, HESI Exit V6
1. A patient with heart failure is prescribed furosemide (Lasix). Which laboratory value should
the nurse monitor most closely?
A Serum sodium
B Serum potassium
C Serum calcium
D Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting, leading to hypokalemia,
which increases the risk of digoxin toxicity and arrhythmias . Potassium is the most critical
parameter to monitor. Sodium (A), calcium (C), and magnesium (D) should also be monitored
but are not the primary concern .
2. A patient with chronic obstructive pulmonary disease (COPD) has a PaCO₂ of 68 mmHg and
an SpO₂ of 88% on room air. The nurse should administer oxygen at:
A 2 L/min via nasal cannula
B 4 L/min via nasal cannula
C 6 L/min via simple mask
D 10 L/min via non-rebreather mask
Correct Answer: A
Rationale: COPD patients with chronic hypercapnia rely on hypoxic drive; high oxygen can
suppress respiratory drive. Target SpO₂ is 88-92%, starting at 1-2 L/min . Higher flow rates (B, C,
D) risk respiratory depression and CO₂ retention .
3. A patient with type 1 diabetes mellitus is found unconscious. The blood glucose reading is 45
mg/dL. The nurse should FIRST:
A Administer 50% dextrose IV push
B Give 15 grams of oral carbohydrate
,C Administer glucagon IM
D Recheck blood glucose in 15 minutes
Correct Answer: A
Rationale: An unconscious patient cannot swallow safely; IV dextrose is the priority treatment
for severe hypoglycemia . Glucagon IM (C) is used if no IV access is available. Oral carbohydrates
(B) are contraindicated in an unconscious client due to aspiration risk .
4. Which finding in a patient with a new cast on the lower leg is most concerning for
compartment syndrome?
A Pain that is relieved by elevation
B Toes that are pink and warm
C Pain that worsens with passive extension of the toes
D Mild swelling around the cast edges
Correct Answer: C
Rationale: Pain out of proportion to injury that worsens with passive stretch is an early sign of
compartment syndrome . Pain relieved by elevation (A) is not typical. Pink, warm toes (B)
indicate adequate perfusion. Mild swelling (D) is expected with a new cast .
5. A patient with peptic ulcer disease is prescribed omeprazole (Prilosec). The nurse should
instruct the patient to take this medication:
A With meals
B 30-60 minutes before breakfast
C At bedtime with a snack
D With antacids
Correct Answer: B
Rationale: PPIs are most effective when taken on an empty stomach, 30-60 minutes before the
first meal of the day . Taking with meals (A) or at bedtime (C) reduces absorption. Antacids (D)
should not be taken simultaneously .
6. A patient with a new diagnosis of tuberculosis is prescribed isoniazid (INH). The nurse should
teach the patient about:
, A Peripheral neuropathy (prevent with vitamin B6)
B Hepatotoxicity
C Orange-red discoloration of body fluids
D Both A and B
Correct Answer: D
Rationale: INH can cause peripheral neuropathy (prevent with pyridoxine/vitamin B6) and
hepatotoxicity . Orange-red discoloration of body fluids (C) is caused by rifampin, not INH .
7. A patient with asthma is prescribed fluticasone (Flovent) inhaler. The nurse should instruct
the patient to:
A Use it as a rescue inhaler for acute symptoms
B Rinse the mouth after each use to prevent oral thrush
C Expect immediate bronchodilation
D Take only during acute attacks
Correct Answer: B
Rationale: Inhaled corticosteroids can cause oropharyngeal candidiasis (oral thrush); rinsing the
mouth after each use reduces this risk . Fluticasone is a controller medication, not a rescue
inhaler (A, D). It does not provide immediate bronchodilation (C) .
8. A patient with chronic kidney disease has a serum phosphate of 6.5 mg/dL (normal 2.5-4.5).
The nurse expects a prescription for:
A Calcium acetate (phosphate binder)
B IV calcium gluconate
C Oral phosphorus supplements
D Vitamin D only
Correct Answer: A
Rationale: Calcium acetate binds dietary phosphate in the gut, reducing absorption and serum
phosphate levels . IV calcium gluconate (B) is used for hyperkalemia, not hyperphosphatemia.
Oral phosphorus (C) would worsen the condition .
1. A patient with heart failure is prescribed furosemide (Lasix). Which laboratory value should
the nurse monitor most closely?
A Serum sodium
B Serum potassium
C Serum calcium
D Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting, leading to hypokalemia,
which increases the risk of digoxin toxicity and arrhythmias . Potassium is the most critical
parameter to monitor. Sodium (A), calcium (C), and magnesium (D) should also be monitored
but are not the primary concern .
2. A patient with chronic obstructive pulmonary disease (COPD) has a PaCO₂ of 68 mmHg and
an SpO₂ of 88% on room air. The nurse should administer oxygen at:
A 2 L/min via nasal cannula
B 4 L/min via nasal cannula
C 6 L/min via simple mask
D 10 L/min via non-rebreather mask
Correct Answer: A
Rationale: COPD patients with chronic hypercapnia rely on hypoxic drive; high oxygen can
suppress respiratory drive. Target SpO₂ is 88-92%, starting at 1-2 L/min . Higher flow rates (B, C,
D) risk respiratory depression and CO₂ retention .
3. A patient with type 1 diabetes mellitus is found unconscious. The blood glucose reading is 45
mg/dL. The nurse should FIRST:
A Administer 50% dextrose IV push
B Give 15 grams of oral carbohydrate
,C Administer glucagon IM
D Recheck blood glucose in 15 minutes
Correct Answer: A
Rationale: An unconscious patient cannot swallow safely; IV dextrose is the priority treatment
for severe hypoglycemia . Glucagon IM (C) is used if no IV access is available. Oral carbohydrates
(B) are contraindicated in an unconscious client due to aspiration risk .
4. Which finding in a patient with a new cast on the lower leg is most concerning for
compartment syndrome?
A Pain that is relieved by elevation
B Toes that are pink and warm
C Pain that worsens with passive extension of the toes
D Mild swelling around the cast edges
Correct Answer: C
Rationale: Pain out of proportion to injury that worsens with passive stretch is an early sign of
compartment syndrome . Pain relieved by elevation (A) is not typical. Pink, warm toes (B)
indicate adequate perfusion. Mild swelling (D) is expected with a new cast .
5. A patient with peptic ulcer disease is prescribed omeprazole (Prilosec). The nurse should
instruct the patient to take this medication:
A With meals
B 30-60 minutes before breakfast
C At bedtime with a snack
D With antacids
Correct Answer: B
Rationale: PPIs are most effective when taken on an empty stomach, 30-60 minutes before the
first meal of the day . Taking with meals (A) or at bedtime (C) reduces absorption. Antacids (D)
should not be taken simultaneously .
6. A patient with a new diagnosis of tuberculosis is prescribed isoniazid (INH). The nurse should
teach the patient about:
, A Peripheral neuropathy (prevent with vitamin B6)
B Hepatotoxicity
C Orange-red discoloration of body fluids
D Both A and B
Correct Answer: D
Rationale: INH can cause peripheral neuropathy (prevent with pyridoxine/vitamin B6) and
hepatotoxicity . Orange-red discoloration of body fluids (C) is caused by rifampin, not INH .
7. A patient with asthma is prescribed fluticasone (Flovent) inhaler. The nurse should instruct
the patient to:
A Use it as a rescue inhaler for acute symptoms
B Rinse the mouth after each use to prevent oral thrush
C Expect immediate bronchodilation
D Take only during acute attacks
Correct Answer: B
Rationale: Inhaled corticosteroids can cause oropharyngeal candidiasis (oral thrush); rinsing the
mouth after each use reduces this risk . Fluticasone is a controller medication, not a rescue
inhaler (A, D). It does not provide immediate bronchodilation (C) .
8. A patient with chronic kidney disease has a serum phosphate of 6.5 mg/dL (normal 2.5-4.5).
The nurse expects a prescription for:
A Calcium acetate (phosphate binder)
B IV calcium gluconate
C Oral phosphorus supplements
D Vitamin D only
Correct Answer: A
Rationale: Calcium acetate binds dietary phosphate in the gut, reducing absorption and serum
phosphate levels . IV calcium gluconate (B) is used for hyperkalemia, not hyperphosphatemia.
Oral phosphorus (C) would worsen the condition .
