HESI Exit Exam Version 1 | Latest
2025/2026 Edition
Actual Questions and Verified Answers | 100% Correct | Grade A NCLEX
Prep
1 Introduction
This document contains 100% correct and verified questions and answers from
HESI Exit Exam Version 1, fully updated for the 2025/2026 academic year. It cov-
ers all major nursing content areas including pharmacology, medical-surgical
nursing, maternal-child care, mental health, and critical thinking for NCLEX
readiness. Designed to reflect the structure and difficulty of the actual HESI
exam, this Grade A resource ensures comprehensive review and confident test
preparation.
2 Exam Questions and Answers
1. A client with heart failure is prescribed furosemide. Which electrolyte im-
balance should the nurse monitor closely?
A) Hypernatremia
B) Hypokalemia
C) Hypercalcemia
D) Hypermagnesemia
Rationale: Furosemide, a loop diuretic, increases potassium excretion, which
can lead to hypokalemia, potentially causing arrhythmias.
2. A postpartum client reports heavy vaginal bleeding. What is the nurse’s
priority action?
A) Administer oxytocin
B) Perform a vaginal exam
C) Assess vital signs and fundal firmness
D) Increase IV fluid rate
Rationale: Heavy bleeding may indicate postpartum hemorrhage; assessing
vital signs and fundal firmness helps determine the cause and severity.
3. A client with schizophrenia is prescribed risperidone. Which side effect
should the nurse teach the client to report immediately?
A) Weight gain
B) Muscle rigidity and fever
C) Dry mouth
D) Insomnia
Rationale: Muscle rigidity and fever may indicate neuroleptic malignant syn-
drome, a life-threatening reaction to antipsychotics.
4. A client is receiving heparin for deep vein thrombosis. Which laboratory
value should the nurse monitor?
1
, A) INR
B) aPTT
C) Platelet count
D) Prothrombin time
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor
heparin therapy to ensure therapeutic anticoagulation.
5. A pediatric client with asthma is prescribed albuterol. What is the primary
purpose of this medication?
A) Reduce inflammation
B) Relieve bronchospasm
C) Prevent infections
D) Thin mucus secretions
Rationale: Albuterol is a beta-2 agonist that relaxes bronchial smooth mus-
cles, relieving bronchospasm in asthma.
6. A client with type 1 diabetes mellitus reports nausea and abdominal pain.
Blood glucose is 450 mg/dL. What should the nurse suspect?
A) Hypoglycemia
B) Diabetic ketoacidosis
C) Hyperosmolar hyperglycemic state
D) Insulin overdose
Rationale: Elevated blood glucose with nausea and abdominal pain in type 1
diabetes suggests diabetic ketoacidosis due to insulin deficiency.
7. A client with a new colostomy asks about dietary restrictions. Which food
should the nurse recommend avoiding?
A) Bananas
B) Popcorn
C) Yogurt
D) Applesauce
Rationale: Popcorn can cause blockages in a new colostomy due to its high
fiber and indigestible nature.
8. A client with major depressive disorder is prescribed fluoxetine. How long
should the nurse inform the client it may take to notice improvement?
A) 1–2 days
B) 2–4 weeks
C) 6–8 weeks
D) 12 weeks
Rationale: SSRIs like fluoxetine typically require 2–4 weeks to achieve thera-
peutic effects on mood.
9. A client is postoperative following a cholecystectomy. Which finding indi-
cates a potential complication?
A) Clear breath sounds
B) Yellow sclera
C) Urine output of 50 mL/hr
D) Pain at incision site
Rationale: Yellow sclera may indicate jaundice, suggesting bile duct obstruc-
2
, tion or liver dysfunction post-cholecystectomy.
10. A pregnant client at 32 weeks gestation reports decreased fetal movement.
What is the nurse’s priority action?
A) Administer oxygen
B) Perform a nonstress test
C) Prepare for immediate delivery
D) Increase IV fluids
Rationale: A nonstress test assesses fetal well-being in response to decreased
movement, guiding further management.
11. A client with chronic kidney disease is prescribed epoetin alfa. What is the
expected outcome of this medication?
A) Lower blood pressure
B) Increased red blood cell production
C) Reduced potassium levels
D) Improved calcium absorption
Rationale: Epoetin alfa stimulates erythropoiesis, increasing red blood cell
production to treat anemia in kidney disease.
12. A client with a burn injury is at risk for which type of shock?
A) Cardiogenic
B) Hypovolemic
C) Neurogenic
D) Anaphylactic
Rationale: Burn injuries cause significant fluid loss, leading to hypovolemic
shock due to decreased intravascular volume.
13. A client with pneumonia is prescribed levofloxacin. Which instruction should
the nurse include?
A) Take with antacids
B) Avoid prolonged sun exposure
C) Discontinue if cough improves
D) Take on an empty stomach
Rationale: Levofloxacin can cause photosensitivity; clients should avoid pro-
longed sun exposure to prevent skin reactions.
14. A client with a history of seizures is prescribed phenytoin. Which labora-
tory value should the nurse monitor?
A) Serum creatinine
B) Serum phenytoin levels
C) Blood glucose
D) Sodium levels
Rationale: Monitoring phenytoin levels ensures therapeutic efficacy and pre-
vents toxicity.
15. A client with bipolar disorder is prescribed lithium. Which symptom indi-
cates lithium toxicity?
A) Increased appetite
B) Tremors and confusion
C) Weight loss
3
2025/2026 Edition
Actual Questions and Verified Answers | 100% Correct | Grade A NCLEX
Prep
1 Introduction
This document contains 100% correct and verified questions and answers from
HESI Exit Exam Version 1, fully updated for the 2025/2026 academic year. It cov-
ers all major nursing content areas including pharmacology, medical-surgical
nursing, maternal-child care, mental health, and critical thinking for NCLEX
readiness. Designed to reflect the structure and difficulty of the actual HESI
exam, this Grade A resource ensures comprehensive review and confident test
preparation.
2 Exam Questions and Answers
1. A client with heart failure is prescribed furosemide. Which electrolyte im-
balance should the nurse monitor closely?
A) Hypernatremia
B) Hypokalemia
C) Hypercalcemia
D) Hypermagnesemia
Rationale: Furosemide, a loop diuretic, increases potassium excretion, which
can lead to hypokalemia, potentially causing arrhythmias.
2. A postpartum client reports heavy vaginal bleeding. What is the nurse’s
priority action?
A) Administer oxytocin
B) Perform a vaginal exam
C) Assess vital signs and fundal firmness
D) Increase IV fluid rate
Rationale: Heavy bleeding may indicate postpartum hemorrhage; assessing
vital signs and fundal firmness helps determine the cause and severity.
3. A client with schizophrenia is prescribed risperidone. Which side effect
should the nurse teach the client to report immediately?
A) Weight gain
B) Muscle rigidity and fever
C) Dry mouth
D) Insomnia
Rationale: Muscle rigidity and fever may indicate neuroleptic malignant syn-
drome, a life-threatening reaction to antipsychotics.
4. A client is receiving heparin for deep vein thrombosis. Which laboratory
value should the nurse monitor?
1
, A) INR
B) aPTT
C) Platelet count
D) Prothrombin time
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor
heparin therapy to ensure therapeutic anticoagulation.
5. A pediatric client with asthma is prescribed albuterol. What is the primary
purpose of this medication?
A) Reduce inflammation
B) Relieve bronchospasm
C) Prevent infections
D) Thin mucus secretions
Rationale: Albuterol is a beta-2 agonist that relaxes bronchial smooth mus-
cles, relieving bronchospasm in asthma.
6. A client with type 1 diabetes mellitus reports nausea and abdominal pain.
Blood glucose is 450 mg/dL. What should the nurse suspect?
A) Hypoglycemia
B) Diabetic ketoacidosis
C) Hyperosmolar hyperglycemic state
D) Insulin overdose
Rationale: Elevated blood glucose with nausea and abdominal pain in type 1
diabetes suggests diabetic ketoacidosis due to insulin deficiency.
7. A client with a new colostomy asks about dietary restrictions. Which food
should the nurse recommend avoiding?
A) Bananas
B) Popcorn
C) Yogurt
D) Applesauce
Rationale: Popcorn can cause blockages in a new colostomy due to its high
fiber and indigestible nature.
8. A client with major depressive disorder is prescribed fluoxetine. How long
should the nurse inform the client it may take to notice improvement?
A) 1–2 days
B) 2–4 weeks
C) 6–8 weeks
D) 12 weeks
Rationale: SSRIs like fluoxetine typically require 2–4 weeks to achieve thera-
peutic effects on mood.
9. A client is postoperative following a cholecystectomy. Which finding indi-
cates a potential complication?
A) Clear breath sounds
B) Yellow sclera
C) Urine output of 50 mL/hr
D) Pain at incision site
Rationale: Yellow sclera may indicate jaundice, suggesting bile duct obstruc-
2
, tion or liver dysfunction post-cholecystectomy.
10. A pregnant client at 32 weeks gestation reports decreased fetal movement.
What is the nurse’s priority action?
A) Administer oxygen
B) Perform a nonstress test
C) Prepare for immediate delivery
D) Increase IV fluids
Rationale: A nonstress test assesses fetal well-being in response to decreased
movement, guiding further management.
11. A client with chronic kidney disease is prescribed epoetin alfa. What is the
expected outcome of this medication?
A) Lower blood pressure
B) Increased red blood cell production
C) Reduced potassium levels
D) Improved calcium absorption
Rationale: Epoetin alfa stimulates erythropoiesis, increasing red blood cell
production to treat anemia in kidney disease.
12. A client with a burn injury is at risk for which type of shock?
A) Cardiogenic
B) Hypovolemic
C) Neurogenic
D) Anaphylactic
Rationale: Burn injuries cause significant fluid loss, leading to hypovolemic
shock due to decreased intravascular volume.
13. A client with pneumonia is prescribed levofloxacin. Which instruction should
the nurse include?
A) Take with antacids
B) Avoid prolonged sun exposure
C) Discontinue if cough improves
D) Take on an empty stomach
Rationale: Levofloxacin can cause photosensitivity; clients should avoid pro-
longed sun exposure to prevent skin reactions.
14. A client with a history of seizures is prescribed phenytoin. Which labora-
tory value should the nurse monitor?
A) Serum creatinine
B) Serum phenytoin levels
C) Blood glucose
D) Sodium levels
Rationale: Monitoring phenytoin levels ensures therapeutic efficacy and pre-
vents toxicity.
15. A client with bipolar disorder is prescribed lithium. Which symptom indi-
cates lithium toxicity?
A) Increased appetite
B) Tremors and confusion
C) Weight loss
3
