HESI EXIT EXAM RN V SCREENSHOTS AND REVIEW
(160) QUESTIONS AND ANSWERS 100%
CORRECT/VERIFIED RATED A+ LATEST UPDATE!!!!!!
EXAM with Questions and Answers/Plus a Rationale Updated
2026 A+/Instant Download PDF
EXAM COVERAGE
1. Medical-Surgical Nursing
2. Pediatric Nursing
3. Maternity and Infant Nursing
4. Psychiatric and Mental Health Nursing
5. Pharmacology and Dosage Calculation
6. Gerontological Nursing
7. Nursing Leadership, Delegation, and Prioritization
1. A client with a history of heart failure is admitted with acute dyspnea, pink frothy sputum, and a
heart rate of 118 beats per minute. The nurse notes diffuse crackles throughout both lung fields.
Which prescription should the nurse implement first?
A. Administer oxygen via nasal cannula at 4 L/min.
B. Administer IV furosemide 40 mg push.
C. Obtain an urgent 12-lead electrocardiogram (ECG).
D. Draw a blood sample for arterial blood gas analysis.
CORRECT ANSWER: B
, Rationale: The client's symptoms indicate acute pulmonary edema, a life-threatening
complication of heart failure requiring immediate reduction of fluid overload. While oxygen
administration is important, IV furosemide directly removes excess circulating volume to resolve
the pulmonary congestion. Obtaining an ECG or drawing arterial blood gases are diagnostic
interventions that should not delay the active administration of the diuretic.
2. A client is admitted to the postpartum unit 2 hours after a vaginal delivery. The nurse notes that
the client's fundus is boggy, displaced to the right, and located 2 centimeters above the
umbilicus. What action should the nurse take first?
A. Assist the client to the bathroom to void.
B. Massage the client's uterine fundus firmly.
C. Increase the rate of the intravenous oxytocin infusion.
D. Notify the primary healthcare provider immediately.
CORRECT ANSWER: A
Rationale: A uterine fundus that is boggy and displaced to the right is highly indicative of a
distended bladder, which prevents the uterus from contracting effectively and increases the risk
of postpartum hemorrhage. Assisting the client to void or straight catheterizing them if unable to
void resolves the displacement, allowing the uterus to contract. Massaging the fundus and
increasing oxytocin are secondary interventions if empty bladder measures fail.
3. The nurse is caring for an infant diagnosed with Tetralogy of Fallot who suddenly becomes
cyanotic, dyspneic, and extremely agitated. Which action should the nurse perform first?
A. Administer a prescribed dose of morphine sulfate.
B. Place high-flow blow-by oxygen near the infant's face.
C. Place the infant in a knee-chest position.
D. Start an intravenous access line for fluid resuscitation.
CORRECT ANSWER: C
Rationale: The infant is experiencing a hypercyanotic spell ("tet spell"), caused by an abrupt
spasm of the right ventricular outflow tract. Placing the infant in a knee-chest position increases
systemic vascular resistance, reducing the right-to-left shunt and forcing more blood into the
lungs. While oxygen and morphine may be indicated later, physical positioning is the quickest
non-invasive intervention that can be executed immediately.
,4. A nurse is preparing to administer the morning medications to a client with chronic kidney
disease. The client's laboratory results reveal a serum potassium level of 6.2 mEq/L (6.2
mmol/L). Which prescribed medication should the nurse withhold?
A. Calcium carbonate 500 mg orally
B. Sevelamer carbonate 800 mg orally
C. Spironolactone 25 mg orally
D. Epoetin alfa 4,000 units subcutaneously
CORRECT ANSWER: C
Rationale: A potassium level of 6.2 mEq/L is critically elevated (hyperkalemia). Spironolactone
is a potassium-sparing diuretic that blocks aldosterone, leading to potassium retention, and
administering it would further worsen the life-threatening hyperkalemia. Calcium carbonate and
sevelamer are phosphate binders used in kidney disease and do not elevate potassium, while
epoetin alfa treats anemia and is safe to give.
5. A client diagnosed with obsessive-compulsive disorder (OCD) is admitted to the inpatient
psychiatric unit. The client spends 45 minutes washing their hands before every meal, causing
severe skin breakdown. Which nursing intervention is most appropriate during the first few days
of admission?
A. Force the client to stop washing their hands by locking the bathroom door.
B. Allow the client to complete the ritual but gradually negotiate a time limit.
C. Confront the client about the irrational nature of the handwashing ritual.
D. Keep the client in isolation to prevent other clients from observing the behavior.
CORRECT ANSWER: B
Rationale: During the initial phase of treatment for OCD, stopping the compulsive behavior
abruptly will cause extreme, unmanageable anxiety and panic. The nurse should allow the ritual
to occur to keep anxiety at a functional level while working collaboratively to gradually reduce
the time spent on it. Confrontation or forced restriction damages the therapeutic relationship
and escalates panic.
6. A client is receiving a continuous intravenous infusion of heparin for the treatment of a deep vein
thrombosis. The nurse reviews the laboratory results and notes an activated partial
thromboplastin time (aPTT) of 135 seconds. Which action should the nurse take first?
A. Stop the heparin infusion immediately.
, B. Prepare to administer protamine sulfate.
C. Obtain a repeat blood draw for aPTT.
D. Notify the healthcare provider of the result.
CORRECT ANSWER: A
Rationale: A normal therapeutic aPTT range for heparin therapy is typically 1.5 to 2.5 times the
control value (around 45 to 80 seconds); an aPTT of 135 seconds is critically high and puts the
client at extreme risk for spontaneous hemorrhage. The priority immediate action is to stop the
infusion to prevent further anticoagulant effect. Protamine sulfate is the antidote but is
administered under specific provider directives based on clinical bleeding signs, while stopping
the drug must happen first.
7. The charge nurse on a pediatric unit is making assignments for the day. Which client is most
appropriate to assign to an experienced Licensed Practical Nurse (LPN)?
A. A 3-year-old child admitted with new-onset diabetic ketoacidosis who is receiving a
continuous insulin infusion.
B. An 8-year-old child with cystic fibrosis who requires chest physiotherapy and pancreatic
enzyme administration.
C. A 12-month-old infant who returned from a cleft palate repair 1 hour ago and has frequent
oral secretions.
D. A 6-year-old child with a closed head injury whose Glasgow Coma Scale score decreased
from 14 to 12.
CORRECT ANSWER: B
Rationale: LPNs can care for stable clients with predictable outcomes; an 8-year-old with cystic
fibrosis requiring routine chest physical therapy and standard medication administration
represents a stable, chronic scenario. The clients with DKA, immediate post-op status, or
deteriorating neurological status require advanced clinical assessment, decision-making, and
titration of critical therapies that fall strictly within the RN scope of practice.
8. An older adult client is admitted with a diagnosis of bacterial meningitis. Which transmission-
based precaution should the nurse implement?
A. Airborne precautions
B. Contact precautions
C. Droplet precautions
(160) QUESTIONS AND ANSWERS 100%
CORRECT/VERIFIED RATED A+ LATEST UPDATE!!!!!!
EXAM with Questions and Answers/Plus a Rationale Updated
2026 A+/Instant Download PDF
EXAM COVERAGE
1. Medical-Surgical Nursing
2. Pediatric Nursing
3. Maternity and Infant Nursing
4. Psychiatric and Mental Health Nursing
5. Pharmacology and Dosage Calculation
6. Gerontological Nursing
7. Nursing Leadership, Delegation, and Prioritization
1. A client with a history of heart failure is admitted with acute dyspnea, pink frothy sputum, and a
heart rate of 118 beats per minute. The nurse notes diffuse crackles throughout both lung fields.
Which prescription should the nurse implement first?
A. Administer oxygen via nasal cannula at 4 L/min.
B. Administer IV furosemide 40 mg push.
C. Obtain an urgent 12-lead electrocardiogram (ECG).
D. Draw a blood sample for arterial blood gas analysis.
CORRECT ANSWER: B
, Rationale: The client's symptoms indicate acute pulmonary edema, a life-threatening
complication of heart failure requiring immediate reduction of fluid overload. While oxygen
administration is important, IV furosemide directly removes excess circulating volume to resolve
the pulmonary congestion. Obtaining an ECG or drawing arterial blood gases are diagnostic
interventions that should not delay the active administration of the diuretic.
2. A client is admitted to the postpartum unit 2 hours after a vaginal delivery. The nurse notes that
the client's fundus is boggy, displaced to the right, and located 2 centimeters above the
umbilicus. What action should the nurse take first?
A. Assist the client to the bathroom to void.
B. Massage the client's uterine fundus firmly.
C. Increase the rate of the intravenous oxytocin infusion.
D. Notify the primary healthcare provider immediately.
CORRECT ANSWER: A
Rationale: A uterine fundus that is boggy and displaced to the right is highly indicative of a
distended bladder, which prevents the uterus from contracting effectively and increases the risk
of postpartum hemorrhage. Assisting the client to void or straight catheterizing them if unable to
void resolves the displacement, allowing the uterus to contract. Massaging the fundus and
increasing oxytocin are secondary interventions if empty bladder measures fail.
3. The nurse is caring for an infant diagnosed with Tetralogy of Fallot who suddenly becomes
cyanotic, dyspneic, and extremely agitated. Which action should the nurse perform first?
A. Administer a prescribed dose of morphine sulfate.
B. Place high-flow blow-by oxygen near the infant's face.
C. Place the infant in a knee-chest position.
D. Start an intravenous access line for fluid resuscitation.
CORRECT ANSWER: C
Rationale: The infant is experiencing a hypercyanotic spell ("tet spell"), caused by an abrupt
spasm of the right ventricular outflow tract. Placing the infant in a knee-chest position increases
systemic vascular resistance, reducing the right-to-left shunt and forcing more blood into the
lungs. While oxygen and morphine may be indicated later, physical positioning is the quickest
non-invasive intervention that can be executed immediately.
,4. A nurse is preparing to administer the morning medications to a client with chronic kidney
disease. The client's laboratory results reveal a serum potassium level of 6.2 mEq/L (6.2
mmol/L). Which prescribed medication should the nurse withhold?
A. Calcium carbonate 500 mg orally
B. Sevelamer carbonate 800 mg orally
C. Spironolactone 25 mg orally
D. Epoetin alfa 4,000 units subcutaneously
CORRECT ANSWER: C
Rationale: A potassium level of 6.2 mEq/L is critically elevated (hyperkalemia). Spironolactone
is a potassium-sparing diuretic that blocks aldosterone, leading to potassium retention, and
administering it would further worsen the life-threatening hyperkalemia. Calcium carbonate and
sevelamer are phosphate binders used in kidney disease and do not elevate potassium, while
epoetin alfa treats anemia and is safe to give.
5. A client diagnosed with obsessive-compulsive disorder (OCD) is admitted to the inpatient
psychiatric unit. The client spends 45 minutes washing their hands before every meal, causing
severe skin breakdown. Which nursing intervention is most appropriate during the first few days
of admission?
A. Force the client to stop washing their hands by locking the bathroom door.
B. Allow the client to complete the ritual but gradually negotiate a time limit.
C. Confront the client about the irrational nature of the handwashing ritual.
D. Keep the client in isolation to prevent other clients from observing the behavior.
CORRECT ANSWER: B
Rationale: During the initial phase of treatment for OCD, stopping the compulsive behavior
abruptly will cause extreme, unmanageable anxiety and panic. The nurse should allow the ritual
to occur to keep anxiety at a functional level while working collaboratively to gradually reduce
the time spent on it. Confrontation or forced restriction damages the therapeutic relationship
and escalates panic.
6. A client is receiving a continuous intravenous infusion of heparin for the treatment of a deep vein
thrombosis. The nurse reviews the laboratory results and notes an activated partial
thromboplastin time (aPTT) of 135 seconds. Which action should the nurse take first?
A. Stop the heparin infusion immediately.
, B. Prepare to administer protamine sulfate.
C. Obtain a repeat blood draw for aPTT.
D. Notify the healthcare provider of the result.
CORRECT ANSWER: A
Rationale: A normal therapeutic aPTT range for heparin therapy is typically 1.5 to 2.5 times the
control value (around 45 to 80 seconds); an aPTT of 135 seconds is critically high and puts the
client at extreme risk for spontaneous hemorrhage. The priority immediate action is to stop the
infusion to prevent further anticoagulant effect. Protamine sulfate is the antidote but is
administered under specific provider directives based on clinical bleeding signs, while stopping
the drug must happen first.
7. The charge nurse on a pediatric unit is making assignments for the day. Which client is most
appropriate to assign to an experienced Licensed Practical Nurse (LPN)?
A. A 3-year-old child admitted with new-onset diabetic ketoacidosis who is receiving a
continuous insulin infusion.
B. An 8-year-old child with cystic fibrosis who requires chest physiotherapy and pancreatic
enzyme administration.
C. A 12-month-old infant who returned from a cleft palate repair 1 hour ago and has frequent
oral secretions.
D. A 6-year-old child with a closed head injury whose Glasgow Coma Scale score decreased
from 14 to 12.
CORRECT ANSWER: B
Rationale: LPNs can care for stable clients with predictable outcomes; an 8-year-old with cystic
fibrosis requiring routine chest physical therapy and standard medication administration
represents a stable, chronic scenario. The clients with DKA, immediate post-op status, or
deteriorating neurological status require advanced clinical assessment, decision-making, and
titration of critical therapies that fall strictly within the RN scope of practice.
8. An older adult client is admitted with a diagnosis of bacterial meningitis. Which transmission-
based precaution should the nurse implement?
A. Airborne precautions
B. Contact precautions
C. Droplet precautions
