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HESI-STYLE EXIT EXAM 2026 QUESTIONS
LATEST VERSION QUESTIONS AND ANSWERS
HESI-STYLE EXIT EXAM PRACTICE QUESTIONS (250 Questions with Detailed
Rationales)
1. The nurse is caring for four clients on a medical-surgical unit. Which client should
the nurse assess first?
• A. A client with diabetes mellitus who has a blood glucose of 180 mg/dL.
• B. A client with pneumonia who has a temperature of 101.2°F (38.4°C).
• C. A client with heart failure who has crackles in the lung bases and is short of breath.
• D. A client with chronic kidney disease who has a potassium level of 5.2 mEq/L.
• Answer: C. Rationale: The client with heart failure who has crackles and is short of
breath is experiencing acute respiratory distress, which could indicate pulmonary
edema—a life-threatening emergency. This client should be assessed first. The
potassium level of 5.2 mEq/L (D) is elevated but not critical (critical is >6.5). The
blood glucose of 180 (A) is elevated but not immediately life-threatening. The fever
(B) is concerning but not the priority.
2. The nurse is delegating tasks to unlicensed assistive personnel (UAP). Which of the
following tasks is appropriate for the nurse to delegate to the UAP?
• A. Administering a scheduled dose of oral metoprolol.
• B. Assessing a client's surgical wound for signs of infection.
• C. Assisting a client with a bed bath and providing oral care.
• D. Interpreting a client's telemetry rhythm strip.
• Answer: C. Rationale: Assisting with a bed bath and providing oral care are tasks
within the scope of UAP. Administration of medications (A), wound assessment (B),
and rhythm interpretation (D) require the knowledge and judgment of a licensed nurse
and cannot be delegated.
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3. A client with a history of alcohol use disorder is admitted with signs of alcohol
withdrawal. Which of the following assessment findings is the priority for the nurse to
monitor?
• A. Tremors and diaphoresis.
• B. Nausea and vomiting.
• C. Seizure activity and autonomic hyperactivity.
• D. Insomnia and anxiety.
• Answer: C. Rationale: Alcohol withdrawal can lead to seizures and autonomic
hyperactivity (tachycardia, hypertension, hyperthermia), which are life-threatening.
Monitoring for these signs is the highest priority. While tremors (A), nausea (B), and
insomnia (D) are common withdrawal symptoms, they are not as immediately life-
threatening as seizures.
4. A client who is 2 days post-operative from a total hip replacement reports sudden
shortness of breath and chest pain. What is the nurse's priority action?
• A. Administer oxygen via nasal cannula at 2 L/min.
• B. Elevate the head of the bed to a high-Fowler's position.
• C. Notify the healthcare provider immediately.
• D. Assess the client's vital signs and oxygen saturation.
• Answer: C. Rationale: Sudden shortness of breath and chest pain are classic
symptoms of a pulmonary embolism (PE) , a life-threatening complication. The
nurse should notify the healthcare provider immediately while simultaneously
initiating other interventions. The provider may need to order diagnostic tests (e.g.,
CT angiogram) and anticoagulation.
5. The nurse is caring for a client with a new tracheostomy. Which of the following
pieces of equipment should be kept at the bedside at all times?
• A. An Ambu bag and a suction catheter.
• B. An obturator and a spare tracheostomy tube.
• C. A sterile tracheostomy dressing and cleaning supplies.
• D. A pulse oximeter and an oxygen saturation monitor.
• Answer: B. Rationale: An obturator and a spare tracheostomy tube of the same
size (or one size smaller) must be kept at the bedside at all times to allow for
immediate replacement if the tube is accidentally dislodged—a life-threatening
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airway emergency. While suctioning equipment (A) is also important, the spare tube
is the priority.
6. A client with heart failure is prescribed furosemide. Which of the following findings
indicates that the medication is having the desired therapeutic effect?
• A. The client's serum potassium level increases to 4.5 mEq/L.
• B. The client's urine output increases to 1,500 mL per 24 hours.
• C. The client's blood pressure decreases from 160/90 to 130/80 mm Hg.
• D. The client's heart rate decreases from 110 to 88 beats per minute.
• Answer: C. Rationale: Furosemide is a loop diuretic that reduces fluid volume, which
subsequently decreases blood pressure and reduces the workload on the heart.
A decrease in blood pressure indicates a positive therapeutic response. While urine
output (B) may increase, the blood pressure reduction is a direct indicator of reduced
preload.
7. The nurse is providing discharge teaching to a client who has a new prescription for
warfarin. Which of the following statements by the client indicates a need for further
teaching?
• A. "I will need to have my blood drawn regularly to check my INR."
• B. "I should avoid eating large amounts of green leafy vegetables."
• C. "I can take ibuprofen for my headaches if I need to."
• D. "I should report any unusual bleeding or bruising to my doctor."
• Answer: C. Rationale: Warfarin is an anticoagulant. Ibuprofen (an NSAID)
increases the risk of bleeding and should be avoided. Clients should use
acetaminophen for pain instead. Regular INR monitoring (A) is required. Vitamin K-
rich foods (B) can interfere with warfarin's effectiveness. Reporting unusual bleeding
(D) is correct.
8. A client with preeclampsia is receiving magnesium sulfate. The nurse notes that the
client's deep tendon reflexes (DTRs) are absent. Which of the following is the priority
nursing action?
• A. Continue to monitor the client's vital signs.
• B. Notify the healthcare provider immediately.
• C. Administer a bolus of magnesium sulfate.
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• D. Document the finding as a normal response.
• Answer: B. Rationale: Absent deep tendon reflexes (DTRs) is a sign of magnesium
toxicity. The antidote is calcium gluconate. The nurse must notify the healthcare
provider immediately so that the magnesium sulfate can be discontinued and
calcium gluconate can be administered. Continuing to monitor (A) or documenting
(D) without intervention is unsafe.
9. The nurse is caring for a client who is receiving a blood transfusion. The client
complains of chills and lower back pain. What is the nurse's priority action?
• A. Slow the rate of the transfusion.
• B. Stop the transfusion and hang normal saline.
• C. Administer an antihistamine.
• D. Document the findings.
• Answer: B. Rationale: Chills and lower back pain are classic signs of a hemolytic
transfusion reaction. The priority is to stop the transfusion immediately to prevent
further reaction, maintain IV access with normal saline, and notify the provider.
Slowing the infusion (A) is not sufficient.
10. The nurse is preparing to administer a dose of digoxin to a client with heart failure.
The client's apical pulse is 52 beats per minute. Which of the following is the most
appropriate nursing action?
• A. Administer the digoxin as ordered.
• B. Hold the digoxin and notify the healthcare provider.
• C. Administer the digoxin and reassess the pulse in 30 minutes.
• D. Increase the client's fluid intake.
• Answer: B. Rationale: The standard protocol is to hold digoxin and notify the
healthcare provider if the apical pulse is below 60 beats per minute (or per facility
policy). Bradycardia can be a sign of digoxin toxicity. Administering it with a slow
pulse is dangerous.
11. The charge nurse is making assignments for the shift. Which client should be
assigned to the most experienced registered nurse on the team?
• A. A client with diabetes mellitus requiring daily insulin injections.
• B. A client with pneumonia who needs IV antibiotics every 6 hours.
HESI-STYLE EXIT EXAM 2026 QUESTIONS
LATEST VERSION QUESTIONS AND ANSWERS
HESI-STYLE EXIT EXAM PRACTICE QUESTIONS (250 Questions with Detailed
Rationales)
1. The nurse is caring for four clients on a medical-surgical unit. Which client should
the nurse assess first?
• A. A client with diabetes mellitus who has a blood glucose of 180 mg/dL.
• B. A client with pneumonia who has a temperature of 101.2°F (38.4°C).
• C. A client with heart failure who has crackles in the lung bases and is short of breath.
• D. A client with chronic kidney disease who has a potassium level of 5.2 mEq/L.
• Answer: C. Rationale: The client with heart failure who has crackles and is short of
breath is experiencing acute respiratory distress, which could indicate pulmonary
edema—a life-threatening emergency. This client should be assessed first. The
potassium level of 5.2 mEq/L (D) is elevated but not critical (critical is >6.5). The
blood glucose of 180 (A) is elevated but not immediately life-threatening. The fever
(B) is concerning but not the priority.
2. The nurse is delegating tasks to unlicensed assistive personnel (UAP). Which of the
following tasks is appropriate for the nurse to delegate to the UAP?
• A. Administering a scheduled dose of oral metoprolol.
• B. Assessing a client's surgical wound for signs of infection.
• C. Assisting a client with a bed bath and providing oral care.
• D. Interpreting a client's telemetry rhythm strip.
• Answer: C. Rationale: Assisting with a bed bath and providing oral care are tasks
within the scope of UAP. Administration of medications (A), wound assessment (B),
and rhythm interpretation (D) require the knowledge and judgment of a licensed nurse
and cannot be delegated.
, Page 2 of 74
3. A client with a history of alcohol use disorder is admitted with signs of alcohol
withdrawal. Which of the following assessment findings is the priority for the nurse to
monitor?
• A. Tremors and diaphoresis.
• B. Nausea and vomiting.
• C. Seizure activity and autonomic hyperactivity.
• D. Insomnia and anxiety.
• Answer: C. Rationale: Alcohol withdrawal can lead to seizures and autonomic
hyperactivity (tachycardia, hypertension, hyperthermia), which are life-threatening.
Monitoring for these signs is the highest priority. While tremors (A), nausea (B), and
insomnia (D) are common withdrawal symptoms, they are not as immediately life-
threatening as seizures.
4. A client who is 2 days post-operative from a total hip replacement reports sudden
shortness of breath and chest pain. What is the nurse's priority action?
• A. Administer oxygen via nasal cannula at 2 L/min.
• B. Elevate the head of the bed to a high-Fowler's position.
• C. Notify the healthcare provider immediately.
• D. Assess the client's vital signs and oxygen saturation.
• Answer: C. Rationale: Sudden shortness of breath and chest pain are classic
symptoms of a pulmonary embolism (PE) , a life-threatening complication. The
nurse should notify the healthcare provider immediately while simultaneously
initiating other interventions. The provider may need to order diagnostic tests (e.g.,
CT angiogram) and anticoagulation.
5. The nurse is caring for a client with a new tracheostomy. Which of the following
pieces of equipment should be kept at the bedside at all times?
• A. An Ambu bag and a suction catheter.
• B. An obturator and a spare tracheostomy tube.
• C. A sterile tracheostomy dressing and cleaning supplies.
• D. A pulse oximeter and an oxygen saturation monitor.
• Answer: B. Rationale: An obturator and a spare tracheostomy tube of the same
size (or one size smaller) must be kept at the bedside at all times to allow for
immediate replacement if the tube is accidentally dislodged—a life-threatening
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airway emergency. While suctioning equipment (A) is also important, the spare tube
is the priority.
6. A client with heart failure is prescribed furosemide. Which of the following findings
indicates that the medication is having the desired therapeutic effect?
• A. The client's serum potassium level increases to 4.5 mEq/L.
• B. The client's urine output increases to 1,500 mL per 24 hours.
• C. The client's blood pressure decreases from 160/90 to 130/80 mm Hg.
• D. The client's heart rate decreases from 110 to 88 beats per minute.
• Answer: C. Rationale: Furosemide is a loop diuretic that reduces fluid volume, which
subsequently decreases blood pressure and reduces the workload on the heart.
A decrease in blood pressure indicates a positive therapeutic response. While urine
output (B) may increase, the blood pressure reduction is a direct indicator of reduced
preload.
7. The nurse is providing discharge teaching to a client who has a new prescription for
warfarin. Which of the following statements by the client indicates a need for further
teaching?
• A. "I will need to have my blood drawn regularly to check my INR."
• B. "I should avoid eating large amounts of green leafy vegetables."
• C. "I can take ibuprofen for my headaches if I need to."
• D. "I should report any unusual bleeding or bruising to my doctor."
• Answer: C. Rationale: Warfarin is an anticoagulant. Ibuprofen (an NSAID)
increases the risk of bleeding and should be avoided. Clients should use
acetaminophen for pain instead. Regular INR monitoring (A) is required. Vitamin K-
rich foods (B) can interfere with warfarin's effectiveness. Reporting unusual bleeding
(D) is correct.
8. A client with preeclampsia is receiving magnesium sulfate. The nurse notes that the
client's deep tendon reflexes (DTRs) are absent. Which of the following is the priority
nursing action?
• A. Continue to monitor the client's vital signs.
• B. Notify the healthcare provider immediately.
• C. Administer a bolus of magnesium sulfate.
, Page 4 of 74
• D. Document the finding as a normal response.
• Answer: B. Rationale: Absent deep tendon reflexes (DTRs) is a sign of magnesium
toxicity. The antidote is calcium gluconate. The nurse must notify the healthcare
provider immediately so that the magnesium sulfate can be discontinued and
calcium gluconate can be administered. Continuing to monitor (A) or documenting
(D) without intervention is unsafe.
9. The nurse is caring for a client who is receiving a blood transfusion. The client
complains of chills and lower back pain. What is the nurse's priority action?
• A. Slow the rate of the transfusion.
• B. Stop the transfusion and hang normal saline.
• C. Administer an antihistamine.
• D. Document the findings.
• Answer: B. Rationale: Chills and lower back pain are classic signs of a hemolytic
transfusion reaction. The priority is to stop the transfusion immediately to prevent
further reaction, maintain IV access with normal saline, and notify the provider.
Slowing the infusion (A) is not sufficient.
10. The nurse is preparing to administer a dose of digoxin to a client with heart failure.
The client's apical pulse is 52 beats per minute. Which of the following is the most
appropriate nursing action?
• A. Administer the digoxin as ordered.
• B. Hold the digoxin and notify the healthcare provider.
• C. Administer the digoxin and reassess the pulse in 30 minutes.
• D. Increase the client's fluid intake.
• Answer: B. Rationale: The standard protocol is to hold digoxin and notify the
healthcare provider if the apical pulse is below 60 beats per minute (or per facility
policy). Bradycardia can be a sign of digoxin toxicity. Administering it with a slow
pulse is dangerous.
11. The charge nurse is making assignments for the shift. Which client should be
assigned to the most experienced registered nurse on the team?
• A. A client with diabetes mellitus requiring daily insulin injections.
• B. A client with pneumonia who needs IV antibiotics every 6 hours.
