HESI RN ELIMINATION ACCURATE
COMPREHENSIVE PRACTICE EXAM WITH ALL
POSSIBLE APPROVED WELL ELABORATED
PRACTICE QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS WITH DETAILED RATIONALES
PLUS EXPERT ANSWER KEY (100% CORRECT
VERIFIED SOLUTIONS) 2026-2027 CURRENTLY
UPDATED VERSION Q&A GUARANTEED PASS A+
INSTANT DOWNLOAD PDF
1. A client with a history of chronic kidney disease is scheduled for a
renal ultrasound. Which pre-procedure nursing action is most
important?
a. Administer a bowel preparation.
b. Ensure the client is NPO for 8 hours.
c. Obtain a signed consent form.
d. Instruct the client to void immediately before the procedure.
Rationale: A full bladder can obscure the view of the kidneys and
pelvic structures during a renal ultrasound. Voiding before the
procedure helps to ensure a clearer image. Bowel preparation
and NPO status are not typically required for a renal ultrasound;
a consent form is needed but the most critical immediate pre-
procedure action is to have the client void.
2. The nurse is caring for a client with an indwelling urinary catheter.
Which finding indicates a need for immediate intervention?
, a. The drainage bag is below the level of the bladder.
b. There is sediment and cloudiness in the urine.
c. The catheter is secured to the client's thigh.
d. The urine output is 50 mL per hour.
Rationale: Sediment and cloudiness can indicate a urinary tract
infection (UTI) or catheter encrustation, which requires
immediate assessment and intervention. The drainage bag
should be below the bladder, the catheter should be secured,
and 50 mL/hr is acceptable urine output.
3. A client is experiencing urinary incontinence after a stroke. Which
nursing intervention is most appropriate to promote continence?
a. Restrict fluid intake to 1000 mL per day.
b. Implement a prompted voiding schedule.
c. Insert an indwelling urinary catheter.
d. Administer anticholinergic medications.
Rationale: Prompted voiding (scheduled toileting) is a behavioral
technique that can help clients with cognitive or mobility
impairments regain bladder control by reminding them to void
at regular intervals. Restricting fluids can lead to dehydration
and urinary concentration, which can irritate the bladder.
Catheters increase infection risk. Anticholinergics may be used
for overactive bladder but are not the first-line behavioral
intervention for post-stroke incontinence.
4. The nurse is assessing a client who has a new ileostomy. Which
assessment finding would be a cause for concern?
a. The stoma is dark pink and moist.
b. The effluent is liquid and continuous.
c. The skin around the stoma is intact.
d. The stoma is slightly edematous.
Rationale: An ileostomy effluent is normally liquid and
, continuous because the ileum absorbs less water. The stoma
should be pink/red and moist, skin around it intact, and some
edema is normal for the first few weeks. If the stoma is dark,
pale, or dry, that is a concern.
5. A client with benign prostatic hyperplasia (BPH) is experiencing
urinary retention. Which medication would the nurse anticipate
being prescribed?
a. Phenazopyridine (Pyridium)
b. Tamsulosin (Flomax)
c. Nitrofurantoin (Macrobid)
d. Oxybutynin (Ditropan)
Rationale: Tamsulosin is an alpha-blocker that relaxes smooth
muscle in the prostate and bladder neck, improving urine flow in
BPH. Phenazopyridine is a urinary analgesic. Nitrofurantoin is an
antibiotic. Oxybutynin is an anticholinergic used for overactive
bladder, which can worsen urinary retention.
6. The nurse is caring for a client with acute pyelonephritis. Which
vital sign finding is most consistent with this diagnosis?
a. Bradycardia and hypotension
b. Fever and tachycardia
c. Hypothermia and bradypnea
d. Normal temperature and hypertension
Rationale: Acute pyelonephritis is a kidney infection; the systemic
inflammatory response typically causes fever and tachycardia.
Bradycardia, hypotension, and hypothermia are not typical
findings in an acute infection.
7. A client is prescribed furosemide (Lasix) for heart failure. Which
laboratory value should the nurse monitor most closely?
a. Serum sodium
, b. Serum potassium
c. Serum calcium
d. Serum glucose
Rationale: Furosemide is a loop diuretic that inhibits sodium and
potassium reabsorption, leading to significant potassium loss
(hypokalemia). While sodium, calcium, and glucose may be
affected, potassium is the most critical electrolyte to monitor
due to the risk of cardiac arrhythmias.
8. An older adult client reports constipation. Which
recommendation should the nurse make first?
a. Administer a tap water enema.
b. Increase dietary fiber and fluid intake.
c. Begin a daily stimulant laxative.
d. Use a bisacodyl suppository daily.
Rationale: The first-line, least invasive intervention for
constipation is increasing dietary fiber and fluid intake. This
promotes natural bowel motility. Enemas and laxatives should
be reserved for when lifestyle changes are ineffective and can
cause dependence or electrolyte imbalances.
9. The nurse is preparing to administer a cleansing enema. In which
position should the client be placed?
a. Prone
b. Left lateral (Sims' position)
c. Supine
d. Right lateral
Rationale: The left lateral (Sims') position allows the enema
solution to flow by gravity into the sigmoid and descending
colon, following the natural anatomical curve of the colon. This
promotes retention and effectiveness.
COMPREHENSIVE PRACTICE EXAM WITH ALL
POSSIBLE APPROVED WELL ELABORATED
PRACTICE QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS WITH DETAILED RATIONALES
PLUS EXPERT ANSWER KEY (100% CORRECT
VERIFIED SOLUTIONS) 2026-2027 CURRENTLY
UPDATED VERSION Q&A GUARANTEED PASS A+
INSTANT DOWNLOAD PDF
1. A client with a history of chronic kidney disease is scheduled for a
renal ultrasound. Which pre-procedure nursing action is most
important?
a. Administer a bowel preparation.
b. Ensure the client is NPO for 8 hours.
c. Obtain a signed consent form.
d. Instruct the client to void immediately before the procedure.
Rationale: A full bladder can obscure the view of the kidneys and
pelvic structures during a renal ultrasound. Voiding before the
procedure helps to ensure a clearer image. Bowel preparation
and NPO status are not typically required for a renal ultrasound;
a consent form is needed but the most critical immediate pre-
procedure action is to have the client void.
2. The nurse is caring for a client with an indwelling urinary catheter.
Which finding indicates a need for immediate intervention?
, a. The drainage bag is below the level of the bladder.
b. There is sediment and cloudiness in the urine.
c. The catheter is secured to the client's thigh.
d. The urine output is 50 mL per hour.
Rationale: Sediment and cloudiness can indicate a urinary tract
infection (UTI) or catheter encrustation, which requires
immediate assessment and intervention. The drainage bag
should be below the bladder, the catheter should be secured,
and 50 mL/hr is acceptable urine output.
3. A client is experiencing urinary incontinence after a stroke. Which
nursing intervention is most appropriate to promote continence?
a. Restrict fluid intake to 1000 mL per day.
b. Implement a prompted voiding schedule.
c. Insert an indwelling urinary catheter.
d. Administer anticholinergic medications.
Rationale: Prompted voiding (scheduled toileting) is a behavioral
technique that can help clients with cognitive or mobility
impairments regain bladder control by reminding them to void
at regular intervals. Restricting fluids can lead to dehydration
and urinary concentration, which can irritate the bladder.
Catheters increase infection risk. Anticholinergics may be used
for overactive bladder but are not the first-line behavioral
intervention for post-stroke incontinence.
4. The nurse is assessing a client who has a new ileostomy. Which
assessment finding would be a cause for concern?
a. The stoma is dark pink and moist.
b. The effluent is liquid and continuous.
c. The skin around the stoma is intact.
d. The stoma is slightly edematous.
Rationale: An ileostomy effluent is normally liquid and
, continuous because the ileum absorbs less water. The stoma
should be pink/red and moist, skin around it intact, and some
edema is normal for the first few weeks. If the stoma is dark,
pale, or dry, that is a concern.
5. A client with benign prostatic hyperplasia (BPH) is experiencing
urinary retention. Which medication would the nurse anticipate
being prescribed?
a. Phenazopyridine (Pyridium)
b. Tamsulosin (Flomax)
c. Nitrofurantoin (Macrobid)
d. Oxybutynin (Ditropan)
Rationale: Tamsulosin is an alpha-blocker that relaxes smooth
muscle in the prostate and bladder neck, improving urine flow in
BPH. Phenazopyridine is a urinary analgesic. Nitrofurantoin is an
antibiotic. Oxybutynin is an anticholinergic used for overactive
bladder, which can worsen urinary retention.
6. The nurse is caring for a client with acute pyelonephritis. Which
vital sign finding is most consistent with this diagnosis?
a. Bradycardia and hypotension
b. Fever and tachycardia
c. Hypothermia and bradypnea
d. Normal temperature and hypertension
Rationale: Acute pyelonephritis is a kidney infection; the systemic
inflammatory response typically causes fever and tachycardia.
Bradycardia, hypotension, and hypothermia are not typical
findings in an acute infection.
7. A client is prescribed furosemide (Lasix) for heart failure. Which
laboratory value should the nurse monitor most closely?
a. Serum sodium
, b. Serum potassium
c. Serum calcium
d. Serum glucose
Rationale: Furosemide is a loop diuretic that inhibits sodium and
potassium reabsorption, leading to significant potassium loss
(hypokalemia). While sodium, calcium, and glucose may be
affected, potassium is the most critical electrolyte to monitor
due to the risk of cardiac arrhythmias.
8. An older adult client reports constipation. Which
recommendation should the nurse make first?
a. Administer a tap water enema.
b. Increase dietary fiber and fluid intake.
c. Begin a daily stimulant laxative.
d. Use a bisacodyl suppository daily.
Rationale: The first-line, least invasive intervention for
constipation is increasing dietary fiber and fluid intake. This
promotes natural bowel motility. Enemas and laxatives should
be reserved for when lifestyle changes are ineffective and can
cause dependence or electrolyte imbalances.
9. The nurse is preparing to administer a cleansing enema. In which
position should the client be placed?
a. Prone
b. Left lateral (Sims' position)
c. Supine
d. Right lateral
Rationale: The left lateral (Sims') position allows the enema
solution to flow by gravity into the sigmoid and descending
colon, following the natural anatomical curve of the colon. This
promotes retention and effectiveness.
