HESI RN Exit Exam 2025 with NGN –
Verified Questions and 100% Correct
Answers with Rationales
Question 1
A client with heart failure is admitted with dyspnea and bilateral crackles. Which assessment
finding requires immediate intervention?
a) Heart rate of 88 beats/min
b) Oxygen saturation of 88%
c) Blood pressure of 130/82 mmHg
d) Respiratory rate of 20 breaths/min
Correct Answer: b) Oxygen saturation of 88%
Rationale: An oxygen saturation of 88% indicates hypoxemia, a critical finding in heart failure
that requires immediate intervention, such as supplemental oxygen, to prevent tissue hypoxia.
Heart rate, blood pressure, and respiratory rate are within normal limits and less urgent.
Question 2
A nurse is caring for a client receiving warfarin. Which laboratory result should the nurse
prioritize?
a) Platelet count
b) International Normalized Ratio (INR)
c) Hemoglobin level
d) Serum potassium
Correct Answer: b) International Normalized Ratio (INR)
Rationale: Warfarin is an anticoagulant, and INR monitors its therapeutic effect (target range:
2.0–3.0 for most conditions). An abnormal INR could indicate a risk of bleeding or clotting,
requiring immediate action. Platelet count, hemoglobin, and potassium are less directly related to
warfarin therapy.
Question 3
,A client with type 1 diabetes presents with confusion, tachycardia, and fruity breath odor. What
is the nurse’s priority action?
a) Administer regular insulin IV
b) Check blood glucose level
c) Provide oral fluids
d) Administer sodium bicarbonate
Correct Answer: b) Check blood glucose level
Rationale: The symptoms suggest diabetic ketoacidosis (DKA), a life-threatening complication.
Checking blood glucose confirms hyperglycemia, guiding treatment (e.g., insulin).
Administering insulin or bicarbonate without glucose confirmation is unsafe, and oral fluids are
contraindicated in acute DKA due to aspiration risk.
Question 4
Which task can the nurse delegate to an unlicensed assistive personnel (UAP)?
a) Assessing a client’s pain level
b) Administering oral medications
c) Assisting with ambulation
d) Evaluating wound healing
Correct Answer: c) Assisting with ambulation
Rationale: UAPs can perform non-invasive tasks like assisting with ambulation. Assessing pain,
administering medications, and evaluating wounds require clinical judgment and are within the
RN’s scope of practice.
Question 5
A client with pneumonia is prescribed azithromycin. The client reports nausea and diarrhea.
What should the nurse do?
a) Discontinue the medication
b) Administer an antiemetic
c) Encourage the client to continue the medication and report worsening symptoms
d) Switch to a different antibiotic
Correct Answer: c) Encourage the client to continue the medication and report worsening
symptoms
Rationale: Nausea and diarrhea are common side effects of azithromycin. The nurse should
encourage adherence to complete the course but monitor for worsening symptoms, such as
severe diarrhea, which may indicate Clostridioides difficile infection. Discontinuing or switching
, antibiotics requires a provider order, and an antiemetic may not be necessary unless symptoms
persist.
Question 6
A client with a new colostomy asks how to prevent skin irritation around the stoma. What should
the nurse teach?
a) Apply petroleum jelly around the stoma
b) Ensure the skin barrier fits snugly around the stoma
c) Clean the stoma with alcohol-based wipes
d) Change the pouch every 12 hours
Correct Answer: b) Ensure the skin barrier fits snugly around the stoma
Rationale: A properly fitted skin barrier prevents leakage of stool, which can cause skin
irritation. Petroleum jelly is not recommended, alcohol-based wipes are irritating, and changing
the pouch every 3–7 days is sufficient unless leakage occurs.
Question 7
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min via
nasal cannula. The client’s oxygen saturation is 90%. What should the nurse do?
a) Increase oxygen to 4 L/min
b) Maintain current oxygen flow
c) Discontinue oxygen therapy
d) Switch to a non-rebreather mask
Correct Answer: b) Maintain current oxygen flow
Rationale: In COPD, oxygen therapy targets a saturation of 88–92% to avoid suppressing the
hypoxic drive. A saturation of 90% is within the target range, so maintaining the current flow is
appropriate. Increasing oxygen or switching delivery methods is unnecessary, and discontinuing
oxygen risks hypoxemia.
Question 8
A nurse is preparing to administer insulin glargine to a client with diabetes. When is the best
time to administer this medication?
a) Before breakfast
b) At bedtime
Verified Questions and 100% Correct
Answers with Rationales
Question 1
A client with heart failure is admitted with dyspnea and bilateral crackles. Which assessment
finding requires immediate intervention?
a) Heart rate of 88 beats/min
b) Oxygen saturation of 88%
c) Blood pressure of 130/82 mmHg
d) Respiratory rate of 20 breaths/min
Correct Answer: b) Oxygen saturation of 88%
Rationale: An oxygen saturation of 88% indicates hypoxemia, a critical finding in heart failure
that requires immediate intervention, such as supplemental oxygen, to prevent tissue hypoxia.
Heart rate, blood pressure, and respiratory rate are within normal limits and less urgent.
Question 2
A nurse is caring for a client receiving warfarin. Which laboratory result should the nurse
prioritize?
a) Platelet count
b) International Normalized Ratio (INR)
c) Hemoglobin level
d) Serum potassium
Correct Answer: b) International Normalized Ratio (INR)
Rationale: Warfarin is an anticoagulant, and INR monitors its therapeutic effect (target range:
2.0–3.0 for most conditions). An abnormal INR could indicate a risk of bleeding or clotting,
requiring immediate action. Platelet count, hemoglobin, and potassium are less directly related to
warfarin therapy.
Question 3
,A client with type 1 diabetes presents with confusion, tachycardia, and fruity breath odor. What
is the nurse’s priority action?
a) Administer regular insulin IV
b) Check blood glucose level
c) Provide oral fluids
d) Administer sodium bicarbonate
Correct Answer: b) Check blood glucose level
Rationale: The symptoms suggest diabetic ketoacidosis (DKA), a life-threatening complication.
Checking blood glucose confirms hyperglycemia, guiding treatment (e.g., insulin).
Administering insulin or bicarbonate without glucose confirmation is unsafe, and oral fluids are
contraindicated in acute DKA due to aspiration risk.
Question 4
Which task can the nurse delegate to an unlicensed assistive personnel (UAP)?
a) Assessing a client’s pain level
b) Administering oral medications
c) Assisting with ambulation
d) Evaluating wound healing
Correct Answer: c) Assisting with ambulation
Rationale: UAPs can perform non-invasive tasks like assisting with ambulation. Assessing pain,
administering medications, and evaluating wounds require clinical judgment and are within the
RN’s scope of practice.
Question 5
A client with pneumonia is prescribed azithromycin. The client reports nausea and diarrhea.
What should the nurse do?
a) Discontinue the medication
b) Administer an antiemetic
c) Encourage the client to continue the medication and report worsening symptoms
d) Switch to a different antibiotic
Correct Answer: c) Encourage the client to continue the medication and report worsening
symptoms
Rationale: Nausea and diarrhea are common side effects of azithromycin. The nurse should
encourage adherence to complete the course but monitor for worsening symptoms, such as
severe diarrhea, which may indicate Clostridioides difficile infection. Discontinuing or switching
, antibiotics requires a provider order, and an antiemetic may not be necessary unless symptoms
persist.
Question 6
A client with a new colostomy asks how to prevent skin irritation around the stoma. What should
the nurse teach?
a) Apply petroleum jelly around the stoma
b) Ensure the skin barrier fits snugly around the stoma
c) Clean the stoma with alcohol-based wipes
d) Change the pouch every 12 hours
Correct Answer: b) Ensure the skin barrier fits snugly around the stoma
Rationale: A properly fitted skin barrier prevents leakage of stool, which can cause skin
irritation. Petroleum jelly is not recommended, alcohol-based wipes are irritating, and changing
the pouch every 3–7 days is sufficient unless leakage occurs.
Question 7
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min via
nasal cannula. The client’s oxygen saturation is 90%. What should the nurse do?
a) Increase oxygen to 4 L/min
b) Maintain current oxygen flow
c) Discontinue oxygen therapy
d) Switch to a non-rebreather mask
Correct Answer: b) Maintain current oxygen flow
Rationale: In COPD, oxygen therapy targets a saturation of 88–92% to avoid suppressing the
hypoxic drive. A saturation of 90% is within the target range, so maintaining the current flow is
appropriate. Increasing oxygen or switching delivery methods is unnecessary, and discontinuing
oxygen risks hypoxemia.
Question 8
A nurse is preparing to administer insulin glargine to a client with diabetes. When is the best
time to administer this medication?
a) Before breakfast
b) At bedtime
