HESI Exit Exam 2023| Comprehensive Study
Guide with Actual Exam Questions with
Correct Answers and Rationales | Latest
Update 2026/2027- Graded A+
Question 1
In planning care for a 6 month-old infant, what must the nurse provide to assist in the
development of trust?
A. Food
B. Warmth
C. Security
D. Comfort
Answer: C
Rationale: According to Erikson's psychosocial theory, the primary task for infants is
developing trust versus mistrust. Security is the foundation for trust development, as the
infant learns that their needs will be consistently met.
Question 2
A nurse has just received a medication order which is not legible. Which statement best
reflects assertive communication?
A. "I cannot give this medication as it is written. I have no idea of what you mean."
B. "Would you please clarify what you have written so I am sure I am reading it
correctly?"
C. "I am having difficulty reading your handwriting. It would save me time if you would
be more careful."
D. "Please print in the future so I do not have to spend extra time attempting to read
your writing."
Answer: B
Rationale: Assertive communication is respectful, direct, and non-confrontational.
Option B uses "I" statements and respectfully requests clarification without blaming or
criticizing.
pg. 1
,Question 3
What is the most important consideration when teaching parents how to reduce risks in
the home?
A. Age and knowledge level of the parents
B. Proximity to emergency services
C. Number of children in the home
D. Age of children in the home
Answer: D
Rationale: The age of children in the home is the most important consideration
because different age groups face different types of risks and safety hazards.
Question 4
A 35 year-old client with sickle cell crisis is talking on the telephone but stops as the
nurse enters the room to request something for pain. The nurse should
A. Administer a placebo
B. Encourage increased fluid intake
C. Administer the prescribed analgesia
D. Recommend relaxation exercises for pain control
Answer: C
Rationale: Pain in sickle cell crisis is real and severe. The nurse should administer the
prescribed analgesia promptly. Placebos are unethical, and relaxation exercises alone
are insufficient for acute pain.
Question 5
While caring for a toddler with croup, which initial sign of croup requires the nurse's
immediate attention?
A. Respiratory rate of 42
B. Lethargy for the past hour
C. Apical pulse of 54
D. Coughing up copious secretions
Answer: A
Rationale: A respiratory rate of 42 in a toddler indicates significant respiratory
distress and requires immediate intervention. Tachypnea is an early sign of impending
respiratory failure.
pg. 2
,Question 6
A client is admitted with low T3 and T4 levels and an elevated TSH level. On initial
assessment, the nurse would anticipate which of the following assessment findings?
A. Lethargy
B. Heat intolerance
C. Diarrhea
D. Skin eruptions
Answer: A
Rationale: Low T3 and T4 with elevated TSH indicates hypothyroidism. Classic
findings include lethargy, cold intolerance, constipation, and dry skin.
Question 7
The emergency room nurse admits a child who experienced a seizure at school. The
father comments that this is the first occurrence, and denies any family history of
epilepsy. What is the best response by the nurse?
A. "Do not worry. Epilepsy can be treated with medications."
B. "The seizure may or may not mean your child has epilepsy."
C. "Since this was the first convulsion, it may not happen again."
D. "Long term treatment will prevent future seizures."
Answer: B
Rationale: A single seizure does not necessarily indicate epilepsy. The nurse should
provide realistic information without giving false reassurance or making premature
diagnoses.
Question 8
Alcohol and drug abuse impairs judgment and increases risk taking behavior. What
nursing diagnosis best applies?
A. Risk for injury
B. Risk for knowledge deficit
C. Altered thought process
D. Disturbance in self-esteem
Answer: A
Rationale: Impaired judgment and increased risk-taking behavior directly increase the
risk for injury, making "Risk for injury" the most appropriate nursing diagnosis.
pg. 3
, Question 9
Which of these findings would the nurse more closely associate with anemia in a 10-
month-old infant?
A. Hemoglobin level of 12 g/dL
B. Pale mucosa of the eyelids and lips
C. Hypoactivity
D. A heart rate between 140 to 160
Answer: B
Rationale: Pallor of the mucous membranes (eyelids and lips) is a classic sign of
anemia in infants. A hemoglobin of 12 g/dL is within normal range for this age.
Question 10
The nurse is caring for a client in hypertensive crisis in an intensive care unit. The
priority assessment in the first hour of care is
A. Heart rate
B. Pedal pulses
C. Lung sounds
D. Pupil responses
Answer: D
Rationale: In hypertensive crisis, the priority is to assess for neurologic changes
indicating end-organ damage. Pupil responses assess for increased intracranial pressure
or neurologic impairment.
Question 11
Which of these clients who are all in the terminal stage of cancer is least appropriate to
suggest the use of patient controlled analgesia (PCA) with a pump?
A. A young adult with a history of Down's syndrome
B. A teenager who reads at a 4th grade level
C. An elderly client with numerous arthritic nodules on the hands
D. A preschooler with intermittent episodes of alertness
Answer: D
Rationale: PCA requires the patient to understand and be able to push the button to
self-administer medication. A preschooler with intermittent alertness cannot reliably
use PCA.
pg. 4
Guide with Actual Exam Questions with
Correct Answers and Rationales | Latest
Update 2026/2027- Graded A+
Question 1
In planning care for a 6 month-old infant, what must the nurse provide to assist in the
development of trust?
A. Food
B. Warmth
C. Security
D. Comfort
Answer: C
Rationale: According to Erikson's psychosocial theory, the primary task for infants is
developing trust versus mistrust. Security is the foundation for trust development, as the
infant learns that their needs will be consistently met.
Question 2
A nurse has just received a medication order which is not legible. Which statement best
reflects assertive communication?
A. "I cannot give this medication as it is written. I have no idea of what you mean."
B. "Would you please clarify what you have written so I am sure I am reading it
correctly?"
C. "I am having difficulty reading your handwriting. It would save me time if you would
be more careful."
D. "Please print in the future so I do not have to spend extra time attempting to read
your writing."
Answer: B
Rationale: Assertive communication is respectful, direct, and non-confrontational.
Option B uses "I" statements and respectfully requests clarification without blaming or
criticizing.
pg. 1
,Question 3
What is the most important consideration when teaching parents how to reduce risks in
the home?
A. Age and knowledge level of the parents
B. Proximity to emergency services
C. Number of children in the home
D. Age of children in the home
Answer: D
Rationale: The age of children in the home is the most important consideration
because different age groups face different types of risks and safety hazards.
Question 4
A 35 year-old client with sickle cell crisis is talking on the telephone but stops as the
nurse enters the room to request something for pain. The nurse should
A. Administer a placebo
B. Encourage increased fluid intake
C. Administer the prescribed analgesia
D. Recommend relaxation exercises for pain control
Answer: C
Rationale: Pain in sickle cell crisis is real and severe. The nurse should administer the
prescribed analgesia promptly. Placebos are unethical, and relaxation exercises alone
are insufficient for acute pain.
Question 5
While caring for a toddler with croup, which initial sign of croup requires the nurse's
immediate attention?
A. Respiratory rate of 42
B. Lethargy for the past hour
C. Apical pulse of 54
D. Coughing up copious secretions
Answer: A
Rationale: A respiratory rate of 42 in a toddler indicates significant respiratory
distress and requires immediate intervention. Tachypnea is an early sign of impending
respiratory failure.
pg. 2
,Question 6
A client is admitted with low T3 and T4 levels and an elevated TSH level. On initial
assessment, the nurse would anticipate which of the following assessment findings?
A. Lethargy
B. Heat intolerance
C. Diarrhea
D. Skin eruptions
Answer: A
Rationale: Low T3 and T4 with elevated TSH indicates hypothyroidism. Classic
findings include lethargy, cold intolerance, constipation, and dry skin.
Question 7
The emergency room nurse admits a child who experienced a seizure at school. The
father comments that this is the first occurrence, and denies any family history of
epilepsy. What is the best response by the nurse?
A. "Do not worry. Epilepsy can be treated with medications."
B. "The seizure may or may not mean your child has epilepsy."
C. "Since this was the first convulsion, it may not happen again."
D. "Long term treatment will prevent future seizures."
Answer: B
Rationale: A single seizure does not necessarily indicate epilepsy. The nurse should
provide realistic information without giving false reassurance or making premature
diagnoses.
Question 8
Alcohol and drug abuse impairs judgment and increases risk taking behavior. What
nursing diagnosis best applies?
A. Risk for injury
B. Risk for knowledge deficit
C. Altered thought process
D. Disturbance in self-esteem
Answer: A
Rationale: Impaired judgment and increased risk-taking behavior directly increase the
risk for injury, making "Risk for injury" the most appropriate nursing diagnosis.
pg. 3
, Question 9
Which of these findings would the nurse more closely associate with anemia in a 10-
month-old infant?
A. Hemoglobin level of 12 g/dL
B. Pale mucosa of the eyelids and lips
C. Hypoactivity
D. A heart rate between 140 to 160
Answer: B
Rationale: Pallor of the mucous membranes (eyelids and lips) is a classic sign of
anemia in infants. A hemoglobin of 12 g/dL is within normal range for this age.
Question 10
The nurse is caring for a client in hypertensive crisis in an intensive care unit. The
priority assessment in the first hour of care is
A. Heart rate
B. Pedal pulses
C. Lung sounds
D. Pupil responses
Answer: D
Rationale: In hypertensive crisis, the priority is to assess for neurologic changes
indicating end-organ damage. Pupil responses assess for increased intracranial pressure
or neurologic impairment.
Question 11
Which of these clients who are all in the terminal stage of cancer is least appropriate to
suggest the use of patient controlled analgesia (PCA) with a pump?
A. A young adult with a history of Down's syndrome
B. A teenager who reads at a 4th grade level
C. An elderly client with numerous arthritic nodules on the hands
D. A preschooler with intermittent episodes of alertness
Answer: D
Rationale: PCA requires the patient to understand and be able to push the button to
self-administer medication. A preschooler with intermittent alertness cannot reliably
use PCA.
pg. 4
