HESI Exit Exam Ultimate Study Guide + Practice
Test 2026/2027 – Verified Q&As with Detailed
Rationales (Test Bank Bundle - 119 Questions)
---
**QUESTION 1:**
A client with heart failure is prescribed furosemide. The nurse should monitor which laboratory value
most closely?
A) Serum potassium
B) Serum sodium
C) Serum calcium
D) Serum magnesium
> 🎯 **CORRECT ANSWER:** A) Serum potassium
> 💡 **CLINICAL RATIONALE:** Loop diuretics cause hypokalemia. Monitor K+ and digoxin toxicity risk.
---
**QUESTION 2:**
A patient with type 2 diabetes is admitted with hyperglycemia. Which assessment finding indicates
diabetic ketoacidosis?
A) Fruity breath and Kussmaul respirations
B) Bradycardia and hypotension
C) Dry skin and increased appetite
D) Polyuria and polydipsia only
> 🎯 **CORRECT ANSWER:** A) Fruity breath and Kussmaul respirations
> 💡 **CLINICAL RATIONALE:** DKA presents with ketosis, acidosis, and compensatory hyperventilation.
---
**QUESTION 3:**
,A 68-year-old male with COPD has an oxygen saturation of 88%. The nurse should first:
A) Check the oxygen delivery device and reposition the cannula
B) Increase oxygen to 4 L/min
C) Administer a bronchodilator
D) Call the provider
> 🎯 **CORRECT ANSWER:** A) Check the oxygen delivery device and reposition the cannula
> 💡 **CLINICAL RATIONALE:** Assess equipment first; avoid high FiO2 in COPD; then escalate.
---
**QUESTION 4:**
The nurse is caring for a patient with a chest tube. The drainage system has continuous bubbling in the
suction chamber. What does this indicate?
A) The suction is functioning properly
B) There is an air leak
C) The chest tube is blocked
D) The water seal is broken
> 🎯 **CORRECT ANSWER:** A) The suction is functioning properly
> 💡 **CLINICAL RATIONALE:** Continuous bubbling in suction chamber indicates active suction.
Bubbling in water seal indicates air leak.
---
**QUESTION 5:**
A patient on warfarin has an INR of 5.2. The nurse should anticipate administering:
A) Vitamin K
B) Protamine sulfate
C) Fresh frozen plasma
D) Platelets
> 🎯 **CORRECT ANSWER:** A) Vitamin K
> 💡 **CLINICAL RATIONALE:** Warfarin reversed with vitamin K; protamine for heparin.
,---
**QUESTION 6:**
Which priority action should the nurse take for a client with suspected meningitis?
A) Administer IV antibiotics after blood cultures
B) Perform a lumbar puncture immediately
C) Administer antipyretics
D) Isolate the client
> 🎯 **CORRECT ANSWER:** A) Administer IV antibiotics after blood cultures
> 💡 **CLINICAL RATIONALE:** Antibiotics start within 30-60 min after cultures; LP can follow.
---
**QUESTION 7:**
A 52-year-old patient with cirrhosis presents with confusion and asterixis. What is the priority nursing
intervention?
A) Assess serum ammonia and initiate lactulose
B) Administer sedatives
C) Restrict fluids
D) Place the patient in supine position
> 🎯 **CORRECT ANSWER:** A) Assess serum ammonia and initiate lactulose
> 💡 **CLINICAL RATIONALE:** Hepatic encephalopathy requires ammonia reduction via lactulose.
---
**QUESTION 8:**
The nurse is teaching a patient with gout about dietary modifications. Which food should be avoided?
A) Red meat and organ meats
B) Leafy greens
C) Whole grains
D) Dairy products
, > 🎯 **CORRECT ANSWER:** A) Red meat and organ meats
> 💡 **CLINICAL RATIONALE:** High-purine foods increase uric acid and trigger gout attacks.
---
**QUESTION 9:**
A patient with a new colostomy asks about pouch care. Which statement indicates a need for further
teaching?
A) "I will empty the pouch when it is one-third full."
B) "I will use lotion around the stoma to keep skin soft."
C) "I will change the pouch every 3-5 days."
D) "I will cut the wafer to the exact stoma size."
> 🎯 **CORRECT ANSWER:** B) "I will use lotion around the stoma to keep skin soft."
> 💡 **CLINICAL RATIONALE:** Lotions interfere with pouch adhesion; use skin barrier products only.
---
**QUESTION 10:**
A 4-year-old with croup has a barking cough and stridor. The nurse should first:
A) Position upright and administer humidified oxygen
B) Administer oral steroids
C) Prepare for intubation
D) Obtain a throat culture
> 🎯 **CORRECT ANSWER:** A) Position upright and administer humidified oxygen
> 💡 **CLINICAL RATIONALE:** Upright position and humidified O2 reduce airway edema and stridor.
---
**QUESTION 11:**
Which finding indicates that a patient with hyperkalemia requires immediate intervention?
A) Peaked T waves on ECG
B) Serum potassium 5.8 mEq/L
Test 2026/2027 – Verified Q&As with Detailed
Rationales (Test Bank Bundle - 119 Questions)
---
**QUESTION 1:**
A client with heart failure is prescribed furosemide. The nurse should monitor which laboratory value
most closely?
A) Serum potassium
B) Serum sodium
C) Serum calcium
D) Serum magnesium
> 🎯 **CORRECT ANSWER:** A) Serum potassium
> 💡 **CLINICAL RATIONALE:** Loop diuretics cause hypokalemia. Monitor K+ and digoxin toxicity risk.
---
**QUESTION 2:**
A patient with type 2 diabetes is admitted with hyperglycemia. Which assessment finding indicates
diabetic ketoacidosis?
A) Fruity breath and Kussmaul respirations
B) Bradycardia and hypotension
C) Dry skin and increased appetite
D) Polyuria and polydipsia only
> 🎯 **CORRECT ANSWER:** A) Fruity breath and Kussmaul respirations
> 💡 **CLINICAL RATIONALE:** DKA presents with ketosis, acidosis, and compensatory hyperventilation.
---
**QUESTION 3:**
,A 68-year-old male with COPD has an oxygen saturation of 88%. The nurse should first:
A) Check the oxygen delivery device and reposition the cannula
B) Increase oxygen to 4 L/min
C) Administer a bronchodilator
D) Call the provider
> 🎯 **CORRECT ANSWER:** A) Check the oxygen delivery device and reposition the cannula
> 💡 **CLINICAL RATIONALE:** Assess equipment first; avoid high FiO2 in COPD; then escalate.
---
**QUESTION 4:**
The nurse is caring for a patient with a chest tube. The drainage system has continuous bubbling in the
suction chamber. What does this indicate?
A) The suction is functioning properly
B) There is an air leak
C) The chest tube is blocked
D) The water seal is broken
> 🎯 **CORRECT ANSWER:** A) The suction is functioning properly
> 💡 **CLINICAL RATIONALE:** Continuous bubbling in suction chamber indicates active suction.
Bubbling in water seal indicates air leak.
---
**QUESTION 5:**
A patient on warfarin has an INR of 5.2. The nurse should anticipate administering:
A) Vitamin K
B) Protamine sulfate
C) Fresh frozen plasma
D) Platelets
> 🎯 **CORRECT ANSWER:** A) Vitamin K
> 💡 **CLINICAL RATIONALE:** Warfarin reversed with vitamin K; protamine for heparin.
,---
**QUESTION 6:**
Which priority action should the nurse take for a client with suspected meningitis?
A) Administer IV antibiotics after blood cultures
B) Perform a lumbar puncture immediately
C) Administer antipyretics
D) Isolate the client
> 🎯 **CORRECT ANSWER:** A) Administer IV antibiotics after blood cultures
> 💡 **CLINICAL RATIONALE:** Antibiotics start within 30-60 min after cultures; LP can follow.
---
**QUESTION 7:**
A 52-year-old patient with cirrhosis presents with confusion and asterixis. What is the priority nursing
intervention?
A) Assess serum ammonia and initiate lactulose
B) Administer sedatives
C) Restrict fluids
D) Place the patient in supine position
> 🎯 **CORRECT ANSWER:** A) Assess serum ammonia and initiate lactulose
> 💡 **CLINICAL RATIONALE:** Hepatic encephalopathy requires ammonia reduction via lactulose.
---
**QUESTION 8:**
The nurse is teaching a patient with gout about dietary modifications. Which food should be avoided?
A) Red meat and organ meats
B) Leafy greens
C) Whole grains
D) Dairy products
, > 🎯 **CORRECT ANSWER:** A) Red meat and organ meats
> 💡 **CLINICAL RATIONALE:** High-purine foods increase uric acid and trigger gout attacks.
---
**QUESTION 9:**
A patient with a new colostomy asks about pouch care. Which statement indicates a need for further
teaching?
A) "I will empty the pouch when it is one-third full."
B) "I will use lotion around the stoma to keep skin soft."
C) "I will change the pouch every 3-5 days."
D) "I will cut the wafer to the exact stoma size."
> 🎯 **CORRECT ANSWER:** B) "I will use lotion around the stoma to keep skin soft."
> 💡 **CLINICAL RATIONALE:** Lotions interfere with pouch adhesion; use skin barrier products only.
---
**QUESTION 10:**
A 4-year-old with croup has a barking cough and stridor. The nurse should first:
A) Position upright and administer humidified oxygen
B) Administer oral steroids
C) Prepare for intubation
D) Obtain a throat culture
> 🎯 **CORRECT ANSWER:** A) Position upright and administer humidified oxygen
> 💡 **CLINICAL RATIONALE:** Upright position and humidified O2 reduce airway edema and stridor.
---
**QUESTION 11:**
Which finding indicates that a patient with hyperkalemia requires immediate intervention?
A) Peaked T waves on ECG
B) Serum potassium 5.8 mEq/L
