HESI RN Exit Exam 2025/2026 (V2) –
Complete Actual Exam Questions with
Correct Verified Answers & Expert
Explanations
1. A nurse is assessing a client with suspected myocardial infarction. Which finding
requires immediate action?
A. Chest pain radiating to the left arm
B. Oxygen saturation of 88%
C. Blood pressure of 140/90 mmHg
D. Heart rate of 100 bpm
Answer: B
Rationale: An oxygen saturation of 88% indicates hypoxia, a life-threatening
condition requiring immediate oxygen administration. Chest pain is expected in MI,
but hypoxia is the priority. Blood pressure and heart rate are concerning but less
urgent.
2. A client with type 1 diabetes reports nausea and vomiting. The blood glucose is 450
mg/dL. What should the nurse suspect?
A. Hypoglycemia
B. Diabetic ketoacidosis
C. Hyperosmolar hyperglycemic state
D. Insulin overdose
Answer: B
Rationale: Nausea, vomiting, and high blood glucose in type 1 diabetes suggest
diabetic ketoacidosis (DKA) due to insulin deficiency. Hypoglycemia causes low
glucose, HHS is more common in type 2, and overdose would cause hypoglycemia.
3. A nurse is delegating tasks to a licensed practical nurse (LPN). Which task is
appropriate?
A. Developing a care plan for a new client
B. Administering oral medications to a stable client
C. Performing an initial client assessment
D. Adjusting IV infusion rates
Answer: B
Rationale: LPNs can administer oral medications to stable clients within their scope.
Developing care plans, initial assessments, and adjusting IV rates are RN
responsibilities requiring advanced judgment.
4. A client with pneumonia is prescribed azithromycin. Which instruction should the nurse
provide?
A. Take with antacids to reduce GI upset
B. Complete the full course of antibiotics
, C. Stop the medication if symptoms resolve
D. Take on an empty stomach only
Answer: B
Rationale: Completing the full antibiotic course prevents resistance and ensures
infection eradication. Antacids may reduce absorption, stopping early risks relapse,
and azithromycin can be taken with or without food.
5. A postpartum client reports heavy vaginal bleeding. What is the priority nursing action?
A. Administer pain medication
B. Assess the fundus for firmness
C. Encourage ambulation
D. Provide perineal ice packs
Answer: B
Rationale: Heavy bleeding may indicate uterine atony, requiring fundal assessment
and possible massage to promote contraction. Pain medication, ambulation, and ice
packs are secondary to controlling bleeding.
6. A nurse is caring for a child with asthma experiencing wheezing. What is the first action?
A. Obtain a peak flow reading
B. Administer albuterol as prescribed
C. Encourage coughing exercises
D. Check oxygen saturation
Answer: B
Rationale: Albuterol, a bronchodilator, is the first-line treatment for acute wheezing
in asthma to relieve bronchospasm. Peak flow, coughing, and saturation are
secondary actions.
7. A client with heart failure has a new prescription for furosemide. Which laboratory value
should the nurse monitor?
A. Serum sodium
B. Serum potassium
C Grown: 4
C. Platelet count
D. Blood glucose
Answer: B
Rationale: Furosemide, a loop diuretic, can cause hypokalemia by increasing
potassium excretion. Monitoring serum potassium is critical. Sodium, platelets, and
glucose are not primarily affected.
8. A nurse is teaching a client with a new colostomy about care. Which instruction is most
important?
A. Change the pouch daily
B. Empty the pouch when one-third full
C. Avoid all high-fiber foods
D. Use adhesive remover daily
Answer: B
Rationale: Emptying the pouch when one-third full prevents leaks and skin
irritation. Daily pouch changes are unnecessary, high-fiber foods are not always
avoided, and adhesive remover is used as needed.
Complete Actual Exam Questions with
Correct Verified Answers & Expert
Explanations
1. A nurse is assessing a client with suspected myocardial infarction. Which finding
requires immediate action?
A. Chest pain radiating to the left arm
B. Oxygen saturation of 88%
C. Blood pressure of 140/90 mmHg
D. Heart rate of 100 bpm
Answer: B
Rationale: An oxygen saturation of 88% indicates hypoxia, a life-threatening
condition requiring immediate oxygen administration. Chest pain is expected in MI,
but hypoxia is the priority. Blood pressure and heart rate are concerning but less
urgent.
2. A client with type 1 diabetes reports nausea and vomiting. The blood glucose is 450
mg/dL. What should the nurse suspect?
A. Hypoglycemia
B. Diabetic ketoacidosis
C. Hyperosmolar hyperglycemic state
D. Insulin overdose
Answer: B
Rationale: Nausea, vomiting, and high blood glucose in type 1 diabetes suggest
diabetic ketoacidosis (DKA) due to insulin deficiency. Hypoglycemia causes low
glucose, HHS is more common in type 2, and overdose would cause hypoglycemia.
3. A nurse is delegating tasks to a licensed practical nurse (LPN). Which task is
appropriate?
A. Developing a care plan for a new client
B. Administering oral medications to a stable client
C. Performing an initial client assessment
D. Adjusting IV infusion rates
Answer: B
Rationale: LPNs can administer oral medications to stable clients within their scope.
Developing care plans, initial assessments, and adjusting IV rates are RN
responsibilities requiring advanced judgment.
4. A client with pneumonia is prescribed azithromycin. Which instruction should the nurse
provide?
A. Take with antacids to reduce GI upset
B. Complete the full course of antibiotics
, C. Stop the medication if symptoms resolve
D. Take on an empty stomach only
Answer: B
Rationale: Completing the full antibiotic course prevents resistance and ensures
infection eradication. Antacids may reduce absorption, stopping early risks relapse,
and azithromycin can be taken with or without food.
5. A postpartum client reports heavy vaginal bleeding. What is the priority nursing action?
A. Administer pain medication
B. Assess the fundus for firmness
C. Encourage ambulation
D. Provide perineal ice packs
Answer: B
Rationale: Heavy bleeding may indicate uterine atony, requiring fundal assessment
and possible massage to promote contraction. Pain medication, ambulation, and ice
packs are secondary to controlling bleeding.
6. A nurse is caring for a child with asthma experiencing wheezing. What is the first action?
A. Obtain a peak flow reading
B. Administer albuterol as prescribed
C. Encourage coughing exercises
D. Check oxygen saturation
Answer: B
Rationale: Albuterol, a bronchodilator, is the first-line treatment for acute wheezing
in asthma to relieve bronchospasm. Peak flow, coughing, and saturation are
secondary actions.
7. A client with heart failure has a new prescription for furosemide. Which laboratory value
should the nurse monitor?
A. Serum sodium
B. Serum potassium
C Grown: 4
C. Platelet count
D. Blood glucose
Answer: B
Rationale: Furosemide, a loop diuretic, can cause hypokalemia by increasing
potassium excretion. Monitoring serum potassium is critical. Sodium, platelets, and
glucose are not primarily affected.
8. A nurse is teaching a client with a new colostomy about care. Which instruction is most
important?
A. Change the pouch daily
B. Empty the pouch when one-third full
C. Avoid all high-fiber foods
D. Use adhesive remover daily
Answer: B
Rationale: Emptying the pouch when one-third full prevents leaks and skin
irritation. Daily pouch changes are unnecessary, high-fiber foods are not always
avoided, and adhesive remover is used as needed.
