RN HESI EXIT EXAM VERSION 3
2026/2027 COMPREHENSIVE REVIEW
QUESTIONS AND ANSWERS
1. A client with an acute myocardial infarction is receiving a heparin infusion. The nurse notes
the client’s aPTT is 98 seconds. Which action should the nurse take first?
A. Decrease the infusion rate by 10%
B. Check the client’s hemoglobin and hematocrit
C. Stop the infusion and notify the healthcare provider
D. Continue the infusion at the current rate
Answer: C
Conceptual Explanation: The normal range for aPTT is 30-40 seconds; the therapeutic
range for heparin is 1.5-2.5 times the normal value (approx 45-75s). 98 seconds is critically
high, increasing the risk for hemorrhage, requiring immediate cessation and provider
notification.
,2. The nurse is caring for a client with Addison’s disease. Which laboratory finding is most
consistent with this diagnosis?
A. Serum Sodium 148 mEq/L
B. Fasting Blood Glucose 150 mg/dL
C. Serum Potassium 6.2 mEq/L
D. Serum Calcium 8.2 mg/dL
Answer: C
Conceptual Explanation: Addison’s disease involves adrenal insufficiency, leading to low
aldosterone levels, which causes the body to lose sodium and retain potassium
(hyperkalemia).
3. A client is admitted with a diagnosis of Pheochromocytoma. What should be the nurse’s
priority assessment?
A. Daily weights
B. Blood pressure monitoring
C. Urine output monitoring
D. Bowel sounds
Answer: B
, Conceptual Explanation: Pheochromocytoma is a tumor of the adrenal medulla that
secretes catecholamines, causing severe hypertension. Monitoring blood pressure is vital to
prevent hypertensive crisis.
4. Which assessment finding in a client with a chest tube requires immediate intervention by
the nurse?
A. 50 mL of serosanguinous drainage in the collection chamber over 4 hours
B. Fluctuation of water in the water seal chamber during inspiration
C. Continuous bubbling in the water seal chamber
D. Bubbling in the suction control chamber
Answer: C
Conceptual Explanation: Continuous bubbling in the water seal chamber indicates an air
leak in the system. Intermittent bubbling or tidaling is normal.
5. A child is admitted with suspected Epiglottitis. Which action is contraindicated for the
nurse to perform?
A. Placing the child in a tripod position
B. Monitoring oxygen saturation
C. Administering humidified oxygen
D. Obtaining a throat culture
Answer: D
2026/2027 COMPREHENSIVE REVIEW
QUESTIONS AND ANSWERS
1. A client with an acute myocardial infarction is receiving a heparin infusion. The nurse notes
the client’s aPTT is 98 seconds. Which action should the nurse take first?
A. Decrease the infusion rate by 10%
B. Check the client’s hemoglobin and hematocrit
C. Stop the infusion and notify the healthcare provider
D. Continue the infusion at the current rate
Answer: C
Conceptual Explanation: The normal range for aPTT is 30-40 seconds; the therapeutic
range for heparin is 1.5-2.5 times the normal value (approx 45-75s). 98 seconds is critically
high, increasing the risk for hemorrhage, requiring immediate cessation and provider
notification.
,2. The nurse is caring for a client with Addison’s disease. Which laboratory finding is most
consistent with this diagnosis?
A. Serum Sodium 148 mEq/L
B. Fasting Blood Glucose 150 mg/dL
C. Serum Potassium 6.2 mEq/L
D. Serum Calcium 8.2 mg/dL
Answer: C
Conceptual Explanation: Addison’s disease involves adrenal insufficiency, leading to low
aldosterone levels, which causes the body to lose sodium and retain potassium
(hyperkalemia).
3. A client is admitted with a diagnosis of Pheochromocytoma. What should be the nurse’s
priority assessment?
A. Daily weights
B. Blood pressure monitoring
C. Urine output monitoring
D. Bowel sounds
Answer: B
, Conceptual Explanation: Pheochromocytoma is a tumor of the adrenal medulla that
secretes catecholamines, causing severe hypertension. Monitoring blood pressure is vital to
prevent hypertensive crisis.
4. Which assessment finding in a client with a chest tube requires immediate intervention by
the nurse?
A. 50 mL of serosanguinous drainage in the collection chamber over 4 hours
B. Fluctuation of water in the water seal chamber during inspiration
C. Continuous bubbling in the water seal chamber
D. Bubbling in the suction control chamber
Answer: C
Conceptual Explanation: Continuous bubbling in the water seal chamber indicates an air
leak in the system. Intermittent bubbling or tidaling is normal.
5. A child is admitted with suspected Epiglottitis. Which action is contraindicated for the
nurse to perform?
A. Placing the child in a tripod position
B. Monitoring oxygen saturation
C. Administering humidified oxygen
D. Obtaining a throat culture
Answer: D
