2026/2027
2026/2027 HESI RN Exit Exam V5
Advanced Exam Preparation and
Study Companion: Comprehensive
Review Modules, Complete Test
Bank, Updated Practice Tests, and
Final Readiness Assessment
Question 16
A client with chronic congestive heart failure is being managed at home. Which finding
s 1. A client admitted with chronic obstructive pulmonary disease (COPD)
suddenly becomes restless, disoriented, and increasingly agitated. Which
assessment finding requires the nurse’s immediate intervention?
A. Persistent nausea and occasional vomiting
B. Restlessness and confusion
C. Low-grade fever accompanied by a productive cough
D. Irritating cough with increased sputum liquefaction
Correct Answer: B. Restlessness and confusion
Rationale: Restlessness and confusion are early signs of hypoxemia and hypercapnia
and may indicate impending respiratory failure.
2. A young adult male diagnosed with testicular cancer discusses his
understanding of treatment options with the nurse. Which statement indicates
a need for additional teaching?
A. “The surgery may involve removal of one or both testicles through an incision in the
groin.”
B. “If fertility is important to me, sperm banking before chemotherapy is an option.”
C. “Stage III cancer means there is less involvement of the cancer.”
D. “A prosthetic testicle may be implanted to maintain a normal appearance.”
Correct Answer: C. “Stage III cancer means there is less involvement of the cancer.”
Rationale: Stage III testicular cancer represents advanced disease with distant spread,
not less involvement.
,2026/2027
3. A newly promoted nurse manager reports difficulty organizing daily
responsibilities. Which recommendation from an experienced manager should
be implemented first?
A. Establish priorities for every hour of the day.
B. Request assistance when workload becomes excessive.
C. Keep a detailed log of activities for one week.
D. Finish one task completely before beginning another.
Correct Answer: C. Keep a detailed log of activities for one week.
Rationale: A time log provides objective data about how time is currently being used
before changes are made.
4. A student nurse reviews care for infants born to mothers positive for
hepatitis B surface antigen (HBsAg). Which statement demonstrates a need
for correction?
A. “Hepatitis B vaccine and HBIG should be administered within 12 hours of birth.”
B. “The second vaccine dose may be given between 1 and 2 months of age.”
C. “The third dose should be administered at least 16 weeks after the second dose.”
D. “The final dose should not be given before 24 weeks of age.”
Correct Answer: C. “The third dose should be administered at least 16 weeks after the
second dose.”
Rationale: The final dose should be given at least 16 weeks after the first dose, not the
second.
5. A 74-year-old client with benign prostatic hyperplasia has been unable to
void for 14 hours. Which assessment finding most strongly suggests bladder
distention?
A. Rebound tenderness
B. Dullness in the left lower quadrant
C. Rounded swelling above the symphysis pubis
D. Urinary drainage from the urethra
Correct Answer: C. Rounded swelling above the symphysis pubis
Rationale: Acute urinary retention causes a smooth, rounded swelling palpable above the
pubic bone.
6. Which statement by a client taking propranolol indicates effective
understanding of medication teaching?
A. “Stopping the medication suddenly may cause seizures.”
B. “My heart rate may increase for several weeks.”
,2026/2027
C. “Feeling nervous is expected during the first month.”
D. “Stopping this medication abruptly could cause a heart attack.”
Correct Answer: D. “Stopping this medication abruptly could cause a heart attack.”
Rationale: Abrupt withdrawal of propranolol can precipitate rebound hypertension,
angina, dysrhythmias, and myocardial infarction.
7. Parents of a 6-month-old infant in a hip spica cast ask about home care.
Which instruction is most important?
A. Use cotton swabs to scratch beneath the cast.
B. Encourage push-pull toys inside the crib.
C. Check the infant’s feet frequently for swelling.
D. Turn the infant every 2 hours using the stabilizer bar.
Correct Answer: C. Check the infant’s feet frequently for swelling.
Rationale: Neurovascular assessment is the highest priority after application of a hip
spica cast.
8. A client with heart disease asks the nurse to explain normal blood flow
through the heart. Which sequence is correct?
A. Right ventricle → Left ventricle → Right atrium → Left atrium
B. Left ventricle → Right ventricle → Left atrium → Right atrium
C. Right atrium → Right ventricle → Left atrium → Left ventricle
D. Right atrium → Left atrium → Right ventricle → Left ventricle
Correct Answer: C. Right atrium → Right ventricle → Left atrium → Left ventricle
Rationale: Deoxygenated blood enters the right atrium, passes to the right ventricle, then
moves through the lungs and returns to the left side of the heart.
9. A nurse manager suspects a staff nurse may have a substance use
disorder. What is the most appropriate initial action?
A. Confront the nurse privately.
B. Gather staff opinions without involving the employee.
C. Consult human resources regarding institutional procedures.
D. Encourage resignation.
Correct Answer: C. Consult human resources regarding institutional procedures.
Rationale: Suspected chemical dependency should be managed according to
organizational policy and legal guidelines.
, 2026/2027
10. A client diagnosed with Raynaud phenomenon asks about lifestyle
modifications. Which recommendation is the highest priority?
A. Stop smoking
B. Keep feet dry
C. Reduce stress
D. Avoid caffeine
Correct Answer: A. Stop smoking
Rationale: Nicotine causes vasoconstriction and worsens the digital ischemia associated
with Raynaud phenomenon.
11. A client experiencing status epilepticus is admitted to the intensive care
unit. Which assessment is the priority?
A. Intravenous infusion rate
B. Level of consciousness
C. Pulse and respirations
D. Extremity injuries
Correct Answer: B. Level of consciousness
Rationale: Continuous seizure activity can compromise cerebral oxygenation and
neurological function.
12. Laboratory analysis of cerebrospinal fluid in bacterial meningitis would
most likely reveal:
A. Elevated protein levels
B. Crystal-clear appearance
C. Increased erythrocyte sedimentation rate
D. Elevated glucose concentration
Correct Answer: A. Elevated protein levels
Rationale: In bacterial meningitis, inflammation increases blood-brain barrier
permeability, leading to elevated CSF protein.
13. A hospital is downsizing personnel. During the unfreezing stage of planned
change, which management action is most appropriate?
A. Address defensive behaviors among staff.
B. Explain why organizational change is necessary.
C. Help staff integrate new processes.
D. Discuss effects on the surrounding community.
2026/2027 HESI RN Exit Exam V5
Advanced Exam Preparation and
Study Companion: Comprehensive
Review Modules, Complete Test
Bank, Updated Practice Tests, and
Final Readiness Assessment
Question 16
A client with chronic congestive heart failure is being managed at home. Which finding
s 1. A client admitted with chronic obstructive pulmonary disease (COPD)
suddenly becomes restless, disoriented, and increasingly agitated. Which
assessment finding requires the nurse’s immediate intervention?
A. Persistent nausea and occasional vomiting
B. Restlessness and confusion
C. Low-grade fever accompanied by a productive cough
D. Irritating cough with increased sputum liquefaction
Correct Answer: B. Restlessness and confusion
Rationale: Restlessness and confusion are early signs of hypoxemia and hypercapnia
and may indicate impending respiratory failure.
2. A young adult male diagnosed with testicular cancer discusses his
understanding of treatment options with the nurse. Which statement indicates
a need for additional teaching?
A. “The surgery may involve removal of one or both testicles through an incision in the
groin.”
B. “If fertility is important to me, sperm banking before chemotherapy is an option.”
C. “Stage III cancer means there is less involvement of the cancer.”
D. “A prosthetic testicle may be implanted to maintain a normal appearance.”
Correct Answer: C. “Stage III cancer means there is less involvement of the cancer.”
Rationale: Stage III testicular cancer represents advanced disease with distant spread,
not less involvement.
,2026/2027
3. A newly promoted nurse manager reports difficulty organizing daily
responsibilities. Which recommendation from an experienced manager should
be implemented first?
A. Establish priorities for every hour of the day.
B. Request assistance when workload becomes excessive.
C. Keep a detailed log of activities for one week.
D. Finish one task completely before beginning another.
Correct Answer: C. Keep a detailed log of activities for one week.
Rationale: A time log provides objective data about how time is currently being used
before changes are made.
4. A student nurse reviews care for infants born to mothers positive for
hepatitis B surface antigen (HBsAg). Which statement demonstrates a need
for correction?
A. “Hepatitis B vaccine and HBIG should be administered within 12 hours of birth.”
B. “The second vaccine dose may be given between 1 and 2 months of age.”
C. “The third dose should be administered at least 16 weeks after the second dose.”
D. “The final dose should not be given before 24 weeks of age.”
Correct Answer: C. “The third dose should be administered at least 16 weeks after the
second dose.”
Rationale: The final dose should be given at least 16 weeks after the first dose, not the
second.
5. A 74-year-old client with benign prostatic hyperplasia has been unable to
void for 14 hours. Which assessment finding most strongly suggests bladder
distention?
A. Rebound tenderness
B. Dullness in the left lower quadrant
C. Rounded swelling above the symphysis pubis
D. Urinary drainage from the urethra
Correct Answer: C. Rounded swelling above the symphysis pubis
Rationale: Acute urinary retention causes a smooth, rounded swelling palpable above the
pubic bone.
6. Which statement by a client taking propranolol indicates effective
understanding of medication teaching?
A. “Stopping the medication suddenly may cause seizures.”
B. “My heart rate may increase for several weeks.”
,2026/2027
C. “Feeling nervous is expected during the first month.”
D. “Stopping this medication abruptly could cause a heart attack.”
Correct Answer: D. “Stopping this medication abruptly could cause a heart attack.”
Rationale: Abrupt withdrawal of propranolol can precipitate rebound hypertension,
angina, dysrhythmias, and myocardial infarction.
7. Parents of a 6-month-old infant in a hip spica cast ask about home care.
Which instruction is most important?
A. Use cotton swabs to scratch beneath the cast.
B. Encourage push-pull toys inside the crib.
C. Check the infant’s feet frequently for swelling.
D. Turn the infant every 2 hours using the stabilizer bar.
Correct Answer: C. Check the infant’s feet frequently for swelling.
Rationale: Neurovascular assessment is the highest priority after application of a hip
spica cast.
8. A client with heart disease asks the nurse to explain normal blood flow
through the heart. Which sequence is correct?
A. Right ventricle → Left ventricle → Right atrium → Left atrium
B. Left ventricle → Right ventricle → Left atrium → Right atrium
C. Right atrium → Right ventricle → Left atrium → Left ventricle
D. Right atrium → Left atrium → Right ventricle → Left ventricle
Correct Answer: C. Right atrium → Right ventricle → Left atrium → Left ventricle
Rationale: Deoxygenated blood enters the right atrium, passes to the right ventricle, then
moves through the lungs and returns to the left side of the heart.
9. A nurse manager suspects a staff nurse may have a substance use
disorder. What is the most appropriate initial action?
A. Confront the nurse privately.
B. Gather staff opinions without involving the employee.
C. Consult human resources regarding institutional procedures.
D. Encourage resignation.
Correct Answer: C. Consult human resources regarding institutional procedures.
Rationale: Suspected chemical dependency should be managed according to
organizational policy and legal guidelines.
, 2026/2027
10. A client diagnosed with Raynaud phenomenon asks about lifestyle
modifications. Which recommendation is the highest priority?
A. Stop smoking
B. Keep feet dry
C. Reduce stress
D. Avoid caffeine
Correct Answer: A. Stop smoking
Rationale: Nicotine causes vasoconstriction and worsens the digital ischemia associated
with Raynaud phenomenon.
11. A client experiencing status epilepticus is admitted to the intensive care
unit. Which assessment is the priority?
A. Intravenous infusion rate
B. Level of consciousness
C. Pulse and respirations
D. Extremity injuries
Correct Answer: B. Level of consciousness
Rationale: Continuous seizure activity can compromise cerebral oxygenation and
neurological function.
12. Laboratory analysis of cerebrospinal fluid in bacterial meningitis would
most likely reveal:
A. Elevated protein levels
B. Crystal-clear appearance
C. Increased erythrocyte sedimentation rate
D. Elevated glucose concentration
Correct Answer: A. Elevated protein levels
Rationale: In bacterial meningitis, inflammation increases blood-brain barrier
permeability, leading to elevated CSF protein.
13. A hospital is downsizing personnel. During the unfreezing stage of planned
change, which management action is most appropriate?
A. Address defensive behaviors among staff.
B. Explain why organizational change is necessary.
C. Help staff integrate new processes.
D. Discuss effects on the surrounding community.
