2026/2027 HESI RN Exit Exam V7 Comprehensive Exam Mastery Guide: In-Depth Study Companion, Updated Practice Tests, Detailed Test Bank Review, and Advanced Knowledge Assessment Manual

1. A client diagnosed with schizophrenia has been prescribed haloperidol 5 mg orally three times daily. The client’s family contacts the clinic stating that the client’s eyes suddenly “rolled upward and would not come down.” Which adverse reaction should the nurse suspect? A. Tardive dyskinesia B. Oculogyric crisis C. Dysphagia D. Nystagmus Correct Answer: B. Oculogyric crisis Rationale: Oculogyric crisis is an acute dystonic reaction characterized by involuntary upward deviation of the eyes and is a known extrapyramidal side effect of haloperidol. 2. The parent of a 9-month-old infant reports that the child developed a severe diaper rash shortly after a new food was introduced into the diet. Which nursing instruction is most appropriate? A. Use commercial baby wipes with every diaper change. B. Apply bleach-rinsed cloth diapers only. C. Avoid all occlusive ointments. D. Discontinue the newly introduced food temporarily. Correct Answer: D. Discontinue the newly introduced food temporarily. Rationale: New foods can alter stool composition and increase the risk of diaper dermatitis. Temporarily stopping the suspected food helps determine whether it is contributing. 3. A mother expresses frustration because her 26-month-old child frequently says “no” and refuses to comply with requests. The nurse explains that this behavior reflects the toddler’s effort to achieve which developmental task? A. Trust B. Initiative C. Independence D. Self-esteem Correct Answer: C. Independence Rationale: Toddlers are in the autonomy versus shame and doubt stage and commonly assert independence by refusing and saying “no.” 4. The nurse caring for a client experiencing intimate partner violence understands that perpetrators commonly demonstrate which behavioral characteristic? A. High frustration tolerance B. Overconfidence C. Chronic alcoholism D. Low self-esteem Correct Answer: D. Low self-esteem Rationale: Perpetrators of domestic violence often have poor self-esteem, jealousy, possessiveness, and a need for control. 5. A client with chronic obstructive pulmonary disease explains the purpose of pursed-lip breathing by stating: A. “It keeps my airway open.” B. “It helps me breathe in more oxygen.” C. “It keeps my mouth moist.” D. “It prevents the tiny air sacs in my lungs from collapsing.” Correct Answer: D. “It prevents the tiny air sacs in my lungs from collapsing.” Rationale: Pursed-lip breathing prolongs exhalation and creates positive pressure, helping prevent airway collapse during expiration. 6. A client with bilateral chronic glaucoma reports difficulty navigating familiar environments. Which client statement best reflects expected visual changes associated with this condition? A. “I have constant blurred central vision.” B. “I see floating spots in front of my eyes.” C. “I have to turn my head to see objects around me.” D. “My vision comes and goes in one eye.” Correct Answer: C. “I have to turn my head to see objects around me.” Rationale: Chronic open-angle glaucoma causes peripheral vision loss, so clients often turn their head to scan their environment. 7. A 19-year-old client who recently experienced a traumatic accident states, “I don’t remember anything that happened.” The nurse interprets this behavior as which defense mechanism? A. Suppression B. Repression C. Denial D. Rationalization Correct Answer: B. Repression Rationale: Repression is an unconscious defense mechanism in which distressing memories are excluded from conscious awareness. 8. A postpartum client is found to have a boggy uterus with moderate vaginal bleeding one hour after delivery. What is the nurse’s priority action? A. Assess vital signs B. Massage the fundus C. Administer oxytocin D. Prepare for surgical intervention Correct Answer: B. Massage the fundus Rationale: A boggy uterus indicates uterine atony, and fundal massage is the immediate priority to stimulate contraction. 9. A newborn weighs 7 lb 8 oz at birth. What is the expected weight at 6 months of age if growth is normal? A. Double birth weight B. Triple birth weight C. Add 2 lb per month D. Gain 6 oz per week Correct Answer: A. Double birth weight Rationale: Healthy infants typically double their birth weight by 4–6 months of age. 10. A psychiatric client appears anxious and fearful upon admission. What is the nurse’s most appropriate initial intervention? A. Explain unit rules and orientation materials B. Escort the client to their room and introduce self C. Ask the client to participate in group activities D. Obtain vital signs and complete admission paperwork 11. A client with asthma demonstrates progression from low-pitched wheezes at the end of expiration to high-pitched wheezes throughout expiration. What does this change indicate? A. Improved airway function B. Increased airway obstruction C. Need for suctioning D. Respiratory alkalosis Correct Answer: B. Increased airway obstruction Rationale: Worsening wheezing indicates increasing airway narrowing and obstruction. 12. A nurse advises a mother on involving siblings in newborn care. What is the most appropriate initial recommendation? A. Focus attention on the older children initially B. Assign tasks to the siblings immediately C. Ask children what roles they would like to play D. Encourage father to spend more time with siblings Correct Answer: A. Focus attention on the older children initially Rationale: Older children need reassurance and focused attention first to reduce jealousy and regression. 13. The most common psychosocial factor contributing to adolescent suicide is: A. Anger and hostility B. Social isolation and alienation C. Impulsive behavior D. Family history of mental illness Correct Answer: B. Social isolation and alienation Rationale: Feelings of isolation, rejection, and lack of belonging are strongly associated with adolescent suicide risk. 14. A newborn is diagnosed with congenital hypothyroidism. What is the most important teaching point for the parents? A. The child will have permanent cognitive impairment B. Thyroid hormone therapy prevents complications C. The condition is always inherited D. Growth delays cannot be corrected Correct Answer: B. Thyroid hormone therapy prevents complications Rationale: Early thyroid hormone replacement prevents intellectual disability and promotes normal growth and development. 15. A client requests a curandero before receiving emergency treatment. The nurse recognizes that a curandero primarily provides: A. Herbal and traditional remedies B. Surgical interventions C. Psychological counseling D. Legal guidance Correct Answer: A. Herbal and traditional remedies Rationale: A curandero is a traditional healer in some Hispanic cultures who may provide herbal, spiritual, and culturally based care. 16. A client with cognitive impairment is most likely to experience deterioration in which area? A. Hearing and vision B. Strength and endurance C. Learning and judgment D. Balance and coordination