RN HESI Exit Exam – Versions 1–7 – 2025/2026
Edition – Complete Package Deal | Each Version
Includes 160 Questions and Correct Answers
Section 1: Fundamentals of Nursing and Safety (Q1–Q20)
1. A client receiving a blood transfusion develops chills, back pain, and hypotension 15
minutes into the infusion. What is the nurse's priority action?
A. Slow the transfusion rate
B. Stop the transfusion immediately
C. Administer acetaminophen
D. Continue the transfusion and monitor
Answer: B
Rationale: Chills, back pain, and hypotension during a transfusion suggest an acute hemolytic
reaction, which is life-threatening. The nurse must stop the transfusion immediately, maintain
IV access with normal saline, and notify the provider.
2. Which fluid will the nurse select to administer with a prescribed blood transfusion?
A. 5% Dextrose and water
B. Normal saline
C. Lactated Ringer's solution
D. 5% Dextrose and lactated Ringer's
Answer: B
Rationale: Normal saline (0.9% sodium chloride) is the only solution compatible with blood
components. Dextrose solutions can cause hemolysis, and Lactated Ringer's contains calcium
which can cause clotting in the blood tubing.
3. When assisting a client from the bed to a chair, which technique is best for the nurse to
use?
A. Place the chair parallel to the bed with its back toward the head of the bed
B. Stand with feet spread apart and knees aligned with the client's knees, then pivot
C. Assist the client by lifting upward underneath the axillae
D. Have the client place arms around the nurse's neck and move to the chair
Answer: B
Rationale: This technique provides a wide base of support for the nurse while stabilizing the
client's knees. Lifting under the axillae can damage nerves, and clients should never place arms
around the nurse's neck due to risk of injury to both parties.
,4. A client is receiving opioid analgesics and is difficult to arouse with a respiratory rate of
7/min. What is the priority action?
A. Administer naloxone
B. Notify the healthcare provider
C. Document the findings
D. Provide oxygen only
Answer: A
Rationale: Naloxone (Narcan) is an opioid antagonist that reverses opioid-induced respiratory
depression and sedation. This is a life-threatening emergency requiring immediate reversal.
5. Which task can the RN delegate to an unlicensed assistive personnel (UAP)?
A. Perform a catheter insertion
B. Assist with ambulation
C. Administer oral medications
D. Evaluate wound healing
Answer: B
Rationale: UAPs can assist with ambulation; medication administration and assessments are
RN/LPN tasks.
6. A nurse is calculating intake for a client. Record includes: 1200 mL water, 4 oz gelatin, 8 oz
orange juice, 355 mL soda, 1 cup soup. How many mL should be documented?
A. 1955 mL
B. 2055 mL
C. 2155 mL
D. 2255 mL
Answer: C
Rationale: Convert ounces to mL (1 oz = 30 mL). 4 oz gelatin = 120 mL; 8 oz juice = 240 mL; 1
cup soup = 240 mL. Total: 1200 + 120 + 240 + 355 + 240 = 2155 mL.
7. The nurse observes a UAP taking a blood pressure in the lower extremity. Which
observation requires intervention?
A. The cuff wraps around the girth of the leg
B. The UAP auscultates the popliteal pulse with the cuff on the lower leg
C. The client is placed in a prone position
D. The systolic reading is 20 mm Hg higher than in the arm
Answer: B
Rationale: The popliteal pulse is auscultated with the cuff placed around the thigh, not the
lower leg. The nurse should intervene to correct this technique.
8. A client reports being sexually assaulted 6 hours ago. What is the nurse's priority question?
A. Did you report the assault to the police?
,B. Have you bathed or showered since the assault?
C. Do you know the assailant?
D. Are you feeling safe now?
Answer: B
Rationale: Asking about bathing or showering is critical to preserve forensic evidence for a
sexual assault examination, which is time-sensitive and takes priority.
9. A client with a new colostomy refuses to look at the stoma. What should the nurse do?
A. Insist the client inspect the stoma
B. Provide education and emotional support
C. Change the appliance without discussion
D. Refer the client to a psychiatrist
Answer: B
Rationale: Education and emotional support address the client's emotional barriers, promoting
acceptance and self-care.
10. Which signs are expected in a client with hypoglycemia? (Select all that apply)
A. Diaphoresis
B. Tremors
C. Confusion
D. Bradycardia
E. Hunger
Answer: A, B, C, E
Rationale: Hypoglycemia activates the sympathetic nervous system, causing diaphoresis,
tremors, tachycardia (not bradycardia), confusion, and hunger.
11. A client with a new colostomy refuses to look at the stoma. What should the nurse do?
A. Insist the client inspect the stoma
B. Provide education and emotional support
C. Change the appliance without discussion
D. Refer the client to a psychiatrist
Answer: B
Rationale: Education and emotional support address the client's emotional barriers, promoting
acceptance and self-care.
12. A nurse is preparing to administer a high-alert medication, such as intravenous (IV)
heparin. Which action is most critical to ensure patient safety?
A. Obtaining a second independent check from another qualified nurse
B. Administering the medication slowly over 5 minutes
C. Asking the patient if they are allergic to aspirin
D. Checking the patient's blood pressure before giving the dose
, Answer: A
Rationale: High-alert medications like heparin require an independent double-check by another
qualified nurse to verify the "Seven Rights" before administration to prevent potentially fatal
errors.
13. A patient states, "I can't swallow these big pills." The nurse recognizes that crushing
which of the following medications could be dangerous due to potential rapid absorption or
tissue damage?
A. Enteric-coated aspirin
B. Acetaminophen (Tylenol)
C. Multivitamin without iron
D. Liquid pain medication
Answer: A
Rationale: Enteric-coated medications should not be crushed because destroying the coating
can lead to rapid drug release, stomach irritation, or destruction of the medication's
effectiveness.
14. The nurse is preparing to draw blood from a patient. Which PPE is minimally required?
A. Gown, Mask, Goggles, Gloves
B. Gloves
C. Mask and Gloves
D. Gown and Gloves
Answer: B
Rationale: Standard Precautions require gloves for any contact with blood or body fluids.
Additional PPE is based on the risk of splashes.
15. A nurse is caring for a client who is 12 hours postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take?
A. Place the client's legs in a high Fowler's position to promote lung expansion
B. Maintain the affected leg in an abducted position using an abduction pillow
C. Perform range of motion exercises on the affected leg every 2 hours to prevent stiffness
D. Apply a heating pad to the surgical site to improve circulation
Answer: B
Rationale: Following a total hip arthroplasty, the primary risk is dislocation of the prosthesis.
The affected leg must be kept in abduction to prevent the prosthesis from dislocating. An
abduction pillow or splint is used to maintain this alignment.
16. A client with a history of falls is admitted. Which intervention is most important to
prevent falls?
A. Keep the call light within reach
B. Raise all four side rails
Edition – Complete Package Deal | Each Version
Includes 160 Questions and Correct Answers
Section 1: Fundamentals of Nursing and Safety (Q1–Q20)
1. A client receiving a blood transfusion develops chills, back pain, and hypotension 15
minutes into the infusion. What is the nurse's priority action?
A. Slow the transfusion rate
B. Stop the transfusion immediately
C. Administer acetaminophen
D. Continue the transfusion and monitor
Answer: B
Rationale: Chills, back pain, and hypotension during a transfusion suggest an acute hemolytic
reaction, which is life-threatening. The nurse must stop the transfusion immediately, maintain
IV access with normal saline, and notify the provider.
2. Which fluid will the nurse select to administer with a prescribed blood transfusion?
A. 5% Dextrose and water
B. Normal saline
C. Lactated Ringer's solution
D. 5% Dextrose and lactated Ringer's
Answer: B
Rationale: Normal saline (0.9% sodium chloride) is the only solution compatible with blood
components. Dextrose solutions can cause hemolysis, and Lactated Ringer's contains calcium
which can cause clotting in the blood tubing.
3. When assisting a client from the bed to a chair, which technique is best for the nurse to
use?
A. Place the chair parallel to the bed with its back toward the head of the bed
B. Stand with feet spread apart and knees aligned with the client's knees, then pivot
C. Assist the client by lifting upward underneath the axillae
D. Have the client place arms around the nurse's neck and move to the chair
Answer: B
Rationale: This technique provides a wide base of support for the nurse while stabilizing the
client's knees. Lifting under the axillae can damage nerves, and clients should never place arms
around the nurse's neck due to risk of injury to both parties.
,4. A client is receiving opioid analgesics and is difficult to arouse with a respiratory rate of
7/min. What is the priority action?
A. Administer naloxone
B. Notify the healthcare provider
C. Document the findings
D. Provide oxygen only
Answer: A
Rationale: Naloxone (Narcan) is an opioid antagonist that reverses opioid-induced respiratory
depression and sedation. This is a life-threatening emergency requiring immediate reversal.
5. Which task can the RN delegate to an unlicensed assistive personnel (UAP)?
A. Perform a catheter insertion
B. Assist with ambulation
C. Administer oral medications
D. Evaluate wound healing
Answer: B
Rationale: UAPs can assist with ambulation; medication administration and assessments are
RN/LPN tasks.
6. A nurse is calculating intake for a client. Record includes: 1200 mL water, 4 oz gelatin, 8 oz
orange juice, 355 mL soda, 1 cup soup. How many mL should be documented?
A. 1955 mL
B. 2055 mL
C. 2155 mL
D. 2255 mL
Answer: C
Rationale: Convert ounces to mL (1 oz = 30 mL). 4 oz gelatin = 120 mL; 8 oz juice = 240 mL; 1
cup soup = 240 mL. Total: 1200 + 120 + 240 + 355 + 240 = 2155 mL.
7. The nurse observes a UAP taking a blood pressure in the lower extremity. Which
observation requires intervention?
A. The cuff wraps around the girth of the leg
B. The UAP auscultates the popliteal pulse with the cuff on the lower leg
C. The client is placed in a prone position
D. The systolic reading is 20 mm Hg higher than in the arm
Answer: B
Rationale: The popliteal pulse is auscultated with the cuff placed around the thigh, not the
lower leg. The nurse should intervene to correct this technique.
8. A client reports being sexually assaulted 6 hours ago. What is the nurse's priority question?
A. Did you report the assault to the police?
,B. Have you bathed or showered since the assault?
C. Do you know the assailant?
D. Are you feeling safe now?
Answer: B
Rationale: Asking about bathing or showering is critical to preserve forensic evidence for a
sexual assault examination, which is time-sensitive and takes priority.
9. A client with a new colostomy refuses to look at the stoma. What should the nurse do?
A. Insist the client inspect the stoma
B. Provide education and emotional support
C. Change the appliance without discussion
D. Refer the client to a psychiatrist
Answer: B
Rationale: Education and emotional support address the client's emotional barriers, promoting
acceptance and self-care.
10. Which signs are expected in a client with hypoglycemia? (Select all that apply)
A. Diaphoresis
B. Tremors
C. Confusion
D. Bradycardia
E. Hunger
Answer: A, B, C, E
Rationale: Hypoglycemia activates the sympathetic nervous system, causing diaphoresis,
tremors, tachycardia (not bradycardia), confusion, and hunger.
11. A client with a new colostomy refuses to look at the stoma. What should the nurse do?
A. Insist the client inspect the stoma
B. Provide education and emotional support
C. Change the appliance without discussion
D. Refer the client to a psychiatrist
Answer: B
Rationale: Education and emotional support address the client's emotional barriers, promoting
acceptance and self-care.
12. A nurse is preparing to administer a high-alert medication, such as intravenous (IV)
heparin. Which action is most critical to ensure patient safety?
A. Obtaining a second independent check from another qualified nurse
B. Administering the medication slowly over 5 minutes
C. Asking the patient if they are allergic to aspirin
D. Checking the patient's blood pressure before giving the dose
, Answer: A
Rationale: High-alert medications like heparin require an independent double-check by another
qualified nurse to verify the "Seven Rights" before administration to prevent potentially fatal
errors.
13. A patient states, "I can't swallow these big pills." The nurse recognizes that crushing
which of the following medications could be dangerous due to potential rapid absorption or
tissue damage?
A. Enteric-coated aspirin
B. Acetaminophen (Tylenol)
C. Multivitamin without iron
D. Liquid pain medication
Answer: A
Rationale: Enteric-coated medications should not be crushed because destroying the coating
can lead to rapid drug release, stomach irritation, or destruction of the medication's
effectiveness.
14. The nurse is preparing to draw blood from a patient. Which PPE is minimally required?
A. Gown, Mask, Goggles, Gloves
B. Gloves
C. Mask and Gloves
D. Gown and Gloves
Answer: B
Rationale: Standard Precautions require gloves for any contact with blood or body fluids.
Additional PPE is based on the risk of splashes.
15. A nurse is caring for a client who is 12 hours postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take?
A. Place the client's legs in a high Fowler's position to promote lung expansion
B. Maintain the affected leg in an abducted position using an abduction pillow
C. Perform range of motion exercises on the affected leg every 2 hours to prevent stiffness
D. Apply a heating pad to the surgical site to improve circulation
Answer: B
Rationale: Following a total hip arthroplasty, the primary risk is dislocation of the prosthesis.
The affected leg must be kept in abduction to prevent the prosthesis from dislocating. An
abduction pillow or splint is used to maintain this alignment.
16. A client with a history of falls is admitted. Which intervention is most important to
prevent falls?
A. Keep the call light within reach
B. Raise all four side rails
