HESI Braindumps HESI Exam 200
Multiple Choice Questions with Verified
Correct Answers and Detailed Rationales
for A+ Graded Admission Assessment
and Exit Exam Success
1. A client reports sudden chest pressure radiating to the left arm with diaphoresis. What is
the nurse’s priority action?
A. Obtain a complete health history
B. Administer oxygen if indicated and assess vital signs
C. Ask the client to rate the pain after 30 minutes
D. Encourage oral fluids
Answer: B
Rationale: Sudden chest pressure with radiation and diaphoresis may indicate acute coronary
syndrome. Immediate assessment and stabilization take priority.
2. Which finding is most concerning in a client with pneumonia?
A. Temperature of 38.2°C
B. Productive cough
C. Oxygen saturation of 86%
D. Fatigue
Answer: C
Rationale: An oxygen saturation of 86% indicates significant hypoxemia and requires prompt
intervention.
3. A client receiving insulin becomes sweaty, shaky, and confused. Which condition should the
nurse suspect?
A. Hypernatremia
B. Hypoglycemia
C. Hypercalcemia
D. Hyperglycemia
Answer: B
Rationale: Sweating, tremors, and confusion are classic manifestations of low blood glucose.
,4. Which instruction is appropriate for a client taking warfarin?
A. Avoid all foods containing vitamin K
B. Maintain a consistent intake of vitamin K
C. Take aspirin for minor pain
D. Stop the medication when bruising occurs
Answer: B
Rationale: Vitamin K intake should remain relatively consistent because significant dietary
changes can affect warfarin's anticoagulant effect.
5. Which assessment finding should the nurse report immediately in a postoperative client?
A. Mild incisional pain
B. Urine output of 20 mL/hr
C. Temperature of 37.4°C
D. Moderate fatigue
Answer: B
Rationale: Urine output below approximately 30 mL/hr in an adult may indicate inadequate
renal perfusion or fluid imbalance.
6. Which intervention best prevents pressure injuries in an immobile client?
A. Massage reddened areas
B. Reposition regularly and offload pressure
C. Restrict fluids
D. Keep the client in one comfortable position
Answer: B
Rationale: Regular repositioning and pressure redistribution reduce prolonged tissue pressure.
7. A client with asthma develops severe wheezing and difficulty speaking. What should the
nurse do first?
A. Encourage ambulation
B. Administer the prescribed rapid-acting bronchodilator
C. Offer a large meal
D. Place the client flat
Answer: B
Rationale: Acute bronchospasm requires rapid treatment to improve airway flow.
8. Which electrolyte imbalance is associated with muscle weakness and cardiac
dysrhythmias?
A. Hypokalemia
,B. Hyperchloremia
C. Hyperphosphatemia
D. Hypocalcemia
Answer: A
Rationale: Low potassium can cause muscle weakness and potentially dangerous cardiac
dysrhythmias.
9. Which finding is most consistent with dehydration?
A. Bounding pulse
B. Moist mucous membranes
C. Orthostatic hypotension
D. Peripheral edema
Answer: C
Rationale: Orthostatic hypotension can occur when intravascular volume is depleted.
10. A nurse is caring for a client with suspected tuberculosis. Which precaution is
appropriate?
A. Contact
B. Droplet
C. Airborne
D. Protective isolation
Answer: C
Rationale: Pulmonary tuberculosis requires airborne precautions because infectious particles
can remain suspended in the air.
11. Which laboratory value is most concerning for a client taking heparin?
A. Hemoglobin 14 g/dL
B. Platelets 85,000/mm³
C. Sodium 140 mEq/L
D. Potassium 4.1 mEq/L
Answer: B
Rationale: Thrombocytopenia may indicate heparin-induced thrombocytopenia and requires
prompt evaluation.
12. Which finding is expected in a client experiencing hypoglycemia?
A. Warm, dry skin
B. Bradycardia
, C. Trembling and diaphoresis
D. Deep, slow respirations
Answer: C
Rationale: Adrenergic responses to low glucose include sweating, tremors, palpitations, and
anxiety.
13. A client taking an ACE inhibitor reports swelling of the lips and tongue. What is the
priority action?
A. Give the next dose
B. Document as an expected effect
C. Treat as a potential emergency and obtain immediate assistance
D. Encourage increased fluid intake
Answer: C
Rationale: Angioedema can compromise the airway and requires immediate intervention.
14. Which food is highest in potassium?
A. White rice
B. Banana
C. Bread
D. Applesauce
Answer: B
Rationale: Bananas are a commonly recognized potassium-rich food.
15. A client with heart failure suddenly develops severe dyspnea and pink, frothy sputum.
What complication should the nurse suspect?
A. Pulmonary edema
B. Constipation
C. Hypoglycemia
D. Deep-vein thrombosis
Answer: A
Rationale: Severe dyspnea with pink, frothy sputum is characteristic of acute pulmonary edema.
16. Which assessment finding is typical of left-sided heart failure?
A. Pulmonary crackles
B. Enlarged liver only
C. Dependent edema only
D. Ascites only
Multiple Choice Questions with Verified
Correct Answers and Detailed Rationales
for A+ Graded Admission Assessment
and Exit Exam Success
1. A client reports sudden chest pressure radiating to the left arm with diaphoresis. What is
the nurse’s priority action?
A. Obtain a complete health history
B. Administer oxygen if indicated and assess vital signs
C. Ask the client to rate the pain after 30 minutes
D. Encourage oral fluids
Answer: B
Rationale: Sudden chest pressure with radiation and diaphoresis may indicate acute coronary
syndrome. Immediate assessment and stabilization take priority.
2. Which finding is most concerning in a client with pneumonia?
A. Temperature of 38.2°C
B. Productive cough
C. Oxygen saturation of 86%
D. Fatigue
Answer: C
Rationale: An oxygen saturation of 86% indicates significant hypoxemia and requires prompt
intervention.
3. A client receiving insulin becomes sweaty, shaky, and confused. Which condition should the
nurse suspect?
A. Hypernatremia
B. Hypoglycemia
C. Hypercalcemia
D. Hyperglycemia
Answer: B
Rationale: Sweating, tremors, and confusion are classic manifestations of low blood glucose.
,4. Which instruction is appropriate for a client taking warfarin?
A. Avoid all foods containing vitamin K
B. Maintain a consistent intake of vitamin K
C. Take aspirin for minor pain
D. Stop the medication when bruising occurs
Answer: B
Rationale: Vitamin K intake should remain relatively consistent because significant dietary
changes can affect warfarin's anticoagulant effect.
5. Which assessment finding should the nurse report immediately in a postoperative client?
A. Mild incisional pain
B. Urine output of 20 mL/hr
C. Temperature of 37.4°C
D. Moderate fatigue
Answer: B
Rationale: Urine output below approximately 30 mL/hr in an adult may indicate inadequate
renal perfusion or fluid imbalance.
6. Which intervention best prevents pressure injuries in an immobile client?
A. Massage reddened areas
B. Reposition regularly and offload pressure
C. Restrict fluids
D. Keep the client in one comfortable position
Answer: B
Rationale: Regular repositioning and pressure redistribution reduce prolonged tissue pressure.
7. A client with asthma develops severe wheezing and difficulty speaking. What should the
nurse do first?
A. Encourage ambulation
B. Administer the prescribed rapid-acting bronchodilator
C. Offer a large meal
D. Place the client flat
Answer: B
Rationale: Acute bronchospasm requires rapid treatment to improve airway flow.
8. Which electrolyte imbalance is associated with muscle weakness and cardiac
dysrhythmias?
A. Hypokalemia
,B. Hyperchloremia
C. Hyperphosphatemia
D. Hypocalcemia
Answer: A
Rationale: Low potassium can cause muscle weakness and potentially dangerous cardiac
dysrhythmias.
9. Which finding is most consistent with dehydration?
A. Bounding pulse
B. Moist mucous membranes
C. Orthostatic hypotension
D. Peripheral edema
Answer: C
Rationale: Orthostatic hypotension can occur when intravascular volume is depleted.
10. A nurse is caring for a client with suspected tuberculosis. Which precaution is
appropriate?
A. Contact
B. Droplet
C. Airborne
D. Protective isolation
Answer: C
Rationale: Pulmonary tuberculosis requires airborne precautions because infectious particles
can remain suspended in the air.
11. Which laboratory value is most concerning for a client taking heparin?
A. Hemoglobin 14 g/dL
B. Platelets 85,000/mm³
C. Sodium 140 mEq/L
D. Potassium 4.1 mEq/L
Answer: B
Rationale: Thrombocytopenia may indicate heparin-induced thrombocytopenia and requires
prompt evaluation.
12. Which finding is expected in a client experiencing hypoglycemia?
A. Warm, dry skin
B. Bradycardia
, C. Trembling and diaphoresis
D. Deep, slow respirations
Answer: C
Rationale: Adrenergic responses to low glucose include sweating, tremors, palpitations, and
anxiety.
13. A client taking an ACE inhibitor reports swelling of the lips and tongue. What is the
priority action?
A. Give the next dose
B. Document as an expected effect
C. Treat as a potential emergency and obtain immediate assistance
D. Encourage increased fluid intake
Answer: C
Rationale: Angioedema can compromise the airway and requires immediate intervention.
14. Which food is highest in potassium?
A. White rice
B. Banana
C. Bread
D. Applesauce
Answer: B
Rationale: Bananas are a commonly recognized potassium-rich food.
15. A client with heart failure suddenly develops severe dyspnea and pink, frothy sputum.
What complication should the nurse suspect?
A. Pulmonary edema
B. Constipation
C. Hypoglycemia
D. Deep-vein thrombosis
Answer: A
Rationale: Severe dyspnea with pink, frothy sputum is characteristic of acute pulmonary edema.
16. Which assessment finding is typical of left-sided heart failure?
A. Pulmonary crackles
B. Enlarged liver only
C. Dependent edema only
D. Ascites only