HESI RN/PN EXIT EXAM 2026/2027 | COMPLETE
QUESTIONS AND ANSWERS (VERIFIED ANSWERS) |
EXAM PREP | COMPREHENSIVE EXAM GUIDE
2026&2027
1. A nurse is assessing a client who reports sudden shortness of breath and chest pain after
returning from a long-distance flight. Which finding requires the nurse's immediate
attention?
A. Mild anxiety
B. Oxygen saturation of 89%
C. Respiratory rate of 20/min
D. Temperature of 37.1°C
Answer: B
An oxygen saturation of 89% indicates hypoxemia. In a client with sudden dyspnea and chest
pain after prolonged immobility, pulmonary embolism is a serious concern requiring
immediate assessment and intervention.
2. A client with heart failure is prescribed furosemide. Which finding best indicates that the
medication is producing the desired therapeutic effect?
A. Increased peripheral edema
B. Increased urine output and decreased dyspnea
C. Increased heart rate
D. Decreased serum sodium
Answer: B
Furosemide promotes diuresis, reducing excess circulating volume. Increased urine output
accompanied by improved breathing indicates effective reduction of fluid overload.
3. A nurse is preparing to administer insulin lispro to a client with diabetes mellitus. When
should the nurse administer this medication?
A. At bedtime
B. One hour before the meal
C. When the meal is available
D. Two hours after the meal
Answer: C
,Insulin lispro is rapid-acting insulin and should generally be administered when the meal is
available because its onset occurs quickly and delayed food intake increases hypoglycemia
risk.
4. A postoperative client suddenly develops restlessness, tachycardia, and decreased oxygen
saturation. What should the nurse do first?
A. Document the findings
B. Apply oxygen and assess respiratory status
C. Administer prescribed analgesia
D. Encourage oral fluids
Answer: B
Restlessness, tachycardia, and hypoxemia can indicate impaired oxygenation. The nurse
should immediately support oxygenation while rapidly assessing the client's respiratory
status.
5. A nurse is caring for a client receiving potassium chloride intravenously. Which action is
essential?
A. Administer the medication by IV push
B. Dilute the medication and administer it using an infusion pump
C. Mix it with insulin in the same syringe
D. Administer it rapidly if the potassium level is low
Answer: B
IV potassium chloride must be diluted and administered at a controlled rate using an infusion
pump. IV push administration can cause fatal cardiac dysrhythmias.
6. A client taking warfarin has an international normalized ratio (INR) of 5.8. Which
action should the nurse anticipate?
A. Administer the next dose as scheduled
B. Encourage foods high in vitamin K immediately
C. Hold the medication and notify the provider
D. Administer aspirin
Answer: C
An INR of 5.8 indicates excessive anticoagulation and increased bleeding risk. The nurse
should hold warfarin and notify the provider for further management.
7. A client receiving morphine becomes difficult to arouse and has a respiratory rate of
7/min. Which medication should the nurse anticipate administering?
,A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Vitamin K
Answer: B
Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression and
central nervous system depression.
8. A nurse is teaching a client with hypertension about lifestyle modifications. Which
statement indicates correct understanding?
A. “I should increase my sodium intake during exercise.”
B. “I should limit sodium and maintain regular physical activity.”
C. “I should stop taking medication when my blood pressure improves.”
D. “I should avoid all dietary potassium.”
Answer: B
Reducing sodium intake and maintaining appropriate physical activity are important
nonpharmacologic strategies for controlling hypertension.
9. A client with chronic obstructive pulmonary disease is receiving oxygen. Which
prescription should the nurse question?
A. Oxygen at 2 L/min by nasal cannula
B. Oxygen titrated according to prescribed saturation parameters
C. Oxygen at 15 L/min by nonrebreather mask for stable chronic hypoxemia
D. Monitoring respiratory effort
Answer: C
A very high oxygen concentration may be inappropriate for a stable client with COPD and
chronic CO2 retention. Oxygen should be administered according to the prescribed target and
clinical condition.
10. A nurse is caring for a client with suspected hypoglycemia. Which finding is most
consistent with this condition?
A. Warm, dry skin
B. Bradycardia
C. Diaphoresis and tremors
D. Deep, slow respirations
Answer: C
, Hypoglycemia commonly produces adrenergic manifestations such as sweating, tremors,
palpitations, anxiety, and hunger.
11. A client with diabetic ketoacidosis has a serum potassium level of 3.0 mEq/L. Which
prescription should the nurse question?
A. Cardiac monitoring
B. IV fluids
C. IV regular insulin immediately
D. Potassium replacement
Answer: C
Insulin drives potassium into cells and can further lower an already dangerous potassium
level. Significant hypokalemia should be corrected before insulin therapy is initiated.
12. A client with a suspected stroke arrives at the emergency department. Which
information is most important to obtain?
A. Last bowel movement
B. Time the client was last known to be well
C. Usual sleep pattern
D. Most recent weight
Answer: B
The exact time the client was last known to be well is critical because eligibility for time-
sensitive stroke interventions depends on the onset or last-known-well time.
13. A client receiving heparin develops bleeding from the gums and has a markedly
elevated aPTT. What is the priority action?
A. Continue the infusion
B. Stop or hold the heparin according to protocol and notify the provider
C. Administer warfarin
D. Encourage ambulation
Answer: B
Active bleeding with excessive anticoagulation requires immediate attention. Heparin should
be held according to institutional protocol and the provider notified.
14. A nurse assesses a client with increased intracranial pressure. Which finding is
concerning?
QUESTIONS AND ANSWERS (VERIFIED ANSWERS) |
EXAM PREP | COMPREHENSIVE EXAM GUIDE
2026&2027
1. A nurse is assessing a client who reports sudden shortness of breath and chest pain after
returning from a long-distance flight. Which finding requires the nurse's immediate
attention?
A. Mild anxiety
B. Oxygen saturation of 89%
C. Respiratory rate of 20/min
D. Temperature of 37.1°C
Answer: B
An oxygen saturation of 89% indicates hypoxemia. In a client with sudden dyspnea and chest
pain after prolonged immobility, pulmonary embolism is a serious concern requiring
immediate assessment and intervention.
2. A client with heart failure is prescribed furosemide. Which finding best indicates that the
medication is producing the desired therapeutic effect?
A. Increased peripheral edema
B. Increased urine output and decreased dyspnea
C. Increased heart rate
D. Decreased serum sodium
Answer: B
Furosemide promotes diuresis, reducing excess circulating volume. Increased urine output
accompanied by improved breathing indicates effective reduction of fluid overload.
3. A nurse is preparing to administer insulin lispro to a client with diabetes mellitus. When
should the nurse administer this medication?
A. At bedtime
B. One hour before the meal
C. When the meal is available
D. Two hours after the meal
Answer: C
,Insulin lispro is rapid-acting insulin and should generally be administered when the meal is
available because its onset occurs quickly and delayed food intake increases hypoglycemia
risk.
4. A postoperative client suddenly develops restlessness, tachycardia, and decreased oxygen
saturation. What should the nurse do first?
A. Document the findings
B. Apply oxygen and assess respiratory status
C. Administer prescribed analgesia
D. Encourage oral fluids
Answer: B
Restlessness, tachycardia, and hypoxemia can indicate impaired oxygenation. The nurse
should immediately support oxygenation while rapidly assessing the client's respiratory
status.
5. A nurse is caring for a client receiving potassium chloride intravenously. Which action is
essential?
A. Administer the medication by IV push
B. Dilute the medication and administer it using an infusion pump
C. Mix it with insulin in the same syringe
D. Administer it rapidly if the potassium level is low
Answer: B
IV potassium chloride must be diluted and administered at a controlled rate using an infusion
pump. IV push administration can cause fatal cardiac dysrhythmias.
6. A client taking warfarin has an international normalized ratio (INR) of 5.8. Which
action should the nurse anticipate?
A. Administer the next dose as scheduled
B. Encourage foods high in vitamin K immediately
C. Hold the medication and notify the provider
D. Administer aspirin
Answer: C
An INR of 5.8 indicates excessive anticoagulation and increased bleeding risk. The nurse
should hold warfarin and notify the provider for further management.
7. A client receiving morphine becomes difficult to arouse and has a respiratory rate of
7/min. Which medication should the nurse anticipate administering?
,A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Vitamin K
Answer: B
Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression and
central nervous system depression.
8. A nurse is teaching a client with hypertension about lifestyle modifications. Which
statement indicates correct understanding?
A. “I should increase my sodium intake during exercise.”
B. “I should limit sodium and maintain regular physical activity.”
C. “I should stop taking medication when my blood pressure improves.”
D. “I should avoid all dietary potassium.”
Answer: B
Reducing sodium intake and maintaining appropriate physical activity are important
nonpharmacologic strategies for controlling hypertension.
9. A client with chronic obstructive pulmonary disease is receiving oxygen. Which
prescription should the nurse question?
A. Oxygen at 2 L/min by nasal cannula
B. Oxygen titrated according to prescribed saturation parameters
C. Oxygen at 15 L/min by nonrebreather mask for stable chronic hypoxemia
D. Monitoring respiratory effort
Answer: C
A very high oxygen concentration may be inappropriate for a stable client with COPD and
chronic CO2 retention. Oxygen should be administered according to the prescribed target and
clinical condition.
10. A nurse is caring for a client with suspected hypoglycemia. Which finding is most
consistent with this condition?
A. Warm, dry skin
B. Bradycardia
C. Diaphoresis and tremors
D. Deep, slow respirations
Answer: C
, Hypoglycemia commonly produces adrenergic manifestations such as sweating, tremors,
palpitations, anxiety, and hunger.
11. A client with diabetic ketoacidosis has a serum potassium level of 3.0 mEq/L. Which
prescription should the nurse question?
A. Cardiac monitoring
B. IV fluids
C. IV regular insulin immediately
D. Potassium replacement
Answer: C
Insulin drives potassium into cells and can further lower an already dangerous potassium
level. Significant hypokalemia should be corrected before insulin therapy is initiated.
12. A client with a suspected stroke arrives at the emergency department. Which
information is most important to obtain?
A. Last bowel movement
B. Time the client was last known to be well
C. Usual sleep pattern
D. Most recent weight
Answer: B
The exact time the client was last known to be well is critical because eligibility for time-
sensitive stroke interventions depends on the onset or last-known-well time.
13. A client receiving heparin develops bleeding from the gums and has a markedly
elevated aPTT. What is the priority action?
A. Continue the infusion
B. Stop or hold the heparin according to protocol and notify the provider
C. Administer warfarin
D. Encourage ambulation
Answer: B
Active bleeding with excessive anticoagulation requires immediate attention. Heparin should
be held according to institutional protocol and the provider notified.
14. A nurse assesses a client with increased intracranial pressure. Which finding is
concerning?
