HESI RN Exit Exam 2026/2027 – Versions V1–V7 |
Actual Exam Questions & Verified Correct
Answers | A+ Prep
SECTION 1: MEDICAL-SURGICAL NURSING
1. A client with a history of heart failure presents to the clinic with nausea,
vomiting, yellow vision, and palpitations. Which finding is most important for the
nurse to assess?
A) Serum potassium level
B) Serum digoxin level
C) Serum sodium level
D) Serum calcium level
Answer: B
Rationale: Yellow vision (xanthopsia), nausea, vomiting, and palpitations are classic signs
of digoxin toxicity. The nurse should assess the client's digoxin level and hold the
medication if toxicity is suspected.
2. A client with chronic kidney disease (CKD) stage 4 is receiving dietary teaching.
Which statement by the client indicates correct understanding?
A) "I should eat plenty of bananas and oranges for potassium."
B) "I will limit foods high in phosphorus like dairy and nuts."
C) "I can use salt substitutes freely because I need to reduce sodium."
D) "I need to increase my protein intake to prevent muscle wasting."
Answer: B
Rationale: In stage 4 CKD (eGFR 15–29 mL/min), the kidneys cannot excrete phosphorus,
leading to hyperphosphatemia. Foods high in phosphorus include dairy, nuts, beans, and
whole grains.
3. A client is receiving a full-strength continuous enteral tube feeding at 50
mL/hour and has developed diarrhea. The client has a new prescription to change
the feeding to half strength. What intervention should the nurse implement?
,A) Add equal amounts of water and feeding to a feeding bag and infuse at 50 mL/hour
B) Decrease the infusion rate to 25 mL/hour
C) Change the feeding to a different formula
D) Stop the feeding and notify the healthcare provider
Answer: A
Rationale: To change to half strength, the nurse should add equal amounts of water and
formula to the feeding bag and infuse at the same rate. This reduces the osmolarity of the
feeding, which may help resolve diarrhea.
4. A client with cirrhosis has ascites and reports feeling short of breath. The client
is in semi-Fowler's position with arms at their sides. What is the best nursing
action?
A) Raise the head of the bed to Fowler's position and support arms with a pillow
B) Administer oxygen at 2 L/min via nasal cannula
C) Notify the healthcare provider immediately
D) Encourage the client to take deep breaths
Answer: A
Rationale: Raising the head of the bed to Fowler's position and supporting the arms with a
pillow allows for maximal chest expansion and improves breathing.
5. A client with end-stage pulmonary disease is alert, oriented, and complaining of
shortness of breath. The client tells the nurse she wants "no heroic measures"
taken if she stops breathing. What should the nurse do?
A) Document the client's request in the medical record
B) Ask the client to discuss "do not resuscitate" with her healthcare provider
C) Contact the hospital ethics committee
D) Honor the client's request immediately
Answer: B
Rationale: A DNR order must be discussed with and ordered by the healthcare provider.
The nurse should encourage the client to have this discussion with her provider and
document the request.
,6. The healthcare provider prescribes IV isoproterenol (Isuprel) 1 mg in 250 mL of
D5W at 300 mcg/hour. How many mL/hour should the nurse program the infusion
pump?
A) 75 mL/hour
B) 125 mL/hour
C) 150 mL/hour
D) 200 mL/hour
Answer: A
Rationale: Convert mg to mcg: 1 mg = 1,000 mcg. Use the formula: Desired dose (300
mcg/hour) / Available dose (1,000 mcg) × Volume (250 mL) = 75 mL/hour.
7. A client with a history of atrial fibrillation fell at home and fractured her left hip.
She is currently taking warfarin 5 mg daily and has an INR of 5.0. Which
prescription should the nurse expect to implement?
A) Administer Vitamin K injection
B) Start continuous heparin infusion
C) Continue warfarin at same dose
D) Increase the warfarin dose
Answer: A
Rationale: An INR of 5.0 indicates excessive anticoagulation. Vitamin K is the antidote for
warfarin and should be administered to reverse the anticoagulant effect, especially before
surgery.
8. A client is 2 hours post-operative after a femoral-popliteal bypass. The upper
leg dressing becomes saturated with blood. What is the nurse's first action?
A) Wrap the leg with elastic bandages
B) Apply direct pressure over the saturated area
C) Notify the healthcare provider immediately
D) Remove the dressing to assess the incision
Answer: B
Rationale: Applying direct pressure over the bleeding site is the immediate priority to
control hemorrhage and prevent further blood loss.
, 9. A client is admitted with low T3 and T4 levels and an elevated TSH level. What
assessment findings would the nurse anticipate?
A) Lethargy, weight gain, and cold intolerance
B) Weight loss, tachycardia, and heat intolerance
C) Hyperactivity and diaphoresis
D) Increased appetite and tremors
Answer: A
Rationale: Low T3/T4 with elevated TSH indicates primary hypothyroidism. Common
findings include lethargy, fatigue, weight gain, bradycardia, cold intolerance, and
constipation.
10. A client with a chest tube has continuous bubbling in the water seal chamber.
What does this indicate and what should the nurse do?
A) Normal functioning; no action needed
B) An air leak; assess the system for leaks
C) Suction is working; document findings
D) The lung has re-expanded; prepare for removal
Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak. The nurse
should assess the chest tube system for loose connections or cracks and notify the provider.
11. A client with a history of COPD has an SpO2 of 88% on room air. What is the
appropriate action?
A) No intervention needed
B) Prescribe home oxygen therapy
C) Increase inhaled corticosteroid dose
D) Refer to pulmonary rehabilitation
Answer: B
Rationale: SpO2 ≤88% indicates hypoxemia and is an indication for home oxygen therapy.
12. A client with asthma has a peak flow of 60% of personal best. This indicates:
A) Green zone (good control)
B) Yellow zone (caution)
Actual Exam Questions & Verified Correct
Answers | A+ Prep
SECTION 1: MEDICAL-SURGICAL NURSING
1. A client with a history of heart failure presents to the clinic with nausea,
vomiting, yellow vision, and palpitations. Which finding is most important for the
nurse to assess?
A) Serum potassium level
B) Serum digoxin level
C) Serum sodium level
D) Serum calcium level
Answer: B
Rationale: Yellow vision (xanthopsia), nausea, vomiting, and palpitations are classic signs
of digoxin toxicity. The nurse should assess the client's digoxin level and hold the
medication if toxicity is suspected.
2. A client with chronic kidney disease (CKD) stage 4 is receiving dietary teaching.
Which statement by the client indicates correct understanding?
A) "I should eat plenty of bananas and oranges for potassium."
B) "I will limit foods high in phosphorus like dairy and nuts."
C) "I can use salt substitutes freely because I need to reduce sodium."
D) "I need to increase my protein intake to prevent muscle wasting."
Answer: B
Rationale: In stage 4 CKD (eGFR 15–29 mL/min), the kidneys cannot excrete phosphorus,
leading to hyperphosphatemia. Foods high in phosphorus include dairy, nuts, beans, and
whole grains.
3. A client is receiving a full-strength continuous enteral tube feeding at 50
mL/hour and has developed diarrhea. The client has a new prescription to change
the feeding to half strength. What intervention should the nurse implement?
,A) Add equal amounts of water and feeding to a feeding bag and infuse at 50 mL/hour
B) Decrease the infusion rate to 25 mL/hour
C) Change the feeding to a different formula
D) Stop the feeding and notify the healthcare provider
Answer: A
Rationale: To change to half strength, the nurse should add equal amounts of water and
formula to the feeding bag and infuse at the same rate. This reduces the osmolarity of the
feeding, which may help resolve diarrhea.
4. A client with cirrhosis has ascites and reports feeling short of breath. The client
is in semi-Fowler's position with arms at their sides. What is the best nursing
action?
A) Raise the head of the bed to Fowler's position and support arms with a pillow
B) Administer oxygen at 2 L/min via nasal cannula
C) Notify the healthcare provider immediately
D) Encourage the client to take deep breaths
Answer: A
Rationale: Raising the head of the bed to Fowler's position and supporting the arms with a
pillow allows for maximal chest expansion and improves breathing.
5. A client with end-stage pulmonary disease is alert, oriented, and complaining of
shortness of breath. The client tells the nurse she wants "no heroic measures"
taken if she stops breathing. What should the nurse do?
A) Document the client's request in the medical record
B) Ask the client to discuss "do not resuscitate" with her healthcare provider
C) Contact the hospital ethics committee
D) Honor the client's request immediately
Answer: B
Rationale: A DNR order must be discussed with and ordered by the healthcare provider.
The nurse should encourage the client to have this discussion with her provider and
document the request.
,6. The healthcare provider prescribes IV isoproterenol (Isuprel) 1 mg in 250 mL of
D5W at 300 mcg/hour. How many mL/hour should the nurse program the infusion
pump?
A) 75 mL/hour
B) 125 mL/hour
C) 150 mL/hour
D) 200 mL/hour
Answer: A
Rationale: Convert mg to mcg: 1 mg = 1,000 mcg. Use the formula: Desired dose (300
mcg/hour) / Available dose (1,000 mcg) × Volume (250 mL) = 75 mL/hour.
7. A client with a history of atrial fibrillation fell at home and fractured her left hip.
She is currently taking warfarin 5 mg daily and has an INR of 5.0. Which
prescription should the nurse expect to implement?
A) Administer Vitamin K injection
B) Start continuous heparin infusion
C) Continue warfarin at same dose
D) Increase the warfarin dose
Answer: A
Rationale: An INR of 5.0 indicates excessive anticoagulation. Vitamin K is the antidote for
warfarin and should be administered to reverse the anticoagulant effect, especially before
surgery.
8. A client is 2 hours post-operative after a femoral-popliteal bypass. The upper
leg dressing becomes saturated with blood. What is the nurse's first action?
A) Wrap the leg with elastic bandages
B) Apply direct pressure over the saturated area
C) Notify the healthcare provider immediately
D) Remove the dressing to assess the incision
Answer: B
Rationale: Applying direct pressure over the bleeding site is the immediate priority to
control hemorrhage and prevent further blood loss.
, 9. A client is admitted with low T3 and T4 levels and an elevated TSH level. What
assessment findings would the nurse anticipate?
A) Lethargy, weight gain, and cold intolerance
B) Weight loss, tachycardia, and heat intolerance
C) Hyperactivity and diaphoresis
D) Increased appetite and tremors
Answer: A
Rationale: Low T3/T4 with elevated TSH indicates primary hypothyroidism. Common
findings include lethargy, fatigue, weight gain, bradycardia, cold intolerance, and
constipation.
10. A client with a chest tube has continuous bubbling in the water seal chamber.
What does this indicate and what should the nurse do?
A) Normal functioning; no action needed
B) An air leak; assess the system for leaks
C) Suction is working; document findings
D) The lung has re-expanded; prepare for removal
Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak. The nurse
should assess the chest tube system for loose connections or cracks and notify the provider.
11. A client with a history of COPD has an SpO2 of 88% on room air. What is the
appropriate action?
A) No intervention needed
B) Prescribe home oxygen therapy
C) Increase inhaled corticosteroid dose
D) Refer to pulmonary rehabilitation
Answer: B
Rationale: SpO2 ≤88% indicates hypoxemia and is an indication for home oxygen therapy.
12. A client with asthma has a peak flow of 60% of personal best. This indicates:
A) Green zone (good control)
B) Yellow zone (caution)
