HESI EXIT RN 2026/2027 – EXAM QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALE | 2027
Q&A | INSTANT DOWNLOAD PDF
1. A client is admitted with a suspected bacterial infection and a temperature of
39.2°C (102.6°F). Which assessment finding requires the nurse's most
immediate attention?
A. Heart rate of 104/min
B. Blood pressure of 86/52 mm Hg
C. Respiratory rate of 22/min
D. White blood cell count of 15,000/mm³
Rationale: Hypotension in a client with a serious infection may indicate systemic deterioration
and impaired tissue perfusion. The blood pressure of 86/52 mm Hg requires immediate
assessment and intervention because inadequate perfusion can progress rapidly to shock.
Tachycardia, mild tachypnea, and leukocytosis are also clinically significant but are less
immediately threatening.
2. A nurse is preparing to administer medications to a hospitalized client. Which
action best demonstrates safe medication practice?
A. Administering medications prepared by another nurse
B. Documenting the medication before administering it
C. Comparing the medication label with the medication administration record before
administration
D. Asking the client to identify medications by their appearance
Rationale: Comparing the medication label with the medication administration record is an
essential safety check that helps prevent medication errors. Documentation should occur after
administration, and medication identification should not depend on appearance or another
nurse's preparation alone.
3. A client with heart failure reports increasing shortness of breath and has gained
2.5 kg (5.5 lb) in four days. Which finding is most concerning?
A. Mild ankle edema
B. Fatigue after walking
C. Occasional nocturnal cough
D. Crackles extending into both lung fields
Rationale: Bilateral crackles indicate pulmonary fluid accumulation and may reflect worsening
heart failure with pulmonary edema. Rapid weight gain also suggests fluid retention. Extensive
crackles combined with dyspnea require prompt intervention.
, 4. A nurse is caring for a client who has just undergone abdominal surgery. Which
intervention is most effective for reducing the risk of postoperative pulmonary
complications?
A. Limiting oral fluids
B. Maintaining the client in a supine position
C. Encouraging incentive spirometry and regular deep-breathing exercises
D. Restricting ambulation for the first 48 hours
Rationale: Incentive spirometry and deep breathing promote alveolar expansion and help
prevent atelectasis and pneumonia. Early mobility also supports respiratory function, whereas
prolonged supine positioning and unnecessary activity restriction increase complications.
5. A client receiving an opioid analgesic becomes difficult to arouse and has a
respiratory rate of 7/min. What is the nurse's priority action?
A. Place the client in a quiet room
B. Support ventilation and prepare to administer naloxone as prescribed
C. Offer oral fluids
D. Reassess the client in 30 minutes
Rationale: Severe respiratory depression is a potentially life-threatening opioid complication.
The nurse should immediately support airway and breathing and administer an opioid
antagonist such as naloxone when prescribed or according to emergency protocol.
6. A nurse is assessing a client with diabetes mellitus. Which finding is most
consistent with hypoglycemia?
A. Warm, dry skin and polyuria
B. Fruity breath and deep respirations
C. Diaphoresis, tremors, and sudden confusion
D. Increased thirst and blurred vision
Rationale: Hypoglycemia activates the sympathetic nervous system, producing sweating,
tremors, palpitations, hunger, and potentially altered mental status. Polyuria, polydipsia, and
fruity breath are more characteristic of significant hyperglycemia.
7. A client with chronic obstructive pulmonary disease is receiving oxygen therapy.
Which nursing intervention is appropriate?
A. Maintaining oxygen saturation at 100% for every client
B. Administering oxygen only when the client reports dyspnea
C. Titrating oxygen according to the prescribed target and monitoring respiratory status
D. Discontinuing oxygen whenever carbon dioxide retention is suspected
, Rationale: Oxygen therapy for COPD should be administered according to the prescribed target
and the client's clinical condition. Excessive oxygen can worsen gas-exchange problems in some
susceptible clients, but oxygen should never be withheld when clinically indicated.
8. A nurse is caring for a client who has a new prescription for warfarin. Which
laboratory value is most important for evaluating the medication's therapeutic
effect?
A. Serum sodium
B. Activated partial thromboplastin time
C. Platelet count
D. International normalized ratio (INR)
Rationale: INR is used to monitor the therapeutic effect of warfarin and guide dosage
adjustments. Activated partial thromboplastin time is primarily associated with unfractionated
heparin monitoring.
9. A client receiving a blood transfusion develops chills, fever, and low back pain 15
minutes after the transfusion begins. What should the nurse do first?
A. Slow the transfusion rate
B. Administer an antipyretic
C. Obtain another blood sample
D. Stop the transfusion immediately
Rationale: Fever, chills, and back pain shortly after starting a transfusion may indicate an acute
transfusion reaction. The transfusion must be stopped immediately, followed by maintaining IV
access with appropriate solution and notifying the appropriate healthcare personnel.
10. A client with chronic kidney disease has a serum potassium level of 6.4 mEq/L.
Which assessment finding requires immediate attention?
A. Mild peripheral edema
B. Decreased appetite
C. Fatigue
D. Newly developed cardiac dysrhythmia
Rationale: Severe hyperkalemia can disrupt cardiac conduction and cause life-threatening
dysrhythmias. Cardiac manifestations take priority because they can rapidly lead to cardiac
arrest.
11. A nurse is teaching a client who is prescribed an angiotensin-converting enzyme
inhibitor. Which statement by the client indicates a need for further teaching?
A. "I will report swelling of my lips or tongue."
B. "I will have my blood pressure monitored."
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALE | 2027
Q&A | INSTANT DOWNLOAD PDF
1. A client is admitted with a suspected bacterial infection and a temperature of
39.2°C (102.6°F). Which assessment finding requires the nurse's most
immediate attention?
A. Heart rate of 104/min
B. Blood pressure of 86/52 mm Hg
C. Respiratory rate of 22/min
D. White blood cell count of 15,000/mm³
Rationale: Hypotension in a client with a serious infection may indicate systemic deterioration
and impaired tissue perfusion. The blood pressure of 86/52 mm Hg requires immediate
assessment and intervention because inadequate perfusion can progress rapidly to shock.
Tachycardia, mild tachypnea, and leukocytosis are also clinically significant but are less
immediately threatening.
2. A nurse is preparing to administer medications to a hospitalized client. Which
action best demonstrates safe medication practice?
A. Administering medications prepared by another nurse
B. Documenting the medication before administering it
C. Comparing the medication label with the medication administration record before
administration
D. Asking the client to identify medications by their appearance
Rationale: Comparing the medication label with the medication administration record is an
essential safety check that helps prevent medication errors. Documentation should occur after
administration, and medication identification should not depend on appearance or another
nurse's preparation alone.
3. A client with heart failure reports increasing shortness of breath and has gained
2.5 kg (5.5 lb) in four days. Which finding is most concerning?
A. Mild ankle edema
B. Fatigue after walking
C. Occasional nocturnal cough
D. Crackles extending into both lung fields
Rationale: Bilateral crackles indicate pulmonary fluid accumulation and may reflect worsening
heart failure with pulmonary edema. Rapid weight gain also suggests fluid retention. Extensive
crackles combined with dyspnea require prompt intervention.
, 4. A nurse is caring for a client who has just undergone abdominal surgery. Which
intervention is most effective for reducing the risk of postoperative pulmonary
complications?
A. Limiting oral fluids
B. Maintaining the client in a supine position
C. Encouraging incentive spirometry and regular deep-breathing exercises
D. Restricting ambulation for the first 48 hours
Rationale: Incentive spirometry and deep breathing promote alveolar expansion and help
prevent atelectasis and pneumonia. Early mobility also supports respiratory function, whereas
prolonged supine positioning and unnecessary activity restriction increase complications.
5. A client receiving an opioid analgesic becomes difficult to arouse and has a
respiratory rate of 7/min. What is the nurse's priority action?
A. Place the client in a quiet room
B. Support ventilation and prepare to administer naloxone as prescribed
C. Offer oral fluids
D. Reassess the client in 30 minutes
Rationale: Severe respiratory depression is a potentially life-threatening opioid complication.
The nurse should immediately support airway and breathing and administer an opioid
antagonist such as naloxone when prescribed or according to emergency protocol.
6. A nurse is assessing a client with diabetes mellitus. Which finding is most
consistent with hypoglycemia?
A. Warm, dry skin and polyuria
B. Fruity breath and deep respirations
C. Diaphoresis, tremors, and sudden confusion
D. Increased thirst and blurred vision
Rationale: Hypoglycemia activates the sympathetic nervous system, producing sweating,
tremors, palpitations, hunger, and potentially altered mental status. Polyuria, polydipsia, and
fruity breath are more characteristic of significant hyperglycemia.
7. A client with chronic obstructive pulmonary disease is receiving oxygen therapy.
Which nursing intervention is appropriate?
A. Maintaining oxygen saturation at 100% for every client
B. Administering oxygen only when the client reports dyspnea
C. Titrating oxygen according to the prescribed target and monitoring respiratory status
D. Discontinuing oxygen whenever carbon dioxide retention is suspected
, Rationale: Oxygen therapy for COPD should be administered according to the prescribed target
and the client's clinical condition. Excessive oxygen can worsen gas-exchange problems in some
susceptible clients, but oxygen should never be withheld when clinically indicated.
8. A nurse is caring for a client who has a new prescription for warfarin. Which
laboratory value is most important for evaluating the medication's therapeutic
effect?
A. Serum sodium
B. Activated partial thromboplastin time
C. Platelet count
D. International normalized ratio (INR)
Rationale: INR is used to monitor the therapeutic effect of warfarin and guide dosage
adjustments. Activated partial thromboplastin time is primarily associated with unfractionated
heparin monitoring.
9. A client receiving a blood transfusion develops chills, fever, and low back pain 15
minutes after the transfusion begins. What should the nurse do first?
A. Slow the transfusion rate
B. Administer an antipyretic
C. Obtain another blood sample
D. Stop the transfusion immediately
Rationale: Fever, chills, and back pain shortly after starting a transfusion may indicate an acute
transfusion reaction. The transfusion must be stopped immediately, followed by maintaining IV
access with appropriate solution and notifying the appropriate healthcare personnel.
10. A client with chronic kidney disease has a serum potassium level of 6.4 mEq/L.
Which assessment finding requires immediate attention?
A. Mild peripheral edema
B. Decreased appetite
C. Fatigue
D. Newly developed cardiac dysrhythmia
Rationale: Severe hyperkalemia can disrupt cardiac conduction and cause life-threatening
dysrhythmias. Cardiac manifestations take priority because they can rapidly lead to cardiac
arrest.
11. A nurse is teaching a client who is prescribed an angiotensin-converting enzyme
inhibitor. Which statement by the client indicates a need for further teaching?
A. "I will report swelling of my lips or tongue."
B. "I will have my blood pressure monitored."
