HESI RN EXIT EXAM | VERSION B (2024–2025)
✅ 160 Questions with Correct Answers & Rationales
🟦 Question 1
The nurse is completing the admission assessment of a 3-year-old admitted with bacterial
meningitis and hydrocephalus. Which assessment finding indicates increased intracranial
pressure (ICP)?
A. Tachycardia and tachypnea
🟩 B. Sluggish and unequal pupillary responses
C. Increased head circumference and bulging fontanels
D. Blood pressure fluctuations and syncope
📘 Rationale:
Sluggish and unequal pupils are a classic sign of increased ICP. This reflects impaired cranial nerve
function due to pressure within the skull.
🟦 Question 2
A client with acute pancreatitis presents with severe abdominal pain and elevated serum amylase.
What symptom is most likely to be reported?
🟩 A. Abdominal pain decreases when lying supine
B. Pain lasts an hour and leaves the abdomen tender
, C. Right upper quadrant pain refers to the right scapula
D. Drinks alcohol until intoxicated at least twice weekly
📘 Rationale:
Supine positioning often relieves abdominal discomfort associated with pancreatitis.
🟦 Question 3
What is the most important discharge teaching for parents of a child newly diagnosed with sickle
cell anemia (SCA)?
🟩 A. Instructions about how much fluid the child should drink daily
B. Signs of addiction to opioid pain medications
C. Non-pharmaceutical pain relief options
D. Referral to social services
📘 Rationale:
Adequate hydration is essential to reduce sickling and prevent vaso-occlusive crises in SCA.
🟦 Question 4
Where should the nurse auscultate to assess for a carotid bruit?
🟩 A. Base of the neck on the right side (confirmed image response)
📘 Rationale:
Carotid bruits are auscultated at the base of the neck where turbulent blood flow may occur.
,🟦 Question 5
Which client should the nurse assess first?
A. Large intestine obstruction with abdominal distension
B. Paralytic ileus post-surgery with absent bowel sounds
C. Small bowel obstruction with NG tube draining green fluid
🟩 D. Volvulus with abdominal rigidity
📘 Rationale:
Abdominal rigidity suggests peritonitis or perforation—a medical emergency.
🟦 Question 6
A teen presents with palpitations and hyperventilation after vaping. Which acid-base imbalance
is expected?
A. Respiratory acidosis
B. Metabolic alkalosis
C. Metabolic acidosis
🟩 D. Respiratory alkalosis
📘 Rationale:
Hyperventilation causes CO₂ loss, leading to respiratory alkalosis.
, 🟦 Question 7
A dyspneic client is being admitted. What bed position is best?
A. Supine
B. Supine, feet elevated
C. Supine, head elevated
🟩 D. Fowler's
📘 Rationale:
Fowler's position promotes lung expansion and comfort during respiratory distress.
🟦 Question 8
What admission findings in a Parkinson’s patient are relevant to blood pressure measurement?
(Select all that apply)
🟩 A. Frequent syncope
B. Occasional nocturia
🟩 C. Flat affect
🟩 D. Blurred vision
E. Frequent drooling
📘 Rationale:
Syncope and blurred vision suggest orthostatic hypotension, relevant during BP assessment.
🟦 Question 9
✅ 160 Questions with Correct Answers & Rationales
🟦 Question 1
The nurse is completing the admission assessment of a 3-year-old admitted with bacterial
meningitis and hydrocephalus. Which assessment finding indicates increased intracranial
pressure (ICP)?
A. Tachycardia and tachypnea
🟩 B. Sluggish and unequal pupillary responses
C. Increased head circumference and bulging fontanels
D. Blood pressure fluctuations and syncope
📘 Rationale:
Sluggish and unequal pupils are a classic sign of increased ICP. This reflects impaired cranial nerve
function due to pressure within the skull.
🟦 Question 2
A client with acute pancreatitis presents with severe abdominal pain and elevated serum amylase.
What symptom is most likely to be reported?
🟩 A. Abdominal pain decreases when lying supine
B. Pain lasts an hour and leaves the abdomen tender
, C. Right upper quadrant pain refers to the right scapula
D. Drinks alcohol until intoxicated at least twice weekly
📘 Rationale:
Supine positioning often relieves abdominal discomfort associated with pancreatitis.
🟦 Question 3
What is the most important discharge teaching for parents of a child newly diagnosed with sickle
cell anemia (SCA)?
🟩 A. Instructions about how much fluid the child should drink daily
B. Signs of addiction to opioid pain medications
C. Non-pharmaceutical pain relief options
D. Referral to social services
📘 Rationale:
Adequate hydration is essential to reduce sickling and prevent vaso-occlusive crises in SCA.
🟦 Question 4
Where should the nurse auscultate to assess for a carotid bruit?
🟩 A. Base of the neck on the right side (confirmed image response)
📘 Rationale:
Carotid bruits are auscultated at the base of the neck where turbulent blood flow may occur.
,🟦 Question 5
Which client should the nurse assess first?
A. Large intestine obstruction with abdominal distension
B. Paralytic ileus post-surgery with absent bowel sounds
C. Small bowel obstruction with NG tube draining green fluid
🟩 D. Volvulus with abdominal rigidity
📘 Rationale:
Abdominal rigidity suggests peritonitis or perforation—a medical emergency.
🟦 Question 6
A teen presents with palpitations and hyperventilation after vaping. Which acid-base imbalance
is expected?
A. Respiratory acidosis
B. Metabolic alkalosis
C. Metabolic acidosis
🟩 D. Respiratory alkalosis
📘 Rationale:
Hyperventilation causes CO₂ loss, leading to respiratory alkalosis.
, 🟦 Question 7
A dyspneic client is being admitted. What bed position is best?
A. Supine
B. Supine, feet elevated
C. Supine, head elevated
🟩 D. Fowler's
📘 Rationale:
Fowler's position promotes lung expansion and comfort during respiratory distress.
🟦 Question 8
What admission findings in a Parkinson’s patient are relevant to blood pressure measurement?
(Select all that apply)
🟩 A. Frequent syncope
B. Occasional nocturia
🟩 C. Flat affect
🟩 D. Blurred vision
E. Frequent drooling
📘 Rationale:
Syncope and blurred vision suggest orthostatic hypotension, relevant during BP assessment.
🟦 Question 9
