HESI RN Exit Exam 2025/2026 – Verified
Questions with Correct Answers and
Rationales for Guaranteed Success
Medical-Surgical Nursing Questions (1–25)
1. Which patient should the nurse prioritize for immediate assessment in the
emergency department?
o a. 50-year-old with chest pain and diaphoresis
o b. 65-year-old with a fever of 100.8°F (38.2°C)
o c. 35-year-old with a sprained wrist, stable vitals
o d. 45-year-old with a scheduled wound dressing change
Correct Answer: a
Rationale: Chest pain with diaphoresis suggests acute coronary syndrome, a life-
threatening condition requiring immediate assessment to prevent myocardial
infarction. Per the ABCs (Airway, Breathing, Circulation), this takes priority over
fever, minor injuries, or routine procedures.
2. Which finding in a patient with a head injury requires immediate provider
notification?
o a. Glasgow Coma Scale score of 13
o b. Clear nasal discharge
o c. Blood pressure of 150/90 mmHg
o d. Mild headache rated 3/10
Correct Answer: b
Rationale: Clear nasal discharge may indicate a cerebrospinal fluid leak,
suggesting a skull fracture, which is a medical emergency due to the risk of
infection like meningitis. Other findings are less urgent or expected.
3. Which intervention should the nurse prioritize for a patient with suspected
pulmonary embolism?
o a. Administering pain medication
o b. Applying oxygen via nasal cannula
o c. Obtaining a chest X-ray
o d. Encouraging coughing and deep breathing
Correct Answer: b
Rationale: Pulmonary embolism causes hypoxia, making oxygen administration
the priority to stabilize breathing per ABCs. Pain management, imaging, and
respiratory exercises follow after oxygenation is addressed.
4. Which finding in a patient with diabetic ketoacidosis (DKA) is most concerning?
o a. Blood glucose of 450 mg/dL
o b. Kussmaul respirations
o c. Serum potassium of 4.2 mEq/L
o d. pH of 7.28 on arterial blood gas
Correct Answer: b
Rationale: Kussmaul respirations indicate severe metabolic acidosis in DKA, a
life-threatening condition requiring immediate intervention to prevent respiratory
failure. Other findings are expected but less urgent.
, 5. Which action is the priority for a patient with a new tracheostomy?
o a. Cleaning the tracheostomy site
o b. Checking tracheostomy tube patency
o c. Teaching self-care techniques
o d. Suctioning as needed
Correct Answer: b
Rationale: Ensuring tracheostomy tube patency maintains the airway, the highest
priority per ABCs. Cleaning, teaching, and suctioning are secondary after airway
confirmation.
6. Which finding in a patient with heart failure requires immediate intervention?
o a. Weight gain of 1 kg in 24 hours
o b. Crackles in bilateral lung bases
o c. Oxygen saturation of 88%
o d. Fatigue during ambulation
Correct Answer: c
Rationale: Low oxygen saturation indicates hypoxia, requiring immediate oxygen
administration per ABCs. Crackles and weight gain suggest fluid overload but are
less urgent, and fatigue is expected.
7. Which intervention should be prioritized for a patient with septic shock?
o a. Administering antibiotics within 1 hour
o b. Monitoring urine output
o c. Obtaining blood cultures
o d. Administering IV fluids
Correct Answer: a
Rationale: Early antibiotic administration within 1 hour reduces mortality in
septic shock, per sepsis protocols. IV fluids and cultures are critical but
secondary, and urine output monitoring follows.
8. Which action should the nurse take for a patient with a suspected stroke?
o a. Administering aspirin immediately
o b. Performing a neurological assessment
o c. Elevating the head of the bed to 90 degrees
o d. Monitoring blood glucose levels
Correct Answer: b
Rationale: A neurological assessment establishes stroke severity and guides time-
sensitive interventions like thrombolytics. Aspirin, head elevation, and glucose
monitoring are secondary.
9. Which finding in a patient with gastrointestinal bleeding is most concerning?
o a. Heart rate of 110 bpm
o b. Blood pressure of 90/60 mmHg
o c. Hematocrit of 28%
o d. Abdominal pain rated 5/10
Correct Answer: b
Rationale: Hypotension indicates hypovolemic shock from significant blood loss,
requiring immediate fluid resuscitation per ABCs. Other findings are concerning
but less urgent.
10. Which intervention is the priority for a patient with a tension pneumothorax?
o a. Preparing for chest tube insertion
o b. Administering oxygen at 2 L/min
o c. Obtaining a chest X-ray
o d. Monitoring respiratory rate
Correct Answer: a
Questions with Correct Answers and
Rationales for Guaranteed Success
Medical-Surgical Nursing Questions (1–25)
1. Which patient should the nurse prioritize for immediate assessment in the
emergency department?
o a. 50-year-old with chest pain and diaphoresis
o b. 65-year-old with a fever of 100.8°F (38.2°C)
o c. 35-year-old with a sprained wrist, stable vitals
o d. 45-year-old with a scheduled wound dressing change
Correct Answer: a
Rationale: Chest pain with diaphoresis suggests acute coronary syndrome, a life-
threatening condition requiring immediate assessment to prevent myocardial
infarction. Per the ABCs (Airway, Breathing, Circulation), this takes priority over
fever, minor injuries, or routine procedures.
2. Which finding in a patient with a head injury requires immediate provider
notification?
o a. Glasgow Coma Scale score of 13
o b. Clear nasal discharge
o c. Blood pressure of 150/90 mmHg
o d. Mild headache rated 3/10
Correct Answer: b
Rationale: Clear nasal discharge may indicate a cerebrospinal fluid leak,
suggesting a skull fracture, which is a medical emergency due to the risk of
infection like meningitis. Other findings are less urgent or expected.
3. Which intervention should the nurse prioritize for a patient with suspected
pulmonary embolism?
o a. Administering pain medication
o b. Applying oxygen via nasal cannula
o c. Obtaining a chest X-ray
o d. Encouraging coughing and deep breathing
Correct Answer: b
Rationale: Pulmonary embolism causes hypoxia, making oxygen administration
the priority to stabilize breathing per ABCs. Pain management, imaging, and
respiratory exercises follow after oxygenation is addressed.
4. Which finding in a patient with diabetic ketoacidosis (DKA) is most concerning?
o a. Blood glucose of 450 mg/dL
o b. Kussmaul respirations
o c. Serum potassium of 4.2 mEq/L
o d. pH of 7.28 on arterial blood gas
Correct Answer: b
Rationale: Kussmaul respirations indicate severe metabolic acidosis in DKA, a
life-threatening condition requiring immediate intervention to prevent respiratory
failure. Other findings are expected but less urgent.
, 5. Which action is the priority for a patient with a new tracheostomy?
o a. Cleaning the tracheostomy site
o b. Checking tracheostomy tube patency
o c. Teaching self-care techniques
o d. Suctioning as needed
Correct Answer: b
Rationale: Ensuring tracheostomy tube patency maintains the airway, the highest
priority per ABCs. Cleaning, teaching, and suctioning are secondary after airway
confirmation.
6. Which finding in a patient with heart failure requires immediate intervention?
o a. Weight gain of 1 kg in 24 hours
o b. Crackles in bilateral lung bases
o c. Oxygen saturation of 88%
o d. Fatigue during ambulation
Correct Answer: c
Rationale: Low oxygen saturation indicates hypoxia, requiring immediate oxygen
administration per ABCs. Crackles and weight gain suggest fluid overload but are
less urgent, and fatigue is expected.
7. Which intervention should be prioritized for a patient with septic shock?
o a. Administering antibiotics within 1 hour
o b. Monitoring urine output
o c. Obtaining blood cultures
o d. Administering IV fluids
Correct Answer: a
Rationale: Early antibiotic administration within 1 hour reduces mortality in
septic shock, per sepsis protocols. IV fluids and cultures are critical but
secondary, and urine output monitoring follows.
8. Which action should the nurse take for a patient with a suspected stroke?
o a. Administering aspirin immediately
o b. Performing a neurological assessment
o c. Elevating the head of the bed to 90 degrees
o d. Monitoring blood glucose levels
Correct Answer: b
Rationale: A neurological assessment establishes stroke severity and guides time-
sensitive interventions like thrombolytics. Aspirin, head elevation, and glucose
monitoring are secondary.
9. Which finding in a patient with gastrointestinal bleeding is most concerning?
o a. Heart rate of 110 bpm
o b. Blood pressure of 90/60 mmHg
o c. Hematocrit of 28%
o d. Abdominal pain rated 5/10
Correct Answer: b
Rationale: Hypotension indicates hypovolemic shock from significant blood loss,
requiring immediate fluid resuscitation per ABCs. Other findings are concerning
but less urgent.
10. Which intervention is the priority for a patient with a tension pneumothorax?
o a. Preparing for chest tube insertion
o b. Administering oxygen at 2 L/min
o c. Obtaining a chest X-ray
o d. Monitoring respiratory rate
Correct Answer: a
