HESI RN Exit Exam
V1–V7 | Latest Test
Bank 2025/2026 |
Questions, Answers &
Rationales
,Contents
HESI RN EXIT EXAM V1 ........................................................................................................................ 1
HESI RN EXIT EXAM V2 ...................................................................................................................... 24
HESI RN EXIT EXAM V3 ...................................................................................................................... 47
HESI RN EXIT EXAM V4 ...................................................................................................................... 70
HESI RN EXIT EXAM V5 ...................................................................................................................... 93
HESI RN EXIT EXAM V6 .................................................................................................................... 116
HESI RN EXIT EXAM V7 .................................................................................................................... 139
HESI RN EXIT EXAM V1
1. A patient with heart failure has crackles in the lungs, jugular venous distention, and S3
gallop. Which medication should the nurse anticipate administering?
• A. Furosemide IV
• B. Spironolactone PO
• C. Digoxin IV
• D. Carvedilol PO
Correct Answer: A
Rationale: IV furosemide is the mainstay for acute pulmonary edema to reduce preload.
Spironolactone and carvedilol are chronic therapies. Digoxin may be used for rate control but
is not first-line for acute fluid overload.
2. A patient with a traumatic brain injury has a GCS of 7. Which nursing intervention is the
priority?
• A. Maintain head of bed flat
• B. Administer prophylactic phenytoin
• C. Ensure adequate oxygenation and airway
• D. Initiate cooling blanket
Correct Answer: C
Rationale: GCS ≤8 indicates severe brain injury and need for airway protection. Ensuring
adequate oxygenation and ventilation is the immediate priority to prevent secondary brain
injury.
Page 1 of 162
,3. A patient with chronic obstructive pulmonary disease has a prescription for 2 L/min oxygen.
Which assessment finding indicates the oxygen is appropriately titrated?
• A. SpO2 88%
• B. SpO2 92%
• C. SpO2 96%
• D. SpO2 100%
Correct Answer: B
Rationale: For COPD patients, target SpO2 is generally 88-92% to avoid carbon dioxide
retention and loss of hypoxic drive. Higher saturation may lead to hypercapnia.
4. A patient with acute kidney injury has potassium 6.8 mEq/L and peaked T waves. Which
intervention should the nurse implement first?
• A. Administer sodium polystyrene sulfonate
• B. Give IV calcium gluconate
• C. Start insulin and dextrose infusion
• D. Prepare for hemodialysis
Correct Answer: B
Rationale: IV calcium gluconate stabilizes the cardiac membrane and is the priority when
ECG changes (peaked T waves) are present. Insulin/dextrose shifts K+ intracellularly, but
membrane stabilization is urgent.
5. A patient with cirrhosis and ascites develops fever and abdominal pain. Paracentesis shows
PMN >250 cells/mm³. What is the most likely diagnosis?
• A. Spontaneous bacterial peritonitis
• B. Acute pancreatitis
• C. Cholecystitis
• D. Bowel perforation
Correct Answer: A
Rationale: Spontaneous bacterial peritonitis (SBP) is a common complication of ascites.
PMN count ≥250/mm³ is diagnostic. Empiric antibiotics (ceftriaxone) are started
immediately.
Page 2 of 162
, 6. A patient on a ventilator has a high-pressure alarm sounding. What is the nurse's priority
action?
• A. Suction the airway
• B. Check for kinks in the tubing
• C. Assess the patient and ventilate with a manual resuscitation bag
• D. Increase the pressure limit
Correct Answer: C
Rationale: The priority is to assess and manually ventilate the patient while troubleshooting.
High pressure may be due to secretions, kinks, or bronchospasm. Patient safety comes first.
7. A 74-year-old with Parkinson's disease is prescribed carbidopa-levodopa. Which side effect
should the nurse monitor?
• A. Dyskinesia
• B. Hypertension
• C. Sedation
• D. Bradycardia
Correct Answer: A
Rationale: Dyskinesia (involuntary movements) is a common long-term side effect of
levodopa. It is dose-related and may require adjustment. Orthostatic hypotension is also
possible.
8. A patient with septic shock is receiving norepinephrine. Which parameter best indicates
adequate tissue perfusion?
• A. Heart rate 110 bpm
• B. Mean arterial pressure 70 mmHg
• C. Central venous oxygen saturation ≥70%
• D. Urine output 20 mL/hr
Correct Answer: C
Rationale: Central venous oxygen saturation (ScvO2) reflects the balance between oxygen
delivery and consumption. A value ≥70% indicates adequate perfusion. MAP is a surrogate,
but ScvO2 is more specific for tissue oxygenation.
Page 3 of 162
V1–V7 | Latest Test
Bank 2025/2026 |
Questions, Answers &
Rationales
,Contents
HESI RN EXIT EXAM V1 ........................................................................................................................ 1
HESI RN EXIT EXAM V2 ...................................................................................................................... 24
HESI RN EXIT EXAM V3 ...................................................................................................................... 47
HESI RN EXIT EXAM V4 ...................................................................................................................... 70
HESI RN EXIT EXAM V5 ...................................................................................................................... 93
HESI RN EXIT EXAM V6 .................................................................................................................... 116
HESI RN EXIT EXAM V7 .................................................................................................................... 139
HESI RN EXIT EXAM V1
1. A patient with heart failure has crackles in the lungs, jugular venous distention, and S3
gallop. Which medication should the nurse anticipate administering?
• A. Furosemide IV
• B. Spironolactone PO
• C. Digoxin IV
• D. Carvedilol PO
Correct Answer: A
Rationale: IV furosemide is the mainstay for acute pulmonary edema to reduce preload.
Spironolactone and carvedilol are chronic therapies. Digoxin may be used for rate control but
is not first-line for acute fluid overload.
2. A patient with a traumatic brain injury has a GCS of 7. Which nursing intervention is the
priority?
• A. Maintain head of bed flat
• B. Administer prophylactic phenytoin
• C. Ensure adequate oxygenation and airway
• D. Initiate cooling blanket
Correct Answer: C
Rationale: GCS ≤8 indicates severe brain injury and need for airway protection. Ensuring
adequate oxygenation and ventilation is the immediate priority to prevent secondary brain
injury.
Page 1 of 162
,3. A patient with chronic obstructive pulmonary disease has a prescription for 2 L/min oxygen.
Which assessment finding indicates the oxygen is appropriately titrated?
• A. SpO2 88%
• B. SpO2 92%
• C. SpO2 96%
• D. SpO2 100%
Correct Answer: B
Rationale: For COPD patients, target SpO2 is generally 88-92% to avoid carbon dioxide
retention and loss of hypoxic drive. Higher saturation may lead to hypercapnia.
4. A patient with acute kidney injury has potassium 6.8 mEq/L and peaked T waves. Which
intervention should the nurse implement first?
• A. Administer sodium polystyrene sulfonate
• B. Give IV calcium gluconate
• C. Start insulin and dextrose infusion
• D. Prepare for hemodialysis
Correct Answer: B
Rationale: IV calcium gluconate stabilizes the cardiac membrane and is the priority when
ECG changes (peaked T waves) are present. Insulin/dextrose shifts K+ intracellularly, but
membrane stabilization is urgent.
5. A patient with cirrhosis and ascites develops fever and abdominal pain. Paracentesis shows
PMN >250 cells/mm³. What is the most likely diagnosis?
• A. Spontaneous bacterial peritonitis
• B. Acute pancreatitis
• C. Cholecystitis
• D. Bowel perforation
Correct Answer: A
Rationale: Spontaneous bacterial peritonitis (SBP) is a common complication of ascites.
PMN count ≥250/mm³ is diagnostic. Empiric antibiotics (ceftriaxone) are started
immediately.
Page 2 of 162
, 6. A patient on a ventilator has a high-pressure alarm sounding. What is the nurse's priority
action?
• A. Suction the airway
• B. Check for kinks in the tubing
• C. Assess the patient and ventilate with a manual resuscitation bag
• D. Increase the pressure limit
Correct Answer: C
Rationale: The priority is to assess and manually ventilate the patient while troubleshooting.
High pressure may be due to secretions, kinks, or bronchospasm. Patient safety comes first.
7. A 74-year-old with Parkinson's disease is prescribed carbidopa-levodopa. Which side effect
should the nurse monitor?
• A. Dyskinesia
• B. Hypertension
• C. Sedation
• D. Bradycardia
Correct Answer: A
Rationale: Dyskinesia (involuntary movements) is a common long-term side effect of
levodopa. It is dose-related and may require adjustment. Orthostatic hypotension is also
possible.
8. A patient with septic shock is receiving norepinephrine. Which parameter best indicates
adequate tissue perfusion?
• A. Heart rate 110 bpm
• B. Mean arterial pressure 70 mmHg
• C. Central venous oxygen saturation ≥70%
• D. Urine output 20 mL/hr
Correct Answer: C
Rationale: Central venous oxygen saturation (ScvO2) reflects the balance between oxygen
delivery and consumption. A value ≥70% indicates adequate perfusion. MAP is a surrogate,
but ScvO2 is more specific for tissue oxygenation.
Page 3 of 162
