HESI Exit Exam 2026 | Mixed Practice
Questions with Verified Answers & Detailed
Rationales | Chamberlain University | Just
Released This Year PDF | Updated This Year
HESI EXIT EXAM 2026 | MIXED PRACTICE QUESTIONS WITH VERIFIED ANSWERS
& DETAILED RATIONALES | CHAMBERLAIN UNIVERSITY
DOCUMENT OVERVIEW
• This practice exam contains comprehensive questions spanning all major nursing
topics tested on the HESI Exit Exam, with verified correct answers and detailed
evidence-based rationales to strengthen clinical reasoning and test-taking
strategies.
• Study this material by reviewing each question's rationale carefully, identifying
knowledge gaps, and focusing on high-yield topics; use this as a full-length practice
assessment to simulate actual exam conditions and build confidence before your
certification exam.
QUESTION 1
A 45-year-old client with a history of hypertension is admitted to the unit. The
nurse reviews the medication list and notes the client is taking lisinopril, a
medication that works by which mechanism of action?
A) Blocks beta-adrenergic receptors in the heart and blood vessels
B) Inhibits the conversion of angiotensin I to angiotensin II
C) Dilates coronary and peripheral blood vessels
D) Blocks calcium channels in cardiac and vascular smooth muscle
E) Reduces sympathetic nervous system activity
CORRECT ANSWER: B) Inhibits the conversion of angiotensin I to angiotensin II
,RATIONALE: Lisinopril is an ACE inhibitor that works by inhibiting the conversion of
angiotensin I to angiotensin II. This mechanism reduces vasoconstriction and
aldosterone secretion, resulting in decreased blood pressure and improved cardiac
output. Option A describes beta-blockers, Option C describes nitrates, Option D
describes calcium channel blockers, and Option E describes centrally-acting agents.
Understanding medication mechanisms is essential for safe and effective nursing
care.
QUESTION 2
A nurse is providing discharge instructions to a client taking metformin for
type 2 diabetes. Which statement by the client indicates a need for further
teaching?
A) "I will take my metformin with food to reduce stomach upset"
B) "I should avoid alcohol because it increases my risk of lactic acidosis"
C) "I will stop taking metformin right away if I develop persistent vomiting"
D) "I can take metformin even if I have kidney disease as long as I monitor closely"
E) "I need to have my kidney function monitored regularly while taking this
medication"
CORRECT ANSWER: D) "I can take metformin even if I have kidney disease as
long as I monitor closely"
RATIONALE: Metformin is contraindicated or requires dose adjustment in clients
with renal impairment because the drug accumulates and increases the risk of
lactic acidosis. Clients with an eGFR below 45 mL/min/1.73m² should not take
metformin. Option A is correct because food reduces GI upset. Option B is correct;
alcohol increases lactic acidosis risk. Option C is correct; gastrointestinal symptoms
may indicate lactic acidosis. Option E is correct; regular kidney function monitoring
is essential. This question tests the nurse's knowledge of drug contraindications
and safety.
,QUESTION 3
A 72-year-old client admitted with acute myocardial infarction is experiencing
chest pain and dyspnea. The nurse assesses lung sounds and hears fine
crackles bilaterally. Which complication should the nurse suspect?
A) Hypovolemic shock
B) Acute pulmonary edema secondary to left ventricular failure
C) Tension pneumothorax
D) Acute respiratory distress syndrome
E) Pulmonary embolism
CORRECT ANSWER: B) Acute pulmonary edema secondary to left ventricular
failure
RATIONALE: In acute MI, damage to the left ventricle reduces its contractility,
causing blood to back up into the pulmonary circulation. This increased hydrostatic
pressure forces fluid into the alveoli, producing fine crackles (pulmonary edema).
The clinical presentation of dyspnea, crackles, and acute MI strongly suggests this
complication. Option A presents with tachycardia and hypotension without lung
sounds. Option C presents with severe distress and tracheal deviation. Option D is
associated with aspiration or sepsis. Option E may present without crackles.
Understanding cardiac complications is critical for ICU nursing.
QUESTION 4
A client with severe burns covering 40% of body surface area (TBSA) is
admitted to the burn unit. According to the Parkland Formula, which
calculation should the nurse use to determine the first 24-hour fluid
requirement?
A) 1 mL × kg × %TBSA
B) 2 mL × kg × %TBSA
C) 4 mL × kg × %TBSA
, D) 500 mL + (kg × %TBSA)
E) 250 mL × %TBSA
CORRECT ANSWER: C) 4 mL × kg × %TBSA
RATIONALE: The Parkland Formula is 4 mL × kg body weight × %TBSA burned,
calculated using Lactated Ringer's solution. Half of the total volume is administered
in the first 8 hours, and the remaining half over the next 16 hours. This calculation
ensures adequate fluid resuscitation to maintain perfusion and prevent burn shock.
Options A and B represent other fluid formulas that are incorrect. Options D and E
do not follow the Parkland calculation. Accurate fluid resuscitation is critical to
prevent organ dysfunction and death in severely burned clients.
QUESTION 5
A nurse is assessing a client who is 8 months pregnant. The client reports
sudden onset of severe headache, visual disturbances, and right upper
quadrant pain. Blood pressure is 165/110 mmHg. Which complication should
the nurse suspect?
A) Gestational diabetes
B) Preeclampsia with severe features
C) Placental abruption
D) Preterm labor
E) Hyperemesis gravidarum
CORRECT ANSWER: B) Preeclampsia with severe features
RATIONALE: The client presents with classic signs of severe preeclampsia:
hypertension (>160/110), severe headache, visual disturbances (scotoma), and right
upper quadrant pain (indicating hepatic involvement). These are signs of end-organ
dysfunction indicating severe preeclampsia. Option A presents with elevated
glucose levels, not these symptoms. Option C presents with vaginal bleeding and
abdominal pain. Option D presents with uterine contractions. Option E involves
Questions with Verified Answers & Detailed
Rationales | Chamberlain University | Just
Released This Year PDF | Updated This Year
HESI EXIT EXAM 2026 | MIXED PRACTICE QUESTIONS WITH VERIFIED ANSWERS
& DETAILED RATIONALES | CHAMBERLAIN UNIVERSITY
DOCUMENT OVERVIEW
• This practice exam contains comprehensive questions spanning all major nursing
topics tested on the HESI Exit Exam, with verified correct answers and detailed
evidence-based rationales to strengthen clinical reasoning and test-taking
strategies.
• Study this material by reviewing each question's rationale carefully, identifying
knowledge gaps, and focusing on high-yield topics; use this as a full-length practice
assessment to simulate actual exam conditions and build confidence before your
certification exam.
QUESTION 1
A 45-year-old client with a history of hypertension is admitted to the unit. The
nurse reviews the medication list and notes the client is taking lisinopril, a
medication that works by which mechanism of action?
A) Blocks beta-adrenergic receptors in the heart and blood vessels
B) Inhibits the conversion of angiotensin I to angiotensin II
C) Dilates coronary and peripheral blood vessels
D) Blocks calcium channels in cardiac and vascular smooth muscle
E) Reduces sympathetic nervous system activity
CORRECT ANSWER: B) Inhibits the conversion of angiotensin I to angiotensin II
,RATIONALE: Lisinopril is an ACE inhibitor that works by inhibiting the conversion of
angiotensin I to angiotensin II. This mechanism reduces vasoconstriction and
aldosterone secretion, resulting in decreased blood pressure and improved cardiac
output. Option A describes beta-blockers, Option C describes nitrates, Option D
describes calcium channel blockers, and Option E describes centrally-acting agents.
Understanding medication mechanisms is essential for safe and effective nursing
care.
QUESTION 2
A nurse is providing discharge instructions to a client taking metformin for
type 2 diabetes. Which statement by the client indicates a need for further
teaching?
A) "I will take my metformin with food to reduce stomach upset"
B) "I should avoid alcohol because it increases my risk of lactic acidosis"
C) "I will stop taking metformin right away if I develop persistent vomiting"
D) "I can take metformin even if I have kidney disease as long as I monitor closely"
E) "I need to have my kidney function monitored regularly while taking this
medication"
CORRECT ANSWER: D) "I can take metformin even if I have kidney disease as
long as I monitor closely"
RATIONALE: Metformin is contraindicated or requires dose adjustment in clients
with renal impairment because the drug accumulates and increases the risk of
lactic acidosis. Clients with an eGFR below 45 mL/min/1.73m² should not take
metformin. Option A is correct because food reduces GI upset. Option B is correct;
alcohol increases lactic acidosis risk. Option C is correct; gastrointestinal symptoms
may indicate lactic acidosis. Option E is correct; regular kidney function monitoring
is essential. This question tests the nurse's knowledge of drug contraindications
and safety.
,QUESTION 3
A 72-year-old client admitted with acute myocardial infarction is experiencing
chest pain and dyspnea. The nurse assesses lung sounds and hears fine
crackles bilaterally. Which complication should the nurse suspect?
A) Hypovolemic shock
B) Acute pulmonary edema secondary to left ventricular failure
C) Tension pneumothorax
D) Acute respiratory distress syndrome
E) Pulmonary embolism
CORRECT ANSWER: B) Acute pulmonary edema secondary to left ventricular
failure
RATIONALE: In acute MI, damage to the left ventricle reduces its contractility,
causing blood to back up into the pulmonary circulation. This increased hydrostatic
pressure forces fluid into the alveoli, producing fine crackles (pulmonary edema).
The clinical presentation of dyspnea, crackles, and acute MI strongly suggests this
complication. Option A presents with tachycardia and hypotension without lung
sounds. Option C presents with severe distress and tracheal deviation. Option D is
associated with aspiration or sepsis. Option E may present without crackles.
Understanding cardiac complications is critical for ICU nursing.
QUESTION 4
A client with severe burns covering 40% of body surface area (TBSA) is
admitted to the burn unit. According to the Parkland Formula, which
calculation should the nurse use to determine the first 24-hour fluid
requirement?
A) 1 mL × kg × %TBSA
B) 2 mL × kg × %TBSA
C) 4 mL × kg × %TBSA
, D) 500 mL + (kg × %TBSA)
E) 250 mL × %TBSA
CORRECT ANSWER: C) 4 mL × kg × %TBSA
RATIONALE: The Parkland Formula is 4 mL × kg body weight × %TBSA burned,
calculated using Lactated Ringer's solution. Half of the total volume is administered
in the first 8 hours, and the remaining half over the next 16 hours. This calculation
ensures adequate fluid resuscitation to maintain perfusion and prevent burn shock.
Options A and B represent other fluid formulas that are incorrect. Options D and E
do not follow the Parkland calculation. Accurate fluid resuscitation is critical to
prevent organ dysfunction and death in severely burned clients.
QUESTION 5
A nurse is assessing a client who is 8 months pregnant. The client reports
sudden onset of severe headache, visual disturbances, and right upper
quadrant pain. Blood pressure is 165/110 mmHg. Which complication should
the nurse suspect?
A) Gestational diabetes
B) Preeclampsia with severe features
C) Placental abruption
D) Preterm labor
E) Hyperemesis gravidarum
CORRECT ANSWER: B) Preeclampsia with severe features
RATIONALE: The client presents with classic signs of severe preeclampsia:
hypertension (>160/110), severe headache, visual disturbances (scotoma), and right
upper quadrant pain (indicating hepatic involvement). These are signs of end-organ
dysfunction indicating severe preeclampsia. Option A presents with elevated
glucose levels, not these symptoms. Option C presents with vaginal bleeding and
abdominal pain. Option D presents with uterine contractions. Option E involves
