HESI RN Exit Exam Practice Questions and Answers
2026: Nursing Questions with Rationales
1. A client with heart failure is prescribed furosemide. Which finding requires the nurse’s
immediate attention?
A. Blood pressure of 108/68 mmHg
B. Potassium level of 2.8 mEq/L
C. Urine output of 1,200 mL/24 hours
D. Weight loss of 1 kg in 2 days
Answer: B. Potassium level of 2.8 mEq/L
Rationale: Furosemide is a loop diuretic that can cause significant potassium loss.
Severe hypokalemia increases the risk of potentially life-threatening cardiac
dysrhythmias and requires prompt intervention.
2. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen.
Which oxygen saturation is generally an appropriate target for many clients with COPD?
A. 70–75%
B. 80–84%
C. 88–92%
D. 98–100%
Answer: C. 88–92%
Rationale: Many clients with COPD who are at risk for hypercapnic respiratory failure
are targeted to an oxygen saturation of approximately 88–92%, while avoiding
unnecessary excessive oxygen administration.
3. A nurse is assessing a client who has received morphine IV. Which finding requires
immediate intervention?
A. Respiratory rate of 8/min
B. Blood pressure of 110/70 mmHg
C. Pain rating of 3/10
D. Mild nausea
Answer: A. Respiratory rate of 8/min
,Rationale: Opioids can cause respiratory depression. A respiratory rate of 8/min is
dangerously low and requires immediate assessment and intervention.
4. A client with diabetes is awake, sweating, and trembling. The blood glucose is 52
mg/dL. What should the nurse do first?
A. Administer regular insulin
B. Give 15 g of rapid-acting carbohydrate
C. Start an IV insulin infusion
D. Have the client exercise
Answer: B. Give 15 g of rapid-acting carbohydrate
Rationale: A conscious client who can safely swallow and has symptomatic
hypoglycemia should receive approximately 15 g of fast-acting carbohydrate, followed
by reassessment of glucose.
5. A client is receiving a blood transfusion and develops chills, fever, and low back pain.
What is the nurse’s priority action?
A. Slow the transfusion
B. Stop the transfusion
C. Administer acetaminophen
D. Continue the transfusion and reassess in 15 minutes
Answer: B. Stop the transfusion
Rationale: Fever, chills, and back pain may indicate an acute hemolytic transfusion
reaction. The transfusion should be stopped immediately, and the nurse should maintain
IV access with appropriate compatible fluid according to protocol and notify the
provider/blood bank.
6. Which finding is most concerning in a client with increased intracranial pressure?
A. Headache
B. Restlessness
C. Decreased level of consciousness
D. Mild nausea
Answer: C. Decreased level of consciousness
,Rationale: A declining level of consciousness is an important indicator of worsening
neurologic function and potentially increasing intracranial pressure.
7. A client taking warfarin asks which laboratory test is used to monitor the medication.
What should the nurse identify?
A. aPTT
B. INR
C. Platelet count
D. Hemoglobin A1c
Answer: B. INR
Rationale: Warfarin therapy is monitored primarily using the prothrombin time expressed
as the international normalized ratio (INR).
8. A client receiving heparin develops a significant decrease in platelet count. Which
complication should the nurse suspect?
A. Hemophilia
B. Heparin-induced thrombocytopenia
C. Iron-deficiency anemia
D. Vitamin K deficiency
Answer: B. Heparin-induced thrombocytopenia
Rationale: A significant platelet decrease after exposure to heparin may indicate HIT, an
immune-mediated condition associated with thrombosis. Heparin should be stopped
and the provider notified.
9. A client with suspected pulmonary embolism suddenly develops dyspnea and chest
pain. What is the priority nursing action?
A. Encourage ambulation
B. Place the client in a position that promotes breathing and administer oxygen as
prescribed
C. Give oral fluids
D. Place the client flat
Answer: B. Place the client in a position that promotes breathing and administer oxygen
as prescribed
, Rationale: Pulmonary embolism can cause acute hypoxemia and respiratory distress.
Supporting oxygenation and breathing is an immediate priority.
10. Which assessment finding is characteristic of hypokalemia?
A. Muscle weakness
B. Hyperactive reflexes only
C. Severe hypertension
D. Facial flushing
Answer: A. Muscle weakness
Rationale: Hypokalemia can cause muscle weakness, fatigue, constipation, and cardiac
dysrhythmias.
11. A client with Addison disease is at risk for which electrolyte imbalance?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Answer: A. Hyperkalemia
Rationale: Reduced aldosterone in Addison disease decreases sodium retention and
potassium excretion, increasing the risk for hyperkalemia.
12. Which finding should the nurse expect in a client experiencing diabetic ketoacidosis
(DKA)?
A. Kussmaul respirations
B. Severe bradycardia
C. Respiratory alkalosis
D. Decreased thirst
Answer: A. Kussmaul respirations
Rationale: DKA causes metabolic acidosis. The body compensates with deep, rapid
respirations known as Kussmaul respirations.
13. A client with SIADH is at greatest risk for which electrolyte abnormality?
A. Hypernatremia
2026: Nursing Questions with Rationales
1. A client with heart failure is prescribed furosemide. Which finding requires the nurse’s
immediate attention?
A. Blood pressure of 108/68 mmHg
B. Potassium level of 2.8 mEq/L
C. Urine output of 1,200 mL/24 hours
D. Weight loss of 1 kg in 2 days
Answer: B. Potassium level of 2.8 mEq/L
Rationale: Furosemide is a loop diuretic that can cause significant potassium loss.
Severe hypokalemia increases the risk of potentially life-threatening cardiac
dysrhythmias and requires prompt intervention.
2. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen.
Which oxygen saturation is generally an appropriate target for many clients with COPD?
A. 70–75%
B. 80–84%
C. 88–92%
D. 98–100%
Answer: C. 88–92%
Rationale: Many clients with COPD who are at risk for hypercapnic respiratory failure
are targeted to an oxygen saturation of approximately 88–92%, while avoiding
unnecessary excessive oxygen administration.
3. A nurse is assessing a client who has received morphine IV. Which finding requires
immediate intervention?
A. Respiratory rate of 8/min
B. Blood pressure of 110/70 mmHg
C. Pain rating of 3/10
D. Mild nausea
Answer: A. Respiratory rate of 8/min
,Rationale: Opioids can cause respiratory depression. A respiratory rate of 8/min is
dangerously low and requires immediate assessment and intervention.
4. A client with diabetes is awake, sweating, and trembling. The blood glucose is 52
mg/dL. What should the nurse do first?
A. Administer regular insulin
B. Give 15 g of rapid-acting carbohydrate
C. Start an IV insulin infusion
D. Have the client exercise
Answer: B. Give 15 g of rapid-acting carbohydrate
Rationale: A conscious client who can safely swallow and has symptomatic
hypoglycemia should receive approximately 15 g of fast-acting carbohydrate, followed
by reassessment of glucose.
5. A client is receiving a blood transfusion and develops chills, fever, and low back pain.
What is the nurse’s priority action?
A. Slow the transfusion
B. Stop the transfusion
C. Administer acetaminophen
D. Continue the transfusion and reassess in 15 minutes
Answer: B. Stop the transfusion
Rationale: Fever, chills, and back pain may indicate an acute hemolytic transfusion
reaction. The transfusion should be stopped immediately, and the nurse should maintain
IV access with appropriate compatible fluid according to protocol and notify the
provider/blood bank.
6. Which finding is most concerning in a client with increased intracranial pressure?
A. Headache
B. Restlessness
C. Decreased level of consciousness
D. Mild nausea
Answer: C. Decreased level of consciousness
,Rationale: A declining level of consciousness is an important indicator of worsening
neurologic function and potentially increasing intracranial pressure.
7. A client taking warfarin asks which laboratory test is used to monitor the medication.
What should the nurse identify?
A. aPTT
B. INR
C. Platelet count
D. Hemoglobin A1c
Answer: B. INR
Rationale: Warfarin therapy is monitored primarily using the prothrombin time expressed
as the international normalized ratio (INR).
8. A client receiving heparin develops a significant decrease in platelet count. Which
complication should the nurse suspect?
A. Hemophilia
B. Heparin-induced thrombocytopenia
C. Iron-deficiency anemia
D. Vitamin K deficiency
Answer: B. Heparin-induced thrombocytopenia
Rationale: A significant platelet decrease after exposure to heparin may indicate HIT, an
immune-mediated condition associated with thrombosis. Heparin should be stopped
and the provider notified.
9. A client with suspected pulmonary embolism suddenly develops dyspnea and chest
pain. What is the priority nursing action?
A. Encourage ambulation
B. Place the client in a position that promotes breathing and administer oxygen as
prescribed
C. Give oral fluids
D. Place the client flat
Answer: B. Place the client in a position that promotes breathing and administer oxygen
as prescribed
, Rationale: Pulmonary embolism can cause acute hypoxemia and respiratory distress.
Supporting oxygenation and breathing is an immediate priority.
10. Which assessment finding is characteristic of hypokalemia?
A. Muscle weakness
B. Hyperactive reflexes only
C. Severe hypertension
D. Facial flushing
Answer: A. Muscle weakness
Rationale: Hypokalemia can cause muscle weakness, fatigue, constipation, and cardiac
dysrhythmias.
11. A client with Addison disease is at risk for which electrolyte imbalance?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Answer: A. Hyperkalemia
Rationale: Reduced aldosterone in Addison disease decreases sodium retention and
potassium excretion, increasing the risk for hyperkalemia.
12. Which finding should the nurse expect in a client experiencing diabetic ketoacidosis
(DKA)?
A. Kussmaul respirations
B. Severe bradycardia
C. Respiratory alkalosis
D. Decreased thirst
Answer: A. Kussmaul respirations
Rationale: DKA causes metabolic acidosis. The body compensates with deep, rapid
respirations known as Kussmaul respirations.
13. A client with SIADH is at greatest risk for which electrolyte abnormality?
A. Hypernatremia
