HESI EXIT EXAM REVIEW 2026 (PDF) | PRACTICE QUESTIONS QUESTIONS AND ANSWERS ALREADY GRADED
A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
The nurse is preparing to administer a blood transfusion to a patient with anemia. Which IV solution should the
nurse use to prime the blood administration tubing?
A. 0.9% normal saline
B. 5% dextrose in water
C. Lactated Ringer's solution
D. 0.45% normal saline
🟢 Correct Answer:
A. 0.9% normal saline
🔴 RATIONALE:
Only 0.9% normal saline should be used to prime blood administration tubing. Dextrose solutions can cause
hemolysis of red blood cells, and lactated Ringer's contains calcium, which can cause clotting in the tubing.
Normal saline maintains isotonicity and is compatible with blood products.
Question 2
A patient with cirrhosis of the liver is exhibiting signs of hepatic encephalopathy. Which dietary modification is
most appropriate for this patient?
,A. High-protein diet
B. Low-protein diet
C. High-sodium diet
D. Low-carbohydrate diet
🟢 Correct Answer:
B. Low-protein diet
🔴 RATIONALE:
In hepatic encephalopathy, ammonia levels are elevated due to the liver's inability to convert ammonia to urea.
A low-protein diet is prescribed to reduce the production of ammonia from protein breakdown. Sodium
restriction is important for ascites, not encephalopathy.
Question 3
A patient is prescribed metformin for type 2 diabetes mellitus. The nurse should monitor for which serious
adverse effect?
A. Lactic acidosis
B. Hypoglycemia
C. Weight gain
D. Peripheral edema
🟢 Correct Answer:
A. Lactic acidosis
,🔴 RATIONALE:
Metformin can cause lactic acidosis, a rare but serious adverse effect. It is more likely to occur in patients with
renal impairment, hepatic disease, or heart failure. The nurse should monitor for signs such as muscle pain,
weakness, and hyperventilation.
Question 4
A patient is receiving continuous enteral nutrition via a nasogastric tube. The nurse checks the gastric residual
volume and finds it to be 400 mL. What is the nurse's best action?
A. Discard the residual and continue the feeding
B. Reinstill the residual and continue the feeding
C. Hold the feeding and notify the healthcare provider
D. Increase the feeding rate
🟢 Correct Answer:
C. Hold the feeding and notify the healthcare provider
🔴 RATIONALE:
A gastric residual volume of 400 mL is considered high and may indicate delayed gastric emptying, increasing
the risk of aspiration. The feeding should be held, and the healthcare provider should be notified for further
orders. Some protocols may use 500 mL as the threshold, but 400 mL is generally concerning.
, Question 5
A patient with a history of deep vein thrombosis (DVT) is prescribed warfarin. The nurse notes an INR of 3.8.
What is the nurse's priority action?
A. Administer the next dose of warfarin as scheduled
B. Hold the next dose and notify the healthcare provider
C. Administer vitamin K intravenously
D. Increase the dose of warfarin
🟢 Correct Answer:
B. Hold the next dose and notify the healthcare provider
🔴 RATIONALE:
A therapeutic INR for warfarin is typically 2.0-3.0. An INR of 3.8 is elevated and indicates an increased risk of
bleeding. The nurse should hold the next dose and notify the healthcare provider for a dose adjustment.
Vitamin K is administered only for significant bleeding or a dangerously elevated INR.
Question 6
A patient with a urinary tract infection is prescribed ciprofloxacin. The nurse should instruct the patient to:
A. Take the medication with dairy products
B. Avoid taking the medication with calcium-fortified juices
C. Take the medication on an empty stomach
D. Take the medication with a full glass of orange juice
A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
The nurse is preparing to administer a blood transfusion to a patient with anemia. Which IV solution should the
nurse use to prime the blood administration tubing?
A. 0.9% normal saline
B. 5% dextrose in water
C. Lactated Ringer's solution
D. 0.45% normal saline
🟢 Correct Answer:
A. 0.9% normal saline
🔴 RATIONALE:
Only 0.9% normal saline should be used to prime blood administration tubing. Dextrose solutions can cause
hemolysis of red blood cells, and lactated Ringer's contains calcium, which can cause clotting in the tubing.
Normal saline maintains isotonicity and is compatible with blood products.
Question 2
A patient with cirrhosis of the liver is exhibiting signs of hepatic encephalopathy. Which dietary modification is
most appropriate for this patient?
,A. High-protein diet
B. Low-protein diet
C. High-sodium diet
D. Low-carbohydrate diet
🟢 Correct Answer:
B. Low-protein diet
🔴 RATIONALE:
In hepatic encephalopathy, ammonia levels are elevated due to the liver's inability to convert ammonia to urea.
A low-protein diet is prescribed to reduce the production of ammonia from protein breakdown. Sodium
restriction is important for ascites, not encephalopathy.
Question 3
A patient is prescribed metformin for type 2 diabetes mellitus. The nurse should monitor for which serious
adverse effect?
A. Lactic acidosis
B. Hypoglycemia
C. Weight gain
D. Peripheral edema
🟢 Correct Answer:
A. Lactic acidosis
,🔴 RATIONALE:
Metformin can cause lactic acidosis, a rare but serious adverse effect. It is more likely to occur in patients with
renal impairment, hepatic disease, or heart failure. The nurse should monitor for signs such as muscle pain,
weakness, and hyperventilation.
Question 4
A patient is receiving continuous enteral nutrition via a nasogastric tube. The nurse checks the gastric residual
volume and finds it to be 400 mL. What is the nurse's best action?
A. Discard the residual and continue the feeding
B. Reinstill the residual and continue the feeding
C. Hold the feeding and notify the healthcare provider
D. Increase the feeding rate
🟢 Correct Answer:
C. Hold the feeding and notify the healthcare provider
🔴 RATIONALE:
A gastric residual volume of 400 mL is considered high and may indicate delayed gastric emptying, increasing
the risk of aspiration. The feeding should be held, and the healthcare provider should be notified for further
orders. Some protocols may use 500 mL as the threshold, but 400 mL is generally concerning.
, Question 5
A patient with a history of deep vein thrombosis (DVT) is prescribed warfarin. The nurse notes an INR of 3.8.
What is the nurse's priority action?
A. Administer the next dose of warfarin as scheduled
B. Hold the next dose and notify the healthcare provider
C. Administer vitamin K intravenously
D. Increase the dose of warfarin
🟢 Correct Answer:
B. Hold the next dose and notify the healthcare provider
🔴 RATIONALE:
A therapeutic INR for warfarin is typically 2.0-3.0. An INR of 3.8 is elevated and indicates an increased risk of
bleeding. The nurse should hold the next dose and notify the healthcare provider for a dose adjustment.
Vitamin K is administered only for significant bleeding or a dangerously elevated INR.
Question 6
A patient with a urinary tract infection is prescribed ciprofloxacin. The nurse should instruct the patient to:
A. Take the medication with dairy products
B. Avoid taking the medication with calcium-fortified juices
C. Take the medication on an empty stomach
D. Take the medication with a full glass of orange juice
