2026|2027|A Comprehensive Review Of 300
Practice Questions with Answers Rationales |Pass
Guaranteed
Introduction
The HESI RN Exit Exam is a comprehensive, standardized assessment designed to
evaluate a nursing student's readiness to enter professional practice and sit for the
NCLEX-RN. It covers eight major content domains: Management of Care, Safety
and Infection Control, Health Promotion and Maintenance, Psychosocial Integrity,
Basic Care and Comfort, Pharmacological and Parenteral Therapies, Reduction of
Risk Potential, and Physiological Adaptation.
This practice set contains 300 unique, non-duplicated questions presented in
multiple-choice format with four options (A, B, C, D). Each question includes the
correct answer and a detailed rationale. Questions are interchanged across all
content domains to simulate the random delivery of the actual exam. Use this as a
supplementary study tool alongside your official Elsevier Evolve materials.
Multichoice questions
1. A nurse is caring for a client with a new colostomy. Which finding requires
immediate intervention?
A. The stoma is pink and moist
B. The stoma is dark purple and dry
C. The client reports mild cramping
D. The pouch has formed a small amount of gas
Correct Answer: B
,Rationale: A dark purple, dry stoma indicates ischemia and possible necrosis. This
requires immediate notification of the provider. A pink, moist stoma is normal.
Mild cramping and gas are expected postoperatively.
2. A nurse is administering digoxin to a client with heart failure. Which
assessment finding should the nurse report before giving the dose?
A. Heart rate of 88 beats/min
B. Heart rate of 52 beats/min
C. Blood pressure of 118/76 mm Hg
D. Respiratory rate of 18 breaths/min
Correct Answer: B
Rationale: Digoxin slows the heart rate. A heart rate below 60 beats/min in an
adult is a contraindication for administration. The nurse should hold the dose and
notify the provider.
3. A client with diabetes mellitus is scheduled for surgery. Which instruction
should the nurse provide regarding insulin administration on the morning of
surgery?
A. "Take your full insulin dose as usual."
B. "Do not take any insulin on the morning of surgery."
C. "You will receive specific instructions from your surgeon about your insulin
dose."
D. "Double your insulin dose to compensate for stress."
Correct Answer: C
Rationale: Insulin dosing on the day of surgery is individualized and must be
directed by the surgeon or anesthesia provider. The nurse should not independently
advise the client to take, skip, or adjust insulin.
,4. A nurse is assessing a client with suspected appendicitis. Which assessment
technique should the nurse avoid?
A. Palpating the right lower quadrant
B. Auscultating bowel sounds
C. Inspecting the abdomen
D. Asking the client to cough
Correct Answer: A
Rationale: Deep palpation of the right lower quadrant in suspected appendicitis
can cause rupture of the appendix. The nurse should avoid palpating the area until
appendicitis is ruled out.
5. A postpartum client is experiencing heavy vaginal bleeding. Which action
should the nurse take first?
A. Administer oxytocin as ordered
B. Massage the fundus
C. Notify the provider
D. Obtain vital signs
Correct Answer: B
Rationale: Uterine atony is the most common cause of postpartum hemorrhage.
Fundal massage is the first-line intervention to stimulate uterine contraction and
control bleeding.
6. A nurse is caring for a client receiving chemotherapy. Which laboratory
value is most important to monitor?
A. Hemoglobin 12 g/dL
B. Platelet count 50,000/mm³
C. WBC 8,000/mm³
D. Creatinine 1.0 mg/dL
Correct Answer: B
, Rationale: A platelet count of 50,000/mm³ indicates severe thrombocytopenia and
places the client at high risk for bleeding. This is the most critical value to monitor
and report.
7. A client is prescribed levothyroxine. Which instruction should the nurse
include in teaching?
A. "Take the medication at bedtime."
B. "Take the medication on an empty stomach in the morning."
C. "Take the medication with a calcium supplement."
D. "Take the medication with grapefruit juice."
Correct Answer: B
Rationale: Levothyroxine should be taken on an empty stomach, 30–60 minutes
before breakfast, for optimal absorption. Calcium and grapefruit juice interfere
with absorption.
8. A nurse is assessing a client with a tracheostomy. Which finding indicates a
need for suctioning?
A. Pink, moist stoma
B. Audible gurgling sounds with respirations
C. Respiratory rate of 18 breaths/min
D. Oxygen saturation of 96%
Correct Answer: B
Rationale: Audible gurgling sounds indicate secretions in the airway and are a
clear indication for suctioning. The other findings are normal.
9. A client with a history of alcohol abuse is admitted with confusion and
ataxia. Which vitamin deficiency should the nurse suspect?
A. Vitamin C
B. Vitamin B1 (thiamine)