HESI RN Exit Exam Practice Test 2026/2027
100 Comprehensive Questions across all Nursing Specialties
1. A client with a history of heart failure is admitted with a potassium level of 2.8
mEq/L. Which medication should the nurse clarify with the healthcare provider?
A. Furosemide
B. Spironolactone
C. Digoxin
D. Potassium Chloride
Correct Answer: C
Rationale: Hypokalemia (2.8) significantly increases the risk of digoxin toxicity. While Furosemide
also lowers potassium, Digoxin is the most dangerous medication to administer when potassium is
critically low due to life-threatening arrhythmias.
2. The nurse is prioritizing care for four clients. Which client should the nurse
assess first?
A. A client with a chest tube who has 50 mL of drainage in the last hour.
B. A client post-appendectomy reporting pain of 8/10.
C. A client with a new cast reporting 'pins and needles' sensation in the toes.
D. A client with COPD and an oxygen saturation of 89%.
Correct Answer: C
Rationale: The 'pins and needles' (paresthesia) is an early sign of Compartment Syndrome, which
is a neurovascular emergency. The other findings are either expected (COPD SpO2, chest tube
drainage) or non-emergent (post-op pain).
3. Which task is most appropriate for the RN to delegate to an Unlicensed
Assistive Personnel (UAP)?
A. Feeding a client with a new diagnosis of dysphagia.
B. Assisting a stable client to ambulate for the first time post-op.
C. Measuring the output from a urinary catheter.
D. Providing discharge instructions to a client after a colonoscopy.
Correct Answer: C
Rationale: Measuring output is a standard task for UAPs. First-time ambulation and dysphagia
feeding carry higher risks and require assessment, and discharge teaching is the responsibility of
the RN.
,4. A 2-year-old child is admitted with a suspected diagnosis of intussusception.
Which clinical finding should the nurse expect?
A. Steatorrhea
B. Currant jelly-like stools
C. Ribbon-like stools
D. Projectile vomiting
Correct Answer: B
Rationale: Currant jelly-like stools (blood and mucus) are the classic finding for intussusception.
Ribbon-like stools are associated with Hirschsprung's disease.
5. A client in active labor is experiencing late decelerations on the fetal monitor.
What is the nurse's priority action?
A. Increase the IV Oxytocin rate.
B. Place the client in a supine position.
C. Apply oxygen via a non-rebreather mask.
D. Prepare for an immediate vacuum extraction.
Correct Answer: C
Rationale: Late decelerations indicate uteroplacental insufficiency. Priority actions (LION) include
Left side positioning, IV bolus, Oxygen, and Notifying the provider. Oxytocin must be stopped, not
increased.
6. A client with schizophrenia is experiencing auditory hallucinations and is
becoming agitated. Which statement by the nurse is most therapeutic?
A. 'Don't worry, the voices are just in your head.'
B. 'I don't hear any voices, but I can see that you are frightened.'
C. 'What are the voices telling you to do?'
D. 'Why do you think you are hearing voices right now?'
Correct Answer: B
Rationale: The nurse should acknowledge the client's feelings without validating the hallucination
(presenting reality).
7. The nurse is caring for a client with a head injury. Which assessment finding
is an early sign of increased intracranial pressure (ICP)?
A. Widening pulse pressure
B. Bradycardia
C. Altered level of consciousness
D. Fixed, dilated pupils
Correct Answer: C
Rationale: A change in Level of Consciousness (LOC) is the earliest and most sensitive indicator
of increased ICP. Cushing's Triad (A and B) and pupil changes (D) are late signs.
, 8. Which food choice is appropriate for a client in the manic phase of Bipolar
Disorder?
A. Soup and salad
B. Steak and baked potato
C. Cheeseburger and an apple
D. Spaghetti and meatballs
Correct Answer: C
Rationale: Clients in mania need high-calorie 'finger foods' that they can eat while moving, as they
often cannot sit still for a meal.
9. A nurse is caring for a client with a magnesium level of 1.1 mEq/L. Which
assessment finding is expected?
A. Diminished deep tendon reflexes
B. Lethargy
C. Hyperactive deep tendon reflexes
D. Bradycardia
Correct Answer: C
Rationale: Hypomagnesemia (low Mg) causes neuromuscular irritability, leading to hyperactive
reflexes, tremors, and seizures. High Mg causes the opposite (diminished reflexes).
10. A client is 4 hours post-op from a total thyroidectomy. The nurse notes the
client's voice is increasingly hoarse. What is the priority nursing action?
A. Reassure the client that hoarseness is expected.
B. Assess the client for airway obstruction and laryngeal nerve damage.
C. Encourage the client to cough and deep breathe.
D. Administer a throat lozenge.
Correct Answer: B
Rationale: While mild hoarseness can be expected, increasing hoarseness or stridor after thyroid
surgery can indicate laryngeal nerve damage or impending airway obstruction due to edema/
hematoma.
11. Exit RN Q11: NG tube placement check?
A. pH of aspirate
B. Air bolus
C. Standard protocol
D. Notify surgeon
Correct Answer: A
Rationale: pH < 5.5 is the most reliable bedside method; X-ray is the gold standard.
100 Comprehensive Questions across all Nursing Specialties
1. A client with a history of heart failure is admitted with a potassium level of 2.8
mEq/L. Which medication should the nurse clarify with the healthcare provider?
A. Furosemide
B. Spironolactone
C. Digoxin
D. Potassium Chloride
Correct Answer: C
Rationale: Hypokalemia (2.8) significantly increases the risk of digoxin toxicity. While Furosemide
also lowers potassium, Digoxin is the most dangerous medication to administer when potassium is
critically low due to life-threatening arrhythmias.
2. The nurse is prioritizing care for four clients. Which client should the nurse
assess first?
A. A client with a chest tube who has 50 mL of drainage in the last hour.
B. A client post-appendectomy reporting pain of 8/10.
C. A client with a new cast reporting 'pins and needles' sensation in the toes.
D. A client with COPD and an oxygen saturation of 89%.
Correct Answer: C
Rationale: The 'pins and needles' (paresthesia) is an early sign of Compartment Syndrome, which
is a neurovascular emergency. The other findings are either expected (COPD SpO2, chest tube
drainage) or non-emergent (post-op pain).
3. Which task is most appropriate for the RN to delegate to an Unlicensed
Assistive Personnel (UAP)?
A. Feeding a client with a new diagnosis of dysphagia.
B. Assisting a stable client to ambulate for the first time post-op.
C. Measuring the output from a urinary catheter.
D. Providing discharge instructions to a client after a colonoscopy.
Correct Answer: C
Rationale: Measuring output is a standard task for UAPs. First-time ambulation and dysphagia
feeding carry higher risks and require assessment, and discharge teaching is the responsibility of
the RN.
,4. A 2-year-old child is admitted with a suspected diagnosis of intussusception.
Which clinical finding should the nurse expect?
A. Steatorrhea
B. Currant jelly-like stools
C. Ribbon-like stools
D. Projectile vomiting
Correct Answer: B
Rationale: Currant jelly-like stools (blood and mucus) are the classic finding for intussusception.
Ribbon-like stools are associated with Hirschsprung's disease.
5. A client in active labor is experiencing late decelerations on the fetal monitor.
What is the nurse's priority action?
A. Increase the IV Oxytocin rate.
B. Place the client in a supine position.
C. Apply oxygen via a non-rebreather mask.
D. Prepare for an immediate vacuum extraction.
Correct Answer: C
Rationale: Late decelerations indicate uteroplacental insufficiency. Priority actions (LION) include
Left side positioning, IV bolus, Oxygen, and Notifying the provider. Oxytocin must be stopped, not
increased.
6. A client with schizophrenia is experiencing auditory hallucinations and is
becoming agitated. Which statement by the nurse is most therapeutic?
A. 'Don't worry, the voices are just in your head.'
B. 'I don't hear any voices, but I can see that you are frightened.'
C. 'What are the voices telling you to do?'
D. 'Why do you think you are hearing voices right now?'
Correct Answer: B
Rationale: The nurse should acknowledge the client's feelings without validating the hallucination
(presenting reality).
7. The nurse is caring for a client with a head injury. Which assessment finding
is an early sign of increased intracranial pressure (ICP)?
A. Widening pulse pressure
B. Bradycardia
C. Altered level of consciousness
D. Fixed, dilated pupils
Correct Answer: C
Rationale: A change in Level of Consciousness (LOC) is the earliest and most sensitive indicator
of increased ICP. Cushing's Triad (A and B) and pupil changes (D) are late signs.
, 8. Which food choice is appropriate for a client in the manic phase of Bipolar
Disorder?
A. Soup and salad
B. Steak and baked potato
C. Cheeseburger and an apple
D. Spaghetti and meatballs
Correct Answer: C
Rationale: Clients in mania need high-calorie 'finger foods' that they can eat while moving, as they
often cannot sit still for a meal.
9. A nurse is caring for a client with a magnesium level of 1.1 mEq/L. Which
assessment finding is expected?
A. Diminished deep tendon reflexes
B. Lethargy
C. Hyperactive deep tendon reflexes
D. Bradycardia
Correct Answer: C
Rationale: Hypomagnesemia (low Mg) causes neuromuscular irritability, leading to hyperactive
reflexes, tremors, and seizures. High Mg causes the opposite (diminished reflexes).
10. A client is 4 hours post-op from a total thyroidectomy. The nurse notes the
client's voice is increasingly hoarse. What is the priority nursing action?
A. Reassure the client that hoarseness is expected.
B. Assess the client for airway obstruction and laryngeal nerve damage.
C. Encourage the client to cough and deep breathe.
D. Administer a throat lozenge.
Correct Answer: B
Rationale: While mild hoarseness can be expected, increasing hoarseness or stridor after thyroid
surgery can indicate laryngeal nerve damage or impending airway obstruction due to edema/
hematoma.
11. Exit RN Q11: NG tube placement check?
A. pH of aspirate
B. Air bolus
C. Standard protocol
D. Notify surgeon
Correct Answer: A
Rationale: pH < 5.5 is the most reliable bedside method; X-ray is the gold standard.
