HESI RN COMPREHENSIVE EXAMINATION - HEALTH EDUCATION
SYSTEMS INCORPORATED (HESI) - 2026/2027 ACADEMIC YEAR -
QUESTIONS AND ANSWERS COVERING FOUR CORE DOMAINS
130 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Apply the nursing process to prioritize care for clients with complex health alterations
2 Evaluate pharmacological interventions for safety, efficacy, and client-specific contraindications
3 Synthesize maternal-child and mental health concepts to plan holistic, evidence-based nursing care
4 Interpret diagnostic data and clinical presentations to make rapid, accurate clinical decisions
5 HESI RN Comprehensive Examination
6 Health Education Systems Incorporated
7 HESI
8 2026
9 2027 Academic Year
10 Questions and Answers Covering Four Core Domains
11 Foundations of Nursing (HESI RN Comprehensive)
12 Applied Nursing (HESI RN Comprehensive)
13 Advanced Nursing (HESI RN Comprehensive)
14 Nursing (HESI RN Comprehensive) Review
ABSTRACT
Page 1
,This study document brings together 130 carefully worded exam questions drawn from HESI RN
Comprehensive Examination - Health Education Systems Incorporated (HESI) - 2026/2027
Academic Year - Questions and Answers Covering Four Core Domains, with the strongest
emphasis placed on Apply the nursing process to prioritize care for clients with complex health
alterations, Evaluate pharmacological interventions for safety, efficacy, and client-specific
contraindications, Synthesize maternal-child and mental health concepts to plan holistic and
evidence-based nursing care. Every item follows the wording style and level of reasoning you meet
in the real paper, and each one is paired with a clear rationale so the correct choice is never a
guess. Work through the set at your own pace, mark the questions that slow you down, then come
back to them until the reasoning feels automatic. Learners who revise this way walk into the exam
room recognising the pattern behind the questions instead of meeting them for the first time. Keep
going - steady, honest practice is what turns a difficult paper into a comfortable pass.
Q1 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH COMPLEX
HEALTH ALTERATIONS
A client with heart failure is receiving IV furosemide 80 mg and oral digoxin 0.25
mg daily. The client's potassium level is 3.1 mEq/L. Which assessment finding
indicates the client is at greatest risk for digoxin toxicity?
A. Muscle weakness and fatigue
B. Nausea and visual halos CORRECT
C. Heart rate of 58 bpm and irregular
D. Serum digoxin level of 1.2 ng/mL
RATIONALE: Hypokalemia potentiates digoxin toxicity; classic signs include GI symptoms
(nausea) and visual disturbances (halos). While bradycardia and arrhythmias can occur, the
hallmark early indicators are GI/visual. Option A is nonspecific, D is within therapeutic range, and
C is a later sign.
Page 2
,Q2 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH COMPLEX
HEALTH ALTERATIONS
A nurse is caring for a client with a chest tube connected to a water-seal drainage
system. The client's family asks why the fluid in the water-seal chamber rises and
falls with respirations. Which response is most accurate?
A. It indicates the lung has re-expanded fully.
B. It reflects normal fluctuations in intrapleural pressure. CORRECT
C. It signals an air leak in the system.
D. It means the suction pressure is set too high.
RATIONALE: Tidaling (rise and fall with respiration) is normal and reflects changes in intrapleural
pressure during breathing. Constant bubbling indicates an air leak; absence of tidaling may
indicate a kink or lung re-expansion. Suction level does not cause tidaling.
Q3 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH COMPLEX
HEALTH ALTERATIONS
A client with diabetic ketoacidosis (DKA) is receiving an insulin infusion at 0.1
units/kg/hr. Blood glucose has dropped from 600 mg/dL to 250 mg/dL. Which
action should the nurse take next?
A. Stop the insulin infusion immediately.
B. Add dextrose to the IV fluids and continue insulin. CORRECT
C. Administer subcutaneous insulin per sliding scale.
D. Decrease the insulin infusion rate by half.
RATIONALE: In DKA management, when blood glucose reaches ~250 mg/dL, dextrose is added
to prevent hypoglycemia while insulin continues to clear ketones. Stopping insulin prematurely
can lead to rebound ketosis. Subcutaneous insulin is not appropriate during IV insulin transition
until criteria are met.
Page 3
, Q4 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH COMPLEX
HEALTH ALTERATIONS
A primigravida at 39 weeks gestation is in active labor. The nurse notes variable
decelerations on the fetal monitor. Which intervention should the nurse implement
first?
A. Reposition the client to side-lying. CORRECT
B. Increase the IV fluid rate.
C. Administer oxygen via face mask.
D. Notify the healthcare provider immediately.
RATIONALE: Variable decelerations are often due to umbilical cord compression; repositioning
(side-lying or knee-chest) is the first-line intervention to relieve pressure. Increasing IV fluids and
oxygen are secondary, and notifying the provider is important but not the first action.
Q5 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH COMPLEX
HEALTH ALTERATIONS
A client with major depressive disorder is prescribed phenelzine, a monoamine
oxidase inhibitor. Which food item should the nurse instruct the client to avoid?
A. Aged cheddar cheese CORRECT
B. Fresh apples
C. Boiled rice
D. Broiled chicken breast
RATIONALE: MAOIs inhibit the breakdown of tyramine; aged cheeses are high in tyramine and
can precipitate a hypertensive crisis. Fresh fruits, rice, and chicken are low in tyramine and safe.
Page 4
SYSTEMS INCORPORATED (HESI) - 2026/2027 ACADEMIC YEAR -
QUESTIONS AND ANSWERS COVERING FOUR CORE DOMAINS
130 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Apply the nursing process to prioritize care for clients with complex health alterations
2 Evaluate pharmacological interventions for safety, efficacy, and client-specific contraindications
3 Synthesize maternal-child and mental health concepts to plan holistic, evidence-based nursing care
4 Interpret diagnostic data and clinical presentations to make rapid, accurate clinical decisions
5 HESI RN Comprehensive Examination
6 Health Education Systems Incorporated
7 HESI
8 2026
9 2027 Academic Year
10 Questions and Answers Covering Four Core Domains
11 Foundations of Nursing (HESI RN Comprehensive)
12 Applied Nursing (HESI RN Comprehensive)
13 Advanced Nursing (HESI RN Comprehensive)
14 Nursing (HESI RN Comprehensive) Review
ABSTRACT
Page 1
,This study document brings together 130 carefully worded exam questions drawn from HESI RN
Comprehensive Examination - Health Education Systems Incorporated (HESI) - 2026/2027
Academic Year - Questions and Answers Covering Four Core Domains, with the strongest
emphasis placed on Apply the nursing process to prioritize care for clients with complex health
alterations, Evaluate pharmacological interventions for safety, efficacy, and client-specific
contraindications, Synthesize maternal-child and mental health concepts to plan holistic and
evidence-based nursing care. Every item follows the wording style and level of reasoning you meet
in the real paper, and each one is paired with a clear rationale so the correct choice is never a
guess. Work through the set at your own pace, mark the questions that slow you down, then come
back to them until the reasoning feels automatic. Learners who revise this way walk into the exam
room recognising the pattern behind the questions instead of meeting them for the first time. Keep
going - steady, honest practice is what turns a difficult paper into a comfortable pass.
Q1 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH COMPLEX
HEALTH ALTERATIONS
A client with heart failure is receiving IV furosemide 80 mg and oral digoxin 0.25
mg daily. The client's potassium level is 3.1 mEq/L. Which assessment finding
indicates the client is at greatest risk for digoxin toxicity?
A. Muscle weakness and fatigue
B. Nausea and visual halos CORRECT
C. Heart rate of 58 bpm and irregular
D. Serum digoxin level of 1.2 ng/mL
RATIONALE: Hypokalemia potentiates digoxin toxicity; classic signs include GI symptoms
(nausea) and visual disturbances (halos). While bradycardia and arrhythmias can occur, the
hallmark early indicators are GI/visual. Option A is nonspecific, D is within therapeutic range, and
C is a later sign.
Page 2
,Q2 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH COMPLEX
HEALTH ALTERATIONS
A nurse is caring for a client with a chest tube connected to a water-seal drainage
system. The client's family asks why the fluid in the water-seal chamber rises and
falls with respirations. Which response is most accurate?
A. It indicates the lung has re-expanded fully.
B. It reflects normal fluctuations in intrapleural pressure. CORRECT
C. It signals an air leak in the system.
D. It means the suction pressure is set too high.
RATIONALE: Tidaling (rise and fall with respiration) is normal and reflects changes in intrapleural
pressure during breathing. Constant bubbling indicates an air leak; absence of tidaling may
indicate a kink or lung re-expansion. Suction level does not cause tidaling.
Q3 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH COMPLEX
HEALTH ALTERATIONS
A client with diabetic ketoacidosis (DKA) is receiving an insulin infusion at 0.1
units/kg/hr. Blood glucose has dropped from 600 mg/dL to 250 mg/dL. Which
action should the nurse take next?
A. Stop the insulin infusion immediately.
B. Add dextrose to the IV fluids and continue insulin. CORRECT
C. Administer subcutaneous insulin per sliding scale.
D. Decrease the insulin infusion rate by half.
RATIONALE: In DKA management, when blood glucose reaches ~250 mg/dL, dextrose is added
to prevent hypoglycemia while insulin continues to clear ketones. Stopping insulin prematurely
can lead to rebound ketosis. Subcutaneous insulin is not appropriate during IV insulin transition
until criteria are met.
Page 3
, Q4 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH COMPLEX
HEALTH ALTERATIONS
A primigravida at 39 weeks gestation is in active labor. The nurse notes variable
decelerations on the fetal monitor. Which intervention should the nurse implement
first?
A. Reposition the client to side-lying. CORRECT
B. Increase the IV fluid rate.
C. Administer oxygen via face mask.
D. Notify the healthcare provider immediately.
RATIONALE: Variable decelerations are often due to umbilical cord compression; repositioning
(side-lying or knee-chest) is the first-line intervention to relieve pressure. Increasing IV fluids and
oxygen are secondary, and notifying the provider is important but not the first action.
Q5 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH COMPLEX
HEALTH ALTERATIONS
A client with major depressive disorder is prescribed phenelzine, a monoamine
oxidase inhibitor. Which food item should the nurse instruct the client to avoid?
A. Aged cheddar cheese CORRECT
B. Fresh apples
C. Boiled rice
D. Broiled chicken breast
RATIONALE: MAOIs inhibit the breakdown of tyramine; aged cheeses are high in tyramine and
can precipitate a hypertensive crisis. Fresh fruits, rice, and chicken are low in tyramine and safe.
Page 4
