1
HESI RN Exit Exam 2025 –
Actual Exam with 100%
Verified Questions, Detailed
Rationales, and Correct
Answers | Guaranteed Pass |
Expert-Approved
Comprehensive Nursing Topics: Medical-Surgical,
Pharmacology, Pediatrics, Maternity, Mental Health,
Leadership, and Fundamentals
1. A client with heart failure is prescribed furosemide 40 mg IV. Which electrolyte
imbalance should the nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hyponatremia
B) Hypokalemia
Rationale: Furosemide, a loop diuretic, increases potassium excretion in the urine,
leading to a risk of hypokalemia. This can cause arrhythmias, especially in heart failure
patients. Hyperkalemia (A) is less likely, while hypernatremia (C) and hyponatremia (D)
are not typically associated with furosemide.
2. A client post-myocardial infarction reports chest pain. What is the nurse’s priority
action?
A) Administer aspirin
B) Notify the healthcare provider
C) Administer oxygen
D) Obtain an ECG
C) Administer oxygen
Rationale: Administering oxygen is the priority to improve myocardial oxygenation in a
, 2
client with chest pain post-myocardial infarction. Aspirin (A) and ECG (D) are important
but secondary, and notifying the provider (B) follows initial intervention.
3. A client with acute kidney injury has a potassium level of 6.5 mEq/L. Which
medication should the nurse anticipate?
A) Furosemide
B) Sodium polystyrene sulfonate
C) Spironolactone
D) Hydrochlorothiazide
B) Sodium polystyrene sulfonate
Rationale: Sodium polystyrene sulfonate reduces hyperkalemia by exchanging sodium
for potassium in the gut. Furosemide (A) and hydrochlorothiazide (D) are diuretics that
may not effectively lower potassium, and spironolactone (C) is potassium-sparing,
worsening hyperkalemia.
4. A client with type 2 diabetes is prescribed metformin. Which instruction should the
nurse provide?
A) Take with meals to reduce GI upset
B) Take on an empty stomach
C) Avoid all carbohydrates
D) Monitor for hyperkalemia
A) Take with meals to reduce GI upset
Rationale: Metformin should be taken with meals to minimize gastrointestinal side
effects like nausea and diarrhea. Taking it on an empty stomach (B) increases GI upset,
avoiding all carbohydrates (C) is unnecessary, and hyperkalemia (D) is not a common
side effect.
5. A client with COPD is experiencing dyspnea. Which position should the nurse
recommend?
A) Supine with head elevated
B) High Fowler’s position
C) Prone position
D) Trendelenburg position
B) High Fowler’s position
Rationale: High Fowler’s position (60–90 degrees upright) maximizes lung expansion
and reduces dyspnea in COPD clients by decreasing abdominal pressure on the
diaphragm. Supine (A) restricts breathing, prone (C) is impractical, and Trendelenburg
(D) worsens respiratory effort.
6. A client is scheduled for a cholecystectomy. Which preoperative teaching is most
important?
A) Avoid eating after midnight
B) Expect a permanent colostomy
C) Take antibiotics post-surgery
D) Avoid all physical activity
A) Avoid eating after midnight
Rationale: Fasting after midnight reduces the risk of aspiration during anesthesia. A
colostomy (B) is not associated with cholecystectomy, antibiotics (C) depend on the case,
and avoiding all activity (D) is unnecessary.
, 3
7. A client with a history of hypertension reports a dry cough after starting lisinopril.
What is the nurse’s best action?
A) Encourage increased fluid intake
B) Discontinue the medication
C) Notify the healthcare provider
D) Administer a cough suppressant
C) Notify the healthcare provider
Rationale: A dry cough is a common side effect of ACE inhibitors like lisinopril, often
requiring a switch to an alternative medication (e.g., ARB). Discontinuing the drug (B)
without provider approval is unsafe, and fluid intake (A) or suppressants (D) do not
address the cause.
8. A pregnant client at 34 weeks presents with painless bright red vaginal bleeding.
What is the most likely diagnosis?
A) Placental abruption
B) Placenta previa
C) Preterm labor
D) Uterine rupture
B) Placenta previa
Rationale: Placenta previa presents with painless bright red bleeding in the third
trimester due to the placenta covering the cervical os. Placental abruption (A) causes
painful bleeding, preterm labor (C) involves contractions, and uterine rupture (D) is rare
and catastrophic.
9. A client with a head injury has a Glasgow Coma Scale score of 12. What is the
nurse’s priority assessment?
A) Pupil response
B) Blood pressure
C) Respiratory rate
D) Level of consciousness
D) Level of consciousness
Rationale: A change in the level of consciousness is the earliest and most sensitive
indicator of altered cerebral function in head injury clients, as assessed by the Glasgow
Coma Scale. Pupil response (A), blood pressure (B), and respiratory rate (C) are
important but less sensitive early indicators.
10. A client with tuberculosis is admitted. Which precaution should the nurse
implement?
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Standard precautions
C) Airborne precautions
Rationale: Tuberculosis is transmitted via airborne droplets, requiring airborne
precautions (e.g., negative pressure room, N95 mask). Contact (A) and droplet (B)
precautions are insufficient, and standard precautions (D) are universal but not specific
enough.
11. A client is receiving warfarin. Which laboratory value should the nurse monitor?
A) Platelet count
, 4
B) INR
C) Hemoglobin
D) Serum creatinine
B) INR
Rationale: Warfarin’s anticoagulant effect is monitored via the International Normalized
Ratio (INR), typically maintained between 2.0–3.0 for most conditions. Platelet count
(A), hemoglobin (C), and creatinine (D) are not directly related to warfarin’s effect.
12. A nurse is caring for a client with a nasogastric tube. Which action ensures proper
placement?
A) Check tube length
B) Aspirate gastric contents
C) Auscultate over the stomach
D) Obtain a chest X-ray
D) Obtain a chest X-ray
Rationale: A chest X-ray is the gold standard to confirm nasogastric tube placement in
the stomach, preventing complications like pulmonary aspiration. Aspirating contents (B)
and auscultation (C) are supportive but not definitive, and tube length (A) is unreliable.
13. A client with pneumonia is prescribed levofloxacin. What should the nurse teach the
client?
A) Take with milk to reduce GI upset
B) Avoid sun exposure
C) Expect red-colored urine
D) Take on an empty stomach
B) Avoid sun exposure
Rationale: Levofloxacin, a fluoroquinolone, increases photosensitivity, risking severe
sunburn. Milk (A) may reduce absorption, red urine (C) is not typical, and it can be taken
with or without food (D).
14. A client with bipolar disorder is prescribed lithium. Which symptom indicates
toxicity?
A) Tremors
B) Weight loss
C) Increased appetite
D) Improved mood
A) Tremors
Rationale: Tremors are an early sign of lithium toxicity, along with nausea, confusion,
and ataxia. Weight loss (B) and increased appetite (C) are not typical, and improved
mood (D) is a therapeutic effect, not toxicity.
15. A postoperative client has a temperature of 101°F. What is the nurse’s first action?
A) Administer acetaminophen
B) Notify the healthcare provider
C) Assess for infection
D) Increase IV fluids
C) Assess for infection
Rationale: A postoperative fever may indicate infection, requiring assessment (e.g.,
wound, lungs) before interventions like acetaminophen (A) or notifying the provider (B).
Increasing fluids (D) is not the priority without further data.
HESI RN Exit Exam 2025 –
Actual Exam with 100%
Verified Questions, Detailed
Rationales, and Correct
Answers | Guaranteed Pass |
Expert-Approved
Comprehensive Nursing Topics: Medical-Surgical,
Pharmacology, Pediatrics, Maternity, Mental Health,
Leadership, and Fundamentals
1. A client with heart failure is prescribed furosemide 40 mg IV. Which electrolyte
imbalance should the nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hyponatremia
B) Hypokalemia
Rationale: Furosemide, a loop diuretic, increases potassium excretion in the urine,
leading to a risk of hypokalemia. This can cause arrhythmias, especially in heart failure
patients. Hyperkalemia (A) is less likely, while hypernatremia (C) and hyponatremia (D)
are not typically associated with furosemide.
2. A client post-myocardial infarction reports chest pain. What is the nurse’s priority
action?
A) Administer aspirin
B) Notify the healthcare provider
C) Administer oxygen
D) Obtain an ECG
C) Administer oxygen
Rationale: Administering oxygen is the priority to improve myocardial oxygenation in a
, 2
client with chest pain post-myocardial infarction. Aspirin (A) and ECG (D) are important
but secondary, and notifying the provider (B) follows initial intervention.
3. A client with acute kidney injury has a potassium level of 6.5 mEq/L. Which
medication should the nurse anticipate?
A) Furosemide
B) Sodium polystyrene sulfonate
C) Spironolactone
D) Hydrochlorothiazide
B) Sodium polystyrene sulfonate
Rationale: Sodium polystyrene sulfonate reduces hyperkalemia by exchanging sodium
for potassium in the gut. Furosemide (A) and hydrochlorothiazide (D) are diuretics that
may not effectively lower potassium, and spironolactone (C) is potassium-sparing,
worsening hyperkalemia.
4. A client with type 2 diabetes is prescribed metformin. Which instruction should the
nurse provide?
A) Take with meals to reduce GI upset
B) Take on an empty stomach
C) Avoid all carbohydrates
D) Monitor for hyperkalemia
A) Take with meals to reduce GI upset
Rationale: Metformin should be taken with meals to minimize gastrointestinal side
effects like nausea and diarrhea. Taking it on an empty stomach (B) increases GI upset,
avoiding all carbohydrates (C) is unnecessary, and hyperkalemia (D) is not a common
side effect.
5. A client with COPD is experiencing dyspnea. Which position should the nurse
recommend?
A) Supine with head elevated
B) High Fowler’s position
C) Prone position
D) Trendelenburg position
B) High Fowler’s position
Rationale: High Fowler’s position (60–90 degrees upright) maximizes lung expansion
and reduces dyspnea in COPD clients by decreasing abdominal pressure on the
diaphragm. Supine (A) restricts breathing, prone (C) is impractical, and Trendelenburg
(D) worsens respiratory effort.
6. A client is scheduled for a cholecystectomy. Which preoperative teaching is most
important?
A) Avoid eating after midnight
B) Expect a permanent colostomy
C) Take antibiotics post-surgery
D) Avoid all physical activity
A) Avoid eating after midnight
Rationale: Fasting after midnight reduces the risk of aspiration during anesthesia. A
colostomy (B) is not associated with cholecystectomy, antibiotics (C) depend on the case,
and avoiding all activity (D) is unnecessary.
, 3
7. A client with a history of hypertension reports a dry cough after starting lisinopril.
What is the nurse’s best action?
A) Encourage increased fluid intake
B) Discontinue the medication
C) Notify the healthcare provider
D) Administer a cough suppressant
C) Notify the healthcare provider
Rationale: A dry cough is a common side effect of ACE inhibitors like lisinopril, often
requiring a switch to an alternative medication (e.g., ARB). Discontinuing the drug (B)
without provider approval is unsafe, and fluid intake (A) or suppressants (D) do not
address the cause.
8. A pregnant client at 34 weeks presents with painless bright red vaginal bleeding.
What is the most likely diagnosis?
A) Placental abruption
B) Placenta previa
C) Preterm labor
D) Uterine rupture
B) Placenta previa
Rationale: Placenta previa presents with painless bright red bleeding in the third
trimester due to the placenta covering the cervical os. Placental abruption (A) causes
painful bleeding, preterm labor (C) involves contractions, and uterine rupture (D) is rare
and catastrophic.
9. A client with a head injury has a Glasgow Coma Scale score of 12. What is the
nurse’s priority assessment?
A) Pupil response
B) Blood pressure
C) Respiratory rate
D) Level of consciousness
D) Level of consciousness
Rationale: A change in the level of consciousness is the earliest and most sensitive
indicator of altered cerebral function in head injury clients, as assessed by the Glasgow
Coma Scale. Pupil response (A), blood pressure (B), and respiratory rate (C) are
important but less sensitive early indicators.
10. A client with tuberculosis is admitted. Which precaution should the nurse
implement?
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Standard precautions
C) Airborne precautions
Rationale: Tuberculosis is transmitted via airborne droplets, requiring airborne
precautions (e.g., negative pressure room, N95 mask). Contact (A) and droplet (B)
precautions are insufficient, and standard precautions (D) are universal but not specific
enough.
11. A client is receiving warfarin. Which laboratory value should the nurse monitor?
A) Platelet count
, 4
B) INR
C) Hemoglobin
D) Serum creatinine
B) INR
Rationale: Warfarin’s anticoagulant effect is monitored via the International Normalized
Ratio (INR), typically maintained between 2.0–3.0 for most conditions. Platelet count
(A), hemoglobin (C), and creatinine (D) are not directly related to warfarin’s effect.
12. A nurse is caring for a client with a nasogastric tube. Which action ensures proper
placement?
A) Check tube length
B) Aspirate gastric contents
C) Auscultate over the stomach
D) Obtain a chest X-ray
D) Obtain a chest X-ray
Rationale: A chest X-ray is the gold standard to confirm nasogastric tube placement in
the stomach, preventing complications like pulmonary aspiration. Aspirating contents (B)
and auscultation (C) are supportive but not definitive, and tube length (A) is unreliable.
13. A client with pneumonia is prescribed levofloxacin. What should the nurse teach the
client?
A) Take with milk to reduce GI upset
B) Avoid sun exposure
C) Expect red-colored urine
D) Take on an empty stomach
B) Avoid sun exposure
Rationale: Levofloxacin, a fluoroquinolone, increases photosensitivity, risking severe
sunburn. Milk (A) may reduce absorption, red urine (C) is not typical, and it can be taken
with or without food (D).
14. A client with bipolar disorder is prescribed lithium. Which symptom indicates
toxicity?
A) Tremors
B) Weight loss
C) Increased appetite
D) Improved mood
A) Tremors
Rationale: Tremors are an early sign of lithium toxicity, along with nausea, confusion,
and ataxia. Weight loss (B) and increased appetite (C) are not typical, and improved
mood (D) is a therapeutic effect, not toxicity.
15. A postoperative client has a temperature of 101°F. What is the nurse’s first action?
A) Administer acetaminophen
B) Notify the healthcare provider
C) Assess for infection
D) Increase IV fluids
C) Assess for infection
Rationale: A postoperative fever may indicate infection, requiring assessment (e.g.,
wound, lungs) before interventions like acetaminophen (A) or notifying the provider (B).
Increasing fluids (D) is not the priority without further data.
