HESI RN EXIT Exam Questions and Verified Answers 2024
High-Quality Exam Material Nursing Essentials
This compilation of NCLEX-style questions, complete with concise rationales, is designed to challenge
your critical thinking skills and solidify your understanding of fundamental nursing concepts. Master
these scenarios to excel in your exams and build a strong foundation for your nursing career.
1. Infant Trust Development (6 months):
In planning care for a 6-month-old infant, what must the nurse provide to assist in the development of
trust? A) Food B) Warmth C) Security D) Comfort Rationale: (C) Security. According to Erikson's
stages of psychosocial development, the primary task of infancy (birth to 1 year) is developing trust
versus mistrust. Consistent and reliable care that provides a sense of security is crucial for the infant to
learn that their needs will be met. While food, warmth, and comfort are important, security
encompasses the predictability and safety that fosters trust.
2. Assertive Communication:
A nurse has just received a medication order which is not legible. Which statement best reflects
assertive communication? A) "I cannot give this medication as it is written. I have no idea of what you
mean." B) "Would you please clarify what you have written so I am sure I am reading it correctly?" C)
"I am having difficulty reading your handwriting. It would save me time if you would be more careful."
D) "Please print in the future so I do not have to spend extra time attempting to read your writing."
Rationale: (B) "Would you please clarify what you have written so I am sure I am reading it
correctly?" Assertive communication involves expressing one's needs and concerns respectfully and
directly. Option B clearly states the problem and proposes a solution without blaming or accusing the
sender.
3. Home Safety Education for Parents:
What is the most important consideration when teaching parents how to reduce risks in the home? A)
Age and knowledge level of the parents B) Proximity to emergency services C) Number of children in
the home D) Age of children in the home Rationale: (D) Age of children in the home. Safety risks in
the home vary significantly depending on the developmental stage of the children residing there.
Education should be tailored to address specific hazards relevant to infants (e.g., choking), toddlers
(e.g., poisoning), preschoolers (e.g., falls), and school-aged children (e.g., burns).
4. Sickle Cell Crisis Pain Management:
A 35-year-old client with sickle cell crisis is talking on the telephone but stops as the nurse enters the
room to request something for pain. The nurse should: A) Administer a placebo B) Encourage increased
,fluid intake C) Administer the prescribed analgesia D) Recommend relaxation exercises for pain control
Rationale: (C) Administer the prescribed analgesia. Clients in sickle cell crisis experience severe pain
due to vaso-occlusion. The nurse's priority is to provide prompt and effective pain relief as prescribed.
While increased fluids and relaxation techniques can be adjunctive measures, they do not replace the
immediate need for analgesia. Administering a placebo is unethical and inappropriate.
5. Croup Initial Sign Requiring Immediate Attention:
While caring for a toddler with croup, which initial sign of croup requires the nurse's immediate
attention? A) Respiratory rate of 42 B) Lethargy for the past hour C) Apical pulse of 54 D) Coughing
up copious secretions Rationale: (A) Respiratory rate of 42. A respiratory rate of 42 in a toddler is
significantly elevated and indicates respiratory distress. While lethargy, a low apical pulse, and copious
secretions are concerning, a rapid respiratory rate suggests the child is working hard to breathe and
requires immediate assessment and intervention to prevent respiratory failure.
6. Hypothyroidism Assessment Findings:
A client is admitted with low T3 and T4 levels and an elevated TSH level. On initial assessment, the
nurse would anticipate which of the following assessment findings? A) Lethargy B) Heat intolerance C)
Diarrhea D) Skin eruptions Rationale: (A) Lethargy. The laboratory findings are indicative of
hypothyroidism, a condition characterized by an underactive thyroid gland. Common signs and
symptoms of hypothyroidism include fatigue, lethargy, cold intolerance, constipation, dry skin, and
weight gain. Heat intolerance and diarrhea are typically associated with hyperthyroidism.
7. First-Time Seizure in a Child:
The emergency room nurse admits a child who experienced a seizure at school. The father comments
that this is the first occurrence and denies any family history of epilepsy. What is the best response by
the nurse? A) "Do not worry. Epilepsy can be treated with medications." B) "The seizure may or may
not mean your child has epilepsy." C) "Since this was the first convulsion, it may not happen again." D)
"Long-term treatment will prevent future seizures." Rationale: (B) "The seizure may or may not mean
your child has epilepsy." A single seizure does not automatically equate to a diagnosis of epilepsy.
Various factors can trigger a first-time seizure. Further evaluation is needed to determine the cause and
whether the child has epilepsy, a condition characterized by recurrent seizures.
8. Nursing Diagnosis for Alcohol and Drug Abuse:
Alcohol and drug abuse impairs judgment and increases risk-taking behavior. What nursing diagnosis
best applies? A) Risk for injury B) Risk for knowledge deficit C) Altered thought process D)
Disturbance in self-esteem Rationale: (A) Risk for injury. Impaired judgment and increased risk-taking
behaviors associated with substance abuse significantly elevate the individual's vulnerability to
accidents, falls, violence, and other forms of injury. While the other diagnoses may be relevant in some
cases, "Risk for injury" directly addresses the immediate safety concerns related to impaired judgment.
,9. Anemia Findings in a 10-Month-Old Infant:
Which of these findings would the nurse more closely associate with anemia in a 10-month-old infant?
A) Hemoglobin level of 12 g/dL B) Pale mucosa of the eyelids and lips C) Hypoactivity D) A heart rate
between 140 to 160 Rationale: (B) Pale mucosa of the eyelids and lips. Pallor, especially in the mucous
membranes, is a classic sign of anemia due to the reduced amount of hemoglobin carrying oxygen. A
hemoglobin level of 12 g/dL is within the normal range for a 10-month-old. While hypoactivity can be
a symptom of anemia, it is less specific than pallor. A heart rate between 140-160 could be normal for a
crying or active infant.
10. Priority Assessment in Hypertensive Crisis:
The nurse is caring for a client in hypertensive crisis in an intensive care unit. The priority assessment
in the first hour of care is: A) Heart rate B) Pedal pulses C) Lung sounds D) Pupil responses Rationale:
(D) Pupil responses. Hypertensive crisis is a severe elevation in blood pressure that can lead to end-
organ damage, including neurological impairment. Assessing pupil responses (size, equality, and
reaction to light) is crucial to detect early signs of increased intracranial pressure or neurological
compromise, making it the priority assessment.
11. PCA Pump Contraindication in Terminal Cancer:
Which of these clients who are all in the terminal stage of cancer is least appropriate to suggest the use
of patient-controlled analgesia (PCA) with a pump? A) A young adult with a history of Down
syndrome B) A teenager who reads at a 4th-grade level C) An elderly client with numerous arthritic
nodules on the hands D) A preschooler with intermittent episodes of alertness Rationale: (D) A
preschooler with intermittent episodes of alertness. PCA requires the patient to understand the concept
of self-administering medication and to be alert enough to do so safely. A preschooler, especially with
fluctuating levels of alertness, lacks the cognitive and developmental capacity to effectively and safely
use a PCA pump.
12. Nonorganic Failure-to-Thrive (NOFTT) Assessment:
The nurse is about to assess a 6-month-old child with nonorganic failure-to-thrive (NOFTT). Upon
entering the room, the nurse would expect the baby to be: A) Irritable and "colicky" with no attempts to
pull to standing B) Alert, laughing, and playing with a rattle, sitting with support C) Skin color dusky
with poor skin turgor over the abdomen D) Pale, thin arms and legs, uninterested in surroundings
Rationale: (D) Pale, thin arms and legs, uninterested in surroundings. NOFTT is often associated with
psychosocial factors and inadequate caloric intake despite the absence of an underlying medical
condition. These infants may exhibit signs of malnutrition, such as poor weight gain, thin extremities,
and a lack of engagement with their environment due to neglect or inadequate stimulation.
13. Chemotherapy Side Effect Interest in Teens:
, As the nurse is speaking with a group of teens, which of these side effects of chemotherapy for cancer
would the nurse expect this group to be more interested in during the discussion? A) Mouth sores B)
Fatigue C) Diarrhea D) Hair loss Rationale: (D) Hair loss. Adolescence is a stage of heightened self-
consciousness and concern about body image. Hair loss is a visible and often distressing side effect of
chemotherapy that can significantly impact a teenager's self-esteem and social interactions.
14. Post-Myocardial Infarction Temperature Elevation:
While caring for a client who was admitted with myocardial infarction (MI) 2 days ago, the nurse notes
today's temperature is 101.1 degrees Fahrenheit (38.5 degrees Celsius). The appropriate nursing
intervention is to: A) Call the health care provider immediately B) Administer acetaminophen as
ordered as this is normal at this time C) Send blood, urine, and sputum for culture D) Increase the
client's fluid intake Rationale: (B) Administer acetaminophen as ordered as this is normal at this time.
A low-grade fever in the first 24-48 hours following an MI is a common inflammatory response to
myocardial tissue injury. Unless accompanied by other signs of infection, it is usually managed
symptomatically with antipyretics as ordered.
15. Priority Nursing Intervention for Facial and Chest Burns:
A client is admitted for first and second-degree burns on the face, neck, anterior chest, and hands. The
nurse's priority should be: A) Cover the areas with dry sterile dressings B) Assess for dyspnea or stridor
C) Initiate intravenous therapy D) Administer pain medication Rationale: (B) Assess for dyspnea or
stridor. Burns to the face, neck, and anterior chest can compromise the airway due to swelling. Dyspnea
(difficulty breathing) and stridor (a high-pitched, whistling sound during breathing) are signs of airway
obstruction and require immediate assessment and intervention to ensure adequate oxygenation.
16. Community Health Clinic Call Requiring Same-Day Visit:
Which of these clients who call the community health clinic would the nurse ask to come in that day to
be seen by the health care provider? A) I started my period and now my urine has turned bright red. B) I
am a diabetic and today I have been going to the bathroom every hour. C) I was started on medicine
yesterday for a urine infection. Now my lower belly hurts when I go to the bathroom. D) I went to the
bathroom and my urine looked very red and it didn't hurt when I went. Rationale: (D) I went to the
bathroom and my urine looked very red and it didn't hurt when I went. Painless hematuria (blood in the
urine) can be a sign of a serious underlying condition, such as bladder cancer, and warrants prompt
medical evaluation. While the other scenarios require attention, painless hematuria carries a higher risk
of a significant underlying pathology.
17. Pyloric Stenosis Initial Finding:
Which of these parents' comments for a newborn would most likely reveal an initial finding of
suspected pyloric stenosis? A) I noticed a little lump a little above the belly button. B) The baby seems
hungry all the time. C) Mild vomiting that progressed to vomiting shooting across the room. D)
High-Quality Exam Material Nursing Essentials
This compilation of NCLEX-style questions, complete with concise rationales, is designed to challenge
your critical thinking skills and solidify your understanding of fundamental nursing concepts. Master
these scenarios to excel in your exams and build a strong foundation for your nursing career.
1. Infant Trust Development (6 months):
In planning care for a 6-month-old infant, what must the nurse provide to assist in the development of
trust? A) Food B) Warmth C) Security D) Comfort Rationale: (C) Security. According to Erikson's
stages of psychosocial development, the primary task of infancy (birth to 1 year) is developing trust
versus mistrust. Consistent and reliable care that provides a sense of security is crucial for the infant to
learn that their needs will be met. While food, warmth, and comfort are important, security
encompasses the predictability and safety that fosters trust.
2. Assertive Communication:
A nurse has just received a medication order which is not legible. Which statement best reflects
assertive communication? A) "I cannot give this medication as it is written. I have no idea of what you
mean." B) "Would you please clarify what you have written so I am sure I am reading it correctly?" C)
"I am having difficulty reading your handwriting. It would save me time if you would be more careful."
D) "Please print in the future so I do not have to spend extra time attempting to read your writing."
Rationale: (B) "Would you please clarify what you have written so I am sure I am reading it
correctly?" Assertive communication involves expressing one's needs and concerns respectfully and
directly. Option B clearly states the problem and proposes a solution without blaming or accusing the
sender.
3. Home Safety Education for Parents:
What is the most important consideration when teaching parents how to reduce risks in the home? A)
Age and knowledge level of the parents B) Proximity to emergency services C) Number of children in
the home D) Age of children in the home Rationale: (D) Age of children in the home. Safety risks in
the home vary significantly depending on the developmental stage of the children residing there.
Education should be tailored to address specific hazards relevant to infants (e.g., choking), toddlers
(e.g., poisoning), preschoolers (e.g., falls), and school-aged children (e.g., burns).
4. Sickle Cell Crisis Pain Management:
A 35-year-old client with sickle cell crisis is talking on the telephone but stops as the nurse enters the
room to request something for pain. The nurse should: A) Administer a placebo B) Encourage increased
,fluid intake C) Administer the prescribed analgesia D) Recommend relaxation exercises for pain control
Rationale: (C) Administer the prescribed analgesia. Clients in sickle cell crisis experience severe pain
due to vaso-occlusion. The nurse's priority is to provide prompt and effective pain relief as prescribed.
While increased fluids and relaxation techniques can be adjunctive measures, they do not replace the
immediate need for analgesia. Administering a placebo is unethical and inappropriate.
5. Croup Initial Sign Requiring Immediate Attention:
While caring for a toddler with croup, which initial sign of croup requires the nurse's immediate
attention? A) Respiratory rate of 42 B) Lethargy for the past hour C) Apical pulse of 54 D) Coughing
up copious secretions Rationale: (A) Respiratory rate of 42. A respiratory rate of 42 in a toddler is
significantly elevated and indicates respiratory distress. While lethargy, a low apical pulse, and copious
secretions are concerning, a rapid respiratory rate suggests the child is working hard to breathe and
requires immediate assessment and intervention to prevent respiratory failure.
6. Hypothyroidism Assessment Findings:
A client is admitted with low T3 and T4 levels and an elevated TSH level. On initial assessment, the
nurse would anticipate which of the following assessment findings? A) Lethargy B) Heat intolerance C)
Diarrhea D) Skin eruptions Rationale: (A) Lethargy. The laboratory findings are indicative of
hypothyroidism, a condition characterized by an underactive thyroid gland. Common signs and
symptoms of hypothyroidism include fatigue, lethargy, cold intolerance, constipation, dry skin, and
weight gain. Heat intolerance and diarrhea are typically associated with hyperthyroidism.
7. First-Time Seizure in a Child:
The emergency room nurse admits a child who experienced a seizure at school. The father comments
that this is the first occurrence and denies any family history of epilepsy. What is the best response by
the nurse? A) "Do not worry. Epilepsy can be treated with medications." B) "The seizure may or may
not mean your child has epilepsy." C) "Since this was the first convulsion, it may not happen again." D)
"Long-term treatment will prevent future seizures." Rationale: (B) "The seizure may or may not mean
your child has epilepsy." A single seizure does not automatically equate to a diagnosis of epilepsy.
Various factors can trigger a first-time seizure. Further evaluation is needed to determine the cause and
whether the child has epilepsy, a condition characterized by recurrent seizures.
8. Nursing Diagnosis for Alcohol and Drug Abuse:
Alcohol and drug abuse impairs judgment and increases risk-taking behavior. What nursing diagnosis
best applies? A) Risk for injury B) Risk for knowledge deficit C) Altered thought process D)
Disturbance in self-esteem Rationale: (A) Risk for injury. Impaired judgment and increased risk-taking
behaviors associated with substance abuse significantly elevate the individual's vulnerability to
accidents, falls, violence, and other forms of injury. While the other diagnoses may be relevant in some
cases, "Risk for injury" directly addresses the immediate safety concerns related to impaired judgment.
,9. Anemia Findings in a 10-Month-Old Infant:
Which of these findings would the nurse more closely associate with anemia in a 10-month-old infant?
A) Hemoglobin level of 12 g/dL B) Pale mucosa of the eyelids and lips C) Hypoactivity D) A heart rate
between 140 to 160 Rationale: (B) Pale mucosa of the eyelids and lips. Pallor, especially in the mucous
membranes, is a classic sign of anemia due to the reduced amount of hemoglobin carrying oxygen. A
hemoglobin level of 12 g/dL is within the normal range for a 10-month-old. While hypoactivity can be
a symptom of anemia, it is less specific than pallor. A heart rate between 140-160 could be normal for a
crying or active infant.
10. Priority Assessment in Hypertensive Crisis:
The nurse is caring for a client in hypertensive crisis in an intensive care unit. The priority assessment
in the first hour of care is: A) Heart rate B) Pedal pulses C) Lung sounds D) Pupil responses Rationale:
(D) Pupil responses. Hypertensive crisis is a severe elevation in blood pressure that can lead to end-
organ damage, including neurological impairment. Assessing pupil responses (size, equality, and
reaction to light) is crucial to detect early signs of increased intracranial pressure or neurological
compromise, making it the priority assessment.
11. PCA Pump Contraindication in Terminal Cancer:
Which of these clients who are all in the terminal stage of cancer is least appropriate to suggest the use
of patient-controlled analgesia (PCA) with a pump? A) A young adult with a history of Down
syndrome B) A teenager who reads at a 4th-grade level C) An elderly client with numerous arthritic
nodules on the hands D) A preschooler with intermittent episodes of alertness Rationale: (D) A
preschooler with intermittent episodes of alertness. PCA requires the patient to understand the concept
of self-administering medication and to be alert enough to do so safely. A preschooler, especially with
fluctuating levels of alertness, lacks the cognitive and developmental capacity to effectively and safely
use a PCA pump.
12. Nonorganic Failure-to-Thrive (NOFTT) Assessment:
The nurse is about to assess a 6-month-old child with nonorganic failure-to-thrive (NOFTT). Upon
entering the room, the nurse would expect the baby to be: A) Irritable and "colicky" with no attempts to
pull to standing B) Alert, laughing, and playing with a rattle, sitting with support C) Skin color dusky
with poor skin turgor over the abdomen D) Pale, thin arms and legs, uninterested in surroundings
Rationale: (D) Pale, thin arms and legs, uninterested in surroundings. NOFTT is often associated with
psychosocial factors and inadequate caloric intake despite the absence of an underlying medical
condition. These infants may exhibit signs of malnutrition, such as poor weight gain, thin extremities,
and a lack of engagement with their environment due to neglect or inadequate stimulation.
13. Chemotherapy Side Effect Interest in Teens:
, As the nurse is speaking with a group of teens, which of these side effects of chemotherapy for cancer
would the nurse expect this group to be more interested in during the discussion? A) Mouth sores B)
Fatigue C) Diarrhea D) Hair loss Rationale: (D) Hair loss. Adolescence is a stage of heightened self-
consciousness and concern about body image. Hair loss is a visible and often distressing side effect of
chemotherapy that can significantly impact a teenager's self-esteem and social interactions.
14. Post-Myocardial Infarction Temperature Elevation:
While caring for a client who was admitted with myocardial infarction (MI) 2 days ago, the nurse notes
today's temperature is 101.1 degrees Fahrenheit (38.5 degrees Celsius). The appropriate nursing
intervention is to: A) Call the health care provider immediately B) Administer acetaminophen as
ordered as this is normal at this time C) Send blood, urine, and sputum for culture D) Increase the
client's fluid intake Rationale: (B) Administer acetaminophen as ordered as this is normal at this time.
A low-grade fever in the first 24-48 hours following an MI is a common inflammatory response to
myocardial tissue injury. Unless accompanied by other signs of infection, it is usually managed
symptomatically with antipyretics as ordered.
15. Priority Nursing Intervention for Facial and Chest Burns:
A client is admitted for first and second-degree burns on the face, neck, anterior chest, and hands. The
nurse's priority should be: A) Cover the areas with dry sterile dressings B) Assess for dyspnea or stridor
C) Initiate intravenous therapy D) Administer pain medication Rationale: (B) Assess for dyspnea or
stridor. Burns to the face, neck, and anterior chest can compromise the airway due to swelling. Dyspnea
(difficulty breathing) and stridor (a high-pitched, whistling sound during breathing) are signs of airway
obstruction and require immediate assessment and intervention to ensure adequate oxygenation.
16. Community Health Clinic Call Requiring Same-Day Visit:
Which of these clients who call the community health clinic would the nurse ask to come in that day to
be seen by the health care provider? A) I started my period and now my urine has turned bright red. B) I
am a diabetic and today I have been going to the bathroom every hour. C) I was started on medicine
yesterday for a urine infection. Now my lower belly hurts when I go to the bathroom. D) I went to the
bathroom and my urine looked very red and it didn't hurt when I went. Rationale: (D) I went to the
bathroom and my urine looked very red and it didn't hurt when I went. Painless hematuria (blood in the
urine) can be a sign of a serious underlying condition, such as bladder cancer, and warrants prompt
medical evaluation. While the other scenarios require attention, painless hematuria carries a higher risk
of a significant underlying pathology.
17. Pyloric Stenosis Initial Finding:
Which of these parents' comments for a newborn would most likely reveal an initial finding of
suspected pyloric stenosis? A) I noticed a little lump a little above the belly button. B) The baby seems
hungry all the time. C) Mild vomiting that progressed to vomiting shooting across the room. D)
