HESI RN Exit Exam 2026 – Versions V1–V7 | Actual
Exam Questions & Verified Correct Answers
1. A client with chronic obstructive pulmonary disease (COPD) is admitted with
worsening dyspnea. Which nursing intervention is the priority?
A) Administer oxygen at 2 L/min via nasal cannula
B) Position the client in high Fowler's position
C) Encourage pursed-lip breathing
D) Auscultate lung sounds
Answer B: Position the client in high Fowler's position
Rationale: High Fowler's position maximizes lung expansion and facilitates
breathing. Positioning is a rapid, non-invasive intervention that improves ventilation-
perfusion matching .
2. The nurse is caring for a client with acute pancreatitis. Which finding
indicates a life-threatening complication requiring immediate intervention?
A) Epigastric pain radiating to the back
B) Serum amylase level of 350 U/L
C) Positive Trousseau's sign
D) Nausea and vomiting
Answer C: Positive Trousseau's sign
Rationale: Trousseau's sign (carpal spasm when a blood pressure cuff is inflated)
indicates hypocalcemia, a potentially life-threatening complication of acute
pancreatitis that can lead to cardiac arrhythmias and seizures .
,3. Which assessment finding indicates that a client with heart failure is
experiencing worsening fluid overload?
A) Weight gain of 2 pounds in 24 hours
B) Jugular venous distention
C) Crackles in the lung bases
D) Peripheral edema in the lower extremities
Answer A: Weight gain of 2 pounds in 24 hours
Rationale: A weight gain of 2–3 pounds in 24 hours or 5 pounds in one week
indicates significant fluid retention (each pound equals approximately 500 mL of
fluid) .
4. A client taking clopidogrel reports the onset of diarrhea. Which nursing
action should the nurse implement first?
A) Observe the appearance of the stool
B) Assess the elasticity of the client's skin
C) Review the client's laboratory values
D) Auscultate the client's bowel sounds
Answer A: Observe the appearance of the stool
Rationale: Clopidogrel can cause gastrointestinal bleeding; the nurse should first
assess the stool for evidence of bleeding (melena or frank blood) .
5. A client is receiving enoxaparin 30 mg subcutaneously twice daily. In
assessing for adverse effects, which laboratory value is most important to
monitor?
A) Prothrombin time (PT)
B) Activated partial thromboplastin time (aPTT)
,C) Platelet count
D) International normalized ratio (INR)
Answer C: Platelet count
Rationale: Enoxaparin can cause heparin-induced thrombocytopenia (HIT);
monitoring platelet count is essential to detect this potentially serious complication .
6. A client with severe preeclampsia is receiving IV magnesium sulfate. Which
finding indicates magnesium toxicity?
A) Deep tendon reflexes 2+
B) Urine output 40 mL/hr
C) Respiratory rate 10 breaths/min
D) Serum magnesium level 4.5 mg/dL
Answer C: Respiratory rate 10 breaths/min
Rationale: Respiratory depression (<12 breaths/min) is a sign of magnesium
toxicity. Calcium gluconate is the antidote and should be readily available.
7. A nurse is assessing a client who returned from the post-anesthesia care unit
(PACU) following a thyroidectomy. Which finding requires immediate
intervention?
A) Stridor and difficulty breathing
B) Mild pain at the incision site
C) Hoarse voice
D) Temperature 37.5°C (99.5°F)
Answer A: Stridor and difficulty breathing
Rationale: After thyroidectomy, stridor may indicate laryngeal edema or
hemorrhage causing airway compression—a medical emergency .
, 8. A client is receiving a continuous heparin infusion. The aPTT result is 110
seconds (control 30 seconds). Which action should the nurse take?
A) Stop the heparin infusion and notify the provider
B) Continue the infusion at the same rate
C) Decrease the infusion rate
D) Increase the infusion rate
Answer A: Stop the heparin infusion and notify the provider
Rationale: The therapeutic aPTT is typically 1.5–2.5 times control (45–75 seconds).
An aPTT of 110 seconds is supratherapeutic and increases bleeding risk .
9. The nurse is demonstrating correct transfer procedures to unlicensed
assistive personnel (UAP). How should the UAP safely move a physically
disabled client from the wheelchair to the bed?
A) Place the client's locked wheelchair on the client's strong side next to the bed
B) Lift the client under the axillae
C) Place the wheelchair at a 90-degree angle to the bed
D) Instruct the client to place arms around the nurse's neck
Answer A: Place the client's locked wheelchair on the client's strong side next
to the bed
Rationale: Positioning the locked wheelchair on the client's strong side provides a
stable base for transfer. Never lift under the axillae or have the client place arms
around the nurse's neck .
Exam Questions & Verified Correct Answers
1. A client with chronic obstructive pulmonary disease (COPD) is admitted with
worsening dyspnea. Which nursing intervention is the priority?
A) Administer oxygen at 2 L/min via nasal cannula
B) Position the client in high Fowler's position
C) Encourage pursed-lip breathing
D) Auscultate lung sounds
Answer B: Position the client in high Fowler's position
Rationale: High Fowler's position maximizes lung expansion and facilitates
breathing. Positioning is a rapid, non-invasive intervention that improves ventilation-
perfusion matching .
2. The nurse is caring for a client with acute pancreatitis. Which finding
indicates a life-threatening complication requiring immediate intervention?
A) Epigastric pain radiating to the back
B) Serum amylase level of 350 U/L
C) Positive Trousseau's sign
D) Nausea and vomiting
Answer C: Positive Trousseau's sign
Rationale: Trousseau's sign (carpal spasm when a blood pressure cuff is inflated)
indicates hypocalcemia, a potentially life-threatening complication of acute
pancreatitis that can lead to cardiac arrhythmias and seizures .
,3. Which assessment finding indicates that a client with heart failure is
experiencing worsening fluid overload?
A) Weight gain of 2 pounds in 24 hours
B) Jugular venous distention
C) Crackles in the lung bases
D) Peripheral edema in the lower extremities
Answer A: Weight gain of 2 pounds in 24 hours
Rationale: A weight gain of 2–3 pounds in 24 hours or 5 pounds in one week
indicates significant fluid retention (each pound equals approximately 500 mL of
fluid) .
4. A client taking clopidogrel reports the onset of diarrhea. Which nursing
action should the nurse implement first?
A) Observe the appearance of the stool
B) Assess the elasticity of the client's skin
C) Review the client's laboratory values
D) Auscultate the client's bowel sounds
Answer A: Observe the appearance of the stool
Rationale: Clopidogrel can cause gastrointestinal bleeding; the nurse should first
assess the stool for evidence of bleeding (melena or frank blood) .
5. A client is receiving enoxaparin 30 mg subcutaneously twice daily. In
assessing for adverse effects, which laboratory value is most important to
monitor?
A) Prothrombin time (PT)
B) Activated partial thromboplastin time (aPTT)
,C) Platelet count
D) International normalized ratio (INR)
Answer C: Platelet count
Rationale: Enoxaparin can cause heparin-induced thrombocytopenia (HIT);
monitoring platelet count is essential to detect this potentially serious complication .
6. A client with severe preeclampsia is receiving IV magnesium sulfate. Which
finding indicates magnesium toxicity?
A) Deep tendon reflexes 2+
B) Urine output 40 mL/hr
C) Respiratory rate 10 breaths/min
D) Serum magnesium level 4.5 mg/dL
Answer C: Respiratory rate 10 breaths/min
Rationale: Respiratory depression (<12 breaths/min) is a sign of magnesium
toxicity. Calcium gluconate is the antidote and should be readily available.
7. A nurse is assessing a client who returned from the post-anesthesia care unit
(PACU) following a thyroidectomy. Which finding requires immediate
intervention?
A) Stridor and difficulty breathing
B) Mild pain at the incision site
C) Hoarse voice
D) Temperature 37.5°C (99.5°F)
Answer A: Stridor and difficulty breathing
Rationale: After thyroidectomy, stridor may indicate laryngeal edema or
hemorrhage causing airway compression—a medical emergency .
, 8. A client is receiving a continuous heparin infusion. The aPTT result is 110
seconds (control 30 seconds). Which action should the nurse take?
A) Stop the heparin infusion and notify the provider
B) Continue the infusion at the same rate
C) Decrease the infusion rate
D) Increase the infusion rate
Answer A: Stop the heparin infusion and notify the provider
Rationale: The therapeutic aPTT is typically 1.5–2.5 times control (45–75 seconds).
An aPTT of 110 seconds is supratherapeutic and increases bleeding risk .
9. The nurse is demonstrating correct transfer procedures to unlicensed
assistive personnel (UAP). How should the UAP safely move a physically
disabled client from the wheelchair to the bed?
A) Place the client's locked wheelchair on the client's strong side next to the bed
B) Lift the client under the axillae
C) Place the wheelchair at a 90-degree angle to the bed
D) Instruct the client to place arms around the nurse's neck
Answer A: Place the client's locked wheelchair on the client's strong side next
to the bed
Rationale: Positioning the locked wheelchair on the client's strong side provides a
stable base for transfer. Never lift under the axillae or have the client place arms
around the nurse's neck .
