HESI – QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS
RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
• Core Domains:*
• Nursing Fundamentals*
• Pharmacology*
• Medical-Surgical Nursing*
• Pediatric Nursing*
• Maternity and Professional Nursing*
• Psychiatric and Mental Health Nursing*
• Geriatric Nursing*
• Pathophysiology*
• Introduction* The purpose of this comprehensive assessment is to evaluate clinical
readiness, safety, and critical decision-making capabilities across key healthcare
domains. The exam evaluates foundational theory, applied clinical knowledge,
regulatory mandates, and professional ethical standards necessary for safe practice.
Utilizing standard multiple-choice and complex scenario-based inquiries, this tool
measures standard knowledge synthesis alongside high-level critical analysis. An
emphasis is placed on real-world application, prioritization, and rapid clinical
reasoning. Candidates must demonstrate systemic assessment skills, pharmacological
safety, and proper nursing intervention workflows to successfully pass this rigorous,
publication-grade evaluation.
SECTION ONE: QUESTIONS 1-100
Question 1 A nurse is assigned to care for a client who is recovering from a thyroidectomy.
The nurse notes that the client has developed muscle spasms, tingling in the fingertips, and
a positive Chvostek's sign. Which action should the nurse take first?
A. Document the findings as expected post-operative variations. B. Administer prescribed
potassium chloride intravenously. C. Assess the client's surgical incision site for hemorrhage.
D. Notify the healthcare provider and prepare calcium gluconate.
Correct answer: D Explanation: A positive Chvostek's sign, muscle spasms, and
tingling indicate acute hypocalcemia, a known complication of thyroidectomy if the
parathyroid glands are accidentally damaged or removed. Intravenous calcium gluconate is
the standard emergency treatment to restore calcium levels and prevent laryngospasm or
seizures.
,Question 2 A client admitted with deep vein thrombosis (DVT) is receiving a continuous
intravenous heparin infusion. The client's activated partial thromboplastin time (aPTT) is 125
seconds. The control value is 35 seconds. Which action should the nurse anticipate taking?
A. Increase the heparin infusion rate by 10 percent. B. Stop the heparin infusion and prepare
protamine sulfate. C. Maintain the current infusion rate and recheck the aPTT in two hours.
D. Administer vitamin K intramuscularly immediately.
Correct answer: B Explanation: The therapeutic range for aPTT during heparin
therapy is typically 1.5 to 2.5 times the control value. A value of 125 seconds is significantly
above the upper therapeutic limit, placing the client at high risk for major hemorrhage. The
infusion must be stopped, and the antidote, protamine sulfate, should be prepared.
Question 3 An emergency department nurse receives a client presenting with crushing chest
pain that radiates to the left jaw, diaphoresis, and nausea. The 12-lead electrocardiogram
(ECG) reveals ST-segment elevation in leads II, III, and aVF. Which intervention is the priority
for this client?
A. Obtain a clean-catch urine specimen for toxicology screening. B. Administer oxygen via
nasal cannula if saturation is below 90 percent. C. Initiate a referral to a cardiac
rehabilitation facility. D. Administer prescribed oral acetaminophen for pain relief.
Correct answer: B Explanation: The client is experiencing an acute inferior
myocardial infarction. Initial management priorities follow standard cardiac protocols:
stabilizing oxygenation, administering aspirin, nitroglycerin, and morphine as prescribed, and
preparing for rapid reperfusion therapy. Acetaminophen is inappropriate for ischemic
cardiac pain.
Question 4 A nurse is teaching a client who has been newly diagnosed with type 1 diabetes
mellitus about insulin self-administration. Which statement by the client indicates a correct
understanding of the instructions?
A. I should massage the injection site vigorously for two minutes after injecting insulin. B. I
will rotate injection sites within the same anatomical area to ensure consistent absorption.
C. I need to discard my open vial of insulin if it sits at room temperature for more than 24
hours. D. I will inject insulin directly into the muscle layer of my upper arm at a 90-degree
angle.
Correct answer: B Explanation: Rotating sites within one anatomical region (such as
the abdomen) prevents lipodystrophy while maintaining consistent insulin absorption rates.
Massaging the site alters absorption, open vials remain stable at room temperature for up to
28 days, and insulin is administered into the subcutaneous tissue, not muscle.
, Question 5 A nurse is preparing to administer an intramuscular injection of iron dextran to
an adult client. Which technique should the nurse implement to ensure safety and proper
medication delivery?
A. Use the deltoid muscle site exclusively. B. Administer the medication via the Z-track
method. C. Aspirate vigorously for 15 seconds before injecting. D. Rub the site firmly with an
alcohol wipe after injection.
Correct answer: B Explanation: The Z-track method prevents medication from
leaking into the subcutaneous tissue and causing permanent skin staining or irritation, which
is highly characteristic of iron dextran injections. Deep ventrogluteal or dorsogluteal muscles
are preferred over the deltoid for large or irritating injections.
Question 6 A client who is at 36 weeks of gestation arrives at the labor and delivery unit
reporting sudden, severe, continuous abdominal pain accompanied by dark red vaginal
bleeding. The nurse notes that the client's abdomen is rigid and tender to palpation. Which
condition should the nurse suspect?
A. Placenta previa B. Abruptio placentae C. Cervical incompetence D. Hydatidiform mole
Correct answer: B Explanation: Abruptio placentae involves the premature
separation of the placenta from the uterine wall, characterized by dark vaginal bleeding,
severe abdominal pain, and a rigid, board-like abdomen. Placenta previa presents with
painless, bright red vaginal bleeding.
Question 7 A nurse is caring for a client with a chest tube attached to a water-seal drainage
system. During assessment, the nurse notes continuous, vigorous bubbling in the water-seal
chamber. How should the nurse interpret this finding?
A. The client's lung has fully re-expanded. B. There is a leak in the drainage system or
thoracic cavity. C. The system is operating perfectly and as intended. D. The suction pressure
needs to be increased manually.
Correct answer: B Explanation: Intermittent tidaling or bubbling during exhalation or
coughing is expected in a water-seal system. Continuous, rapid bubbling indicates an air leak
within the system connections or from the client's pleural space, requiring immediate
investigation and troubleshooting.
Question 8 A home health nurse is reviewing the laboratory results of an older adult client
who takes digoxin daily for heart failure. The client's serum digoxin level is 2.4 ng/mL, and
the serum potassium level is 3.2 mEq/L. Which action must the nurse take immediately?
A. Instruct the client to double the next dose of digoxin to stabilize levels. B. Advise the
client to withhold the digoxin and contact the healthcare provider. C. Tell the client that
these values are within normal therapeutic ranges. D. Encourage the client to avoid all
potassium-rich foods for the next week.
RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
• Core Domains:*
• Nursing Fundamentals*
• Pharmacology*
• Medical-Surgical Nursing*
• Pediatric Nursing*
• Maternity and Professional Nursing*
• Psychiatric and Mental Health Nursing*
• Geriatric Nursing*
• Pathophysiology*
• Introduction* The purpose of this comprehensive assessment is to evaluate clinical
readiness, safety, and critical decision-making capabilities across key healthcare
domains. The exam evaluates foundational theory, applied clinical knowledge,
regulatory mandates, and professional ethical standards necessary for safe practice.
Utilizing standard multiple-choice and complex scenario-based inquiries, this tool
measures standard knowledge synthesis alongside high-level critical analysis. An
emphasis is placed on real-world application, prioritization, and rapid clinical
reasoning. Candidates must demonstrate systemic assessment skills, pharmacological
safety, and proper nursing intervention workflows to successfully pass this rigorous,
publication-grade evaluation.
SECTION ONE: QUESTIONS 1-100
Question 1 A nurse is assigned to care for a client who is recovering from a thyroidectomy.
The nurse notes that the client has developed muscle spasms, tingling in the fingertips, and
a positive Chvostek's sign. Which action should the nurse take first?
A. Document the findings as expected post-operative variations. B. Administer prescribed
potassium chloride intravenously. C. Assess the client's surgical incision site for hemorrhage.
D. Notify the healthcare provider and prepare calcium gluconate.
Correct answer: D Explanation: A positive Chvostek's sign, muscle spasms, and
tingling indicate acute hypocalcemia, a known complication of thyroidectomy if the
parathyroid glands are accidentally damaged or removed. Intravenous calcium gluconate is
the standard emergency treatment to restore calcium levels and prevent laryngospasm or
seizures.
,Question 2 A client admitted with deep vein thrombosis (DVT) is receiving a continuous
intravenous heparin infusion. The client's activated partial thromboplastin time (aPTT) is 125
seconds. The control value is 35 seconds. Which action should the nurse anticipate taking?
A. Increase the heparin infusion rate by 10 percent. B. Stop the heparin infusion and prepare
protamine sulfate. C. Maintain the current infusion rate and recheck the aPTT in two hours.
D. Administer vitamin K intramuscularly immediately.
Correct answer: B Explanation: The therapeutic range for aPTT during heparin
therapy is typically 1.5 to 2.5 times the control value. A value of 125 seconds is significantly
above the upper therapeutic limit, placing the client at high risk for major hemorrhage. The
infusion must be stopped, and the antidote, protamine sulfate, should be prepared.
Question 3 An emergency department nurse receives a client presenting with crushing chest
pain that radiates to the left jaw, diaphoresis, and nausea. The 12-lead electrocardiogram
(ECG) reveals ST-segment elevation in leads II, III, and aVF. Which intervention is the priority
for this client?
A. Obtain a clean-catch urine specimen for toxicology screening. B. Administer oxygen via
nasal cannula if saturation is below 90 percent. C. Initiate a referral to a cardiac
rehabilitation facility. D. Administer prescribed oral acetaminophen for pain relief.
Correct answer: B Explanation: The client is experiencing an acute inferior
myocardial infarction. Initial management priorities follow standard cardiac protocols:
stabilizing oxygenation, administering aspirin, nitroglycerin, and morphine as prescribed, and
preparing for rapid reperfusion therapy. Acetaminophen is inappropriate for ischemic
cardiac pain.
Question 4 A nurse is teaching a client who has been newly diagnosed with type 1 diabetes
mellitus about insulin self-administration. Which statement by the client indicates a correct
understanding of the instructions?
A. I should massage the injection site vigorously for two minutes after injecting insulin. B. I
will rotate injection sites within the same anatomical area to ensure consistent absorption.
C. I need to discard my open vial of insulin if it sits at room temperature for more than 24
hours. D. I will inject insulin directly into the muscle layer of my upper arm at a 90-degree
angle.
Correct answer: B Explanation: Rotating sites within one anatomical region (such as
the abdomen) prevents lipodystrophy while maintaining consistent insulin absorption rates.
Massaging the site alters absorption, open vials remain stable at room temperature for up to
28 days, and insulin is administered into the subcutaneous tissue, not muscle.
, Question 5 A nurse is preparing to administer an intramuscular injection of iron dextran to
an adult client. Which technique should the nurse implement to ensure safety and proper
medication delivery?
A. Use the deltoid muscle site exclusively. B. Administer the medication via the Z-track
method. C. Aspirate vigorously for 15 seconds before injecting. D. Rub the site firmly with an
alcohol wipe after injection.
Correct answer: B Explanation: The Z-track method prevents medication from
leaking into the subcutaneous tissue and causing permanent skin staining or irritation, which
is highly characteristic of iron dextran injections. Deep ventrogluteal or dorsogluteal muscles
are preferred over the deltoid for large or irritating injections.
Question 6 A client who is at 36 weeks of gestation arrives at the labor and delivery unit
reporting sudden, severe, continuous abdominal pain accompanied by dark red vaginal
bleeding. The nurse notes that the client's abdomen is rigid and tender to palpation. Which
condition should the nurse suspect?
A. Placenta previa B. Abruptio placentae C. Cervical incompetence D. Hydatidiform mole
Correct answer: B Explanation: Abruptio placentae involves the premature
separation of the placenta from the uterine wall, characterized by dark vaginal bleeding,
severe abdominal pain, and a rigid, board-like abdomen. Placenta previa presents with
painless, bright red vaginal bleeding.
Question 7 A nurse is caring for a client with a chest tube attached to a water-seal drainage
system. During assessment, the nurse notes continuous, vigorous bubbling in the water-seal
chamber. How should the nurse interpret this finding?
A. The client's lung has fully re-expanded. B. There is a leak in the drainage system or
thoracic cavity. C. The system is operating perfectly and as intended. D. The suction pressure
needs to be increased manually.
Correct answer: B Explanation: Intermittent tidaling or bubbling during exhalation or
coughing is expected in a water-seal system. Continuous, rapid bubbling indicates an air leak
within the system connections or from the client's pleural space, requiring immediate
investigation and troubleshooting.
Question 8 A home health nurse is reviewing the laboratory results of an older adult client
who takes digoxin daily for heart failure. The client's serum digoxin level is 2.4 ng/mL, and
the serum potassium level is 3.2 mEq/L. Which action must the nurse take immediately?
A. Instruct the client to double the next dose of digoxin to stabilize levels. B. Advise the
client to withhold the digoxin and contact the healthcare provider. C. Tell the client that
these values are within normal therapeutic ranges. D. Encourage the client to avoid all
potassium-rich foods for the next week.
