HESI Comprehensive Review for the
NCLEX-RN Examination 7th Edition by
HESI: Ultimate 2025/2026 HESI EXIT
RN Prep (Versions V1-V7) with NGN
Questions & Rationales - Pass on First
Attempt
1. A nurse is caring for a client with heart failure who
complains of sudden shortness of breath and coughs up pink,
frothy sputum. Which action should the nurse take first?
A) Administer furosemide IV push
B) Place the client in high-Fowler’s position
C) Apply oxygen via non-rebreather mask
D) Check oxygen saturation
Answer: B – High-Fowler’s position reduces venous return and
decreases pulmonary congestion, which is the priority before
further interventions. Oxygen and diuretics come next, but
positioning is immediate.
2. A client with type 1 diabetes mellitus has a blood glucose
of 350 mg/dL and moderate ketones in urine. Which order
should the nurse question?
A) Regular insulin IV infusion
B) 0.9% normal saline at 250 mL/hr
, C) Potassium chloride 20 mEq IV push
D) Urinalysis every 4 hours
Answer: C – IV push potassium chloride can cause cardiac arrest.
Potassium should be infused slowly (max 10 mEq/hr) and only
after confirming renal function and urine output.
3. A postpartum client reports a large gush of blood and feels
faint. The fundus is boggy and displaced above and to the
right of the umbilicus. What is the priority nursing action?
A) Administer oxytocin IV
B) Massage the fundus
C) Catheterize the client
D) Notify the provider immediately
Answer: B – The boggy, displaced fundus indicates uterine atony
and a full bladder. Massage the fundus first while another nurse
assists with catheterization to empty the bladder.
4. A nurse is teaching a client with hypertension about the
DASH diet. Which meal choice indicates understanding?
A) Cheeseburger, french fries, and cola
B) Grilled chicken salad with low-sodium dressing, an orange,
and water
C) Pepperoni pizza and a diet soda
D) Canned soup with saltine crackers and iced tea
Answer: B – The DASH diet emphasizes low sodium, fruits,
vegetables, lean protein, and whole grains.
,5. A client with chronic kidney disease has a potassium level
of 6.8 mEq/L. Which ECG change is most concerning?
A) Prominent U wave
B) Peaked T waves
C) Prolonged PR interval
D) ST segment depression
Answer: B – Peaked T waves are the earliest sign of hyperkalemia.
This requires immediate intervention (calcium gluconate,
insulin/glucose, albuterol, or kayexalate).
6. A nurse is caring for a client post-cardiac catheterization
via the femoral artery. The client reports sudden severe pain
and coolness in the right foot. What is the nurse’s priority
action?
A) Administer prescribed analgesics
B) Assess pedal pulses and doppler
C) Elevate the affected leg
D) Apply warm compresses
Answer: B – These signs suggest acute arterial occlusion. The
nurse must assess pulses and notify the provider immediately.
7. A client receiving morphine via PCA pump has a respiratory
rate of 8 breaths/min and is difficult to arouse. Which
medication should the nurse prepare to administer?
A) Naloxone
B) Flumazenil
C) Acetylcysteine
, D) Vitamin K
Answer: A – Naloxone (Narcan) reverses opioid-induced
respiratory depression.
8. A nurse is assessing a newborn at 5 minutes of life. Heart
rate is 110, respiratory effort is good, muscle tone is active,
reflex irritability is a cry, and color is pink with blue
extremities. What is the Apgar score?
A) 7
B) 8
C) 9
D) 10
Answer: C – Heart rate 110 (2 points), respiration good (2),
muscle tone active (2), reflex cry (2), color pink with blue
extremities (1 – acrocyanosis). Total = 9.
9. A client with major depressive disorder has been taking
phenelzine, an MAOI. Which food choice would require
immediate intervention?
A) Yogurt
B) Smoked fish
C) Apple juice
D) White rice
Answer: B – Smoked fish (and aged cheeses, cured meats,
fermented foods) contain tyramine, which can cause hypertensive
crisis with MAOIs.
NCLEX-RN Examination 7th Edition by
HESI: Ultimate 2025/2026 HESI EXIT
RN Prep (Versions V1-V7) with NGN
Questions & Rationales - Pass on First
Attempt
1. A nurse is caring for a client with heart failure who
complains of sudden shortness of breath and coughs up pink,
frothy sputum. Which action should the nurse take first?
A) Administer furosemide IV push
B) Place the client in high-Fowler’s position
C) Apply oxygen via non-rebreather mask
D) Check oxygen saturation
Answer: B – High-Fowler’s position reduces venous return and
decreases pulmonary congestion, which is the priority before
further interventions. Oxygen and diuretics come next, but
positioning is immediate.
2. A client with type 1 diabetes mellitus has a blood glucose
of 350 mg/dL and moderate ketones in urine. Which order
should the nurse question?
A) Regular insulin IV infusion
B) 0.9% normal saline at 250 mL/hr
, C) Potassium chloride 20 mEq IV push
D) Urinalysis every 4 hours
Answer: C – IV push potassium chloride can cause cardiac arrest.
Potassium should be infused slowly (max 10 mEq/hr) and only
after confirming renal function and urine output.
3. A postpartum client reports a large gush of blood and feels
faint. The fundus is boggy and displaced above and to the
right of the umbilicus. What is the priority nursing action?
A) Administer oxytocin IV
B) Massage the fundus
C) Catheterize the client
D) Notify the provider immediately
Answer: B – The boggy, displaced fundus indicates uterine atony
and a full bladder. Massage the fundus first while another nurse
assists with catheterization to empty the bladder.
4. A nurse is teaching a client with hypertension about the
DASH diet. Which meal choice indicates understanding?
A) Cheeseburger, french fries, and cola
B) Grilled chicken salad with low-sodium dressing, an orange,
and water
C) Pepperoni pizza and a diet soda
D) Canned soup with saltine crackers and iced tea
Answer: B – The DASH diet emphasizes low sodium, fruits,
vegetables, lean protein, and whole grains.
,5. A client with chronic kidney disease has a potassium level
of 6.8 mEq/L. Which ECG change is most concerning?
A) Prominent U wave
B) Peaked T waves
C) Prolonged PR interval
D) ST segment depression
Answer: B – Peaked T waves are the earliest sign of hyperkalemia.
This requires immediate intervention (calcium gluconate,
insulin/glucose, albuterol, or kayexalate).
6. A nurse is caring for a client post-cardiac catheterization
via the femoral artery. The client reports sudden severe pain
and coolness in the right foot. What is the nurse’s priority
action?
A) Administer prescribed analgesics
B) Assess pedal pulses and doppler
C) Elevate the affected leg
D) Apply warm compresses
Answer: B – These signs suggest acute arterial occlusion. The
nurse must assess pulses and notify the provider immediately.
7. A client receiving morphine via PCA pump has a respiratory
rate of 8 breaths/min and is difficult to arouse. Which
medication should the nurse prepare to administer?
A) Naloxone
B) Flumazenil
C) Acetylcysteine
, D) Vitamin K
Answer: A – Naloxone (Narcan) reverses opioid-induced
respiratory depression.
8. A nurse is assessing a newborn at 5 minutes of life. Heart
rate is 110, respiratory effort is good, muscle tone is active,
reflex irritability is a cry, and color is pink with blue
extremities. What is the Apgar score?
A) 7
B) 8
C) 9
D) 10
Answer: C – Heart rate 110 (2 points), respiration good (2),
muscle tone active (2), reflex cry (2), color pink with blue
extremities (1 – acrocyanosis). Total = 9.
9. A client with major depressive disorder has been taking
phenelzine, an MAOI. Which food choice would require
immediate intervention?
A) Yogurt
B) Smoked fish
C) Apple juice
D) White rice
Answer: B – Smoked fish (and aged cheeses, cured meats,
fermented foods) contain tyramine, which can cause hypertensive
crisis with MAOIs.
