2026 HESI RN Exit Exam (LATEST EDITION)
Comprehensive Practice Examination | Complete
Questions & Verified Answers 2026/2027 | 100%
Correct | Grade A – Elsevier
300 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Medical-Surgical Nursing
2 Pharmacology
3 Maternal Newborn
4 Pediatric Nursing
5 Mental Health Nursing
6 Fundamentals
7 Critical Care
8 Leadership & Management
9 Community Health
10 Nutrition
,Q1
A client with heart failure has crackles in bilateral lung bases, JVD, and an S3 gallop. Which
medication should the nurse prepare to administer first?
A) Metoprolol
B) Furosemide IV CORRECT
C) Digoxin
D) Spironolactone
Rationale
IV furosemide rapidly reduces preload and pulmonary congestion in acute heart failure.
Q2
A client with COPD has an SpO2 of 88% on room air. Which oxygen delivery device is safest?
A) Non-rebreather at 15 L/min
B) Nasal cannula at 1-2 L/min CORRECT
C) Simple face mask at 6 L/min
D) Venturi mask at 40%
Rationale
Low-flow oxygen prevents CO2 retention in COPD clients.
Q3
A client with diabetes has a blood glucose of 45 mg/dL and is conscious. What should the nurse
administer first?
A) Insulin
B) 15 g of oral carbohydrate CORRECT
C) Glucagon IM
D) D50W IV
2
,Rationale
Conscious hypoglycemia is treated with oral fast-acting carbohydrate.
Q4
A client is receiving IV heparin. The aPTT is 110 seconds. What should the nurse do?
A) Increase the infusion rate
B) Hold the infusion and notify the provider CORRECT
C) Administer vitamin K
D) Continue the infusion
Rationale
aPTT >100 seconds indicates supratherapeutic anticoagulation.
Q5
A client with preeclampsia is receiving magnesium sulfate. Which finding indicates toxicity?
A) DTRs 2+
B) Respiratory rate 10 breaths/min CORRECT
C) Urine output 50 mL/hr
D) Magnesium level 5 mg/dL
Rationale
Respiratory depression indicates magnesium toxicity; antidote is calcium gluconate.
Q6
A postpartum client has a boggy fundus. What should the nurse do first?
A) Administer oxytocin
3
, B) Massage the fundus CORRECT
C) Notify the provider
D) Increase IV fluids
Rationale
Fundal massage stimulates uterine contraction to control bleeding.
Q7
A newborn has an Apgar score of 4 at 1 minute. What should the nurse do first?
A) Begin chest compressions
B) Dry and stimulate the infant CORRECT
C) Administer epinephrine
D) Intubate
Rationale
Initial steps for moderate depression include drying, warming, and stimulation.
Q8
A client with schizophrenia has command hallucinations to harm self. What is the priority action?
A) Ask what the voices are saying
B) Implement suicide precautions CORRECT
C) Administer PRN antipsychotic
D) Document the finding
Rationale
Command hallucinations to self-harm require immediate safety interventions.
4
Comprehensive Practice Examination | Complete
Questions & Verified Answers 2026/2027 | 100%
Correct | Grade A – Elsevier
300 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Medical-Surgical Nursing
2 Pharmacology
3 Maternal Newborn
4 Pediatric Nursing
5 Mental Health Nursing
6 Fundamentals
7 Critical Care
8 Leadership & Management
9 Community Health
10 Nutrition
,Q1
A client with heart failure has crackles in bilateral lung bases, JVD, and an S3 gallop. Which
medication should the nurse prepare to administer first?
A) Metoprolol
B) Furosemide IV CORRECT
C) Digoxin
D) Spironolactone
Rationale
IV furosemide rapidly reduces preload and pulmonary congestion in acute heart failure.
Q2
A client with COPD has an SpO2 of 88% on room air. Which oxygen delivery device is safest?
A) Non-rebreather at 15 L/min
B) Nasal cannula at 1-2 L/min CORRECT
C) Simple face mask at 6 L/min
D) Venturi mask at 40%
Rationale
Low-flow oxygen prevents CO2 retention in COPD clients.
Q3
A client with diabetes has a blood glucose of 45 mg/dL and is conscious. What should the nurse
administer first?
A) Insulin
B) 15 g of oral carbohydrate CORRECT
C) Glucagon IM
D) D50W IV
2
,Rationale
Conscious hypoglycemia is treated with oral fast-acting carbohydrate.
Q4
A client is receiving IV heparin. The aPTT is 110 seconds. What should the nurse do?
A) Increase the infusion rate
B) Hold the infusion and notify the provider CORRECT
C) Administer vitamin K
D) Continue the infusion
Rationale
aPTT >100 seconds indicates supratherapeutic anticoagulation.
Q5
A client with preeclampsia is receiving magnesium sulfate. Which finding indicates toxicity?
A) DTRs 2+
B) Respiratory rate 10 breaths/min CORRECT
C) Urine output 50 mL/hr
D) Magnesium level 5 mg/dL
Rationale
Respiratory depression indicates magnesium toxicity; antidote is calcium gluconate.
Q6
A postpartum client has a boggy fundus. What should the nurse do first?
A) Administer oxytocin
3
, B) Massage the fundus CORRECT
C) Notify the provider
D) Increase IV fluids
Rationale
Fundal massage stimulates uterine contraction to control bleeding.
Q7
A newborn has an Apgar score of 4 at 1 minute. What should the nurse do first?
A) Begin chest compressions
B) Dry and stimulate the infant CORRECT
C) Administer epinephrine
D) Intubate
Rationale
Initial steps for moderate depression include drying, warming, and stimulation.
Q8
A client with schizophrenia has command hallucinations to harm self. What is the priority action?
A) Ask what the voices are saying
B) Implement suicide precautions CORRECT
C) Administer PRN antipsychotic
D) Document the finding
Rationale
Command hallucinations to self-harm require immediate safety interventions.
4
