2025/2026 (Versions 1–7) + BONUS
Past Papers 2022–2024 with
Diagrams, Rationales & Pictures
c
,TABLEmOFmCONTENTS
HESImRNmExitmExammv1 ...................................................................................... 3
HESImRNmExitmExammv2 .................................................................................. 149
HESImRNmExitmV3............................................................................................. 204
m m HESImExitmRNmV4 ........................................................................................... 261
HESImExitmRNmV5............................................................................................. 304
HESImExitmRNmV6............................................................................................. 349
HESImEXITmRNm V7........................................................................................... 391
ADDITIONALmHESImEXITmRNmEXAMmV1-V7mPASTmPAPERmFROMm2022-
2024m WITHmPICTURES,RATIONALESm ANDmDIAGRAMS............................... 528
WISHINGmYOUmALLmTHEmBESTmASmYOUmEXPLOREmTHEmBE
STmMASTERPIECEmEVER
RATEm MYmWORKmFORmMORE
HESI EXIT EXAMS V1 – V7
m m m m m
,HESI RN Exit Exam v1
m m m m
Themnursemismcompletingmthemadmissionmassessmentmofmam3-year-
oldmwhomismadmittedmwithmbacterialmmeningitismandmhydrocephalus.m
Which
assessmentmfindingmismevidencemthatmthemchildmismexperiencingmincrea
sedmintracranialmpressurem(ICP)?
A.mTachycardiamandmtachypnea
B.mSluggishmandmunequalmpupillarymresponses
C.mIncreasedmheadmcircumferencemandmbulgingmfontanels
D.mBloodmpressuremfluctuationsmandmsyncope
-m✔✔-mANSWER-✔✔-
B.mSluggishmandmunequalmpupillary
responses
Rationale:
Sluggishmandmunequalmpupillarymresponsesmaremamdirectmsignmofmincr
easedmintracranialmpressuremaffectingmcranialmnerves,mparticularlymth
e
oculomotormnervem(cranialmnervemIII).mThesemfindingsmindicatemneuro
logicmdeteriorationmandmwarrantmimmediatemintervention.
ExplanationmofmIncorrectmOptions:
• A.mTachycardiamandmtachypnea:mThesemaremnonspecificmfind
ingsmandmmaymoccurmwithmfevermorminfectionmbutmaremnotm
reliable
indicatorsmofmincreasedmICP.mInmfact,mbradycardiam(notmtachycar
dia)mismoftenmseenmwithmrisingmICP.
• C.mIncreasedmheadmcircumferencemandmbulgingmfontanels:mTh
esemaremsignsmmoremtypicallymseenminminfantsmduemtomopenms
utures.mBym3myearsmofmage,mthemfontanelsmaremgenerallymclos
ed,mmakingmthismlessmlikely.
• D.mBloodmpressuremfluctuationsmandmsyncope:mWhilemlatemsig
, nsmofmincreasedmICPmcanmincludemchangesminmvitalmsigns,msyn
copemismnotmtypicallymassociatedmwithmelevatedmICPminmchild
renmandmismmoremcommonmwithmcardiacmormvasovagalmevent
s.