1
Test Bank: HESI RN Exit Exam 2025 – Versions
1, 2 & 3 | Actual Questions, 100% Verified
Answers with Rationales
1. A nurse is assessing a client with suspected myocardial infarction. Which finding
should the nurse prioritize for immediate reporting?
A. Blood pressure of 140/90 mmHg
B. Chest pain radiating to the left arm
C. Heart rate of 80 bpm
D. Oxygen saturation of 95%
Answer: B
Rationale: Chest pain radiating to the left arm is a classic symptom of myocardial
infarction, indicating potential cardiac ischemia requiring urgent intervention. Blood
pressure, heart rate, and oxygen saturation are important but less specific without context
of worsening trends.
2. A client with heart failure is prescribed digoxin. Which laboratory result should the
nurse monitor closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Answer: B
Rationale: Digoxin toxicity risk increases with hypokalemia, as potassium competes
with digoxin for binding sites on cardiac cells. Monitoring serum potassium is critical to
prevent dysrhythmias. Other electrolytes are less directly related to digoxin’s effects.
3. A nurse is caring for a client post-appendectomy who reports severe abdominal
pain. Which action should the nurse take first?
A. Administer prescribed analgesic
B. Assess the surgical site
C. Notify the healthcare provider
D. Apply a warm compress
Answer: B
Rationale: Severe pain post-appendectomy may indicate complications like infection or
perforation. Assessing the surgical site for redness, swelling, or drainage guides further
action. Analgesics may mask symptoms, notification follows assessment, and warm
compresses are contraindicated.
4. A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 89%. What is the nurse’s priority action?
A. Increase oxygen to 5 L/min
B. Encourage pursed-lip breathing
C. Administer a bronchodilator
, 2
D. Position in semi-Fowler’s
Answer: B
Rationale: An oxygen saturation of 89% is within the target range (88–92%) for COPD
to avoid suppressing the hypoxic drive. Pursed-lip breathing improves ventilation by
prolonging exhalation. Increasing oxygen, administering bronchodilators, or
repositioning may be appropriate after further assessment.
5. A nurse is teaching a client with diabetes mellitus about insulin storage. Which
client statement indicates a need for further teaching?
A. “I’ll store unopened insulin in the refrigerator.”
B. “I can keep my current insulin pen at room temperature.”
C. “I’ll discard insulin that’s been open for over a month.”
D. “I can freeze my insulin to extend its shelf life.”
Answer: D
Rationale: Freezing insulin damages its structure, rendering it ineffective. Unopened
insulin is refrigerated, opened pens can be stored at room temperature for up to 28–30
days, and expired insulin should be discarded.
6. A client with atrial fibrillation is prescribed warfarin. Which instruction should the
nurse provide?
A. Avoid foods high in vitamin K
B. Take the medication in the morning
C. Expect bruising to resolve quickly
D. Stop the medication if bleeding occurs
Answer: A
Rationale: Vitamin K-rich foods (e.g., leafy greens) antagonize warfarin’s anticoagulant
effect, requiring consistent intake to maintain stable INR. Timing is flexible, bruising is
expected, and stopping medication requires medical guidance.
7. A nurse observes tidaling in the water-seal chamber of a client’s chest tube. What
does this indicate?
A. An air leak
B. Normal respiratory function
C. Tube obstruction
D. Excessive suction
Answer: B
Rationale: Tidaling (fluctuations in the water-seal chamber with breathing) indicates
normal respiratory function and patent chest tube. Continuous bubbling suggests an air
leak, obstruction stops tidaling, and suction affects the suction chamber.
8. A client with acute kidney injury has a potassium level of 6.5 mEq/L. Which
medication should the nurse anticipate?
A. Potassium chloride
B. Sodium bicarbonate
C. Sodium polystyrene sulfonate
D. Furosemide
Answer: C
Rationale: Sodium polystyrene sulfonate binds potassium in the gut, reducing
hyperkalemia, a life-threatening condition in acute kidney injury. Potassium chloride
, 3
worsens hyperkalemia, bicarbonate corrects acidosis, and furosemide is less effective
acutely.
9. A nurse is assessing a client with hypovolemic shock. Which finding is most
indicative?
A. Warm, dry skin
B. Tachycardia
C. Hypertension
D. Slow capillary refill
Answer: B
Rationale: Tachycardia is a primary compensatory mechanism in hypovolemic shock to
maintain cardiac output. Skin is typically cool and clammy, hypotension (not
hypertension) occurs, and slow capillary refill is supportive but less specific.
10. A client post-total knee replacement reports calf pain. What is the nurse’s priority
action?
A. Administer pain medication
B. Assess for deep vein thrombosis
C. Elevate the leg
D. Apply a cold pack
Answer: B
Rationale: Calf pain post-surgery suggests possible deep vein thrombosis (DVT), a
serious complication. Assessing for swelling, redness, or warmth is the priority. Pain
medication, elevation, or cold packs may follow but could delay diagnosis.
11. A client receiving total parenteral nutrition (TPN) develops dyspnea. Which finding
requires immediate intervention?
A. Blood glucose of 200 mg/dL
B. Crackles in lung bases
C. Weight gain of 0.5 kg
D. Mild catheter site redness
Answer: B
Rationale: Crackles indicate fluid overload, a critical TPN complication due to high
dextrose and fluid volume, risking pulmonary edema. Hyperglycemia, weight gain, and
mild redness are less urgent but require monitoring.
12. A client with cirrhosis has ascites. Which dietary restriction should the nurse
reinforce?
A. Low protein
B. Low sodium
C. Low carbohydrate
D. Low potassium
Answer: B
Rationale: Low sodium reduces fluid retention in cirrhosis, managing ascites by
decreasing portal hypertension. Protein is moderated, carbohydrates are not restricted,
and potassium restriction is unnecessary unless hyperkalemia is present.
13. A nurse is preparing to administer furosemide to a client with heart failure. Which
finding warrants withholding the dose?
A. Blood pressure of 110/70 mmHg
B. Serum potassium of 2.8 mEq/L
, 4
C. Heart rate of 90 bpm
D. Urine output of 50 mL/hr
Answer: B
Rationale: Hypokalemia (2.8 mEq/L) increases the risk of dysrhythmias with
furosemide, a potassium-wasting diuretic. The dose should be withheld and the provider
notified. Other findings are within acceptable ranges.
14. A client with a new tracheostomy has difficulty breathing. What is the nurse’s
priority action?
A. Suction the tracheostomy
B. Assess for tube obstruction
C. Increase oxygen flow
D. Notify the respiratory therapist
Answer: B
Rationale: Difficulty breathing may indicate tracheostomy obstruction (e.g., mucus
plug), a life-threatening emergency. Assessing for obstruction guides intervention.
Suctioning, increasing oxygen, or notifying the therapist follow assessment.
15. A nurse is assessing a client with a suspected stroke. Which tool should be used to
evaluate neurological status?
A. Glasgow Coma Scale
B. NIH Stroke Scale
C. Braden Scale
D. Morse Fall Scale
Answer: B
Rationale: The NIH Stroke Scale assesses stroke-specific neurological deficits (e.g.,
motor, speech), guiding treatment decisions. Glasgow Coma Scale evaluates
consciousness, Braden assesses pressure ulcer risk, and Morse assesses fall risk.
16. A client with pancreatitis has elevated amylase. Which intervention is most
appropriate?
A. Administer insulin
B. Maintain NPO status
C. Provide a high-fat diet
D. Encourage ambulation
Answer: B
Rationale: Maintaining NPO status rests the pancreas, reducing enzyme secretion and
inflammation in pancreatitis. Insulin may be needed for hyperglycemia, high-fat diets
worsen symptoms, and ambulation is secondary.
17. A nurse is teaching a client with hypertension about lifestyle changes. Which
recommendation is most effective?
A. Limit alcohol to three drinks daily
B. Engage in 30 minutes of aerobic exercise most days
C. Increase sodium intake
D. Practice meditation weekly
Answer: B
Rationale: Aerobic exercise (30 minutes most days) lowers blood pressure by improving
vascular function. Alcohol should be limited to one (women) or two (men) drinks,
sodium should be reduced, and meditation is beneficial but less impactful.
Test Bank: HESI RN Exit Exam 2025 – Versions
1, 2 & 3 | Actual Questions, 100% Verified
Answers with Rationales
1. A nurse is assessing a client with suspected myocardial infarction. Which finding
should the nurse prioritize for immediate reporting?
A. Blood pressure of 140/90 mmHg
B. Chest pain radiating to the left arm
C. Heart rate of 80 bpm
D. Oxygen saturation of 95%
Answer: B
Rationale: Chest pain radiating to the left arm is a classic symptom of myocardial
infarction, indicating potential cardiac ischemia requiring urgent intervention. Blood
pressure, heart rate, and oxygen saturation are important but less specific without context
of worsening trends.
2. A client with heart failure is prescribed digoxin. Which laboratory result should the
nurse monitor closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Answer: B
Rationale: Digoxin toxicity risk increases with hypokalemia, as potassium competes
with digoxin for binding sites on cardiac cells. Monitoring serum potassium is critical to
prevent dysrhythmias. Other electrolytes are less directly related to digoxin’s effects.
3. A nurse is caring for a client post-appendectomy who reports severe abdominal
pain. Which action should the nurse take first?
A. Administer prescribed analgesic
B. Assess the surgical site
C. Notify the healthcare provider
D. Apply a warm compress
Answer: B
Rationale: Severe pain post-appendectomy may indicate complications like infection or
perforation. Assessing the surgical site for redness, swelling, or drainage guides further
action. Analgesics may mask symptoms, notification follows assessment, and warm
compresses are contraindicated.
4. A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 89%. What is the nurse’s priority action?
A. Increase oxygen to 5 L/min
B. Encourage pursed-lip breathing
C. Administer a bronchodilator
, 2
D. Position in semi-Fowler’s
Answer: B
Rationale: An oxygen saturation of 89% is within the target range (88–92%) for COPD
to avoid suppressing the hypoxic drive. Pursed-lip breathing improves ventilation by
prolonging exhalation. Increasing oxygen, administering bronchodilators, or
repositioning may be appropriate after further assessment.
5. A nurse is teaching a client with diabetes mellitus about insulin storage. Which
client statement indicates a need for further teaching?
A. “I’ll store unopened insulin in the refrigerator.”
B. “I can keep my current insulin pen at room temperature.”
C. “I’ll discard insulin that’s been open for over a month.”
D. “I can freeze my insulin to extend its shelf life.”
Answer: D
Rationale: Freezing insulin damages its structure, rendering it ineffective. Unopened
insulin is refrigerated, opened pens can be stored at room temperature for up to 28–30
days, and expired insulin should be discarded.
6. A client with atrial fibrillation is prescribed warfarin. Which instruction should the
nurse provide?
A. Avoid foods high in vitamin K
B. Take the medication in the morning
C. Expect bruising to resolve quickly
D. Stop the medication if bleeding occurs
Answer: A
Rationale: Vitamin K-rich foods (e.g., leafy greens) antagonize warfarin’s anticoagulant
effect, requiring consistent intake to maintain stable INR. Timing is flexible, bruising is
expected, and stopping medication requires medical guidance.
7. A nurse observes tidaling in the water-seal chamber of a client’s chest tube. What
does this indicate?
A. An air leak
B. Normal respiratory function
C. Tube obstruction
D. Excessive suction
Answer: B
Rationale: Tidaling (fluctuations in the water-seal chamber with breathing) indicates
normal respiratory function and patent chest tube. Continuous bubbling suggests an air
leak, obstruction stops tidaling, and suction affects the suction chamber.
8. A client with acute kidney injury has a potassium level of 6.5 mEq/L. Which
medication should the nurse anticipate?
A. Potassium chloride
B. Sodium bicarbonate
C. Sodium polystyrene sulfonate
D. Furosemide
Answer: C
Rationale: Sodium polystyrene sulfonate binds potassium in the gut, reducing
hyperkalemia, a life-threatening condition in acute kidney injury. Potassium chloride
, 3
worsens hyperkalemia, bicarbonate corrects acidosis, and furosemide is less effective
acutely.
9. A nurse is assessing a client with hypovolemic shock. Which finding is most
indicative?
A. Warm, dry skin
B. Tachycardia
C. Hypertension
D. Slow capillary refill
Answer: B
Rationale: Tachycardia is a primary compensatory mechanism in hypovolemic shock to
maintain cardiac output. Skin is typically cool and clammy, hypotension (not
hypertension) occurs, and slow capillary refill is supportive but less specific.
10. A client post-total knee replacement reports calf pain. What is the nurse’s priority
action?
A. Administer pain medication
B. Assess for deep vein thrombosis
C. Elevate the leg
D. Apply a cold pack
Answer: B
Rationale: Calf pain post-surgery suggests possible deep vein thrombosis (DVT), a
serious complication. Assessing for swelling, redness, or warmth is the priority. Pain
medication, elevation, or cold packs may follow but could delay diagnosis.
11. A client receiving total parenteral nutrition (TPN) develops dyspnea. Which finding
requires immediate intervention?
A. Blood glucose of 200 mg/dL
B. Crackles in lung bases
C. Weight gain of 0.5 kg
D. Mild catheter site redness
Answer: B
Rationale: Crackles indicate fluid overload, a critical TPN complication due to high
dextrose and fluid volume, risking pulmonary edema. Hyperglycemia, weight gain, and
mild redness are less urgent but require monitoring.
12. A client with cirrhosis has ascites. Which dietary restriction should the nurse
reinforce?
A. Low protein
B. Low sodium
C. Low carbohydrate
D. Low potassium
Answer: B
Rationale: Low sodium reduces fluid retention in cirrhosis, managing ascites by
decreasing portal hypertension. Protein is moderated, carbohydrates are not restricted,
and potassium restriction is unnecessary unless hyperkalemia is present.
13. A nurse is preparing to administer furosemide to a client with heart failure. Which
finding warrants withholding the dose?
A. Blood pressure of 110/70 mmHg
B. Serum potassium of 2.8 mEq/L
, 4
C. Heart rate of 90 bpm
D. Urine output of 50 mL/hr
Answer: B
Rationale: Hypokalemia (2.8 mEq/L) increases the risk of dysrhythmias with
furosemide, a potassium-wasting diuretic. The dose should be withheld and the provider
notified. Other findings are within acceptable ranges.
14. A client with a new tracheostomy has difficulty breathing. What is the nurse’s
priority action?
A. Suction the tracheostomy
B. Assess for tube obstruction
C. Increase oxygen flow
D. Notify the respiratory therapist
Answer: B
Rationale: Difficulty breathing may indicate tracheostomy obstruction (e.g., mucus
plug), a life-threatening emergency. Assessing for obstruction guides intervention.
Suctioning, increasing oxygen, or notifying the therapist follow assessment.
15. A nurse is assessing a client with a suspected stroke. Which tool should be used to
evaluate neurological status?
A. Glasgow Coma Scale
B. NIH Stroke Scale
C. Braden Scale
D. Morse Fall Scale
Answer: B
Rationale: The NIH Stroke Scale assesses stroke-specific neurological deficits (e.g.,
motor, speech), guiding treatment decisions. Glasgow Coma Scale evaluates
consciousness, Braden assesses pressure ulcer risk, and Morse assesses fall risk.
16. A client with pancreatitis has elevated amylase. Which intervention is most
appropriate?
A. Administer insulin
B. Maintain NPO status
C. Provide a high-fat diet
D. Encourage ambulation
Answer: B
Rationale: Maintaining NPO status rests the pancreas, reducing enzyme secretion and
inflammation in pancreatitis. Insulin may be needed for hyperglycemia, high-fat diets
worsen symptoms, and ambulation is secondary.
17. A nurse is teaching a client with hypertension about lifestyle changes. Which
recommendation is most effective?
A. Limit alcohol to three drinks daily
B. Engage in 30 minutes of aerobic exercise most days
C. Increase sodium intake
D. Practice meditation weekly
Answer: B
Rationale: Aerobic exercise (30 minutes most days) lowers blood pressure by improving
vascular function. Alcohol should be limited to one (women) or two (men) drinks,
sodium should be reduced, and meditation is beneficial but less impactful.
