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HESI RN EXIT EXAM (V7) - ACTUAL EXAM 2026/2027 |
NGN-STYLE | EXPERT VERIFIED | 160 VERIFIED Q&A |
DETAILED RATIONALES | PASS GUARANTEED - A+
GRADED
QUESTION 1
A client at 38 weeks gestation is admitted with preeclampsia. Which finding should the RN report
immediately?
A. Blood pressure of 160/110 mmHg
B. Mild ankle edema
C. Urine protein of 1+
D. Headache that resolves with rest
Rationale: A blood pressure of 160/110 mmHg indicates severe preeclampsia and requires immediate
intervention. Mild ankle edema, urine protein of 1+, and headache that resolves with rest are expected
findings in preeclampsia but do not require immediate intervention.
QUESTION 2
The RN is caring for a postpartum client who is Rh-negative and has given birth to an Rh-positive infant.
Which medication should the RN expect to administer?
A. Rh₀(D) immune globulin (RhoGAM)
B. Methylergonovine (Methergine)
C. Hepatitis B vaccine
D. Vitamin K
Rationale: RhoGAM is administered to Rh-negative mothers after delivery of an Rh-positive infant to prevent
maternal sensitization and hemolytic disease of the newborn in future pregnancies. It should be given within
72 hours of delivery.
QUESTION 3
A newborn is diagnosed with phenylketonuria (PKU). Which dietary instruction should the RN reinforce?
A. The infant should be placed on a low-phenylalanine formula
B. The infant should receive breast milk only
C. The infant should receive a soy-based formula
D. The infant should receive a standard cow's milk formula
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Rationale: PKU is a metabolic disorder that requires a low-phenylalanine diet. Infants with PKU should be
placed on a special low-phenylalanine formula. Breast milk and standard formulas contain phenylalanine and
are not appropriate.
QUESTION 4
The RN is caring for a newborn with hyperbilirubinemia. Which intervention is most important?
A. Phototherapy
B. Exchange transfusion
C. Administration of phenobarbital
D. Increased oral feedings
Rationale: Phototherapy is the first-line treatment for hyperbilirubinemia in newborns. Exchange transfusion
is reserved for severe cases. Phenobarbital may be used for conjugation defects, and increased oral feedings
help promote excretion but are not the primary treatment.
QUESTION 5
A mother reports that her 6-month-old infant has been irritable, has a fever, and is pulling at the ears. Which
assessment finding is most consistent with otitis media?
A. Bulging, red tympanic membrane
B. Clear, non-bulging tympanic membrane
C. Excessive cerumen in the ear canal
D. Normal tympanic membrane
Rationale: Otitis media is characterized by a bulging, red tympanic membrane. A clear, non-bulging tympanic
membrane and excessive cerumen are not consistent with otitis media. The infant's symptoms of irritability,
fever, and ear pulling are consistent with otitis media.
QUESTION 6
A client at 36 weeks gestation is admitted with a diagnosis of placenta previa. Which assessment finding
requires immediate intervention?
A. Painless bright red vaginal bleeding
B. Mild uterine contractions
C. Fetal heart rate of 150 bpm
D. Maternal blood pressure of 130/80 mmHg
Rationale: Painless bright red vaginal bleeding is a classic sign of placenta previa and requires immediate
intervention. Mild uterine contractions, fetal heart rate of 150 bpm, and maternal blood pressure of 130/80
mmHg are expected findings.
,3
QUESTION 7
The RN is caring for a newborn with a cleft lip and palate. Which feeding intervention should the RN
implement?
A. Use a special feeder with a soft nipple
B. Feed the infant in a supine position
C. Use a standard bottle and nipple
D. Feed the infant with a spoon
Rationale: Infants with a cleft lip and palate may have difficulty feeding due to the inability to create a seal. A
special feeder with a soft nipple can help. The infant should be fed in an upright position to prevent aspiration.
QUESTION 8
A client at 39 weeks gestation is in active labor. Which finding indicates that the client is ready to push?
A. Complete cervical dilation (10 cm)
B. Cervical dilation of 8 cm
C. Cervical effacement of 90%
D. Contractions every 5 minutes
Rationale: The client is ready to push when the cervix is completely dilated (10 cm). Cervical dilation of 8 cm
is still in the transition phase, and the client should not push until complete dilation is achieved.
QUESTION 9
The RN is caring for a newborn with neonatal abstinence syndrome (NAS). Which finding is most consistent
with NAS?
A. Irritability and high-pitched cry
B. Sleepiness and lethargy
C. Decreased muscle tone
D. Hypothermia
Rationale: Neonatal abstinence syndrome (NAS) is characterized by irritability, high-pitched cry, tremors,
and feeding difficulties. Sleepiness, decreased muscle tone, and hypothermia are not typical findings and may
indicate other conditions.
QUESTION 10
A client at 34 weeks gestation is admitted with preterm premature rupture of membranes (PPROM). Which
finding requires immediate intervention?
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A. Foul-smelling vaginal discharge
B. Clear vaginal discharge
C. Mild uterine contractions
D. Fetal heart rate of 140 bpm
Rationale: Foul-smelling vaginal discharge indicates infection (chorioamnionitis) and requires immediate
intervention. Clear vaginal discharge, mild uterine contractions, and a fetal heart rate of 140 bpm are expected
findings in PPROM.
QUESTION 11
The RN is caring for a newborn with meconium aspiration syndrome. Which intervention is most important?
A. Suctioning the airway
B. Administering antibiotics
C. Providing oxygen therapy
D. Monitoring blood glucose levels
Rationale: Suctioning the airway is the most important intervention for meconium aspiration syndrome to
clear the airway and prevent respiratory distress. Antibiotics, oxygen therapy, and glucose monitoring are also
important but suctioning is the priority.
QUESTION 12
A client at 40 weeks gestation is in the second stage of labor. Which finding indicates that the client is
experiencing a complication?
A. Fetal heart rate of 100 bpm
B. Maternal heart rate of 100 bpm
C. Contractions every 2 minutes
D. Strong urge to push
Rationale: A fetal heart rate of 100 bpm is bradycardic and may indicate fetal distress. Maternal heart rate of
100 bpm, contractions every 2 minutes, and a strong urge to push are expected findings in the second stage of
labor.
QUESTION 13
The RN is caring for a postpartum client who is experiencing uterine atony. Which medication should the RN
expect to administer?
A. Oxytocin (Pitocin)
B. Magnesium sulfate
HESI RN EXIT EXAM (V7) - ACTUAL EXAM 2026/2027 |
NGN-STYLE | EXPERT VERIFIED | 160 VERIFIED Q&A |
DETAILED RATIONALES | PASS GUARANTEED - A+
GRADED
QUESTION 1
A client at 38 weeks gestation is admitted with preeclampsia. Which finding should the RN report
immediately?
A. Blood pressure of 160/110 mmHg
B. Mild ankle edema
C. Urine protein of 1+
D. Headache that resolves with rest
Rationale: A blood pressure of 160/110 mmHg indicates severe preeclampsia and requires immediate
intervention. Mild ankle edema, urine protein of 1+, and headache that resolves with rest are expected
findings in preeclampsia but do not require immediate intervention.
QUESTION 2
The RN is caring for a postpartum client who is Rh-negative and has given birth to an Rh-positive infant.
Which medication should the RN expect to administer?
A. Rh₀(D) immune globulin (RhoGAM)
B. Methylergonovine (Methergine)
C. Hepatitis B vaccine
D. Vitamin K
Rationale: RhoGAM is administered to Rh-negative mothers after delivery of an Rh-positive infant to prevent
maternal sensitization and hemolytic disease of the newborn in future pregnancies. It should be given within
72 hours of delivery.
QUESTION 3
A newborn is diagnosed with phenylketonuria (PKU). Which dietary instruction should the RN reinforce?
A. The infant should be placed on a low-phenylalanine formula
B. The infant should receive breast milk only
C. The infant should receive a soy-based formula
D. The infant should receive a standard cow's milk formula
,2
Rationale: PKU is a metabolic disorder that requires a low-phenylalanine diet. Infants with PKU should be
placed on a special low-phenylalanine formula. Breast milk and standard formulas contain phenylalanine and
are not appropriate.
QUESTION 4
The RN is caring for a newborn with hyperbilirubinemia. Which intervention is most important?
A. Phototherapy
B. Exchange transfusion
C. Administration of phenobarbital
D. Increased oral feedings
Rationale: Phototherapy is the first-line treatment for hyperbilirubinemia in newborns. Exchange transfusion
is reserved for severe cases. Phenobarbital may be used for conjugation defects, and increased oral feedings
help promote excretion but are not the primary treatment.
QUESTION 5
A mother reports that her 6-month-old infant has been irritable, has a fever, and is pulling at the ears. Which
assessment finding is most consistent with otitis media?
A. Bulging, red tympanic membrane
B. Clear, non-bulging tympanic membrane
C. Excessive cerumen in the ear canal
D. Normal tympanic membrane
Rationale: Otitis media is characterized by a bulging, red tympanic membrane. A clear, non-bulging tympanic
membrane and excessive cerumen are not consistent with otitis media. The infant's symptoms of irritability,
fever, and ear pulling are consistent with otitis media.
QUESTION 6
A client at 36 weeks gestation is admitted with a diagnosis of placenta previa. Which assessment finding
requires immediate intervention?
A. Painless bright red vaginal bleeding
B. Mild uterine contractions
C. Fetal heart rate of 150 bpm
D. Maternal blood pressure of 130/80 mmHg
Rationale: Painless bright red vaginal bleeding is a classic sign of placenta previa and requires immediate
intervention. Mild uterine contractions, fetal heart rate of 150 bpm, and maternal blood pressure of 130/80
mmHg are expected findings.
,3
QUESTION 7
The RN is caring for a newborn with a cleft lip and palate. Which feeding intervention should the RN
implement?
A. Use a special feeder with a soft nipple
B. Feed the infant in a supine position
C. Use a standard bottle and nipple
D. Feed the infant with a spoon
Rationale: Infants with a cleft lip and palate may have difficulty feeding due to the inability to create a seal. A
special feeder with a soft nipple can help. The infant should be fed in an upright position to prevent aspiration.
QUESTION 8
A client at 39 weeks gestation is in active labor. Which finding indicates that the client is ready to push?
A. Complete cervical dilation (10 cm)
B. Cervical dilation of 8 cm
C. Cervical effacement of 90%
D. Contractions every 5 minutes
Rationale: The client is ready to push when the cervix is completely dilated (10 cm). Cervical dilation of 8 cm
is still in the transition phase, and the client should not push until complete dilation is achieved.
QUESTION 9
The RN is caring for a newborn with neonatal abstinence syndrome (NAS). Which finding is most consistent
with NAS?
A. Irritability and high-pitched cry
B. Sleepiness and lethargy
C. Decreased muscle tone
D. Hypothermia
Rationale: Neonatal abstinence syndrome (NAS) is characterized by irritability, high-pitched cry, tremors,
and feeding difficulties. Sleepiness, decreased muscle tone, and hypothermia are not typical findings and may
indicate other conditions.
QUESTION 10
A client at 34 weeks gestation is admitted with preterm premature rupture of membranes (PPROM). Which
finding requires immediate intervention?
, 4
A. Foul-smelling vaginal discharge
B. Clear vaginal discharge
C. Mild uterine contractions
D. Fetal heart rate of 140 bpm
Rationale: Foul-smelling vaginal discharge indicates infection (chorioamnionitis) and requires immediate
intervention. Clear vaginal discharge, mild uterine contractions, and a fetal heart rate of 140 bpm are expected
findings in PPROM.
QUESTION 11
The RN is caring for a newborn with meconium aspiration syndrome. Which intervention is most important?
A. Suctioning the airway
B. Administering antibiotics
C. Providing oxygen therapy
D. Monitoring blood glucose levels
Rationale: Suctioning the airway is the most important intervention for meconium aspiration syndrome to
clear the airway and prevent respiratory distress. Antibiotics, oxygen therapy, and glucose monitoring are also
important but suctioning is the priority.
QUESTION 12
A client at 40 weeks gestation is in the second stage of labor. Which finding indicates that the client is
experiencing a complication?
A. Fetal heart rate of 100 bpm
B. Maternal heart rate of 100 bpm
C. Contractions every 2 minutes
D. Strong urge to push
Rationale: A fetal heart rate of 100 bpm is bradycardic and may indicate fetal distress. Maternal heart rate of
100 bpm, contractions every 2 minutes, and a strong urge to push are expected findings in the second stage of
labor.
QUESTION 13
The RN is caring for a postpartum client who is experiencing uterine atony. Which medication should the RN
expect to administer?
A. Oxytocin (Pitocin)
B. Magnesium sulfate
