HESI RN Exit Practice Exam | Latest Updated
Version 2026/2027- Real Questions with Verified
Correct Answers and Detailed Rationales
Nightingale College
Question 1
A 3-year-old boy was successfully toilet-trained before his admission to the hospital for
injuries sustained from a fall. His parents are very concerned that the child has
regressed in his toileting behaviors. Which information should the nurse provide to the
parents?
A. A retraining program will need to be initiated when the child returns home
B. Diapering will be provided since hospitalization is stressful to preschoolers
C. A potty chair should be brought from home so he can maintain his toileting skills
D. Children usually resume their toileting behaviors when they leave the hospital
Answer: D
Rationale: Regression is a common stress response in hospitalized preschoolers, and
toileting behaviors typically resume after the child returns home.
Question 2
A 7-year-old is admitted to the hospital with persistent vomiting, and a nasogastric tube
attached to low intermittent suction is applied. Which finding is most important for the
nurse to report to the healthcare provider?
A. Shift intake of 640mL IV fluids plus 30mL PO ice chips
B. Serum pH of 7.45
C. Gastric output of 100 mL in the last 8 hours
D. Serum potassium of 3.0 mg/dL
Answer: D
Rationale: A serum potassium of 3.0 mEq/L indicates hypokalemia, which can be
caused by prolonged NG suctioning and can lead to cardiac arrhythmias.
Question 3
A child newly diagnosed with sickle cell anemia (SCA) is being discharged from the
hospital. Which information is most important for the nurse to provide to the parents
pg. 1
,prior to discharge?
A. Instructions about how much fluid the child should drink daily
B. Signs of addiction to opioid pain medications
C. Information about non-pharmaceutical pain relief measures
D. Referral for social services for the child and family
Answer: A
Rationale: Adequate hydration is crucial in sickle cell anemia to prevent sickling
crises; parents need specific fluid intake instructions.
Question 4
A client asks the nurse for information about how to reduce risk factors for benign
prostatic hyperplasia (BPH). Which information should the nurse provide?
A. Consume a high protein diet
B. Increase physical activity
C. Take vitamin supplements
D. Obtain a prostate-specific antigen blood level test
Answer: B
Rationale: Regular physical activity may help reduce the risk of BPH.
Question 5
A client at 12 weeks gestation is admitted to the antepartum unit with a diagnosis of
hyperemesis gravidarum. Which action is most important for the nurse to implement?
A. Obtain the client's 24-hour dietary recall
B. Document mucosal membrane status
C. Schedule a consult with a nutritionist
D. Initiate prescribed intravenous fluids
Answer: D
Rationale: Hyperemesis gravidarum causes severe dehydration and electrolyte
imbalance; IV fluid replacement is the priority.
Question 6
A client diagnosed with calcium kidney stones has a history of gout. A new prescription
for aluminum hydroxide is scheduled to begin at 0730. Which client medication should
the nurse bring to the healthcare provider's attention?
A. Enalapril
pg. 2
,B. Allopurinol
C. Furosemide
D. Aspirin, low dose
Answer: B
Rationale: Allopurinol is used to treat gout, but aluminum hydroxide can bind to it
and reduce its absorption. This combination should be evaluated.
Question 7
A client fell in the bathroom when left unattended by the unlicensed assistive personnel
(UAP). Which information should the nurse include in the client's health record?
A. The UAP left the client to assist another client
B. The last time client was assisted to the bathroom
C. The unit was understaffed when the client fell
D. The client fell sustaining a fracture to the left hip
Answer: D
Rationale: The documentation should include the objective outcome of the fall
(fracture) rather than blaming staff or making subjective statements.
Question 8
A client in the emergency center demonstrates rapid speech, flight of ideas, and reports
sleeping only three hours during the past 48 hours. Based on these findings, it is most
important for the nurse to review the laboratory value for which medication?
A. Lorazepam
B. Fluoxetine
C. Divalproex
D. Olanzapine
Answer: C
Rationale: The client is showing signs of a manic episode, and divalproex is a mood
stabilizer that requires therapeutic drug level monitoring.
Question 9
A client in the third trimester of pregnancy reports that she feels some "lumpy places" in
her breasts and that her nipples sometimes leak a yellowish fluid. She has an
appointment with her healthcare provider in two weeks. What action should the nurse
take?
pg. 3
, A. Tell the client to begin nipple stimulation to prepare for breast feeding
B. Reschedule the client's prenatal appointment for the following day
C. Explain that this normal secretion can be assessed at the next visit
D. Recommend that the client start wearing a supportive brassiere
Answer: C
Rationale: Colostrum and breast nodularity are normal findings in the third trimester
and do not require immediate intervention.
Question 10
A client is admitted with a diagnosis of urolithiasis. Which finding is most important for
the nurse to report to the healthcare provider?
A. Volume of each voiding is more than 300mL
B. Serum potassium that is elevated
C. Relief of flank pain that radiated into the groin
D. Hematuria that is beginning to turn pink
Answer: D
Rationale: Hematuria that is worsening indicates possible ongoing urinary tract
trauma or obstruction and should be reported.
Question 11
A client is diagnosed with Meniere's disease. Which problem should the nurse identify
as most important in the plan of care?
A. Risk for ineffective self-health management related to deficient knowledge
B. Ineffective coping related to personal vulnerability
C. Risk for injury related to vertigo
D. Anxiety related to disruption of lifestyle
Answer: C
Rationale: Vertigo is a hallmark symptom of Meniere's disease and places the client at
high risk for falls and injury.
Question 12
A client is receiving enoxaparin 30mg subcutaneously twice a day. In assessing for
adverse effects of the medication, which serum laboratory value is most important for
the nurse to monitor?
A. Glucose
pg. 4
Version 2026/2027- Real Questions with Verified
Correct Answers and Detailed Rationales
Nightingale College
Question 1
A 3-year-old boy was successfully toilet-trained before his admission to the hospital for
injuries sustained from a fall. His parents are very concerned that the child has
regressed in his toileting behaviors. Which information should the nurse provide to the
parents?
A. A retraining program will need to be initiated when the child returns home
B. Diapering will be provided since hospitalization is stressful to preschoolers
C. A potty chair should be brought from home so he can maintain his toileting skills
D. Children usually resume their toileting behaviors when they leave the hospital
Answer: D
Rationale: Regression is a common stress response in hospitalized preschoolers, and
toileting behaviors typically resume after the child returns home.
Question 2
A 7-year-old is admitted to the hospital with persistent vomiting, and a nasogastric tube
attached to low intermittent suction is applied. Which finding is most important for the
nurse to report to the healthcare provider?
A. Shift intake of 640mL IV fluids plus 30mL PO ice chips
B. Serum pH of 7.45
C. Gastric output of 100 mL in the last 8 hours
D. Serum potassium of 3.0 mg/dL
Answer: D
Rationale: A serum potassium of 3.0 mEq/L indicates hypokalemia, which can be
caused by prolonged NG suctioning and can lead to cardiac arrhythmias.
Question 3
A child newly diagnosed with sickle cell anemia (SCA) is being discharged from the
hospital. Which information is most important for the nurse to provide to the parents
pg. 1
,prior to discharge?
A. Instructions about how much fluid the child should drink daily
B. Signs of addiction to opioid pain medications
C. Information about non-pharmaceutical pain relief measures
D. Referral for social services for the child and family
Answer: A
Rationale: Adequate hydration is crucial in sickle cell anemia to prevent sickling
crises; parents need specific fluid intake instructions.
Question 4
A client asks the nurse for information about how to reduce risk factors for benign
prostatic hyperplasia (BPH). Which information should the nurse provide?
A. Consume a high protein diet
B. Increase physical activity
C. Take vitamin supplements
D. Obtain a prostate-specific antigen blood level test
Answer: B
Rationale: Regular physical activity may help reduce the risk of BPH.
Question 5
A client at 12 weeks gestation is admitted to the antepartum unit with a diagnosis of
hyperemesis gravidarum. Which action is most important for the nurse to implement?
A. Obtain the client's 24-hour dietary recall
B. Document mucosal membrane status
C. Schedule a consult with a nutritionist
D. Initiate prescribed intravenous fluids
Answer: D
Rationale: Hyperemesis gravidarum causes severe dehydration and electrolyte
imbalance; IV fluid replacement is the priority.
Question 6
A client diagnosed with calcium kidney stones has a history of gout. A new prescription
for aluminum hydroxide is scheduled to begin at 0730. Which client medication should
the nurse bring to the healthcare provider's attention?
A. Enalapril
pg. 2
,B. Allopurinol
C. Furosemide
D. Aspirin, low dose
Answer: B
Rationale: Allopurinol is used to treat gout, but aluminum hydroxide can bind to it
and reduce its absorption. This combination should be evaluated.
Question 7
A client fell in the bathroom when left unattended by the unlicensed assistive personnel
(UAP). Which information should the nurse include in the client's health record?
A. The UAP left the client to assist another client
B. The last time client was assisted to the bathroom
C. The unit was understaffed when the client fell
D. The client fell sustaining a fracture to the left hip
Answer: D
Rationale: The documentation should include the objective outcome of the fall
(fracture) rather than blaming staff or making subjective statements.
Question 8
A client in the emergency center demonstrates rapid speech, flight of ideas, and reports
sleeping only three hours during the past 48 hours. Based on these findings, it is most
important for the nurse to review the laboratory value for which medication?
A. Lorazepam
B. Fluoxetine
C. Divalproex
D. Olanzapine
Answer: C
Rationale: The client is showing signs of a manic episode, and divalproex is a mood
stabilizer that requires therapeutic drug level monitoring.
Question 9
A client in the third trimester of pregnancy reports that she feels some "lumpy places" in
her breasts and that her nipples sometimes leak a yellowish fluid. She has an
appointment with her healthcare provider in two weeks. What action should the nurse
take?
pg. 3
, A. Tell the client to begin nipple stimulation to prepare for breast feeding
B. Reschedule the client's prenatal appointment for the following day
C. Explain that this normal secretion can be assessed at the next visit
D. Recommend that the client start wearing a supportive brassiere
Answer: C
Rationale: Colostrum and breast nodularity are normal findings in the third trimester
and do not require immediate intervention.
Question 10
A client is admitted with a diagnosis of urolithiasis. Which finding is most important for
the nurse to report to the healthcare provider?
A. Volume of each voiding is more than 300mL
B. Serum potassium that is elevated
C. Relief of flank pain that radiated into the groin
D. Hematuria that is beginning to turn pink
Answer: D
Rationale: Hematuria that is worsening indicates possible ongoing urinary tract
trauma or obstruction and should be reported.
Question 11
A client is diagnosed with Meniere's disease. Which problem should the nurse identify
as most important in the plan of care?
A. Risk for ineffective self-health management related to deficient knowledge
B. Ineffective coping related to personal vulnerability
C. Risk for injury related to vertigo
D. Anxiety related to disruption of lifestyle
Answer: C
Rationale: Vertigo is a hallmark symptom of Meniere's disease and places the client at
high risk for falls and injury.
Question 12
A client is receiving enoxaparin 30mg subcutaneously twice a day. In assessing for
adverse effects of the medication, which serum laboratory value is most important for
the nurse to monitor?
A. Glucose
pg. 4
