HESI RN Exit Exam |
2025/2026 Verified
Questions and 100%
Correct Answers
Section 1: Pharmacology (Questions 1–40)
1. A client with hypertension is prescribed lisinopril. The nurse should
monitor for which common side effect? A. Hyperglycemia B. Dry cough C.
Bradycardia D. Constipation
Correct Answer: B
Rationale: Lisinopril, an ACE inhibitor, commonly causes a dry, nonproductive
cough due to bradykinin accumulation. This is a key monitoring point for
compliance and potential switch to an ARB.
2. A client receiving gentamicin IV complains of tinnitus. The nurse
recognizes this as a sign of: A. Nephrotoxicity B. Ototoxicity C. Hepatotoxicity
D. Cardiotoxicity
Correct Answer: B
Rationale: Gentamicin, an aminoglycoside, can cause ototoxicity manifested by
tinnitus or hearing loss. Monitor peak and trough levels to prevent irreversible
damage.
3. The nurse is administering warfarin to a client. Which lab value indicates
therapeutic effect? A. PT 11-13.5 seconds B. INR 2-3 C. aPTT 25-35 seconds D.
Platelet count 150,000-450,000
,Correct Answer: B
Rationale: Warfarin therapy targets an INR of 2-3 for most indications like AFib.
INR monitors vitamin K antagonism; educate on consistent vitamin K intake.
4. A client with type 2 diabetes is started on metformin. The nurse should
instruct to report: A. Hypoglycemia B. Lactic acidosis symptoms C. Weight gain
D. Constipation
Correct Answer: B
Rationale: Metformin can rarely cause lactic acidosis, especially in renal
impairment. Symptoms include muscle pain and hyperventilation; contraindicated
if eGFR <30 mL/min.
5. Digoxin is administered to a client with heart failure. The nurse holds the
dose if apical pulse is: A. 88 bpm B. 56 bpm C. 72 bpm D. 100 bpm
Correct Answer: B
Rationale: Hold digoxin if pulse <60 bpm to avoid toxicity. Therapeutic levels
0.5-2 ng/mL; monitor for nausea and yellow vision.
6. A client on clopidogrel post-stent should avoid: A. Grapefruit juice B. Aspirin
C. OTC ibuprofen D. Vitamin D
Correct Answer: C
Rationale: Clopidogrel with NSAIDs increases bleeding risk. Dual antiplatelet
therapy is standard; monitor for bruising.
7. Albuterol nebulizer is given for asthma. Peak effect occurs in: A. 30 minutes
B. 5-15 minutes C. 1 hour D. 2 hours
Correct Answer: B
Rationale: Albuterol, a SABA, provides rapid bronchodilation within 5-15
minutes. Rinse mouth to prevent thrush if using with steroids.
8. A client receiving furosemide develops muscle cramps. The nurse suspects:
A. Hyperkalemia B. Hypokalemia C. Hyponatremia D. Hypercalcemia
, Correct Answer: B
Rationale: Loop diuretics like furosemide cause potassium loss. Supplement K+
and monitor electrolytes.
9. Levothyroxine dose is adjusted based on: A. T3 levels B. TSH levels C. Free
T4 only D. Total T4
Correct Answer: B
Rationale: TSH is the primary monitor for hypothyroidism treatment. Take on
empty stomach; avoid soy.
10. A client on SSRI sertraline reports sexual dysfunction. The nurse suggests:
A. Discontinue abruptly B. Switch to bupropion C. Ignore as normal D. Add
estrogen
Correct Answer: B
Rationale: Bupropion has less sexual side effects. SSRIs inhibit serotonin
reuptake; taper to avoid withdrawal.
11. Vancomycin trough level for serious infections should be: A. 5-10 mcg/mL
B. 15-20 mcg/mL C. 1-5 mcg/mL D. 20-30 mcg/mL
Correct Answer: B
Rationale: Trough 15-20 mcg/mL for MRSA pneumonia. Monitor for
nephrotoxicity.
12. Nitroglycerin sublingual for angina onset: A. 1 tablet q5min x3 B. 1 tablet
daily C. IV infusion D. Topical patch
Correct Answer: A
Rationale: Sublingual for acute relief; call 911 if no relief after 3 doses.
13. A client on lithium for bipolar should maintain sodium intake to prevent:
A. Hyperkalemia B. Lithium toxicity C. Hypocalcemia D. Dehydration only
Correct Answer: B
2025/2026 Verified
Questions and 100%
Correct Answers
Section 1: Pharmacology (Questions 1–40)
1. A client with hypertension is prescribed lisinopril. The nurse should
monitor for which common side effect? A. Hyperglycemia B. Dry cough C.
Bradycardia D. Constipation
Correct Answer: B
Rationale: Lisinopril, an ACE inhibitor, commonly causes a dry, nonproductive
cough due to bradykinin accumulation. This is a key monitoring point for
compliance and potential switch to an ARB.
2. A client receiving gentamicin IV complains of tinnitus. The nurse
recognizes this as a sign of: A. Nephrotoxicity B. Ototoxicity C. Hepatotoxicity
D. Cardiotoxicity
Correct Answer: B
Rationale: Gentamicin, an aminoglycoside, can cause ototoxicity manifested by
tinnitus or hearing loss. Monitor peak and trough levels to prevent irreversible
damage.
3. The nurse is administering warfarin to a client. Which lab value indicates
therapeutic effect? A. PT 11-13.5 seconds B. INR 2-3 C. aPTT 25-35 seconds D.
Platelet count 150,000-450,000
,Correct Answer: B
Rationale: Warfarin therapy targets an INR of 2-3 for most indications like AFib.
INR monitors vitamin K antagonism; educate on consistent vitamin K intake.
4. A client with type 2 diabetes is started on metformin. The nurse should
instruct to report: A. Hypoglycemia B. Lactic acidosis symptoms C. Weight gain
D. Constipation
Correct Answer: B
Rationale: Metformin can rarely cause lactic acidosis, especially in renal
impairment. Symptoms include muscle pain and hyperventilation; contraindicated
if eGFR <30 mL/min.
5. Digoxin is administered to a client with heart failure. The nurse holds the
dose if apical pulse is: A. 88 bpm B. 56 bpm C. 72 bpm D. 100 bpm
Correct Answer: B
Rationale: Hold digoxin if pulse <60 bpm to avoid toxicity. Therapeutic levels
0.5-2 ng/mL; monitor for nausea and yellow vision.
6. A client on clopidogrel post-stent should avoid: A. Grapefruit juice B. Aspirin
C. OTC ibuprofen D. Vitamin D
Correct Answer: C
Rationale: Clopidogrel with NSAIDs increases bleeding risk. Dual antiplatelet
therapy is standard; monitor for bruising.
7. Albuterol nebulizer is given for asthma. Peak effect occurs in: A. 30 minutes
B. 5-15 minutes C. 1 hour D. 2 hours
Correct Answer: B
Rationale: Albuterol, a SABA, provides rapid bronchodilation within 5-15
minutes. Rinse mouth to prevent thrush if using with steroids.
8. A client receiving furosemide develops muscle cramps. The nurse suspects:
A. Hyperkalemia B. Hypokalemia C. Hyponatremia D. Hypercalcemia
, Correct Answer: B
Rationale: Loop diuretics like furosemide cause potassium loss. Supplement K+
and monitor electrolytes.
9. Levothyroxine dose is adjusted based on: A. T3 levels B. TSH levels C. Free
T4 only D. Total T4
Correct Answer: B
Rationale: TSH is the primary monitor for hypothyroidism treatment. Take on
empty stomach; avoid soy.
10. A client on SSRI sertraline reports sexual dysfunction. The nurse suggests:
A. Discontinue abruptly B. Switch to bupropion C. Ignore as normal D. Add
estrogen
Correct Answer: B
Rationale: Bupropion has less sexual side effects. SSRIs inhibit serotonin
reuptake; taper to avoid withdrawal.
11. Vancomycin trough level for serious infections should be: A. 5-10 mcg/mL
B. 15-20 mcg/mL C. 1-5 mcg/mL D. 20-30 mcg/mL
Correct Answer: B
Rationale: Trough 15-20 mcg/mL for MRSA pneumonia. Monitor for
nephrotoxicity.
12. Nitroglycerin sublingual for angina onset: A. 1 tablet q5min x3 B. 1 tablet
daily C. IV infusion D. Topical patch
Correct Answer: A
Rationale: Sublingual for acute relief; call 911 if no relief after 3 doses.
13. A client on lithium for bipolar should maintain sodium intake to prevent:
A. Hyperkalemia B. Lithium toxicity C. Hypocalcemia D. Dehydration only
Correct Answer: B
