HESI RN Exit Exam 2026 V1–V5 Verified Examplify
Pack – Complete Actual Exam Questions & Rationales
Comprehensive Practice Examination – 142 Questions
with Answers and Rationales
1. An RN is caring for a client with a new diagnosis of heart failure. Which of the following findings requires
immediate intervention?
A) Weight gain of 2 pounds in 1 day
B) Blood pressure of 110/70 mmHg
C) Heart rate of 88 beats per minute
D) Oxygen saturation of 95% on room air
Correct Answer: A) Weight gain of 2 pounds in 1 day
Rationale: A weight gain of 2-3 pounds in 1 day or 5 pounds in 1 week indicates fluid retention and
worsening heart failure, requiring immediate intervention. The other findings are within normal limits.
2. An RN is preparing to administer digoxin to a client. Which of the following findings should the RN report
before administering the medication?
A) Heart rate of 58 beats per minute
B) Blood pressure of 120/80 mmHg
C) Respiratory rate of 18 breaths per minute
D) Temperature of 98.6°F
Correct Answer: A) Heart rate of 58 beats per minute
Rationale: Digoxin should be withheld if the heart rate is below 60 beats per minute in adults. The other
vital signs are within normal limits and do not require withholding the medication.
3. An RN is caring for a client with a chest tube. Which of the following findings indicates a need for
immediate intervention?
A) Continuous bubbling in the water seal chamber
B) Tidaling in the water seal chamber
C) Drainage of 50 mL in the first hour
D) Chest tube secured with tape
Correct Answer: A) Continuous bubbling in the water seal chamber
,Rationale: Continuous bubbling in the water seal chamber indicates an air leak, which requires immediate
intervention. Tidaling is normal. Drainage of 50 mL in the first hour is expected. Securing the chest tube is
appropriate.
4. An RN is administering a blood transfusion. Which of the following findings indicates a transfusion
reaction?
A) Urticaria and fever
B) Blood pressure of 110/70 mmHg
C) Heart rate of 80 beats per minute
D) Respiratory rate of 16 breaths per minute
Correct Answer: A) Urticaria and fever
Rationale: Urticaria (hives) and fever are signs of a transfusion reaction, which requires stopping the
transfusion immediately. The other findings are within normal limits.
5. An RN is caring for a client with an IV infusion of potassium chloride. Which of the following findings
requires immediate intervention?
A) Cardiac arrhythmias
B) Blood pressure of 120/80 mmHg
C) Heart rate of 88 beats per minute
D) Respiratory rate of 18 breaths per minute
Correct Answer: A) Cardiac arrhythmias
Rationale: Cardiac arrhythmias are a sign of hyperkalemia, which can occur with rapid IV potassium
infusion. Potassium should never be given as a bolus. The other findings are within normal limits.
6. An RN is caring for a client with a new colostomy. Which of the following statements by the client
indicates a need for further teaching?
A) "I should avoid foods that cause gas."
B) "I should empty the pouch when it is one-third full."
C) "I should change the pouch every day."
D) "I should cleanse the skin around the stoma with warm water."
Correct Answer: C) "I should change the pouch every day."
Rationale: An ostomy pouch should be changed every 3-7 days, not daily, unless there is leakage. Daily
changes can irritate the skin. Emptying the pouch when it is one-third full prevents leakage and weight.
Avoiding gas-producing foods and cleansing with warm water are correct.
,7. An RN is caring for a client with a tracheostomy. Which of the following findings requires immediate
intervention?
A) Copious secretions
B) Oxygen saturation of 98%
C) Respiratory rate of 16 breaths per minute
D) Clear breath sounds
Correct Answer: A) Copious secretions
Rationale: Copious secretions can obstruct the tracheostomy tube and require immediate suctioning. The
other findings are normal.
8. An RN is caring for a client with a new below-the-knee amputation. Which of the following positions is
appropriate for the residual limb?
A) Elevated on a pillow
B) Dependent
C) Extended
D) Flexed
Correct Answer: C) Extended
Rationale: The residual limb should be extended, not elevated on a pillow, to prevent contractures.
Elevating the limb on a pillow can cause hip flexion contractures. Dependent positioning can cause edema.
Flexion can cause contractures.
9. An RN is caring for a client with a nasogastric tube. Which of the following findings indicates a need for
further intervention?
A) Absent bowel sounds
B) Bowel sounds in all quadrants
C) Passage of flatus
D) Abdomen soft and non-tender
Correct Answer: A) Absent bowel sounds
Rationale: Absent bowel sounds indicate paralytic ileus and require further intervention. Bowel sounds in all
quadrants, passage of flatus, and a soft, non-tender abdomen are normal findings.
10. An RN is caring for a client with a new diagnosis of diabetes mellitus. Which of the following statements
indicates understanding of hypoglycemia management?
A) "I should eat 15 grams of carbohydrate if my blood sugar is low."
B) "I should skip meals if I feel shaky."
C) "I should take extra insulin if my blood sugar is low."
D) "I should drink water if my blood sugar is low."
, Correct Answer: A) "I should eat 15 grams of carbohydrate if my blood sugar is low."
Rationale: The rule of 15 is used to treat hypoglycemia: consume 15 grams of carbohydrate, wait 15
minutes, and recheck blood glucose. Skipping meals, taking extra insulin, or drinking water does not treat
hypoglycemia.
11. An RN is caring for a client with a new diagnosis of hypertension. Which of the following statements
indicates understanding of lifestyle modifications?
A) "I should limit my sodium intake."
B) "I should increase my sodium intake."
C) "I should stop taking my medication when my blood pressure is normal."
D) "I should avoid exercise."
Correct Answer: A) "I should limit my sodium intake."
Rationale: Limiting sodium intake is a key lifestyle modification for hypertension. Increasing sodium,
stopping medication, and avoiding exercise are incorrect.
12. An RN is caring for a client with a urinary tract infection. Which of the following findings requires
immediate intervention?
A) Fever and chills
B) Cloudy urine
C) Urgency
D) Dysuria
Correct Answer: A) Fever and chills
Rationale: Fever and chills indicate systemic infection (pyelonephritis) and require immediate intervention.
Cloudy urine, urgency, and dysuria are common but less urgent.
13. An RN is caring for a client with a new diagnosis of COPD. Which of the following statements indicates
understanding of the disease process?
A) "I should use my inhaler as prescribed."
B) "I should smoke only one cigarette a day."
C) "I should avoid all activity."
D) "I should stop taking my medication when I feel better."
Correct Answer: A) "I should use my inhaler as prescribed."
Rationale: Using inhalers as prescribed is essential for COPD management. Smoking, avoiding activity,
and stopping medication are incorrect.
Pack – Complete Actual Exam Questions & Rationales
Comprehensive Practice Examination – 142 Questions
with Answers and Rationales
1. An RN is caring for a client with a new diagnosis of heart failure. Which of the following findings requires
immediate intervention?
A) Weight gain of 2 pounds in 1 day
B) Blood pressure of 110/70 mmHg
C) Heart rate of 88 beats per minute
D) Oxygen saturation of 95% on room air
Correct Answer: A) Weight gain of 2 pounds in 1 day
Rationale: A weight gain of 2-3 pounds in 1 day or 5 pounds in 1 week indicates fluid retention and
worsening heart failure, requiring immediate intervention. The other findings are within normal limits.
2. An RN is preparing to administer digoxin to a client. Which of the following findings should the RN report
before administering the medication?
A) Heart rate of 58 beats per minute
B) Blood pressure of 120/80 mmHg
C) Respiratory rate of 18 breaths per minute
D) Temperature of 98.6°F
Correct Answer: A) Heart rate of 58 beats per minute
Rationale: Digoxin should be withheld if the heart rate is below 60 beats per minute in adults. The other
vital signs are within normal limits and do not require withholding the medication.
3. An RN is caring for a client with a chest tube. Which of the following findings indicates a need for
immediate intervention?
A) Continuous bubbling in the water seal chamber
B) Tidaling in the water seal chamber
C) Drainage of 50 mL in the first hour
D) Chest tube secured with tape
Correct Answer: A) Continuous bubbling in the water seal chamber
,Rationale: Continuous bubbling in the water seal chamber indicates an air leak, which requires immediate
intervention. Tidaling is normal. Drainage of 50 mL in the first hour is expected. Securing the chest tube is
appropriate.
4. An RN is administering a blood transfusion. Which of the following findings indicates a transfusion
reaction?
A) Urticaria and fever
B) Blood pressure of 110/70 mmHg
C) Heart rate of 80 beats per minute
D) Respiratory rate of 16 breaths per minute
Correct Answer: A) Urticaria and fever
Rationale: Urticaria (hives) and fever are signs of a transfusion reaction, which requires stopping the
transfusion immediately. The other findings are within normal limits.
5. An RN is caring for a client with an IV infusion of potassium chloride. Which of the following findings
requires immediate intervention?
A) Cardiac arrhythmias
B) Blood pressure of 120/80 mmHg
C) Heart rate of 88 beats per minute
D) Respiratory rate of 18 breaths per minute
Correct Answer: A) Cardiac arrhythmias
Rationale: Cardiac arrhythmias are a sign of hyperkalemia, which can occur with rapid IV potassium
infusion. Potassium should never be given as a bolus. The other findings are within normal limits.
6. An RN is caring for a client with a new colostomy. Which of the following statements by the client
indicates a need for further teaching?
A) "I should avoid foods that cause gas."
B) "I should empty the pouch when it is one-third full."
C) "I should change the pouch every day."
D) "I should cleanse the skin around the stoma with warm water."
Correct Answer: C) "I should change the pouch every day."
Rationale: An ostomy pouch should be changed every 3-7 days, not daily, unless there is leakage. Daily
changes can irritate the skin. Emptying the pouch when it is one-third full prevents leakage and weight.
Avoiding gas-producing foods and cleansing with warm water are correct.
,7. An RN is caring for a client with a tracheostomy. Which of the following findings requires immediate
intervention?
A) Copious secretions
B) Oxygen saturation of 98%
C) Respiratory rate of 16 breaths per minute
D) Clear breath sounds
Correct Answer: A) Copious secretions
Rationale: Copious secretions can obstruct the tracheostomy tube and require immediate suctioning. The
other findings are normal.
8. An RN is caring for a client with a new below-the-knee amputation. Which of the following positions is
appropriate for the residual limb?
A) Elevated on a pillow
B) Dependent
C) Extended
D) Flexed
Correct Answer: C) Extended
Rationale: The residual limb should be extended, not elevated on a pillow, to prevent contractures.
Elevating the limb on a pillow can cause hip flexion contractures. Dependent positioning can cause edema.
Flexion can cause contractures.
9. An RN is caring for a client with a nasogastric tube. Which of the following findings indicates a need for
further intervention?
A) Absent bowel sounds
B) Bowel sounds in all quadrants
C) Passage of flatus
D) Abdomen soft and non-tender
Correct Answer: A) Absent bowel sounds
Rationale: Absent bowel sounds indicate paralytic ileus and require further intervention. Bowel sounds in all
quadrants, passage of flatus, and a soft, non-tender abdomen are normal findings.
10. An RN is caring for a client with a new diagnosis of diabetes mellitus. Which of the following statements
indicates understanding of hypoglycemia management?
A) "I should eat 15 grams of carbohydrate if my blood sugar is low."
B) "I should skip meals if I feel shaky."
C) "I should take extra insulin if my blood sugar is low."
D) "I should drink water if my blood sugar is low."
, Correct Answer: A) "I should eat 15 grams of carbohydrate if my blood sugar is low."
Rationale: The rule of 15 is used to treat hypoglycemia: consume 15 grams of carbohydrate, wait 15
minutes, and recheck blood glucose. Skipping meals, taking extra insulin, or drinking water does not treat
hypoglycemia.
11. An RN is caring for a client with a new diagnosis of hypertension. Which of the following statements
indicates understanding of lifestyle modifications?
A) "I should limit my sodium intake."
B) "I should increase my sodium intake."
C) "I should stop taking my medication when my blood pressure is normal."
D) "I should avoid exercise."
Correct Answer: A) "I should limit my sodium intake."
Rationale: Limiting sodium intake is a key lifestyle modification for hypertension. Increasing sodium,
stopping medication, and avoiding exercise are incorrect.
12. An RN is caring for a client with a urinary tract infection. Which of the following findings requires
immediate intervention?
A) Fever and chills
B) Cloudy urine
C) Urgency
D) Dysuria
Correct Answer: A) Fever and chills
Rationale: Fever and chills indicate systemic infection (pyelonephritis) and require immediate intervention.
Cloudy urine, urgency, and dysuria are common but less urgent.
13. An RN is caring for a client with a new diagnosis of COPD. Which of the following statements indicates
understanding of the disease process?
A) "I should use my inhaler as prescribed."
B) "I should smoke only one cigarette a day."
C) "I should avoid all activity."
D) "I should stop taking my medication when I feel better."
Correct Answer: A) "I should use my inhaler as prescribed."
Rationale: Using inhalers as prescribed is essential for COPD management. Smoking, avoiding activity,
and stopping medication are incorrect.
