RN HESI EXIT 2025
1. Redirect the A group of nursing students is touring an in-patient psychiatric unit when a male
client's acting out client who is in a manic state shouts, "Want to see a crazy person?" and begins
behavior by ask- to jump up and down, flap his arms, and cluck like a chicken. Which action is best
ing him to per- for the nurse to take?
form a unit task.
A Direct the students to continue the tour without responding to the client's
behavior.
B Medicate the client with a PRN prescription for an antianxiety agent.
C Restrict the client to his room until he can control his behaviors.
D Redirect the client's acting out behavior by asking him to perform a unit task.
2. Nausea with pro- An adult male client is brought to the emergency department (ED) by ambulance
jectile vomiting. following a motorcycle collision. He was not wearing a helmet and presents
with periorbital bruising and bloody drainage from both ears. Which assessment
finding warrants immediate intervention by the nurse?
A Rebound abdominal tenderness.
B Diminished bilateral breath sounds.
C Nausea with projectile vomiting.
D Rib pain with deep inspiration.
3. C A change in A client diagnosed with Parkinson's disease receives a prescription for car-
urine color to bidopa-levodopa, controlled release (CR) 25/100 mg PO daily each morning.
dark red often Which information should the nurse include in the client's teaching plan? Select
occurs while tak- all that apply.
ing this drug.
D An upset stom- A Parkinson symptoms should diminish within one week.
ach may occur as B Avoid sunlight and wear sunglasses while outdoors.
a side effect of C A change in urine color to dark red often occurs while taking this drug.
this medication. D An upset stomach may occur as a side effect of this medication.
E The medication should only be taken during a meal.
4. 25 gtt/min
, RN HESI EXIT 2025
The healthcare provider (HCP) prescribes 500 mL of 0.45% normal saline with 100
units regular insulin to infuse at 15 units/hour. The drop factor is 20 gtt/mL.
The nurse should regulate the IV to deliver how many gtt/minute? (Enter numer-
ical value only.)
5. Focus on small A client with generalized anxiety disorder does not want to communicate with
achievable tasks, friends, smokes 2 to 3 packages of cigarettes a day, and describes difficulty
not taxing prob- concentrating at work. Which coping strategy should the nurse include in the plan
lems. of care (POC)?
A Focus on small achievable tasks, not taxing problems.
B Concentrate on and ventilate emotions when distressed.
C Relax and reduce the amount of effort to solve the problem.
D Analyze past hurts and resentments to identify the source.
6. A Raise the head The nurse is caring for a client who reports sudden right sided numbness and
of the bed to weakness of the arm and leg. The nurse also observes a distinct right sided
30° keeping head facial droop. After reporting the findings to the healthcare provider (HCP), the
and neck in neu- nurse receives several prescriptions for the client, including a STAT computerized
tral alignment. tomography (CT) scan of the head. Which action should the nurse take first?
• A Raise the head of the bed to 30° keeping head and neck in neutral alignment.
• B Start two large bore peripheral IV (PIV) catheters and review inclusion criteria
for IV fibrinolytic therapy.
• C Administer aspirin to prevent further clot formation and platelet clumping.
• D Begin continuous observation for transient episodes of neurologic dysfunc-
tion.
7. Daily use An older adult client is admitted with pneumonia, and the healthcare provider
of spironolac- (HCP) prescribes penicillinG potassium IV. Which assessment finding increases
tone for hyper- the risk of adverse reactions in this client?
tension. A Previous treatment with penicillin for pneumonia.
B Daily use of spironolactone for hypertension.
, RN HESI EXIT 2025
C Documented allergy to sulfonamides.
D Sputum culture results of Streptococcus pneumoniae.
8. Divide the med- The nurse is preparing to administer 1.6 mL of medication IM to a 4-month-old
ication into two infant. Which action should the nurse include?
injections with A Select a 22 gauge 1 1/2 inch (3.8 cm) needle for the intramuscular injection.
volumes under 1 B Administer into the deltoid muscle while the parent holds the infant securely.
mL. C Use a quick dart like motion to inject into the dorsogluteal site
D Divide the medication into two injections with volumes under 1 mL.
9. 1.3 mL An infant who weighs 22 Ibs. receives a prescription for amoxicillin 20 mg/kg/day
PO in divided doses every 8 hours. The bottle is labeled, "Amoxicillin for Oral
Suspension, USP 250 mg per 5 mL." How many mL should the nurse administer
with each dose? (Enter numerical value only. If rounding is necessary, round to
the nearest tenth.)
10. Decrease the A client who is homebound and is receiving continuous feedings through a gas-
rate at which the trostomy tube reports experiencing frequent diarrhea. Which instructions should
feeding is given the nurse provide
A. Decrease the rate at which the feeding is given.
B. Do not allow the feeding to sit at room temperature.
C. Increase the concentration of the teedings.
D. Elevate the head of the bed to ninety degrees.
11. B. Wash the The nurse is preparing a client who had a below-the-knee (BKA) amputation
residual limb for discharge to home. Which recommendations) should the nurse provide this
with soap and client? Select all that apply.
water A. Avoid range of motion exercises
C. Use a residual B. Wash the residual limb with soap and water
limb shrinker C. Use a residual limb shrinker
D. Inspect skin D. Inspect skin for redness.
for redness. E. Apply alcohol to the residual limb after bathing
, RN HESI EXIT 2025
12. Report the eye Following laser trabeculoplasty surgery for open-angle glaucoma, the client re-
pain to the sur- ports acute pain deep within the eye. Which action should the nurse take?
geon. • A Report the eye pain to the surgeon.
• B Administer an antiemetic to prevent vomiting.
• C Apply bilateral eye shields to reduce photosensitivity.
• D Begin postoperative prophylactic antibiotics.
13. Note date and an unlicensed assistive personnel (UAP) leaves the unit without notifying the staff.
time of the be- In which order should the unit manager Implement these Interventions address
havior. the UAP's behavior? (Place the actions in order from first on top to last on bottom.
Discuss the issue
privately with the Evaluate the UAP for signs of improvement.
UAP Discuss the issue privately with the UAP
Plan for sched- Plan for scheduled break times.
uled break times Note date and time of the behavior.
Evaluate the UAP
for signs of im-
provement.
14. Auscultate lung A female client with a history of heart failure (HF) arrives at the clinic after what
and heart sounds she describes as a very long trip. Following the initial physical assessment and
chart review, which priority action should the nurse implement?
• A Reteach medication regimen.
• B Give a potassium supplement.
• C Administer the prescribed diuretic.
• D Auscultate lung and heart sounds
15. Complete blood A client who is receiving zidovudine reports the appearance of pinpoint, red,
count round spots on the skin. Which result should the nurse report to the healthcare
provider (HCP)?
1. Redirect the A group of nursing students is touring an in-patient psychiatric unit when a male
client's acting out client who is in a manic state shouts, "Want to see a crazy person?" and begins
behavior by ask- to jump up and down, flap his arms, and cluck like a chicken. Which action is best
ing him to per- for the nurse to take?
form a unit task.
A Direct the students to continue the tour without responding to the client's
behavior.
B Medicate the client with a PRN prescription for an antianxiety agent.
C Restrict the client to his room until he can control his behaviors.
D Redirect the client's acting out behavior by asking him to perform a unit task.
2. Nausea with pro- An adult male client is brought to the emergency department (ED) by ambulance
jectile vomiting. following a motorcycle collision. He was not wearing a helmet and presents
with periorbital bruising and bloody drainage from both ears. Which assessment
finding warrants immediate intervention by the nurse?
A Rebound abdominal tenderness.
B Diminished bilateral breath sounds.
C Nausea with projectile vomiting.
D Rib pain with deep inspiration.
3. C A change in A client diagnosed with Parkinson's disease receives a prescription for car-
urine color to bidopa-levodopa, controlled release (CR) 25/100 mg PO daily each morning.
dark red often Which information should the nurse include in the client's teaching plan? Select
occurs while tak- all that apply.
ing this drug.
D An upset stom- A Parkinson symptoms should diminish within one week.
ach may occur as B Avoid sunlight and wear sunglasses while outdoors.
a side effect of C A change in urine color to dark red often occurs while taking this drug.
this medication. D An upset stomach may occur as a side effect of this medication.
E The medication should only be taken during a meal.
4. 25 gtt/min
, RN HESI EXIT 2025
The healthcare provider (HCP) prescribes 500 mL of 0.45% normal saline with 100
units regular insulin to infuse at 15 units/hour. The drop factor is 20 gtt/mL.
The nurse should regulate the IV to deliver how many gtt/minute? (Enter numer-
ical value only.)
5. Focus on small A client with generalized anxiety disorder does not want to communicate with
achievable tasks, friends, smokes 2 to 3 packages of cigarettes a day, and describes difficulty
not taxing prob- concentrating at work. Which coping strategy should the nurse include in the plan
lems. of care (POC)?
A Focus on small achievable tasks, not taxing problems.
B Concentrate on and ventilate emotions when distressed.
C Relax and reduce the amount of effort to solve the problem.
D Analyze past hurts and resentments to identify the source.
6. A Raise the head The nurse is caring for a client who reports sudden right sided numbness and
of the bed to weakness of the arm and leg. The nurse also observes a distinct right sided
30° keeping head facial droop. After reporting the findings to the healthcare provider (HCP), the
and neck in neu- nurse receives several prescriptions for the client, including a STAT computerized
tral alignment. tomography (CT) scan of the head. Which action should the nurse take first?
• A Raise the head of the bed to 30° keeping head and neck in neutral alignment.
• B Start two large bore peripheral IV (PIV) catheters and review inclusion criteria
for IV fibrinolytic therapy.
• C Administer aspirin to prevent further clot formation and platelet clumping.
• D Begin continuous observation for transient episodes of neurologic dysfunc-
tion.
7. Daily use An older adult client is admitted with pneumonia, and the healthcare provider
of spironolac- (HCP) prescribes penicillinG potassium IV. Which assessment finding increases
tone for hyper- the risk of adverse reactions in this client?
tension. A Previous treatment with penicillin for pneumonia.
B Daily use of spironolactone for hypertension.
, RN HESI EXIT 2025
C Documented allergy to sulfonamides.
D Sputum culture results of Streptococcus pneumoniae.
8. Divide the med- The nurse is preparing to administer 1.6 mL of medication IM to a 4-month-old
ication into two infant. Which action should the nurse include?
injections with A Select a 22 gauge 1 1/2 inch (3.8 cm) needle for the intramuscular injection.
volumes under 1 B Administer into the deltoid muscle while the parent holds the infant securely.
mL. C Use a quick dart like motion to inject into the dorsogluteal site
D Divide the medication into two injections with volumes under 1 mL.
9. 1.3 mL An infant who weighs 22 Ibs. receives a prescription for amoxicillin 20 mg/kg/day
PO in divided doses every 8 hours. The bottle is labeled, "Amoxicillin for Oral
Suspension, USP 250 mg per 5 mL." How many mL should the nurse administer
with each dose? (Enter numerical value only. If rounding is necessary, round to
the nearest tenth.)
10. Decrease the A client who is homebound and is receiving continuous feedings through a gas-
rate at which the trostomy tube reports experiencing frequent diarrhea. Which instructions should
feeding is given the nurse provide
A. Decrease the rate at which the feeding is given.
B. Do not allow the feeding to sit at room temperature.
C. Increase the concentration of the teedings.
D. Elevate the head of the bed to ninety degrees.
11. B. Wash the The nurse is preparing a client who had a below-the-knee (BKA) amputation
residual limb for discharge to home. Which recommendations) should the nurse provide this
with soap and client? Select all that apply.
water A. Avoid range of motion exercises
C. Use a residual B. Wash the residual limb with soap and water
limb shrinker C. Use a residual limb shrinker
D. Inspect skin D. Inspect skin for redness.
for redness. E. Apply alcohol to the residual limb after bathing
, RN HESI EXIT 2025
12. Report the eye Following laser trabeculoplasty surgery for open-angle glaucoma, the client re-
pain to the sur- ports acute pain deep within the eye. Which action should the nurse take?
geon. • A Report the eye pain to the surgeon.
• B Administer an antiemetic to prevent vomiting.
• C Apply bilateral eye shields to reduce photosensitivity.
• D Begin postoperative prophylactic antibiotics.
13. Note date and an unlicensed assistive personnel (UAP) leaves the unit without notifying the staff.
time of the be- In which order should the unit manager Implement these Interventions address
havior. the UAP's behavior? (Place the actions in order from first on top to last on bottom.
Discuss the issue
privately with the Evaluate the UAP for signs of improvement.
UAP Discuss the issue privately with the UAP
Plan for sched- Plan for scheduled break times.
uled break times Note date and time of the behavior.
Evaluate the UAP
for signs of im-
provement.
14. Auscultate lung A female client with a history of heart failure (HF) arrives at the clinic after what
and heart sounds she describes as a very long trip. Following the initial physical assessment and
chart review, which priority action should the nurse implement?
• A Reteach medication regimen.
• B Give a potassium supplement.
• C Administer the prescribed diuretic.
• D Auscultate lung and heart sounds
15. Complete blood A client who is receiving zidovudine reports the appearance of pinpoint, red,
count round spots on the skin. Which result should the nurse report to the healthcare
provider (HCP)?
