HESI Exit Exam 2025: 750
NCLEX-Style RN Practice
Questions with Comprehensive
Rationales
Prepared for Nursing Students
July 10, 2025
Contents
1 Introduction 1
2 Practice Questions and Rationales 1
3 Conclusion 12
1
, 1 Introduction
This document provides a refactored set of 100 NCLEX-style practice questions with
detailed, concise rationales for the HESI Exit Exam 2025, representing a subset of the
750 questions referenced in the title. Each question is highlighted in very dark black
for clarity, focusing on key nursing concepts to enhance critical thinking and clinical
decision-making for NCLEX-RN preparation.
2 Practice Questions and Rationales
Question 1: What should a nurse prioritize when monitoring a client on furosemide
for heart failure?
Answer: Serum potassium levels.
Rationale: Furosemide, a loop diuretic, promotes potassium excretion, which can
lead to hypokalemia. Low potassium levels increase the risk of cardiac arrhythmias,
particularly in heart failure clients, where cardiac stability is critical. Regular
monitoring ensures early detection and correction of imbalances.
Question 2: What is the immediate action for a client experiencing an anaphylactic
reaction?
Answer: Administer epinephrine intramuscularly.
Rationale: Anaphylaxis is a life-threatening allergic reaction causing airway con-
striction and hypotension. Epinephrine, a vasoconstrictor and bronchodilator,
rapidly reverses these symptoms by relaxing airway muscles and stabilizing blood
pressure, making it the first-line intervention.
Question 3: A client with type 1 diabetes reports feeling shaky and sweaty. What
should the nurse do first?
Answer: Measure blood glucose levels.
Rationale: Shakiness and sweating are classic signs of hypoglycemia in a conscious
client. Checking blood glucose confirms the diagnosis, guiding treatment such as
administering glucose if levels are below 70 mg/dL, preventing further deterioration.
Question 4: What is the leading cause of hospital-acquired infections?
Answer: Inadequate hand hygiene.
Rationale: Hand hygiene is the most effective measure to prevent pathogen trans-
mission in healthcare settings. Failure to wash hands or use alcohol-based sanitiz-
ers allows bacteria and viruses to spread, contributing to infections like MRSA or
CLABSIs.
Question 5: Which lab value should a nurse monitor for a client receiving heparin
therapy?
Answer: Activated partial thromboplastin time (aPTT).
Rationale: Heparin, an anticoagulant, prolongs clotting time, monitored via aPTT
to ensure therapeutic levels (typically 1.52.5 times the control value). This prevents
excessive bleeding or inadequate anticoagulation, balancing efficacy and safety.
Question 6: What is the priority nursing action for a client with a new tracheostomy?
Answer: Ensure airway patency.
Rationale: A tracheostomy bypasses the upper airway, making patency critical to
1
NCLEX-Style RN Practice
Questions with Comprehensive
Rationales
Prepared for Nursing Students
July 10, 2025
Contents
1 Introduction 1
2 Practice Questions and Rationales 1
3 Conclusion 12
1
, 1 Introduction
This document provides a refactored set of 100 NCLEX-style practice questions with
detailed, concise rationales for the HESI Exit Exam 2025, representing a subset of the
750 questions referenced in the title. Each question is highlighted in very dark black
for clarity, focusing on key nursing concepts to enhance critical thinking and clinical
decision-making for NCLEX-RN preparation.
2 Practice Questions and Rationales
Question 1: What should a nurse prioritize when monitoring a client on furosemide
for heart failure?
Answer: Serum potassium levels.
Rationale: Furosemide, a loop diuretic, promotes potassium excretion, which can
lead to hypokalemia. Low potassium levels increase the risk of cardiac arrhythmias,
particularly in heart failure clients, where cardiac stability is critical. Regular
monitoring ensures early detection and correction of imbalances.
Question 2: What is the immediate action for a client experiencing an anaphylactic
reaction?
Answer: Administer epinephrine intramuscularly.
Rationale: Anaphylaxis is a life-threatening allergic reaction causing airway con-
striction and hypotension. Epinephrine, a vasoconstrictor and bronchodilator,
rapidly reverses these symptoms by relaxing airway muscles and stabilizing blood
pressure, making it the first-line intervention.
Question 3: A client with type 1 diabetes reports feeling shaky and sweaty. What
should the nurse do first?
Answer: Measure blood glucose levels.
Rationale: Shakiness and sweating are classic signs of hypoglycemia in a conscious
client. Checking blood glucose confirms the diagnosis, guiding treatment such as
administering glucose if levels are below 70 mg/dL, preventing further deterioration.
Question 4: What is the leading cause of hospital-acquired infections?
Answer: Inadequate hand hygiene.
Rationale: Hand hygiene is the most effective measure to prevent pathogen trans-
mission in healthcare settings. Failure to wash hands or use alcohol-based sanitiz-
ers allows bacteria and viruses to spread, contributing to infections like MRSA or
CLABSIs.
Question 5: Which lab value should a nurse monitor for a client receiving heparin
therapy?
Answer: Activated partial thromboplastin time (aPTT).
Rationale: Heparin, an anticoagulant, prolongs clotting time, monitored via aPTT
to ensure therapeutic levels (typically 1.52.5 times the control value). This prevents
excessive bleeding or inadequate anticoagulation, balancing efficacy and safety.
Question 6: What is the priority nursing action for a client with a new tracheostomy?
Answer: Ensure airway patency.
Rationale: A tracheostomy bypasses the upper airway, making patency critical to
1
