HESI RN Exit Exam Versions 1 - 7 Multiple Choice Questions &
Answers (Verified Answers), 100% Guaranteed Pass ||Complete
A+ Guide - PDF with rationale EXAM with Questions and
Answers/Plus a Rationale Updated 2026 A+/Instant Download
PDF
EXAM COVERAGE
1. Medical-Surgical Nursing: Management of Acute and Chronic Multisystem Alterations
2. Pharmacology and Parenteral Therapies: Pharmacokinetics, Drug Interactions, and Safe
Administration
3. Maternal-Newborn and Women's Health Nursing: Antepartum, Intrapartum, Postpartum, and
Neonatal Care
4. Pediatric Nursing: Growth and Development, Congenital Disorders, and Childhood Illnesses
5. Mental Health and Psychiatric Nursing: Therapeutic Communication, Psychopathology, and
Crisis Intervention
6. Community Health and Leadership: Triage, Disaster Management, Prioritization, and Delegation
7. Critical Care and Emergency Nursing: Hemodynamic Monitoring, Shock States, and Advanced
Life Support
1. A nurse is caring for a client admitted with acute pancreatitis who reports severe, boring
epigastric pain radiating to the back. Which nursing intervention is the highest priority in the
initial plan of care?
A. Administering oral pancreatic enzyme replacements with meals
B. Maintaining strict NPO status and initiating aggressive intravenous fluid resuscitation
C. Encouraging high-protein, low-fat nutritional snacks
D. Positioning the client flat in a supine position to reduce abdominal pressure
, CORRECT ANSWER : B
Rationale: Resting the pancreas by keeping the client NPO and restoring intravascular volume
with aggressive IV fluids is vital to prevent systemic hypoperfusion and pancreatic necrosis. Oral
enzymes are used for chronic, not acute, pancreatitis, high-protein diets stimulate pancreatic
secretions, and a supine position typically exacerbates pain.
2. A client receiving a blood transfusion of packed red blood cells (PRBCs) suddenly develops
fever, chills, low back pain, and anxiety 15 minutes after initiation. What is the immediate action
the nurse must take?
A. Slow the infusion rate to half and reassess vital signs in 15 minutes
B. Stop the transfusion immediately and infuse normal saline through a separate new
tubing line
C. Administer prescribed prophylactic acetaminophen and diphenhydramine
D. Document the reaction and notify the healthcare provider at the end of the shift
CORRECT ANSWER : B
Rationale: These symptoms indicate an acute hemolytic transfusion reaction, which is a medical
emergency requiring immediate cessation of the transfusion and replacement with normal saline
through new tubing to maintain vascular access while preserving uninfused blood for lab
analysis.
3. A nurse receives a shift report on four clients on a medical-surgical unit. Which client should the
nurse assess first?
A. A client with type 1 diabetes mellitus reporting mild tremors and hunger with a blood glucose
of 68 mg/dL
B. A client with heart failure who received intravenous furosemide 1 hour ago and reports
sudden shortness of breath and pink, frothy sputum
C. A client with chronic obstructive pulmonary disease (COPD) whose pulse oximetry reading is
89% on room air
D. A client scheduled for a laparoscopic cholecystectomy later this morning who is asking about
preoperative instructions
CORRECT ANSWER : B
Rationale: Pink, frothy sputum combined with sudden dyspnea following diuretic administration
indicates acute pulmonary edema, a life-threatening complication requiring immediate
, emergency intervention. The client with hypoglycemia needs attention, but pulmonary edema
presents an immediate airway and breathing threat.
4. A nurse is evaluating a client who is 24 hours post-thyroidectomy. Which assessment finding
requires immediate nursing notification and intervention?
A. Mild sore throat and hoarseness when speaking
B. Involuntary muscle twitching of the hands and positive Trousseau's sign
C. Serosanguineous drainage on the surgical dressing measuring 2 cm
D. Pain score of 4 out of 10 at the surgical incision site
CORRECT ANSWER : B
Rationale: Involuntary muscle twitching and a positive Trousseau's sign indicate hypocalcemia
resulting from accidental trauma or removal of the parathyroid glands during thyroid surgery,
which can lead to tetany and airway compromise. Mild hoarseness, minor drainage, and
moderate pain are expected early postoperative findings.
5. A client with a newly placed tracheostomy is coughing violently, and the nurse notes accidental
decannulation of the tracheostomy tube. What is the nurse's immediate action?
A. Call the rapid response team and wait at the bedside
B. Insert a sterile obturator into the tracheostomy tube and reinsert the tube into the stoma
C. Apply a non-rebreather mask over the open stoma and provide manual breaths
D. Suction the open stoma deeply to clear any remaining mucus plugs
CORRECT ANSWER : B
Rationale: During accidental decannulation within the first 72 hours post-placement, the nurse
must quickly reinsert the tracheostomy tube using an obturator to guide placement, or use a
spare tracheostomy tube of the same or smaller size to secure the airway. Waiting for a team or
covering the stoma without attempting replacement risks asphyxiation.
6. A client with paranoid schizophrenia is admitted to the psychiatric unit and refuses to eat, stating
that the hospital food is poisoned by the government. Which approach should the nurse
implement?
A. Taste the food in front of the client to prove it is safe
B. Provide commercially sealed foods and pre-packaged beverages
, C. Insist that the client eat the meal to maintain proper metabolic nutrition
D. Explain to the client logically that the government has no interest in their food
CORRECT ANSWER : B
Rationale: Offering unopened, commercially sealed foods minimizes the client's paranoia and
anxiety regarding contamination without validating the delusion or engaging in power struggles.
Tasting food or arguing logic is ineffective and counterproductive.
7. A nurse is caring for a client in active labor who is receiving an intravenous infusion of oxytocin.
The external fetal monitor reveals late decelerations with minimal variability. What is the
priority nursing action?
A. Increase the oxytocin infusion rate to expedite delivery
B. Position the client on her left side and administer oxygen via non-rebreather mask at 10
L/min
C. Prepare the client for an immediate spontaneous vaginal delivery
D. Encourage the client to push vigorously with each uterine contraction
CORRECT ANSWER : B
Rationale: Late decelerations indicate uteroplacental insufficiency and fetal hypoxia. Turning
the client to the left side relieves aortocaval compression, oxygen improves maternal and fetal
saturation, and stopping or reducing oxytocin is necessary to decrease uterine activity.
8. A client with chronic kidney disease (CKD) has a serum potassium level of 6.2 mEq/L and
peaked T-waves on the electrocardiogram. Which medication should the nurse anticipate
administering first?
A. Sodium polystyrene sulfonate orally
B. Regular insulin and 50% dextrose intravenously
C. Oral calcium carbonate with meals
D. Subcutaneous erythropoietin injection
CORRECT ANSWER : B
Rationale: Severe hyperkalemia with ECG changes requires immediate emergency intervention
to shift potassium intracellularly; regular insulin paired with IV glucose prevents hypoglycemia
Answers (Verified Answers), 100% Guaranteed Pass ||Complete
A+ Guide - PDF with rationale EXAM with Questions and
Answers/Plus a Rationale Updated 2026 A+/Instant Download
EXAM COVERAGE
1. Medical-Surgical Nursing: Management of Acute and Chronic Multisystem Alterations
2. Pharmacology and Parenteral Therapies: Pharmacokinetics, Drug Interactions, and Safe
Administration
3. Maternal-Newborn and Women's Health Nursing: Antepartum, Intrapartum, Postpartum, and
Neonatal Care
4. Pediatric Nursing: Growth and Development, Congenital Disorders, and Childhood Illnesses
5. Mental Health and Psychiatric Nursing: Therapeutic Communication, Psychopathology, and
Crisis Intervention
6. Community Health and Leadership: Triage, Disaster Management, Prioritization, and Delegation
7. Critical Care and Emergency Nursing: Hemodynamic Monitoring, Shock States, and Advanced
Life Support
1. A nurse is caring for a client admitted with acute pancreatitis who reports severe, boring
epigastric pain radiating to the back. Which nursing intervention is the highest priority in the
initial plan of care?
A. Administering oral pancreatic enzyme replacements with meals
B. Maintaining strict NPO status and initiating aggressive intravenous fluid resuscitation
C. Encouraging high-protein, low-fat nutritional snacks
D. Positioning the client flat in a supine position to reduce abdominal pressure
, CORRECT ANSWER : B
Rationale: Resting the pancreas by keeping the client NPO and restoring intravascular volume
with aggressive IV fluids is vital to prevent systemic hypoperfusion and pancreatic necrosis. Oral
enzymes are used for chronic, not acute, pancreatitis, high-protein diets stimulate pancreatic
secretions, and a supine position typically exacerbates pain.
2. A client receiving a blood transfusion of packed red blood cells (PRBCs) suddenly develops
fever, chills, low back pain, and anxiety 15 minutes after initiation. What is the immediate action
the nurse must take?
A. Slow the infusion rate to half and reassess vital signs in 15 minutes
B. Stop the transfusion immediately and infuse normal saline through a separate new
tubing line
C. Administer prescribed prophylactic acetaminophen and diphenhydramine
D. Document the reaction and notify the healthcare provider at the end of the shift
CORRECT ANSWER : B
Rationale: These symptoms indicate an acute hemolytic transfusion reaction, which is a medical
emergency requiring immediate cessation of the transfusion and replacement with normal saline
through new tubing to maintain vascular access while preserving uninfused blood for lab
analysis.
3. A nurse receives a shift report on four clients on a medical-surgical unit. Which client should the
nurse assess first?
A. A client with type 1 diabetes mellitus reporting mild tremors and hunger with a blood glucose
of 68 mg/dL
B. A client with heart failure who received intravenous furosemide 1 hour ago and reports
sudden shortness of breath and pink, frothy sputum
C. A client with chronic obstructive pulmonary disease (COPD) whose pulse oximetry reading is
89% on room air
D. A client scheduled for a laparoscopic cholecystectomy later this morning who is asking about
preoperative instructions
CORRECT ANSWER : B
Rationale: Pink, frothy sputum combined with sudden dyspnea following diuretic administration
indicates acute pulmonary edema, a life-threatening complication requiring immediate
, emergency intervention. The client with hypoglycemia needs attention, but pulmonary edema
presents an immediate airway and breathing threat.
4. A nurse is evaluating a client who is 24 hours post-thyroidectomy. Which assessment finding
requires immediate nursing notification and intervention?
A. Mild sore throat and hoarseness when speaking
B. Involuntary muscle twitching of the hands and positive Trousseau's sign
C. Serosanguineous drainage on the surgical dressing measuring 2 cm
D. Pain score of 4 out of 10 at the surgical incision site
CORRECT ANSWER : B
Rationale: Involuntary muscle twitching and a positive Trousseau's sign indicate hypocalcemia
resulting from accidental trauma or removal of the parathyroid glands during thyroid surgery,
which can lead to tetany and airway compromise. Mild hoarseness, minor drainage, and
moderate pain are expected early postoperative findings.
5. A client with a newly placed tracheostomy is coughing violently, and the nurse notes accidental
decannulation of the tracheostomy tube. What is the nurse's immediate action?
A. Call the rapid response team and wait at the bedside
B. Insert a sterile obturator into the tracheostomy tube and reinsert the tube into the stoma
C. Apply a non-rebreather mask over the open stoma and provide manual breaths
D. Suction the open stoma deeply to clear any remaining mucus plugs
CORRECT ANSWER : B
Rationale: During accidental decannulation within the first 72 hours post-placement, the nurse
must quickly reinsert the tracheostomy tube using an obturator to guide placement, or use a
spare tracheostomy tube of the same or smaller size to secure the airway. Waiting for a team or
covering the stoma without attempting replacement risks asphyxiation.
6. A client with paranoid schizophrenia is admitted to the psychiatric unit and refuses to eat, stating
that the hospital food is poisoned by the government. Which approach should the nurse
implement?
A. Taste the food in front of the client to prove it is safe
B. Provide commercially sealed foods and pre-packaged beverages
, C. Insist that the client eat the meal to maintain proper metabolic nutrition
D. Explain to the client logically that the government has no interest in their food
CORRECT ANSWER : B
Rationale: Offering unopened, commercially sealed foods minimizes the client's paranoia and
anxiety regarding contamination without validating the delusion or engaging in power struggles.
Tasting food or arguing logic is ineffective and counterproductive.
7. A nurse is caring for a client in active labor who is receiving an intravenous infusion of oxytocin.
The external fetal monitor reveals late decelerations with minimal variability. What is the
priority nursing action?
A. Increase the oxytocin infusion rate to expedite delivery
B. Position the client on her left side and administer oxygen via non-rebreather mask at 10
L/min
C. Prepare the client for an immediate spontaneous vaginal delivery
D. Encourage the client to push vigorously with each uterine contraction
CORRECT ANSWER : B
Rationale: Late decelerations indicate uteroplacental insufficiency and fetal hypoxia. Turning
the client to the left side relieves aortocaval compression, oxygen improves maternal and fetal
saturation, and stopping or reducing oxytocin is necessary to decrease uterine activity.
8. A client with chronic kidney disease (CKD) has a serum potassium level of 6.2 mEq/L and
peaked T-waves on the electrocardiogram. Which medication should the nurse anticipate
administering first?
A. Sodium polystyrene sulfonate orally
B. Regular insulin and 50% dextrose intravenously
C. Oral calcium carbonate with meals
D. Subcutaneous erythropoietin injection
CORRECT ANSWER : B
Rationale: Severe hyperkalemia with ECG changes requires immediate emergency intervention
to shift potassium intracellularly; regular insulin paired with IV glucose prevents hypoglycemia
