HESI EXIT EXAM –
COMPREHENSIVE TEST (2026
UPDATE) QUESTIONS AND
ANSWERS WITH
RATIONALES/GRADED A+/2026
UPDATE/100% CORRECT
/INSTANT DOWNLOAD
1. Priority & Triage (Questions 1–5)
1. A nurse in the emergency department is triaging four clients. Which client should
be seen first?
a) 72-year-old with confusion and blood glucose of 45 mg/dL
b) 45-year-old with substernal chest pain radiating to the jaw and diaphoresis
c) 30-year-old with ankle swelling after a fall
d) 60-year-old with a headache and blood pressure 168/92 mmHg
Rationale: Chest pain radiating to jaw with diaphoresis suggests acute myocardial
infarction – highest priority (life-threatening). Hypoglycemia (a) is serious but can be
treated orally if conscious.
2. A mass casualty incident occurs. Which client should be tagged “expectant” (black
tag)?
a) Open femur fracture, conscious, pulse 110/min
b) Unresponsive, no pulse, no respirations, extensive burns
c) Partial-thickness burns on 20% of body, crying
d) Deep laceration to forearm, bleeding controlled
Rationale: Expectant (black) = unlikely to survive even with care. No
pulse/respirations with massive burns meets criteria.
,3. During a fire in the hospital, which action by the nurse is most appropriate?
a) Use the elevator to move bedridden patients quickly
b) Close all doors in the immediate area
c) Leave oxygen cylinders in place to avoid delay
d) Run to activate the alarm before assisting patients
Rationale: RACE: Rescue, Alarm, Contain (close doors), Extinguish. Closing doors
contains fire and smoke.
4. A client is brought in after a motor vehicle accident with decreased breath sounds
on left side and tracheal deviation to the right. Priority action?
a) Prepare for chest tube insertion
b) Needle decompression of left chest
c) Administer 100% oxygen via non-rebreather
d) Obtain stat chest X-ray
Rationale: Tracheal deviation and absent breath signs = tension pneumothorax.
Immediate needle decompression before chest tube.
5. A nurse receives report on 4 patients. Which to assess first?
a) Post-op day 2, T 99.1°F, HR 90, pain 4/10
b) 2 hours post-thoracentesis, sudden shortness of breath and absent breath
sounds on right
c) Diabetic with glucose 185, requesting insulin
d) COPD patient with O2 sat 91% on 2L nasal cannula
Rationale: Sudden SOB post-thoracentesis = possible pneumothorax – acute
respiratory compromise.
2. Pharmacology (Questions 6–15)
6. A client on digoxin presents with nausea, vomiting, and yellow-tinged vision.
Which lab value is most important to check?
a) Digoxin level
b) Potassium level
c) Magnesium level
d) BUN/Creatinine
Rationale: Yellow vision, N/V = digoxin toxicity. Check digoxin level. Potassium
affects toxicity risk but level is secondary.
, 7. Which medication requires the nurse to avoid giving with grapefruit juice?
a) Lisinopril
b) Simvastatin
c) Metformin
d) Albuterol
Rationale: Grapefruit juice inhibits CYP3A4, increasing simvastatin levels and risk of
myopathy/rhabdomyolysis.
8. A client is started on warfarin. Which patient statement indicates understanding?
a) “I will use an electric razor for shaving.”
b) “I can continue taking ibuprofen for headaches.”
c) “I will eat more leafy green vegetables daily.”
d) “If I miss a dose, I’ll take two the next day.”
Rationale: Electric razor prevents bleeding from cuts. Ibuprofen increases bleeding
risk. Green vegetables decrease warfarin effect. Never double dose.
9. The nurse administers naloxone to a client with opioid overdose. What is the
priority assessment after administration?
a) Pain level
b) Respiratory rate and oxygen saturation
c) Level of consciousness
d) Blood pressure
Rationale: Opioid overdose causes respiratory depression. Naloxone reverses this –
assess breathing first.
10. A client with asthma is prescribed albuterol and fluticasone inhalers. How should
the nurse instruct the client to use them?
a) Fluticasone first, then albuterol
b) Albuterol first, wait 5 minutes, then fluticasone
c) Use both at the same time
d) Fluticasone only when symptomatic
Rationale: Bronchodilator (albuterol) opens airways; steroid (fluticasone) then
penetrates deeper.
11. A client taking lithium reports hand tremors, nausea, and blurred vision. What is
the nurse’s priority action?
a) Hold next dose and obtain lithium level
b) Administer propranolol for tremors
c) Encourage increased fluid intake
d) Give the dose as scheduled
COMPREHENSIVE TEST (2026
UPDATE) QUESTIONS AND
ANSWERS WITH
RATIONALES/GRADED A+/2026
UPDATE/100% CORRECT
/INSTANT DOWNLOAD
1. Priority & Triage (Questions 1–5)
1. A nurse in the emergency department is triaging four clients. Which client should
be seen first?
a) 72-year-old with confusion and blood glucose of 45 mg/dL
b) 45-year-old with substernal chest pain radiating to the jaw and diaphoresis
c) 30-year-old with ankle swelling after a fall
d) 60-year-old with a headache and blood pressure 168/92 mmHg
Rationale: Chest pain radiating to jaw with diaphoresis suggests acute myocardial
infarction – highest priority (life-threatening). Hypoglycemia (a) is serious but can be
treated orally if conscious.
2. A mass casualty incident occurs. Which client should be tagged “expectant” (black
tag)?
a) Open femur fracture, conscious, pulse 110/min
b) Unresponsive, no pulse, no respirations, extensive burns
c) Partial-thickness burns on 20% of body, crying
d) Deep laceration to forearm, bleeding controlled
Rationale: Expectant (black) = unlikely to survive even with care. No
pulse/respirations with massive burns meets criteria.
,3. During a fire in the hospital, which action by the nurse is most appropriate?
a) Use the elevator to move bedridden patients quickly
b) Close all doors in the immediate area
c) Leave oxygen cylinders in place to avoid delay
d) Run to activate the alarm before assisting patients
Rationale: RACE: Rescue, Alarm, Contain (close doors), Extinguish. Closing doors
contains fire and smoke.
4. A client is brought in after a motor vehicle accident with decreased breath sounds
on left side and tracheal deviation to the right. Priority action?
a) Prepare for chest tube insertion
b) Needle decompression of left chest
c) Administer 100% oxygen via non-rebreather
d) Obtain stat chest X-ray
Rationale: Tracheal deviation and absent breath signs = tension pneumothorax.
Immediate needle decompression before chest tube.
5. A nurse receives report on 4 patients. Which to assess first?
a) Post-op day 2, T 99.1°F, HR 90, pain 4/10
b) 2 hours post-thoracentesis, sudden shortness of breath and absent breath
sounds on right
c) Diabetic with glucose 185, requesting insulin
d) COPD patient with O2 sat 91% on 2L nasal cannula
Rationale: Sudden SOB post-thoracentesis = possible pneumothorax – acute
respiratory compromise.
2. Pharmacology (Questions 6–15)
6. A client on digoxin presents with nausea, vomiting, and yellow-tinged vision.
Which lab value is most important to check?
a) Digoxin level
b) Potassium level
c) Magnesium level
d) BUN/Creatinine
Rationale: Yellow vision, N/V = digoxin toxicity. Check digoxin level. Potassium
affects toxicity risk but level is secondary.
, 7. Which medication requires the nurse to avoid giving with grapefruit juice?
a) Lisinopril
b) Simvastatin
c) Metformin
d) Albuterol
Rationale: Grapefruit juice inhibits CYP3A4, increasing simvastatin levels and risk of
myopathy/rhabdomyolysis.
8. A client is started on warfarin. Which patient statement indicates understanding?
a) “I will use an electric razor for shaving.”
b) “I can continue taking ibuprofen for headaches.”
c) “I will eat more leafy green vegetables daily.”
d) “If I miss a dose, I’ll take two the next day.”
Rationale: Electric razor prevents bleeding from cuts. Ibuprofen increases bleeding
risk. Green vegetables decrease warfarin effect. Never double dose.
9. The nurse administers naloxone to a client with opioid overdose. What is the
priority assessment after administration?
a) Pain level
b) Respiratory rate and oxygen saturation
c) Level of consciousness
d) Blood pressure
Rationale: Opioid overdose causes respiratory depression. Naloxone reverses this –
assess breathing first.
10. A client with asthma is prescribed albuterol and fluticasone inhalers. How should
the nurse instruct the client to use them?
a) Fluticasone first, then albuterol
b) Albuterol first, wait 5 minutes, then fluticasone
c) Use both at the same time
d) Fluticasone only when symptomatic
Rationale: Bronchodilator (albuterol) opens airways; steroid (fluticasone) then
penetrates deeper.
11. A client taking lithium reports hand tremors, nausea, and blurred vision. What is
the nurse’s priority action?
a) Hold next dose and obtain lithium level
b) Administer propranolol for tremors
c) Encourage increased fluid intake
d) Give the dose as scheduled
