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HESI EXIT RN V5 EXAM LATEST VERSION QUESTIONS AND
ANSWERS 2026 EDITION
HESI EXIT RN V5 EXAM - 250 Questions with Detailed Rationales
Based on NGN-Style Questions & Current NCLEX Test Plan
SECTION 1: MEDICAL-SURGICAL NURSING (Questions 1-70)
Question 1
A client is admitted with a severe asthma attack. Over the last 3 hours, the client
has had increasing shortness of breath. Recent ABG results are: pH 7.22, PaCO₂ 55
mmHg, HCO₃ 25 mEq/L. Which intervention should the nurse implement?
A) Alert the anesthesia team for emergency intubation
B) Increase the client's fluid intake to 3000 mL/day
C) Administer a PRN dose of albuterol
D) Place the client in Trendelenburg position
Answer: C
Rationale: The ABG results indicate respiratory acidosis (low pH, high PaCO₂) due to
inadequate ventilation. A fast-acting bronchodilator (albuterol) can improve airflow,
help the client blow off CO₂, and may prevent the need for intubation. Intubation (A)
may be needed if the client does not respond to bronchodilators, but it is not the first
step. Increasing fluids (B) does not address bronchospasm. Trendelenburg position (D)
would worsen respiratory effort. Monitoring the client's respiratory status and oxygen
saturation is also essential .
Question 2
A client is receiving teaching about lifestyle changes to slow the progression of
coronary artery disease (CAD). Which client responses indicate a need for further
teaching? (Select all that apply.)
A) "I'll keep a food diary."
B) "I'll eat more canned vegetables."
C) "I'll consume foods with saturated fat."
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D) "I'll walk 30 minutes a day."
E) "I'll include oatmeal at breakfast."
F) "I'll use a salt substitute."
Answer: B, C
Rationale: Canned vegetables (B) are often high in sodium, which can increase blood
pressure. Saturated fats (C) raise serum cholesterol and accelerate CAD progression.
Keeping a food diary (A), walking 30 minutes a day (D), including oatmeal (E), and using
a salt substitute (F) are all positive lifestyle modifications for CAD prevention. Patients
should be taught to choose fresh or low-sodium vegetables and limit saturated fat
intake .
Question 3
A client recovering on the outpatient surgical unit after an endoscopic carpal
tunnel release has stable vital signs, controlled pain, and a clean dressing. What
should the nurse do before discharging the client?
A) Teach sterile dressing changes in 3 days
B) Assess neurovascular status of the affected digits
C) Provide an informational pamphlet on carpal tunnel syndrome
D) Schedule outpatient physical therapy for next week
Answer: B
Rationale: After carpal tunnel release, neurovascular integrity (sensation, circulation,
and movement) of the affected digits is crucial to evaluate before discharge. Although
other actions such as providing information and scheduling physical therapy are
important, assessing the client's neurovascular status is the priority to identify any early
signs of complications. Routine sterile dressing changes (A) are not needed for this
clean surgical incision. Providing a pamphlet (C) is not the priority. Physical therapy (D)
is typically scheduled later .
Question 4
A client with an xenograft asks the nurse about the source of the graft. Which
response by the nurse is correct?
A) "The xenograft is derived from a living Jewish donor."
B) "The xenograft is from human cadaver skin."
C) "The xenograft is artificially created in a laboratory."
D) "The xenograft is taken from nonhuman sources."
Answer: D
Rationale: A xenograft (heterograft) is a graft taken from a nonhuman source, most
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commonly from pigs (porcine) or other animals. Human cadaver skin is an allograft (B).
The nurse should provide accurate information so the client can make informed
decisions regarding consent .
Question 5
An older female client is diagnosed with osteoporosis. Which expected outcome
has the highest priority for this client?
A) Names three foods high in calcium
B) Explains the role of vitamin D in bone health
C) Demonstrates weight-bearing exercise technique
D) Identifies three home safety hazards to correct immediately
Answer: D
Rationale: Falls in clients with osteoporosis are a major concern because of the high
risk of fractures. Prevention of injury is paramount, making elimination of safety hazards
the top priority. While knowledge of calcium-rich foods (A), vitamin D (B), and exercise
(C) are important for long-term bone health, they do not address the immediate risk of
fall-related fractures .
Question 6
A nurse is providing teaching to a client with type 2 diabetes mellitus about
important points for disease and symptom management. Which statement by the
client indicates understanding?
A) "Using salt, herbs, and spices will improve the flavor of foods."
B) "I will get my eyes examined by an ophthalmologist every year."
C) "I need to arrange my diet schedule around three regular meals a day."
D) "I'll inspect my feet every month for ingrown nails, cuts, and calluses."
Answer: B
Rationale: Annual dilated eye examinations by an ophthalmologist are recommended
for clients with diabetes to detect and treat retinopathy early. While salt and herbs (A)
are appropriate for flavoring food, this alone does not indicate comprehensive
understanding of diabetes management. Three regular meals (C) is not the focus; meal
timing should align with medication. Feet should be inspected daily (D), not monthly .
Question 7
A male client with a brain tumor has a 50-second tonic-clonic seizure and is now
lethargic and confused. His wife says this is his first seizure. What should the nurse
do first?
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A) Ask the wife to wait outside
B) Keep reorienting him until confusion subsides
C) Notify the emergency response team
D) Explain the postictal state that usually follows seizures
Answer: D
Rationale: After a major seizure, the postictal phase (confusion, lethargy) is a normal
phenomenon. Explaining this to the wife immediately can reassure her and reduce
anxiety. Asking her to wait outside (A) is not supportive. Reorienting (B) is important but
explaining the postictal state is the priority for family education. The emergency
response team (C) is not needed unless seizures recur or there is respiratory
compromise .
Question 8
The charge nurse is planning assignments for the shift with an RN and a PN. Which
client should be assigned to the RN?
A) A 75-year-old with renal calculi requiring urine straining
B) A client with a new tracheostomy
C) A client with a urinary tract infection
D) A client with a pressure injury
Answer: B
Rationale: A client with a new tracheostomy requires a nurse with experience in airway
management and tracheostomy care. Clients with stable conditions such as renal
calculi (A), UTI (C), and pressure injury (D) can be managed by a PN under RN
supervision. The charge nurse should match client acuity with staff competency .
Question 9
A client recovering from an abdominal hysterectomy is 2 days postoperative. Which
finding should the nurse report to the healthcare provider?
A) Pain at the incision site
B) Temperature of 100.4°F (38°C)
C) WBC count 12,000/mm³
D) Heart rate 88 beats/min
Answer: B
Rationale: A temperature of 100.4°F (38°C) 2 days postoperatively may indicate
infection. Pain (A) is expected; WBC 12,000 (C) is within expected postoperative range;
HR 88 (D) is within normal limits. The nurse should continue to monitor the client's vital
signs and assess the incision for signs of infection .
HESI EXIT RN V5 EXAM LATEST VERSION QUESTIONS AND
ANSWERS 2026 EDITION
HESI EXIT RN V5 EXAM - 250 Questions with Detailed Rationales
Based on NGN-Style Questions & Current NCLEX Test Plan
SECTION 1: MEDICAL-SURGICAL NURSING (Questions 1-70)
Question 1
A client is admitted with a severe asthma attack. Over the last 3 hours, the client
has had increasing shortness of breath. Recent ABG results are: pH 7.22, PaCO₂ 55
mmHg, HCO₃ 25 mEq/L. Which intervention should the nurse implement?
A) Alert the anesthesia team for emergency intubation
B) Increase the client's fluid intake to 3000 mL/day
C) Administer a PRN dose of albuterol
D) Place the client in Trendelenburg position
Answer: C
Rationale: The ABG results indicate respiratory acidosis (low pH, high PaCO₂) due to
inadequate ventilation. A fast-acting bronchodilator (albuterol) can improve airflow,
help the client blow off CO₂, and may prevent the need for intubation. Intubation (A)
may be needed if the client does not respond to bronchodilators, but it is not the first
step. Increasing fluids (B) does not address bronchospasm. Trendelenburg position (D)
would worsen respiratory effort. Monitoring the client's respiratory status and oxygen
saturation is also essential .
Question 2
A client is receiving teaching about lifestyle changes to slow the progression of
coronary artery disease (CAD). Which client responses indicate a need for further
teaching? (Select all that apply.)
A) "I'll keep a food diary."
B) "I'll eat more canned vegetables."
C) "I'll consume foods with saturated fat."
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D) "I'll walk 30 minutes a day."
E) "I'll include oatmeal at breakfast."
F) "I'll use a salt substitute."
Answer: B, C
Rationale: Canned vegetables (B) are often high in sodium, which can increase blood
pressure. Saturated fats (C) raise serum cholesterol and accelerate CAD progression.
Keeping a food diary (A), walking 30 minutes a day (D), including oatmeal (E), and using
a salt substitute (F) are all positive lifestyle modifications for CAD prevention. Patients
should be taught to choose fresh or low-sodium vegetables and limit saturated fat
intake .
Question 3
A client recovering on the outpatient surgical unit after an endoscopic carpal
tunnel release has stable vital signs, controlled pain, and a clean dressing. What
should the nurse do before discharging the client?
A) Teach sterile dressing changes in 3 days
B) Assess neurovascular status of the affected digits
C) Provide an informational pamphlet on carpal tunnel syndrome
D) Schedule outpatient physical therapy for next week
Answer: B
Rationale: After carpal tunnel release, neurovascular integrity (sensation, circulation,
and movement) of the affected digits is crucial to evaluate before discharge. Although
other actions such as providing information and scheduling physical therapy are
important, assessing the client's neurovascular status is the priority to identify any early
signs of complications. Routine sterile dressing changes (A) are not needed for this
clean surgical incision. Providing a pamphlet (C) is not the priority. Physical therapy (D)
is typically scheduled later .
Question 4
A client with an xenograft asks the nurse about the source of the graft. Which
response by the nurse is correct?
A) "The xenograft is derived from a living Jewish donor."
B) "The xenograft is from human cadaver skin."
C) "The xenograft is artificially created in a laboratory."
D) "The xenograft is taken from nonhuman sources."
Answer: D
Rationale: A xenograft (heterograft) is a graft taken from a nonhuman source, most
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commonly from pigs (porcine) or other animals. Human cadaver skin is an allograft (B).
The nurse should provide accurate information so the client can make informed
decisions regarding consent .
Question 5
An older female client is diagnosed with osteoporosis. Which expected outcome
has the highest priority for this client?
A) Names three foods high in calcium
B) Explains the role of vitamin D in bone health
C) Demonstrates weight-bearing exercise technique
D) Identifies three home safety hazards to correct immediately
Answer: D
Rationale: Falls in clients with osteoporosis are a major concern because of the high
risk of fractures. Prevention of injury is paramount, making elimination of safety hazards
the top priority. While knowledge of calcium-rich foods (A), vitamin D (B), and exercise
(C) are important for long-term bone health, they do not address the immediate risk of
fall-related fractures .
Question 6
A nurse is providing teaching to a client with type 2 diabetes mellitus about
important points for disease and symptom management. Which statement by the
client indicates understanding?
A) "Using salt, herbs, and spices will improve the flavor of foods."
B) "I will get my eyes examined by an ophthalmologist every year."
C) "I need to arrange my diet schedule around three regular meals a day."
D) "I'll inspect my feet every month for ingrown nails, cuts, and calluses."
Answer: B
Rationale: Annual dilated eye examinations by an ophthalmologist are recommended
for clients with diabetes to detect and treat retinopathy early. While salt and herbs (A)
are appropriate for flavoring food, this alone does not indicate comprehensive
understanding of diabetes management. Three regular meals (C) is not the focus; meal
timing should align with medication. Feet should be inspected daily (D), not monthly .
Question 7
A male client with a brain tumor has a 50-second tonic-clonic seizure and is now
lethargic and confused. His wife says this is his first seizure. What should the nurse
do first?
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A) Ask the wife to wait outside
B) Keep reorienting him until confusion subsides
C) Notify the emergency response team
D) Explain the postictal state that usually follows seizures
Answer: D
Rationale: After a major seizure, the postictal phase (confusion, lethargy) is a normal
phenomenon. Explaining this to the wife immediately can reassure her and reduce
anxiety. Asking her to wait outside (A) is not supportive. Reorienting (B) is important but
explaining the postictal state is the priority for family education. The emergency
response team (C) is not needed unless seizures recur or there is respiratory
compromise .
Question 8
The charge nurse is planning assignments for the shift with an RN and a PN. Which
client should be assigned to the RN?
A) A 75-year-old with renal calculi requiring urine straining
B) A client with a new tracheostomy
C) A client with a urinary tract infection
D) A client with a pressure injury
Answer: B
Rationale: A client with a new tracheostomy requires a nurse with experience in airway
management and tracheostomy care. Clients with stable conditions such as renal
calculi (A), UTI (C), and pressure injury (D) can be managed by a PN under RN
supervision. The charge nurse should match client acuity with staff competency .
Question 9
A client recovering from an abdominal hysterectomy is 2 days postoperative. Which
finding should the nurse report to the healthcare provider?
A) Pain at the incision site
B) Temperature of 100.4°F (38°C)
C) WBC count 12,000/mm³
D) Heart rate 88 beats/min
Answer: B
Rationale: A temperature of 100.4°F (38°C) 2 days postoperatively may indicate
infection. Pain (A) is expected; WBC 12,000 (C) is within expected postoperative range;
HR 88 (D) is within normal limits. The nurse should continue to monitor the client's vital
signs and assess the incision for signs of infection .
