HESI RN Exit Exam 2025/2026 (V1) – 75
Updated Actual Questions with Verified
Correct Answers & Detailed Rationales
Question 1
A client with heart failure is admitted with dyspnea and bilateral crackles. Which assessment
finding requires immediate intervention?
A. Blood pressure of 140/90 mmHg
B. Oxygen saturation of 88%
C. Heart rate of 92 beats/min
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 damage.
Other findings are concerning but less urgent.
Question 2
The nurse is caring for a client post-myocardial infarction who is prescribed aspirin. The client
asks, "Why do I need this medication?" What is the nurse’s best response?
A. "It reduces inflammation in your heart."
B. "It prevents blood clots from forming."
C. "It lowers your blood pressure."
D. "It helps regulate your heart rhythm."
Correct Answer: B. It prevents blood clots from forming.
Rationale: Aspirin is an antiplatelet medication that reduces the risk of thrombus formation,
critical in preventing further cardiac events post-myocardial infarction. Other options are
incorrect for aspirin’s primary action.
Question 3
A pediatric client with asthma is experiencing an acute exacerbation. Which medication should
the nurse administer first?
,A. Montelukast
B. Albuterol
C. Prednisone
D. Ipratropium
Correct Answer: B. Albuterol
Rationale: Albuterol, a short-acting beta-agonist, is the first-line treatment for acute asthma
exacerbation to relieve bronchospasm and improve airflow. Other medications are used for
maintenance or adjunct therapy.
Question 4
A postpartum client reports heavy vaginal bleeding and a boggy uterus. What is the nurse’s
priority action?
A. Administer oxytocin as prescribed.
B. Perform fundal massage.
C. Insert a urinary catheter.
D. Notify the healthcare provider.
Correct Answer: B. Perform fundal massage.
Rationale: A boggy uterus indicates uterine atony, a common cause of postpartum hemorrhage.
Fundal massage is the priority to stimulate uterine contraction and control bleeding. Oxytocin,
catheterization, or notification are secondary actions.
Question 5
A client with schizophrenia says, "The voices are telling me to leave." What is the nurse’s best
response?
A. "Those voices aren’t real; ignore them."
B. "What are the voices saying to you?"
C. "Why do you think you’re hearing voices?"
D. "Let’s talk about something else."
Correct Answer: B. What are the voices saying to you?
Rationale: Exploring the content of hallucinations validates the client’s experience without
reinforcing the delusion and helps assess for safety risks. Other responses may dismiss the client
or miss critical information.
Question 6
, The nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A. Assessing a client’s pain level
B. Administering oral medications
C. Obtaining vital signs
D. Developing a care plan
Correct Answer: C. Obtaining vital signs
Rationale: Obtaining vital signs is within the UAP’s scope of practice. Assessing pain,
administering medications, and developing care plans require nursing judgment and are not
delegable.
Question 7
A client with diabetes mellitus reports nausea and vomiting. The blood glucose level is 350
mg/dL. What is the nurse’s priority action?
A. Administer insulin as prescribed.
B. Encourage oral fluid intake.
C. Check for ketone levels.
D. Notify the healthcare provider.
Correct Answer: C. Check for ketone levels.
Rationale: Nausea, vomiting, and elevated blood glucose suggest possible diabetic ketoacidosis
(DKA). Checking ketone levels is the priority to confirm the diagnosis and guide treatment.
Other actions follow assessment.
Question 8
The nurse is teaching a client with hypertension about dietary modifications. Which food should
the client avoid?
A. Fresh apples
B. Grilled chicken
C. Canned soup
D. Whole-grain bread
Correct Answer: C. Canned soup
Rationale: Canned soup is high in sodium, which can exacerbate hypertension. Fresh apples,
grilled chicken, and whole-grain bread are heart-healthy choices.
Question 9
Updated Actual Questions with Verified
Correct Answers & Detailed Rationales
Question 1
A client with heart failure is admitted with dyspnea and bilateral crackles. Which assessment
finding requires immediate intervention?
A. Blood pressure of 140/90 mmHg
B. Oxygen saturation of 88%
C. Heart rate of 92 beats/min
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 damage.
Other findings are concerning but less urgent.
Question 2
The nurse is caring for a client post-myocardial infarction who is prescribed aspirin. The client
asks, "Why do I need this medication?" What is the nurse’s best response?
A. "It reduces inflammation in your heart."
B. "It prevents blood clots from forming."
C. "It lowers your blood pressure."
D. "It helps regulate your heart rhythm."
Correct Answer: B. It prevents blood clots from forming.
Rationale: Aspirin is an antiplatelet medication that reduces the risk of thrombus formation,
critical in preventing further cardiac events post-myocardial infarction. Other options are
incorrect for aspirin’s primary action.
Question 3
A pediatric client with asthma is experiencing an acute exacerbation. Which medication should
the nurse administer first?
,A. Montelukast
B. Albuterol
C. Prednisone
D. Ipratropium
Correct Answer: B. Albuterol
Rationale: Albuterol, a short-acting beta-agonist, is the first-line treatment for acute asthma
exacerbation to relieve bronchospasm and improve airflow. Other medications are used for
maintenance or adjunct therapy.
Question 4
A postpartum client reports heavy vaginal bleeding and a boggy uterus. What is the nurse’s
priority action?
A. Administer oxytocin as prescribed.
B. Perform fundal massage.
C. Insert a urinary catheter.
D. Notify the healthcare provider.
Correct Answer: B. Perform fundal massage.
Rationale: A boggy uterus indicates uterine atony, a common cause of postpartum hemorrhage.
Fundal massage is the priority to stimulate uterine contraction and control bleeding. Oxytocin,
catheterization, or notification are secondary actions.
Question 5
A client with schizophrenia says, "The voices are telling me to leave." What is the nurse’s best
response?
A. "Those voices aren’t real; ignore them."
B. "What are the voices saying to you?"
C. "Why do you think you’re hearing voices?"
D. "Let’s talk about something else."
Correct Answer: B. What are the voices saying to you?
Rationale: Exploring the content of hallucinations validates the client’s experience without
reinforcing the delusion and helps assess for safety risks. Other responses may dismiss the client
or miss critical information.
Question 6
, The nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A. Assessing a client’s pain level
B. Administering oral medications
C. Obtaining vital signs
D. Developing a care plan
Correct Answer: C. Obtaining vital signs
Rationale: Obtaining vital signs is within the UAP’s scope of practice. Assessing pain,
administering medications, and developing care plans require nursing judgment and are not
delegable.
Question 7
A client with diabetes mellitus reports nausea and vomiting. The blood glucose level is 350
mg/dL. What is the nurse’s priority action?
A. Administer insulin as prescribed.
B. Encourage oral fluid intake.
C. Check for ketone levels.
D. Notify the healthcare provider.
Correct Answer: C. Check for ketone levels.
Rationale: Nausea, vomiting, and elevated blood glucose suggest possible diabetic ketoacidosis
(DKA). Checking ketone levels is the priority to confirm the diagnosis and guide treatment.
Other actions follow assessment.
Question 8
The nurse is teaching a client with hypertension about dietary modifications. Which food should
the client avoid?
A. Fresh apples
B. Grilled chicken
C. Canned soup
D. Whole-grain bread
Correct Answer: C. Canned soup
Rationale: Canned soup is high in sodium, which can exacerbate hypertension. Fresh apples,
grilled chicken, and whole-grain bread are heart-healthy choices.
Question 9
