HESI RN EXIT FULL EXAM – QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED
ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains
• Management of Care
• Safety and Infection Control
• Health Promotion and Maintenance
• Psychosocial Integrity
• Basic Care and Comfort
• Pharmacological and Parenteral Therapies
• Reduction of Risk Potential
• Physiological Adaptation
Introduction
This comprehensive examination is designed to assess the clinical readiness and professional
competency of nursing candidates. The purpose of this assessment is to evaluate the
integration of foundational theory, evidence-based practice, and clinical judgment required
for safe entry-level nursing practice. Candidates will be tested on their ability to synthesize
knowledge across diverse patient care scenarios, emphasizing ethical decision-making,
regulatory compliance, and real-world application. Through a series of rigorous multiple-
choice and scenario-based questions, this exam measures the critical thinking skills necessary
to provide high-quality care, manage complex patient needs, and ensure patient safety in
dynamic healthcare environments.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client with a suspected pheochromocytoma. Which
assessment finding requires immediate intervention? A. Blood pressure of 180/110
mm Hg B. Sudden onset of severe headache C. Profuse diaphoresis D. Blood
glucose of 140 mg/dL Explanation: A pheochromocytoma is a catecholamine-
secreting tumor. A sudden, severe headache is often indicative of a hypertensive
crisis, which can lead to a cerebrovascular accident.
2. A client diagnosed with schizophrenia is prescribed clozapine. Which laboratory
result must be monitored weekly? A. Hemoglobin and hematocrit B. Serum
creatinine C. Absolute neutrophil count (ANC) D. Liver enzymes Explanation:
Clozapine carries a black box warning for agranulocytosis. Monitoring the ANC is
essential to detect early signs of neutropenia.
,3. When preparing a client for a lumbar puncture, the nurse should place the client in
which position? A. Prone with a pillow under the abdomen B. Lateral recumbent
with knees drawn to the chest C. High-Fowler's position D. Supine with the head of
the bed elevated 30 degrees Explanation: The lateral recumbent position with
the neck and knees flexed opens the vertebral spaces, facilitating the insertion of the
needle.
4. A nurse is assessing a client who has experienced a stroke. The client has difficulty
swallowing. Which action should the nurse prioritize? A. Offer thin liquids to keep the
client hydrated B. Perform a bedside swallow screening C. Request a mechanical
soft diet D. Place the client in a supine position during feedings Explanation:
Safety is the priority. A formal swallow screen must be conducted before the client is
given anything by mouth to prevent aspiration.
5. A client with type 1 diabetes is found unresponsive. Which action should the nurse
take first? A. Administer subcutaneous insulin B. Check the client's urine for ketones
C. Administer intravenous dextrose D. Assess the client’s blood pressure
Explanation: An unresponsive diabetic client is likely experiencing severe
hypoglycemia. Intravenous dextrose is the fastest way to raise blood glucose levels.
6. Which assessment finding in a newborn indicates respiratory distress? A.
Acrocyanosis B. Irregular respiratory rate C. Nasal flaring D. Periodic breathing
Explanation: Nasal flaring is a classic sign of increased work of breathing and
respiratory distress in a neonate.
7. A nurse is teaching a client about warfarin therapy. Which statement by the client
indicates understanding? A. I will increase my intake of green leafy vegetables B. I will
use a stiff-bristled toothbrush to maintain oral hygiene C. I will report any
unexplained bruising or bleeding to my doctor D. I will take aspirin if I develop a
headache Explanation: Warfarin increases bleeding risk. Clients must monitor for
signs of hemorrhage and avoid medications like aspirin that further affect clotting.
8. A client is receiving magnesium sulfate for preeclampsia. The nurse notes absent
deep tendon reflexes. What is the priority nursing action? A. Increase the infusion
rate B. Administer a bolus of IV fluids C. Stop the infusion D. Document the
finding Explanation: Absent deep tendon reflexes are a sign of magnesium
toxicity. The infusion must be stopped immediately to prevent respiratory depression
or cardiac arrest.
9. A client in the emergency department reports crushing chest pain radiating to the
left arm. Which action is the priority? A. Obtain an ECG B. Administer morphine
C. Administer sublingual nitroglycerin D. Order troponin levels Explanation:
, Relieving myocardial ischemia is the priority. Nitroglycerin acts as a vasodilator to
improve oxygen supply to the heart muscle.
10. A nurse is caring for a client with hyperkalemia. Which ECG change should the nurse
monitor for? A. U waves B. Tall, peaked T waves C. ST segment depression D.
Prolonged QT interval Explanation: Elevated potassium levels disrupt cardiac
repolarization, manifesting as tall, peaked T waves on an ECG.
11. A nurse is providing care to a client with a chest tube. The nurse notes continuous
bubbling in the water seal chamber. What does this indicate? A. Normal lung
expansion B. An air leak in the system C. Obstruction of the tube D. Successful
suctioning Explanation: Continuous bubbling in the water seal chamber suggests
that air is entering the system, indicating an air leak.
12. A nurse is reviewing the plan of care for a client with anorexia nervosa. Which
intervention is most appropriate? A. Allow the client to choose meal times B. Focus
on the amount of calories consumed C. Establish a structured, consistent meal
schedule D. Discuss weight loss strategies Explanation: Structure and consistency
are vital in managing eating disorders to help the client regain a sense of control and
nutritional stability.
13. A client is diagnosed with hyperthyroidism. Which clinical manifestation should the
nurse expect? A. Weight gain B. Bradycardia C. Heat intolerance D. Constipation
Explanation: Hyperthyroidism increases the metabolic rate, leading to symptoms
like heat intolerance, tachycardia, and weight loss.
14. A nurse is caring for a client with a history of seizures. Which intervention is essential
during a tonic-clonic seizure? A. Restrain the client’s extremities B. Place a tongue
blade in the client's mouth C. Turn the client to the side D. Attempt to force the
jaws open Explanation: Placing the client on their side prevents aspiration of
secretions and maintains an open airway during the seizure.
15. A nurse is caring for a client who is post-operative following a total hip replacement.
Which instruction should be included in the discharge plan? A. Flex the hip to 90
degrees when sitting B. Adduct the legs while sleeping C. Avoid crossing the legs
D. Use a low-seated chair for easier transfer Explanation: Crossing the legs can
cause hip dislocation. Clients must adhere to hip precautions to ensure proper
healing of the prosthetic joint.
16. A nurse is assessing a client with fluid volume overload. Which finding is expected? A.
Decreased blood pressure B. Bounding peripheral pulses C. Concentrated urine
D. Dry mucous membranes Explanation: Fluid overload increases intravascular
volume, which manifests as bounding pulses and potential hypertension.
ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains
• Management of Care
• Safety and Infection Control
• Health Promotion and Maintenance
• Psychosocial Integrity
• Basic Care and Comfort
• Pharmacological and Parenteral Therapies
• Reduction of Risk Potential
• Physiological Adaptation
Introduction
This comprehensive examination is designed to assess the clinical readiness and professional
competency of nursing candidates. The purpose of this assessment is to evaluate the
integration of foundational theory, evidence-based practice, and clinical judgment required
for safe entry-level nursing practice. Candidates will be tested on their ability to synthesize
knowledge across diverse patient care scenarios, emphasizing ethical decision-making,
regulatory compliance, and real-world application. Through a series of rigorous multiple-
choice and scenario-based questions, this exam measures the critical thinking skills necessary
to provide high-quality care, manage complex patient needs, and ensure patient safety in
dynamic healthcare environments.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client with a suspected pheochromocytoma. Which
assessment finding requires immediate intervention? A. Blood pressure of 180/110
mm Hg B. Sudden onset of severe headache C. Profuse diaphoresis D. Blood
glucose of 140 mg/dL Explanation: A pheochromocytoma is a catecholamine-
secreting tumor. A sudden, severe headache is often indicative of a hypertensive
crisis, which can lead to a cerebrovascular accident.
2. A client diagnosed with schizophrenia is prescribed clozapine. Which laboratory
result must be monitored weekly? A. Hemoglobin and hematocrit B. Serum
creatinine C. Absolute neutrophil count (ANC) D. Liver enzymes Explanation:
Clozapine carries a black box warning for agranulocytosis. Monitoring the ANC is
essential to detect early signs of neutropenia.
,3. When preparing a client for a lumbar puncture, the nurse should place the client in
which position? A. Prone with a pillow under the abdomen B. Lateral recumbent
with knees drawn to the chest C. High-Fowler's position D. Supine with the head of
the bed elevated 30 degrees Explanation: The lateral recumbent position with
the neck and knees flexed opens the vertebral spaces, facilitating the insertion of the
needle.
4. A nurse is assessing a client who has experienced a stroke. The client has difficulty
swallowing. Which action should the nurse prioritize? A. Offer thin liquids to keep the
client hydrated B. Perform a bedside swallow screening C. Request a mechanical
soft diet D. Place the client in a supine position during feedings Explanation:
Safety is the priority. A formal swallow screen must be conducted before the client is
given anything by mouth to prevent aspiration.
5. A client with type 1 diabetes is found unresponsive. Which action should the nurse
take first? A. Administer subcutaneous insulin B. Check the client's urine for ketones
C. Administer intravenous dextrose D. Assess the client’s blood pressure
Explanation: An unresponsive diabetic client is likely experiencing severe
hypoglycemia. Intravenous dextrose is the fastest way to raise blood glucose levels.
6. Which assessment finding in a newborn indicates respiratory distress? A.
Acrocyanosis B. Irregular respiratory rate C. Nasal flaring D. Periodic breathing
Explanation: Nasal flaring is a classic sign of increased work of breathing and
respiratory distress in a neonate.
7. A nurse is teaching a client about warfarin therapy. Which statement by the client
indicates understanding? A. I will increase my intake of green leafy vegetables B. I will
use a stiff-bristled toothbrush to maintain oral hygiene C. I will report any
unexplained bruising or bleeding to my doctor D. I will take aspirin if I develop a
headache Explanation: Warfarin increases bleeding risk. Clients must monitor for
signs of hemorrhage and avoid medications like aspirin that further affect clotting.
8. A client is receiving magnesium sulfate for preeclampsia. The nurse notes absent
deep tendon reflexes. What is the priority nursing action? A. Increase the infusion
rate B. Administer a bolus of IV fluids C. Stop the infusion D. Document the
finding Explanation: Absent deep tendon reflexes are a sign of magnesium
toxicity. The infusion must be stopped immediately to prevent respiratory depression
or cardiac arrest.
9. A client in the emergency department reports crushing chest pain radiating to the
left arm. Which action is the priority? A. Obtain an ECG B. Administer morphine
C. Administer sublingual nitroglycerin D. Order troponin levels Explanation:
, Relieving myocardial ischemia is the priority. Nitroglycerin acts as a vasodilator to
improve oxygen supply to the heart muscle.
10. A nurse is caring for a client with hyperkalemia. Which ECG change should the nurse
monitor for? A. U waves B. Tall, peaked T waves C. ST segment depression D.
Prolonged QT interval Explanation: Elevated potassium levels disrupt cardiac
repolarization, manifesting as tall, peaked T waves on an ECG.
11. A nurse is providing care to a client with a chest tube. The nurse notes continuous
bubbling in the water seal chamber. What does this indicate? A. Normal lung
expansion B. An air leak in the system C. Obstruction of the tube D. Successful
suctioning Explanation: Continuous bubbling in the water seal chamber suggests
that air is entering the system, indicating an air leak.
12. A nurse is reviewing the plan of care for a client with anorexia nervosa. Which
intervention is most appropriate? A. Allow the client to choose meal times B. Focus
on the amount of calories consumed C. Establish a structured, consistent meal
schedule D. Discuss weight loss strategies Explanation: Structure and consistency
are vital in managing eating disorders to help the client regain a sense of control and
nutritional stability.
13. A client is diagnosed with hyperthyroidism. Which clinical manifestation should the
nurse expect? A. Weight gain B. Bradycardia C. Heat intolerance D. Constipation
Explanation: Hyperthyroidism increases the metabolic rate, leading to symptoms
like heat intolerance, tachycardia, and weight loss.
14. A nurse is caring for a client with a history of seizures. Which intervention is essential
during a tonic-clonic seizure? A. Restrain the client’s extremities B. Place a tongue
blade in the client's mouth C. Turn the client to the side D. Attempt to force the
jaws open Explanation: Placing the client on their side prevents aspiration of
secretions and maintains an open airway during the seizure.
15. A nurse is caring for a client who is post-operative following a total hip replacement.
Which instruction should be included in the discharge plan? A. Flex the hip to 90
degrees when sitting B. Adduct the legs while sleeping C. Avoid crossing the legs
D. Use a low-seated chair for easier transfer Explanation: Crossing the legs can
cause hip dislocation. Clients must adhere to hip precautions to ensure proper
healing of the prosthetic joint.
16. A nurse is assessing a client with fluid volume overload. Which finding is expected? A.
Decreased blood pressure B. Bounding peripheral pulses C. Concentrated urine
D. Dry mucous membranes Explanation: Fluid overload increases intravascular
volume, which manifests as bounding pulses and potential hypertension.
