2025: Actual Exam Content and
Verified Clinical Solutions
Document Control ID: HESI-RN-NGN-2025-V1 Security Level: High-Yield / Confidential Date:
Academic Year 2025 Prepared By: Department of Nursing Education & Curriculum Standards
Verification Status: A+ GRADED | 100% CORRECT | VERIFIED SOLUTIONS
CONFIDENTIALITY NOTICE: This document contains high-yield clinical analysis and verified
rationales for the 2025 HESI RN Exit Exam. The content is structured to simulate the rigor of the
actual testing environment, focusing on physiological adaptation, pharmacology, safety, and
management of care. The rationale and clinical analysis sections are designed to bridge the gap
between theoretical knowledge and clinical application, ensuring NCLEX-readiness.
Table of Contents
1. Topic Index & Concept Map
2. Comprehensive Glossary of High-Yield Terms
3. Essential Nursing Formula Sheet & Math Review
4. Section I: Physiological Adaptation & Medical-Surgical Nursing (Questions 1-20)
5. Section II: Pharmacology & Parenteral Therapies (Questions 21-30)
6. Section III: Maternal-Child & Pediatric Nursing (Questions 31-40)
7. Section IV: Psychiatric & Mental Health Nursing (Questions 41-48)
8. Section V: Management of Care, Delegation & Prioritization (Questions 49-55)
Topic Index & Concept Map
The following concept map organizes the 2025 HESI RN Exit Exam content into high-yield
clusters. Mastery of these domains correlates with a score >900.
● 1. Physiological Adaptation (Medical-Surgical)
○ Cardiovascular Dynamics
■ Hemodynamics: MAP calculation , CVP monitoring, Shock states
(Hypovolemic vs. Cardiogenic).
■ Pathology: Myocardial Infarction (Atypical presentations), Heart Failure (Left
vs. Right), Hypertension Crisis.
■ Dysrhythmias: Identification and treatment protocols (Atropine, Adenosine,
Amiodarone).
○ Respiratory Function
■ Oxygenation: COPD management (Hypoxic drive mechanisms) , Asthma
(Peak flow monitoring), Pneumonia.
■ Emergencies: Pulmonary Embolism, Pneumothorax (Chest tube
troubleshooting), ARDS, Epiglottitis.
, ○ Neurological Integrity
■ Intracranial Regulation: ICP monitoring, CPP calculation , Cushing’s Triad,
Seizure precautions.
■ Pathology: Stroke (Ischemic vs. Hemorrhagic), Meningitis (Kernig/Brudzinski
signs) , Spinal Cord Injury (Autonomic Dysreflexia).
○ Endocrine & Metabolic
■ Glucose Regulation: DKA vs. HHNS (fluid resuscitation priorities),
Hypoglycemia protocols.
■ Glandular Disorders: Thyroid Storm , Addison’s Crisis (Steroid management),
Cushing’s Syndrome, SIADH vs. Diabetes Insipidus.
○ Fluid & Electrolytes
■ Imbalances: Hyperkalemia (Cardiac arrest risk) , Hypocalcemia
(Chvostek’s/Trousseau’s signs) , Hyponatremia (Seizure risk).
■ Burn Management: Parkland Formula , Fluid resuscitation phases, Rule of
Nines.
● 2. Pharmacology
○ Calculations: Dosage by weight, IV drip rates (gtt/min), reconstitution.
○ High-Alert Medications: Insulin (Peaks/Onsets), Heparin/Warfarin (Antidotes &
Labs) , Digoxin, Lithium.
○ Psychotropics: SSRIs (Serotonin Syndrome), Antipsychotics (Neuroleptic Malignant
Syndrome).
● 3. Maternal-Child Health
○ Obstetrics: Naegele’s Rule , Preeclampsia (Magnesium Sulfate toxicity) ,
Postpartum Hemorrhage, Fetal Monitoring (VEAL CHOP).
○ Pediatrics: Congenital Heart Defects (Tetralogy of Fallot) , Respiratory
Emergencies, Developmental Milestones, Pyloric Stenosis.
● 4. Management of Care
○ Delegation: RN vs. LPN vs. UAP scope of practice.
○ Prioritization: ABCs (Airway, Breathing, Circulation), Maslow’s Hierarchy, Stable vs.
Unstable, Acute vs. Chronic.
○ Legal/Ethical: Informed Consent, Advance Directives, HIPAA, Torts (Negligence vs.
Malpractice).
Comprehensive Glossary of High-Yield Terms
Understanding the specific lexicon used in HESI questions is critical for deciphering the "stem"
of the question.
Term Definition & Clinical Context Source
Abate To reduce in amount, degree,
or intensity. Ex: "The fever
abated after acetaminophen."
Anuria Non-passage of urine (<100
mL/24hr). Context: A critical
sign of renal failure or shock.
Bilateral Affecting both sides. Ex:
"Bilateral crackles" suggests
fluid overload/HF.
, Term Definition & Clinical Context Source
Contraindication A situation where a
drug/procedure should not be
used due to harm risk.
Dehiscence Separation of surgical incision
layers. Risk factors: Obesity,
diabetes, coughing.
Dilate To expand/widen. Context:
Pupils in dark; vessels in shock
(vasodilation).
Dyspnea Difficult or labored breathing.
Context: The subjective feeling
of air hunger.
Emaciated Abnormally thin/weak. Context:
Cancer cachexia, anorexia
nervosa.
Exacerbate To make a problem worse. Ex:
"Stress exacerbates
autoimmune flare-ups."
Flaccid Lacking firmness; limp.
Context: Flaccid paralysis in
spinal shock.
Insidious Gradual, subtle, but harmful.
Ex: "The insidious onset of
ovarian cancer."
Labile Easily altered/changed. Ex:
"Labile hypertension" or
emotional mood swings.
Occluded Obstructed or closed. Ex:
"Occluded coronary artery"
causes MI.
Ominous Suggesting a bad outcome. Ex:
"Ominous sign" like
fixed/dilated pupils.
Palliative Relieving pain without curing
the underlying cause.
Paroxysmal Sudden
recurrence/intensification. Ex:
Paroxysmal Nocturnal Dyspnea
(PND).
Patent Open/unobstructed. Ex:
"Maintain a patent airway."
Precipitous Rapid/sudden. Ex: "Precipitous
labor" (<3 hours).
Triage Sorting patients by urgency.
Tags: Red (Immediate), Yellow
(Delayed), Green (Minor), Black