HESI Exit
HESI Exit Practice Exam 2026 Edition 100
Advanced Questions with Answers and
Detailed Rationales
1. A nurse is caring for a client admitted with septic shock. Which finding
requires immediate intervention?
A. Temperature of 38.3°C (100.9°F)
B. Heart rate of 112/min
C. Urine output of 15 mL/hr
D. White blood cell count of 18,000/mm³
Correct Answer: C
Rationale:
A urine output of less than 30 mL/hr indicates decreased renal perfusion and possible worsening
shock. Septic shock causes systemic vasodilation and impaired tissue perfusion. The nurse must
prioritize organ perfusion indicators. Fever, tachycardia, and leukocytosis are expected findings
in infection.
2. The nurse receives report on four clients. Which client should be assessed
first?
A. Client with COPD reporting oxygen saturation of 91%
B. Client receiving chemotherapy with a temperature of 38.5°C (101.3°F)
C. Client with diabetes requesting pain medication
D. Client with hypertension needing discharge teaching
Correct Answer: B
Rationale:
A chemotherapy client with fever is at risk for neutropenic sepsis, a life-threatening emergency.
Infection in an immunocompromised client requires immediate assessment and intervention.
3. A client receiving IV heparin develops bleeding gums and hematuria. Which
action should the nurse take first?
A. Administer vitamin K
B. Stop the heparin infusion
, HESI Exit
C. Apply pressure to bleeding sites
D. Prepare protamine sulfate
Correct Answer: B
Rationale:
The first action is to stop the source of anticoagulation. Protamine sulfate may be administered
after provider notification, but stopping heparin prevents additional anticoagulant effects.
4. A nurse is caring for a client after thyroidectomy. Which assessment finding
requires immediate action?
A. Mild throat discomfort
B. Hoarse voice
C. Stridor
D. Incisional pain
Correct Answer: C
Rationale:
Stridor indicates airway obstruction, possibly from swelling, hemorrhage, or laryngeal nerve
injury. Airway always takes priority.
5. A client with heart failure is receiving furosemide. Which laboratory value
requires immediate follow-up?
A. Sodium 138 mEq/L
B. Potassium 2.8 mEq/L
C. Calcium 9.2 mg/dL
D. Glucose 110 mg/dL
Correct Answer: B
Rationale:
Furosemide causes potassium loss. Severe hypokalemia increases risk for dysrhythmias and
requires replacement.
6. The nurse is teaching a client taking warfarin. Which statement indicates
correct understanding?
, HESI Exit
A. “I will stop eating foods containing vitamin K.”
B. “I will take aspirin for headaches.”
C. “I will keep my intake of leafy greens consistent.”
D. “I do not need blood tests.”
Correct Answer: C
Rationale:
Clients taking warfarin should maintain consistent vitamin K intake rather than eliminate it. INR
monitoring is required.
7. A client with increased intracranial pressure is positioned by the nurse. Which
position is best?
A. Flat with legs elevated
B. Head of bed elevated 30 degrees
C. Trendelenburg position
D. Side-lying with neck flexed
Correct Answer: B
Rationale:
Elevating the head promotes venous drainage and reduces intracranial pressure. Neck flexion can
obstruct venous return.
8. A nurse caring for a client receiving morphine notes respirations of 8/min.
Which medication should the nurse prepare?
A. Flumazenil
B. Naloxone
C. Atropine
D. Epinephrine
Correct Answer: B
Rationale:
Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression.
9. Which client statement demonstrates understanding of diabetic foot care?
, HESI Exit
A. “I will walk barefoot indoors.”
B. “I will inspect my feet every day.”
C. “I will soak my feet in hot water.”
D. “I will trim calluses with a razor.”
Correct Answer: B
Rationale:
Daily inspection prevents unnoticed injuries. Diabetes decreases sensation and increases
infection risk.
10. A client with pneumonia has an oxygen saturation of 84% despite oxygen
therapy. What is the nurse’s priority action?
A. Encourage oral fluids
B. Notify the provider immediately
C. Obtain a sputum culture
D. Administer cough medication
Correct Answer: B
Rationale:
Severe hypoxemia indicates respiratory compromise requiring urgent intervention.
Case Study: Questions 11–15
A 72-year-old client is admitted with acute myocardial infarction. Assessment findings include:
Chest pressure radiating to left arm
BP 88/54 mmHg
HR 118/min
Cool clammy skin
11. Which finding is most concerning?
A. Chest discomfort
B. Tachycardia
C. Hypotension
D. Anxiety
HESI Exit Practice Exam 2026 Edition 100
Advanced Questions with Answers and
Detailed Rationales
1. A nurse is caring for a client admitted with septic shock. Which finding
requires immediate intervention?
A. Temperature of 38.3°C (100.9°F)
B. Heart rate of 112/min
C. Urine output of 15 mL/hr
D. White blood cell count of 18,000/mm³
Correct Answer: C
Rationale:
A urine output of less than 30 mL/hr indicates decreased renal perfusion and possible worsening
shock. Septic shock causes systemic vasodilation and impaired tissue perfusion. The nurse must
prioritize organ perfusion indicators. Fever, tachycardia, and leukocytosis are expected findings
in infection.
2. The nurse receives report on four clients. Which client should be assessed
first?
A. Client with COPD reporting oxygen saturation of 91%
B. Client receiving chemotherapy with a temperature of 38.5°C (101.3°F)
C. Client with diabetes requesting pain medication
D. Client with hypertension needing discharge teaching
Correct Answer: B
Rationale:
A chemotherapy client with fever is at risk for neutropenic sepsis, a life-threatening emergency.
Infection in an immunocompromised client requires immediate assessment and intervention.
3. A client receiving IV heparin develops bleeding gums and hematuria. Which
action should the nurse take first?
A. Administer vitamin K
B. Stop the heparin infusion
, HESI Exit
C. Apply pressure to bleeding sites
D. Prepare protamine sulfate
Correct Answer: B
Rationale:
The first action is to stop the source of anticoagulation. Protamine sulfate may be administered
after provider notification, but stopping heparin prevents additional anticoagulant effects.
4. A nurse is caring for a client after thyroidectomy. Which assessment finding
requires immediate action?
A. Mild throat discomfort
B. Hoarse voice
C. Stridor
D. Incisional pain
Correct Answer: C
Rationale:
Stridor indicates airway obstruction, possibly from swelling, hemorrhage, or laryngeal nerve
injury. Airway always takes priority.
5. A client with heart failure is receiving furosemide. Which laboratory value
requires immediate follow-up?
A. Sodium 138 mEq/L
B. Potassium 2.8 mEq/L
C. Calcium 9.2 mg/dL
D. Glucose 110 mg/dL
Correct Answer: B
Rationale:
Furosemide causes potassium loss. Severe hypokalemia increases risk for dysrhythmias and
requires replacement.
6. The nurse is teaching a client taking warfarin. Which statement indicates
correct understanding?
, HESI Exit
A. “I will stop eating foods containing vitamin K.”
B. “I will take aspirin for headaches.”
C. “I will keep my intake of leafy greens consistent.”
D. “I do not need blood tests.”
Correct Answer: C
Rationale:
Clients taking warfarin should maintain consistent vitamin K intake rather than eliminate it. INR
monitoring is required.
7. A client with increased intracranial pressure is positioned by the nurse. Which
position is best?
A. Flat with legs elevated
B. Head of bed elevated 30 degrees
C. Trendelenburg position
D. Side-lying with neck flexed
Correct Answer: B
Rationale:
Elevating the head promotes venous drainage and reduces intracranial pressure. Neck flexion can
obstruct venous return.
8. A nurse caring for a client receiving morphine notes respirations of 8/min.
Which medication should the nurse prepare?
A. Flumazenil
B. Naloxone
C. Atropine
D. Epinephrine
Correct Answer: B
Rationale:
Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression.
9. Which client statement demonstrates understanding of diabetic foot care?
, HESI Exit
A. “I will walk barefoot indoors.”
B. “I will inspect my feet every day.”
C. “I will soak my feet in hot water.”
D. “I will trim calluses with a razor.”
Correct Answer: B
Rationale:
Daily inspection prevents unnoticed injuries. Diabetes decreases sensation and increases
infection risk.
10. A client with pneumonia has an oxygen saturation of 84% despite oxygen
therapy. What is the nurse’s priority action?
A. Encourage oral fluids
B. Notify the provider immediately
C. Obtain a sputum culture
D. Administer cough medication
Correct Answer: B
Rationale:
Severe hypoxemia indicates respiratory compromise requiring urgent intervention.
Case Study: Questions 11–15
A 72-year-old client is admitted with acute myocardial infarction. Assessment findings include:
Chest pressure radiating to left arm
BP 88/54 mmHg
HR 118/min
Cool clammy skin
11. Which finding is most concerning?
A. Chest discomfort
B. Tachycardia
C. Hypotension
D. Anxiety
