ELSEVIER HESI RN EXIT EXAM – RN HESI EXIT V1 | ALL
QUESTIONS AND ANSWERS AND RATIONALES | LATEST
EXAM 2026/2027 | A+ GRADED | COMPREHENSIVE
NURSING EXAM GUIDE
1. A nurse is caring for a client who reports sudden shortness of breath and chest
discomfort. Which action should the nurse take first?
A. Obtain a complete health history
B. Apply oxygen and assess respiratory status
C. Administer the prescribed analgesic
D. Encourage the client to ambulate
Answer: B
Immediate assessment and support of oxygenation take priority when a client develops acute
respiratory symptoms. The nurse should rapidly assess airway and breathing while providing
appropriate oxygen support.
2. A client with heart failure reports a 2-kg (4.4-lb) weight gain over 2 days. How should
the nurse interpret this finding?
A. Expected variation in body weight
B. Evidence of improved nutritional status
C. Possible fluid retention
D. Evidence of medication effectiveness
Answer: C
A rapid increase in weight is more consistent with fluid accumulation than tissue gain and can
indicate worsening heart failure.
3. A nurse is preparing to administer insulin lispro to a client with diabetes mellitus. Which
action is most appropriate?
A. Administer it when the meal is available
B. Give it 1 hour before the meal
C. Administer it only at bedtime
D. Hold it whenever the client reports hunger
Answer: A
Insulin lispro is rapid-acting insulin and should generally be administered close to mealtime so
its action corresponds with the rise in blood glucose after eating.
,4. A postoperative client suddenly becomes restless, tachycardic, and short of breath.
Which complication should the nurse suspect?
A. Constipation
B. Urinary retention
C. Hypoglycemia
D. Pulmonary embolism
Answer: D
Sudden dyspnea, tachycardia, and unexplained restlessness after surgery are concerning for
pulmonary embolism and require immediate assessment and intervention.
5. A client receiving furosemide has a potassium level of 3.0 mEq/L. Which finding should
the nurse monitor most closely?
A. Increased appetite
B. Cardiac dysrhythmias
C. Flushed skin
D. Increased bowel sounds
Answer: B
Furosemide can cause potassium loss. Significant hypokalemia increases the risk for
potentially serious cardiac dysrhythmias.
6. A nurse is assessing a client with pneumonia. Which finding requires the most immediate
intervention?
A. Productive cough
B. Temperature of 38.2°C (100.8°F)
C. Oxygen saturation of 86%
D. Fatigue with activity
Answer: C
An oxygen saturation of 86% indicates significant hypoxemia. Airway and breathing take
priority over fever, cough, and fatigue.
7. A client receiving warfarin asks which laboratory test is used to monitor therapy. Which
response is correct?
A. INR
B. aPTT
C. Troponin
D. Serum creatinine
Answer: A
,Warfarin therapy is monitored primarily using the prothrombin time expressed as the
international normalized ratio (INR).
8. A nurse is teaching a client who has newly prescribed nitroglycerin sublingual tablets.
Which instruction is most important?
A. Swallow the tablet with water
B. Store the tablets in the bathroom
C. Take the medication only after eating
D. Sit or lie down before taking the medication
Answer: D
Nitroglycerin can cause significant hypotension and dizziness. Sitting or lying down helps
reduce the risk of injury from a sudden drop in blood pressure.
9. A client with chronic obstructive pulmonary disease is receiving oxygen. Which finding
indicates improvement?
A. Increasing confusion
B. Respiratory rate of 8/min
C. Improved oxygen saturation and reduced dyspnea
D. Increasing use of accessory muscles
Answer: C
Improved oxygenation accompanied by decreased respiratory distress indicates a positive
response to treatment.
10. A nurse is caring for a client who has a chest tube connected to a drainage system.
Which finding requires immediate follow-up?
A. Tidaling in the water-seal chamber
B. Mild discomfort at the insertion site
C. Drainage of 50 mL during the first hour
D. Continuous vigorous bubbling in the water-seal chamber
Answer: D
Continuous vigorous bubbling in the water-seal chamber can indicate an air leak and requires
assessment of the system and connections.
11. A client with a history of diabetes becomes pale, shaky, and diaphoretic. The client is
awake and able to swallow. What should the nurse do first?
A. Administer a rapid source of glucose
B. Administer long-acting insulin
C. Restrict oral fluids
D. Encourage exercise
, Answer: A
These are classic manifestations of hypoglycemia. A conscious client who can swallow should
receive a rapidly absorbed carbohydrate.
12. A nurse is assessing a client with suspected stroke. Which finding is most concerning?
A. Mild headache
B. Sudden unilateral weakness
C. Chronic fatigue
D. Increased appetite
Answer: B
Sudden unilateral weakness is a classic sign of acute stroke and requires immediate
evaluation because timely treatment can affect neurological outcomes.
13. A client with chronic kidney disease has an elevated serum potassium level. Which food
should the nurse recommend limiting?
A. Apples
B. White rice
C. Bananas
D. Cranberries
Answer: C
Bananas contain substantial potassium. Clients with hyperkalemia may need to restrict high-
potassium foods according to their prescribed dietary plan.
14. A nurse is caring for a client with suspected meningitis. Which precaution is
appropriate initially?
A. Contact precautions only
B. Airborne precautions only
C. Droplet precautions
D. Protective isolation
Answer: C
Suspected bacterial meningitis requires droplet precautions because respiratory secretions
can transmit the causative organisms.
15. A client receiving morphine becomes difficult to arouse and has a respiratory rate of
7/min. Which medication should the nurse anticipate administering?
A. Naloxone
B. Protamine sulfate
C. Vitamin K
D. Flumazenil
QUESTIONS AND ANSWERS AND RATIONALES | LATEST
EXAM 2026/2027 | A+ GRADED | COMPREHENSIVE
NURSING EXAM GUIDE
1. A nurse is caring for a client who reports sudden shortness of breath and chest
discomfort. Which action should the nurse take first?
A. Obtain a complete health history
B. Apply oxygen and assess respiratory status
C. Administer the prescribed analgesic
D. Encourage the client to ambulate
Answer: B
Immediate assessment and support of oxygenation take priority when a client develops acute
respiratory symptoms. The nurse should rapidly assess airway and breathing while providing
appropriate oxygen support.
2. A client with heart failure reports a 2-kg (4.4-lb) weight gain over 2 days. How should
the nurse interpret this finding?
A. Expected variation in body weight
B. Evidence of improved nutritional status
C. Possible fluid retention
D. Evidence of medication effectiveness
Answer: C
A rapid increase in weight is more consistent with fluid accumulation than tissue gain and can
indicate worsening heart failure.
3. A nurse is preparing to administer insulin lispro to a client with diabetes mellitus. Which
action is most appropriate?
A. Administer it when the meal is available
B. Give it 1 hour before the meal
C. Administer it only at bedtime
D. Hold it whenever the client reports hunger
Answer: A
Insulin lispro is rapid-acting insulin and should generally be administered close to mealtime so
its action corresponds with the rise in blood glucose after eating.
,4. A postoperative client suddenly becomes restless, tachycardic, and short of breath.
Which complication should the nurse suspect?
A. Constipation
B. Urinary retention
C. Hypoglycemia
D. Pulmonary embolism
Answer: D
Sudden dyspnea, tachycardia, and unexplained restlessness after surgery are concerning for
pulmonary embolism and require immediate assessment and intervention.
5. A client receiving furosemide has a potassium level of 3.0 mEq/L. Which finding should
the nurse monitor most closely?
A. Increased appetite
B. Cardiac dysrhythmias
C. Flushed skin
D. Increased bowel sounds
Answer: B
Furosemide can cause potassium loss. Significant hypokalemia increases the risk for
potentially serious cardiac dysrhythmias.
6. A nurse is assessing a client with pneumonia. Which finding requires the most immediate
intervention?
A. Productive cough
B. Temperature of 38.2°C (100.8°F)
C. Oxygen saturation of 86%
D. Fatigue with activity
Answer: C
An oxygen saturation of 86% indicates significant hypoxemia. Airway and breathing take
priority over fever, cough, and fatigue.
7. A client receiving warfarin asks which laboratory test is used to monitor therapy. Which
response is correct?
A. INR
B. aPTT
C. Troponin
D. Serum creatinine
Answer: A
,Warfarin therapy is monitored primarily using the prothrombin time expressed as the
international normalized ratio (INR).
8. A nurse is teaching a client who has newly prescribed nitroglycerin sublingual tablets.
Which instruction is most important?
A. Swallow the tablet with water
B. Store the tablets in the bathroom
C. Take the medication only after eating
D. Sit or lie down before taking the medication
Answer: D
Nitroglycerin can cause significant hypotension and dizziness. Sitting or lying down helps
reduce the risk of injury from a sudden drop in blood pressure.
9. A client with chronic obstructive pulmonary disease is receiving oxygen. Which finding
indicates improvement?
A. Increasing confusion
B. Respiratory rate of 8/min
C. Improved oxygen saturation and reduced dyspnea
D. Increasing use of accessory muscles
Answer: C
Improved oxygenation accompanied by decreased respiratory distress indicates a positive
response to treatment.
10. A nurse is caring for a client who has a chest tube connected to a drainage system.
Which finding requires immediate follow-up?
A. Tidaling in the water-seal chamber
B. Mild discomfort at the insertion site
C. Drainage of 50 mL during the first hour
D. Continuous vigorous bubbling in the water-seal chamber
Answer: D
Continuous vigorous bubbling in the water-seal chamber can indicate an air leak and requires
assessment of the system and connections.
11. A client with a history of diabetes becomes pale, shaky, and diaphoretic. The client is
awake and able to swallow. What should the nurse do first?
A. Administer a rapid source of glucose
B. Administer long-acting insulin
C. Restrict oral fluids
D. Encourage exercise
, Answer: A
These are classic manifestations of hypoglycemia. A conscious client who can swallow should
receive a rapidly absorbed carbohydrate.
12. A nurse is assessing a client with suspected stroke. Which finding is most concerning?
A. Mild headache
B. Sudden unilateral weakness
C. Chronic fatigue
D. Increased appetite
Answer: B
Sudden unilateral weakness is a classic sign of acute stroke and requires immediate
evaluation because timely treatment can affect neurological outcomes.
13. A client with chronic kidney disease has an elevated serum potassium level. Which food
should the nurse recommend limiting?
A. Apples
B. White rice
C. Bananas
D. Cranberries
Answer: C
Bananas contain substantial potassium. Clients with hyperkalemia may need to restrict high-
potassium foods according to their prescribed dietary plan.
14. A nurse is caring for a client with suspected meningitis. Which precaution is
appropriate initially?
A. Contact precautions only
B. Airborne precautions only
C. Droplet precautions
D. Protective isolation
Answer: C
Suspected bacterial meningitis requires droplet precautions because respiratory secretions
can transmit the causative organisms.
15. A client receiving morphine becomes difficult to arouse and has a respiratory rate of
7/min. Which medication should the nurse anticipate administering?
A. Naloxone
B. Protamine sulfate
C. Vitamin K
D. Flumazenil
