HESI EXIT RN EXAM WITH NGN 2026/2027 – EXAM
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALE | 2027 Q&A | INSTANT
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1. A client with heart failure is receiving IV furosemide. Which assessment finding
requires the nurse's immediate attention?
A. Urine output of 900 mL over 8 hours
B. Blood pressure of 108/64 mm Hg
C. Serum potassium of 2.8 mEq/L
D. Weight loss of 1 kg over 24 hours
Rationale: Severe hypokalemia can cause dangerous cardiac dysrhythmias, particularly in a
client receiving a loop diuretic. The potassium level requires prompt intervention. The other
findings may be expected or indicate therapeutic response.
2. A nurse is caring for a client admitted with suspected bacterial meningitis. Which
intervention should be implemented first?
A. Encourage oral fluids
B. Initiate appropriate transmission-based precautions
C. Place the client in a brightly lit room
D. Encourage frequent ambulation
Rationale: Suspected bacterial meningitis requires prompt implementation of appropriate
transmission-based precautions to reduce exposure to respiratory secretions. Additional
treatment and assessment should proceed after immediate infection-control measures are
established.
3. A client with chronic obstructive pulmonary disease has an oxygen saturation of
86% and increasing dyspnea. Which action is most appropriate?
A. Withhold oxygen because of the risk of respiratory depression
B. Place the client supine
C. Encourage rapid deep breathing
D. Administer oxygen as prescribed and reassess respiratory status
Rationale: Hypoxemia requires treatment. Oxygen should not be withheld because of concern
about carbon dioxide retention. Oxygen is administered at the prescribed concentration while
respiratory status and response are monitored.
4. A client receiving warfarin has an international normalized ratio (INR) of 5.8.
Which finding is most concerning?
,A. Heart rate of 88/min
B. Mild ankle edema
C. New-onset hematuria
D. Blood pressure of 128/76 mm Hg
Rationale: Hematuria can indicate clinically significant bleeding in a client whose INR is
markedly elevated. The nurse should promptly notify the provider and follow the prescribed
management plan.
5. A postoperative client suddenly develops dyspnea, pleuritic chest pain,
tachycardia, and anxiety. Which complication should the nurse suspect?
A. Atelectasis
B. Pulmonary embolism
C. Fluid overload
D. Hypoglycemia
Rationale: Sudden dyspnea, pleuritic chest pain, tachycardia, and anxiety are classic warning
signs of pulmonary embolism. This is an emergency requiring immediate assessment and
intervention.
6. A client with diabetes mellitus is diaphoretic, confused, and trembling. The
bedside glucose is 48 mg/dL. The client is awake and able to swallow. What
should the nurse do?
A. Administer scheduled insulin
B. Give a high-protein meal only
C. Administer a rapid-acting carbohydrate
D. Restrict oral intake until the glucose is rechecked
Rationale: A conscious client with symptomatic hypoglycemia who can safely swallow should
receive a rapid-acting carbohydrate, followed by reassessment of glucose and additional
treatment if needed.
7. A client taking digoxin reports nausea and seeing yellow-green halos around
lights. Which action should the nurse take?
A. Administer the next dose with food
B. Encourage increased potassium restriction
C. Document the findings as expected effects
D. Hold the medication and notify the healthcare provider
Rationale: Nausea, visual disturbances, and other symptoms may indicate digoxin toxicity. The
medication should be withheld and the provider notified for further evaluation.
, 8. A client with a traumatic brain injury develops a decreasing level of
consciousness and unequal pupils. Which action has the highest priority?
A. Offer oral fluids
B. Encourage coughing
C. Notify the provider or emergency response team immediately
D. Place the client in Trendelenburg position
Rationale: A decreasing level of consciousness and unequal pupils can indicate increasing
intracranial pressure or cerebral herniation. Immediate escalation is required.
9. A nurse is assessing a client with diabetic ketoacidosis. Which finding is most
characteristic of this condition?
A. Bradycardia and shallow respirations
B. Deep, rapid respirations
C. Severe hypertension with bounding pulses
D. Decreased thirst and increased urine concentration
Rationale: Kussmaul respirations are deep and rapid and occur as the body attempts to
compensate for metabolic acidosis associated with diabetic ketoacidosis.
10. A client with a new tracheostomy becomes restless and has noisy respirations.
Oxygen saturation decreases from 96% to 84%. What should the nurse do first?
A. Offer oral fluids
B. Lower the head of the bed
C. Assess the tracheostomy for obstruction and maintain airway patency
D. Remove the tracheostomy tube immediately
Rationale: Restlessness, noisy breathing, and falling oxygen saturation suggest airway
obstruction. The nurse should rapidly assess and restore airway patency while obtaining
additional assistance as needed.
11. A client with acute kidney injury has a potassium level of 6.7 mEq/L. Which ECG
change should the nurse anticipate?
A. Prolonged QT interval
B. Peaked T waves
C. ST elevation caused by myocardial infarction
D. Prominent U waves
Rationale: Hyperkalemia commonly produces tall, peaked T waves and can progress to
conduction abnormalities and life-threatening dysrhythmias.
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALE | 2027 Q&A | INSTANT
DOWNLOAD PDF
1. A client with heart failure is receiving IV furosemide. Which assessment finding
requires the nurse's immediate attention?
A. Urine output of 900 mL over 8 hours
B. Blood pressure of 108/64 mm Hg
C. Serum potassium of 2.8 mEq/L
D. Weight loss of 1 kg over 24 hours
Rationale: Severe hypokalemia can cause dangerous cardiac dysrhythmias, particularly in a
client receiving a loop diuretic. The potassium level requires prompt intervention. The other
findings may be expected or indicate therapeutic response.
2. A nurse is caring for a client admitted with suspected bacterial meningitis. Which
intervention should be implemented first?
A. Encourage oral fluids
B. Initiate appropriate transmission-based precautions
C. Place the client in a brightly lit room
D. Encourage frequent ambulation
Rationale: Suspected bacterial meningitis requires prompt implementation of appropriate
transmission-based precautions to reduce exposure to respiratory secretions. Additional
treatment and assessment should proceed after immediate infection-control measures are
established.
3. A client with chronic obstructive pulmonary disease has an oxygen saturation of
86% and increasing dyspnea. Which action is most appropriate?
A. Withhold oxygen because of the risk of respiratory depression
B. Place the client supine
C. Encourage rapid deep breathing
D. Administer oxygen as prescribed and reassess respiratory status
Rationale: Hypoxemia requires treatment. Oxygen should not be withheld because of concern
about carbon dioxide retention. Oxygen is administered at the prescribed concentration while
respiratory status and response are monitored.
4. A client receiving warfarin has an international normalized ratio (INR) of 5.8.
Which finding is most concerning?
,A. Heart rate of 88/min
B. Mild ankle edema
C. New-onset hematuria
D. Blood pressure of 128/76 mm Hg
Rationale: Hematuria can indicate clinically significant bleeding in a client whose INR is
markedly elevated. The nurse should promptly notify the provider and follow the prescribed
management plan.
5. A postoperative client suddenly develops dyspnea, pleuritic chest pain,
tachycardia, and anxiety. Which complication should the nurse suspect?
A. Atelectasis
B. Pulmonary embolism
C. Fluid overload
D. Hypoglycemia
Rationale: Sudden dyspnea, pleuritic chest pain, tachycardia, and anxiety are classic warning
signs of pulmonary embolism. This is an emergency requiring immediate assessment and
intervention.
6. A client with diabetes mellitus is diaphoretic, confused, and trembling. The
bedside glucose is 48 mg/dL. The client is awake and able to swallow. What
should the nurse do?
A. Administer scheduled insulin
B. Give a high-protein meal only
C. Administer a rapid-acting carbohydrate
D. Restrict oral intake until the glucose is rechecked
Rationale: A conscious client with symptomatic hypoglycemia who can safely swallow should
receive a rapid-acting carbohydrate, followed by reassessment of glucose and additional
treatment if needed.
7. A client taking digoxin reports nausea and seeing yellow-green halos around
lights. Which action should the nurse take?
A. Administer the next dose with food
B. Encourage increased potassium restriction
C. Document the findings as expected effects
D. Hold the medication and notify the healthcare provider
Rationale: Nausea, visual disturbances, and other symptoms may indicate digoxin toxicity. The
medication should be withheld and the provider notified for further evaluation.
, 8. A client with a traumatic brain injury develops a decreasing level of
consciousness and unequal pupils. Which action has the highest priority?
A. Offer oral fluids
B. Encourage coughing
C. Notify the provider or emergency response team immediately
D. Place the client in Trendelenburg position
Rationale: A decreasing level of consciousness and unequal pupils can indicate increasing
intracranial pressure or cerebral herniation. Immediate escalation is required.
9. A nurse is assessing a client with diabetic ketoacidosis. Which finding is most
characteristic of this condition?
A. Bradycardia and shallow respirations
B. Deep, rapid respirations
C. Severe hypertension with bounding pulses
D. Decreased thirst and increased urine concentration
Rationale: Kussmaul respirations are deep and rapid and occur as the body attempts to
compensate for metabolic acidosis associated with diabetic ketoacidosis.
10. A client with a new tracheostomy becomes restless and has noisy respirations.
Oxygen saturation decreases from 96% to 84%. What should the nurse do first?
A. Offer oral fluids
B. Lower the head of the bed
C. Assess the tracheostomy for obstruction and maintain airway patency
D. Remove the tracheostomy tube immediately
Rationale: Restlessness, noisy breathing, and falling oxygen saturation suggest airway
obstruction. The nurse should rapidly assess and restore airway patency while obtaining
additional assistance as needed.
11. A client with acute kidney injury has a potassium level of 6.7 mEq/L. Which ECG
change should the nurse anticipate?
A. Prolonged QT interval
B. Peaked T waves
C. ST elevation caused by myocardial infarction
D. Prominent U waves
Rationale: Hyperkalemia commonly produces tall, peaked T waves and can progress to
conduction abnormalities and life-threatening dysrhythmias.
