalysis shows positive nitrites and leukocyte esterase. Which antibiotic is
considered first-line for uncomplicated urinary tract infection in non-pregnant
adults?
A. Nitrofurantoin
B. Ciprofloxacin
C. Amoxicillin
D. Trimethoprim-sulfamethoxazole
, 2
Answer: A
Rationale: Nitrofurantoin is recommended for uncomplicated UTIs due to efficacy
against common pathogens and low resistance. Fluoroquinolones and amoxicillin
are reserved for specific situations or resistant infections.
4. A patient with type 2 diabetes reports frequent episodes of hypoglycemia despite
following the prescribed insulin regimen. Which factor is most likely contributing
to these episodes?
A. Skipping meals after insulin administration
B. Increasing physical activity moderately
C. Taking metformin with meals
D. Drinking water before bedtime
Answer: A
Rationale: Insulin-induced hypoglycemia often occurs if a patient skips meals or
delays eating. Metformin rarely causes hypoglycemia, and hydration or moderate
exercise alone is unlikely to cause recurrent episodes.
5. A patient presents with acute asthma exacerbation and wheezing. The provider
orders albuterol via nebulizer every 20 minutes for three doses. What is the
primary rationale for this medication regimen?
A. Albuterol is a short-acting beta-agonist that rapidly relieves bronchospasm
B. Albuterol is an anti-inflammatory used for long-term asthma control
C. Albuterol prevents nocturnal asthma symptoms
D. Albuterol is a leukotriene receptor antagonist
Answer: A
Rationale: Short-acting beta-agonists like albuterol provide quick relief of acute
bronchospasm. Anti-inflammatory agents are for maintenance therapy and do not
act immediately.
6. A 55-year-old male with hypertension is prescribed lisinopril. He reports a
persistent dry cough. What is the most appropriate nursing action?
A. Notify the provider to consider switching to an ARB
B. Advise the patient to continue the medication as prescribed
C. Suggest taking the medication with food to reduce cough
D. Prescribe a cough suppressant
Answer: A
Rationale: ACE inhibitors can cause a persistent, dry cough. Switching to an
angiotensin receptor blocker (ARB) often resolves this side effect while
maintaining blood pressure control.
, 3
7. A patient is admitted with community-acquired pneumonia and has an oxygen
saturation of 88% on room air. Which nursing intervention is priority?
A. Administer supplemental oxygen to maintain SpO2 above 92%
B. Begin intravenous antibiotics immediately
C. Encourage coughing and deep breathing exercises
D. Obtain blood cultures before starting antibiotics
Answer: A
Rationale: Oxygen therapy is immediately necessary to prevent hypoxia and organ
damage. While antibiotics and cultures are important, oxygenation is the first
priority in hypoxemic patients.
8. A patient presents with chest pain radiating to the left arm, diaphoresis, and
shortness of breath. Which initial action should the nurse take?
A. Obtain a 12-lead ECG and notify the provider immediately
B. Administer nitroglycerin without assessing vital signs
C. Begin chest compressions immediately
D. Ask the patient to rest and monitor for changes
Answer: A
Rationale: Rapid assessment and ECG are critical for suspected myocardial
infarction. Timely diagnosis guides treatment such as reperfusion therapy.
Immediate CPR is not indicated unless the patient is pulseless.
9. A patient with chronic kidney disease is prescribed gentamicin. Which lab
parameter is most critical to monitor to prevent toxicity?
A. Serum creatinine and BUN
B. Serum potassium
C. Liver function tests
D. Complete blood count
Answer: A
Rationale: Gentamicin is nephrotoxic; renal function tests guide dosing
adjustments to prevent accumulation and kidney damage.
10. A patient receiving chemotherapy reports oral ulcers and pain while
swallowing. Which nursing intervention is most appropriate?
A. Recommend saline or baking soda mouth rinses
B. Encourage acidic foods to reduce microbial growth
C. Administer oral aspirin for pain relief
D. Suggest skipping oral hygiene to prevent irritation
Answer: A
, 4
Rationale: Gentle oral rinses maintain hygiene and reduce irritation. Acidic foods
worsen mucositis, and aspirin may increase bleeding risk.
11. A 70-year-old patient with atrial fibrillation is taking warfarin and reports
black, tarry stools. Which action should the nurse take first?
A. Notify the provider immediately for possible bleeding
B. Advise the patient to continue medication as prescribed
C. Instruct the patient to drink more water
D. Check the patient’s blood pressure only
Answer: A
Rationale: Black, tarry stools indicate gastrointestinal bleeding. Immediate
provider notification is critical; continued warfarin may worsen bleeding.
12. A patient with newly diagnosed type 2 diabetes asks why metformin is
prescribed. Which explanation is most accurate?
A. Metformin decreases hepatic glucose production and improves insulin
sensitivity
B. Metformin increases insulin secretion from the pancreas
C. Metformin promotes rapid weight gain to improve energy
D. Metformin blocks glucose absorption in the kidneys
Answer: A
Rationale: Metformin reduces hepatic gluconeogenesis and enhances peripheral
insulin sensitivity. It does not stimulate insulin secretion directly.
13. A patient receiving vancomycin reports flushing and itching after an infusion.
What is the likely cause and appropriate nursing action?
A. Red man syndrome; slow the infusion rate and notify the provider
B. Anaphylaxis; discontinue the drug immediately and administer epinephrine
C. Allergic reaction; continue infusion with antihistamines
D. Nephrotoxicity; increase the infusion rate
Answer: A
Rationale: Red man syndrome is an infusion-related reaction. Slowing the rate and
premedicating with antihistamines reduces symptoms.
14. A patient is prescribed a short-acting beta-agonist inhaler for asthma. How
should the nurse instruct the patient regarding its use?
A. Use the inhaler as needed for acute symptoms only
B. Use the inhaler twice daily for long-term control
C. Take it every morning regardless of symptoms
D. Avoid using it before exercise
