2025-2026 HESI RN EXIT EXAM VERSIONS
1-7 FULL TEST BANK WITH VERIFIED
MULTIPLE CHOICE QUESTIONS,
ANSWERS & NGN RATIONALES
(COMPLETE PASS GUIDE PDF)
This comprehensive study guide features the
complete 2025/2026 HESI RN Exit Exam Versions 1–
7, offering real multiple-choice questions with
verified correct answers and high-yield rationales.
Optimized for the Next Generation NCLEX (NGN)
format, it delivers targeted preparation across
pharmacology, prioritization, med-surg, and
maternal-child health to guarantee a passing score.
It serves as an essential, premium resource for
nursing students looking to ace their final diagnostic
benchmarks and secure their professional licensure.
Question 1
The nurse on a medical-surgical unit receives a change-of-shift report
for four clients. Which client should the nurse assess first?
,A) A client with chronic obstructive pulmonary disease (COPD) whose
oxygen saturation is 89% on 2 L/min nasal cannula.
B) A client who had an abdominal cholecystectomy 12 hours ago and
reports severe pain rated 8/10 at the incision site.
C) A client with deep vein thrombosis (DVT) who reports sudden chest
pain and shortness of breath.
D) A client admitted with gastroenteritis who has a serum potassium
level of 3.6 mEq/L.
Answer: C
Rationale: A sudden onset of chest pain and dyspnea in a client with a
known DVT is highly indicative of a pulmonary embolism (PE), which is
a life-threatening emergency requiring immediate intervention
(Airway-Breathing-Circulation priority). Option A represents an
expected finding for a client with stable COPD. Option B represents
expected postoperative pain that requires an analgesic, but it is not
immediately life-threatening. Option C is a low-normal potassium
level that requires monitoring but not immediate emergency rescue.
Question 2
The nurse is preparing to administer a scheduled dose of digoxin 0.25
mg PO to an adult client with heart failure. The client’s apical pulse is 52
beats/minute. Which action should the nurse take first?
A) Administer the medication and document the pulse rate.
B) Hold the medication and notify the healthcare provider.
C) Administer half the dose and reassess the heart rate in 1 hour.
D) Calculate the client's pulse deficit before administering the dose.
,Answer: B
Rationale: Digoxin is a cardiac glycoside that exerts a negative
chronotropic effect, slowing the heart rate. For adult clients, the
standard nursing parameter is to hold the medication and notify the
provider if the apical pulse is less than 60 beats/minute to avoid
severe bradycardia and digoxin toxicity. Options A, C, and D are
unsafe nursing practices.
Question 3
A client is admitted to the emergency department with a severe asthma
exacerbation. The nurse notes audible wheezing, tachypnea, and a peak
expiratory flow rate (PEFR) in the red zone. Which medication should
the nurse prepare to administer immediately?
A) Fluticasone propionate via metered-dose inhaler
B) Salmeterol xinafoate via dry-powder inhaler
C) Albuterol sulfate via nebulizer
D) Montelukast sodium orally
Answer: C
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that acts
as a rapid rescue bronchodilator to relieve acute bronchospasm.
Fluticasone is an inhaled corticosteroid used for long-term
maintenance, not acute attacks. Salmeterol is a long-acting beta-2
agonist (LABA) and has a delayed onset, making it inappropriate for
emergency rescue. Montelukast is an oral leukotriene modifier used
for maintenance therapy.
, Question 4
The nurse is caring for an infant diagnosed with Tetralogy of Fallot who
suddenly becomes cyanotic, dyspneic, and agitated during a blood
draw. Which immediate action should the nurse implement?
A) Place the infant in a knee-chest position.
B) Administer a high-flow oxygen blow-by mask.
C) Prepare for urgent endotracheal intubation.
D) Administer a bolus of intravenous normal saline.
Answer: A
Rationale: The infant is experiencing a hypercyanotic spell, commonly
known as a "tet spell." Placing the infant in a knee-chest position
increases systemic vascular resistance, which decreases the right-to-
left cardiac shunt and improves pulmonary blood flow. Oxygen and
intravenous fluids may be utilized afterward, but physical positioning
is the immediate first-line nursing intervention to resolve the severe
hypoxia. Intubation is a last resort.
Question 5
A client with type 1 diabetes mellitus is found unresponsive in bed. The
nurse performs a rapid capillary blood glucose test, and the glucometer
reads "Low" (less than 20 mg/dL). The client does not have intravenous
access. Which action should the nurse take immediately?
A) Administer 15 grams of simple carbohydrates orally.
B) Administer 1 mg of glucagon subcutaneously or intramuscularly.
C) Establish a peripheral intravenous line to infuse 50% dextrose.
D) Administer 10 units of regular insulin subcutaneously.
1-7 FULL TEST BANK WITH VERIFIED
MULTIPLE CHOICE QUESTIONS,
ANSWERS & NGN RATIONALES
(COMPLETE PASS GUIDE PDF)
This comprehensive study guide features the
complete 2025/2026 HESI RN Exit Exam Versions 1–
7, offering real multiple-choice questions with
verified correct answers and high-yield rationales.
Optimized for the Next Generation NCLEX (NGN)
format, it delivers targeted preparation across
pharmacology, prioritization, med-surg, and
maternal-child health to guarantee a passing score.
It serves as an essential, premium resource for
nursing students looking to ace their final diagnostic
benchmarks and secure their professional licensure.
Question 1
The nurse on a medical-surgical unit receives a change-of-shift report
for four clients. Which client should the nurse assess first?
,A) A client with chronic obstructive pulmonary disease (COPD) whose
oxygen saturation is 89% on 2 L/min nasal cannula.
B) A client who had an abdominal cholecystectomy 12 hours ago and
reports severe pain rated 8/10 at the incision site.
C) A client with deep vein thrombosis (DVT) who reports sudden chest
pain and shortness of breath.
D) A client admitted with gastroenteritis who has a serum potassium
level of 3.6 mEq/L.
Answer: C
Rationale: A sudden onset of chest pain and dyspnea in a client with a
known DVT is highly indicative of a pulmonary embolism (PE), which is
a life-threatening emergency requiring immediate intervention
(Airway-Breathing-Circulation priority). Option A represents an
expected finding for a client with stable COPD. Option B represents
expected postoperative pain that requires an analgesic, but it is not
immediately life-threatening. Option C is a low-normal potassium
level that requires monitoring but not immediate emergency rescue.
Question 2
The nurse is preparing to administer a scheduled dose of digoxin 0.25
mg PO to an adult client with heart failure. The client’s apical pulse is 52
beats/minute. Which action should the nurse take first?
A) Administer the medication and document the pulse rate.
B) Hold the medication and notify the healthcare provider.
C) Administer half the dose and reassess the heart rate in 1 hour.
D) Calculate the client's pulse deficit before administering the dose.
,Answer: B
Rationale: Digoxin is a cardiac glycoside that exerts a negative
chronotropic effect, slowing the heart rate. For adult clients, the
standard nursing parameter is to hold the medication and notify the
provider if the apical pulse is less than 60 beats/minute to avoid
severe bradycardia and digoxin toxicity. Options A, C, and D are
unsafe nursing practices.
Question 3
A client is admitted to the emergency department with a severe asthma
exacerbation. The nurse notes audible wheezing, tachypnea, and a peak
expiratory flow rate (PEFR) in the red zone. Which medication should
the nurse prepare to administer immediately?
A) Fluticasone propionate via metered-dose inhaler
B) Salmeterol xinafoate via dry-powder inhaler
C) Albuterol sulfate via nebulizer
D) Montelukast sodium orally
Answer: C
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that acts
as a rapid rescue bronchodilator to relieve acute bronchospasm.
Fluticasone is an inhaled corticosteroid used for long-term
maintenance, not acute attacks. Salmeterol is a long-acting beta-2
agonist (LABA) and has a delayed onset, making it inappropriate for
emergency rescue. Montelukast is an oral leukotriene modifier used
for maintenance therapy.
, Question 4
The nurse is caring for an infant diagnosed with Tetralogy of Fallot who
suddenly becomes cyanotic, dyspneic, and agitated during a blood
draw. Which immediate action should the nurse implement?
A) Place the infant in a knee-chest position.
B) Administer a high-flow oxygen blow-by mask.
C) Prepare for urgent endotracheal intubation.
D) Administer a bolus of intravenous normal saline.
Answer: A
Rationale: The infant is experiencing a hypercyanotic spell, commonly
known as a "tet spell." Placing the infant in a knee-chest position
increases systemic vascular resistance, which decreases the right-to-
left cardiac shunt and improves pulmonary blood flow. Oxygen and
intravenous fluids may be utilized afterward, but physical positioning
is the immediate first-line nursing intervention to resolve the severe
hypoxia. Intubation is a last resort.
Question 5
A client with type 1 diabetes mellitus is found unresponsive in bed. The
nurse performs a rapid capillary blood glucose test, and the glucometer
reads "Low" (less than 20 mg/dL). The client does not have intravenous
access. Which action should the nurse take immediately?
A) Administer 15 grams of simple carbohydrates orally.
B) Administer 1 mg of glucagon subcutaneously or intramuscularly.
C) Establish a peripheral intravenous line to infuse 50% dextrose.
D) Administer 10 units of regular insulin subcutaneously.
