, TEST BANK REGARDING HESI RN EXIT EXAM CONTAINING ACCURATE&FACTUAL
QUESTIONS AND ANSWERS WHICH ARE ENHANCED WITH USEFUL RATIONALES|A
DIRECT TICKET TO YOUR DESIRED GRADE!!|A NEW VERSION OF 2026 <UPDATED AND
VERIFIED NOT LEAVING ALSO COMPLETE>
1. Priority & Clinical Judgment (Airway/Oxygenation)
A 68-year-old male with a long history of chronic obstructive pulmonary disease (COPD) is admitted to
the medical unit with complaints of worsening shortness of breath, fatigue, and productive cough over the
past three days. On assessment, the nurse notes that the client is using accessory muscles to breathe, is
slightly cyanotic around the lips, and appears restless and anxious. Vital signs include: BP 146/88 mmHg,
HR 112 bpm, RR 30/min, and SpO₂ 89% on 2 L/min nasal cannula. Which of the following nursing
actions is the priority intervention?
A. Increase oxygen flow rate to 6 L/min via nasal cannula to rapidly improve oxygen saturation
B. Assist the client into a high Fowler’s position and encourage pursed-lip breathing techniques
C. Administer a prescribed PRN sedative to reduce anxiety and decrease oxygen demand
D. Obtain a sputum sample for culture and sensitivity testing to identify infection
Correct Answer: B
Rationale: Positioning and breathing techniques improve ventilation without suppressing
respiratory drive. High oxygen (A) may reduce hypoxic drive in COPD. Sedatives (C) can worsen
respiratory depression. Sputum collection (D) is important but not immediate.
2. Acid-Base Interpretation (Advanced)
A critically ill patient in the ICU has the following arterial blood gas (ABG) results: pH 7.25, PaCO₂ 55
mmHg, HCO₃⁻ 24 mEq/L. The patient is lethargic with shallow respirations following opioid
administration for pain management. Which interpretation and intervention are most appropriate?
A. The patient is experiencing metabolic acidosis; administer sodium bicarbonate as prescribed
B. The patient is experiencing respiratory acidosis; prepare to support ventilation and consider
naloxone
C. The patient is experiencing metabolic alkalosis; administer IV fluids to correct imbalance
D. The patient is experiencing respiratory alkalosis; encourage deep breathing exercises
Correct Answer: B
Rationale: Low pH + high CO₂ = respiratory acidosis, likely from opioid-induced hypoventilation.
Naloxone may reverse respiratory depression.
3. Pharmacology – High-Risk Medication (Digoxin)
A 75-year-old female with heart failure is prescribed digoxin 0.125 mg daily. During the morning
assessment, the nurse notes the client complains of nausea, decreased appetite, and “seeing yellow halos
around lights.” Her apical pulse is 52 bpm. What is the most appropriate nursing action?
,A. Administer the medication as prescribed since symptoms are common side effects
B. Hold the dose of digoxin and notify the healthcare provider immediately
C. Administer an antiemetic and reassess the patient after one hour
D. Encourage oral intake and administer the medication with food
Correct Answer: B
Rationale: Bradycardia + visual changes = digoxin toxicity. Medication must be held.
4. Delegation & Scope of Practice
The RN is managing care for four patients on a busy medical-surgical unit. Which task is most
appropriate to delegate to an experienced unlicensed assistive personnel (UAP)?
A. Assessing a postoperative patient for early signs of hemorrhage and shock
B. Reinforcing discharge teaching for a patient newly diagnosed with diabetes mellitus
C. Assisting a stable patient with ambulation and recording intake and output
D. Evaluating the effectiveness of pain medication in a patient receiving opioids
Correct Answer: C
Rationale: UAPs can assist with basic care tasks. Assessment, teaching, and evaluation remain RN
responsibilities.
5. Infection Control & Isolation
A patient is admitted with suspected pulmonary tuberculosis (TB). The nurse must implement appropriate
infection control precautions while awaiting confirmation of diagnosis. Which intervention is most
appropriate?
A. Place the patient in a private room and require all visitors to wear surgical masks
B. Place the patient in a negative-pressure room and require staff to wear N95 respirators
C. Implement contact precautions and ensure the use of gowns and gloves for all interactions
D. Allow the patient to remain in a semi-private room if a curtain divider is used
Correct Answer: B
Rationale: TB requires airborne precautions, including negative pressure room and N95 masks.
6. Cardiac Emergency (MI Management)
A 59-year-old male presents to the emergency department with severe chest pain radiating to his left arm
and jaw. He appears diaphoretic and anxious. Vital signs are BP 150/92 mmHg, HR 110 bpm, RR 24/min.
Which action should the nurse take first?
A. Administer sublingual nitroglycerin as prescribed to relieve chest pain
B. Obtain a 12-lead ECG to confirm myocardial infarction
C. Apply oxygen via nasal cannula to improve myocardial oxygenation
D. Administer morphine sulfate to decrease pain and anxiety
, Correct Answer: C
Rationale: Oxygen improves tissue perfusion immediately. Other actions follow quickly but
airway/oxygenation is priority.
7. Pediatric – Fluid & Electrolyte Imbalance
A 2-year-old child is brought to the emergency department with a history of vomiting and diarrhea for 48
hours. Assessment findings include dry mucous membranes, sunken eyes, decreased urine output, and
lethargy. Which finding indicates severe dehydration requiring immediate intervention?
A. Slight irritability and thirst
B. Capillary refill time of 2 seconds
C. Sunken fontanelle and weak peripheral pulses
D. Mild decrease in urine output
Correct Answer: C
Rationale: Indicates severe dehydration and possible shock.
8. Obstetrics – Preeclampsia Complications
A pregnant client at 34 weeks gestation presents with elevated blood pressure (150/96 mmHg), +2
proteinuria, and complaints of severe headache and blurred vision. Which assessment finding is most
concerning and requires immediate action?
A. Mild swelling of the ankles and feet
B. Blood pressure reading of 150/96 mmHg
C. Complaint of persistent headache and visual disturbances
D. Presence of protein in the urine
Correct Answer: C
Rationale: Indicates risk of eclampsia (seizures).
9. Neurological Emergency – Stroke
A patient arrives at the emergency department with sudden onset right-sided weakness, slurred speech,
and facial drooping. The nurse suspects an acute ischemic stroke. What is the priority nursing
intervention?
A. Administer aspirin immediately to prevent clot progression
B. Maintain airway patency and ensure adequate oxygenation
C. Obtain a complete health history from the patient’s family
D. Prepare the patient for immediate physical therapy
Correct Answer: B
Rationale: Airway and oxygenation always come first before diagnostics or medications.
10. Renal/Electrolyte Emergency
QUESTIONS AND ANSWERS WHICH ARE ENHANCED WITH USEFUL RATIONALES|A
DIRECT TICKET TO YOUR DESIRED GRADE!!|A NEW VERSION OF 2026 <UPDATED AND
VERIFIED NOT LEAVING ALSO COMPLETE>
1. Priority & Clinical Judgment (Airway/Oxygenation)
A 68-year-old male with a long history of chronic obstructive pulmonary disease (COPD) is admitted to
the medical unit with complaints of worsening shortness of breath, fatigue, and productive cough over the
past three days. On assessment, the nurse notes that the client is using accessory muscles to breathe, is
slightly cyanotic around the lips, and appears restless and anxious. Vital signs include: BP 146/88 mmHg,
HR 112 bpm, RR 30/min, and SpO₂ 89% on 2 L/min nasal cannula. Which of the following nursing
actions is the priority intervention?
A. Increase oxygen flow rate to 6 L/min via nasal cannula to rapidly improve oxygen saturation
B. Assist the client into a high Fowler’s position and encourage pursed-lip breathing techniques
C. Administer a prescribed PRN sedative to reduce anxiety and decrease oxygen demand
D. Obtain a sputum sample for culture and sensitivity testing to identify infection
Correct Answer: B
Rationale: Positioning and breathing techniques improve ventilation without suppressing
respiratory drive. High oxygen (A) may reduce hypoxic drive in COPD. Sedatives (C) can worsen
respiratory depression. Sputum collection (D) is important but not immediate.
2. Acid-Base Interpretation (Advanced)
A critically ill patient in the ICU has the following arterial blood gas (ABG) results: pH 7.25, PaCO₂ 55
mmHg, HCO₃⁻ 24 mEq/L. The patient is lethargic with shallow respirations following opioid
administration for pain management. Which interpretation and intervention are most appropriate?
A. The patient is experiencing metabolic acidosis; administer sodium bicarbonate as prescribed
B. The patient is experiencing respiratory acidosis; prepare to support ventilation and consider
naloxone
C. The patient is experiencing metabolic alkalosis; administer IV fluids to correct imbalance
D. The patient is experiencing respiratory alkalosis; encourage deep breathing exercises
Correct Answer: B
Rationale: Low pH + high CO₂ = respiratory acidosis, likely from opioid-induced hypoventilation.
Naloxone may reverse respiratory depression.
3. Pharmacology – High-Risk Medication (Digoxin)
A 75-year-old female with heart failure is prescribed digoxin 0.125 mg daily. During the morning
assessment, the nurse notes the client complains of nausea, decreased appetite, and “seeing yellow halos
around lights.” Her apical pulse is 52 bpm. What is the most appropriate nursing action?
,A. Administer the medication as prescribed since symptoms are common side effects
B. Hold the dose of digoxin and notify the healthcare provider immediately
C. Administer an antiemetic and reassess the patient after one hour
D. Encourage oral intake and administer the medication with food
Correct Answer: B
Rationale: Bradycardia + visual changes = digoxin toxicity. Medication must be held.
4. Delegation & Scope of Practice
The RN is managing care for four patients on a busy medical-surgical unit. Which task is most
appropriate to delegate to an experienced unlicensed assistive personnel (UAP)?
A. Assessing a postoperative patient for early signs of hemorrhage and shock
B. Reinforcing discharge teaching for a patient newly diagnosed with diabetes mellitus
C. Assisting a stable patient with ambulation and recording intake and output
D. Evaluating the effectiveness of pain medication in a patient receiving opioids
Correct Answer: C
Rationale: UAPs can assist with basic care tasks. Assessment, teaching, and evaluation remain RN
responsibilities.
5. Infection Control & Isolation
A patient is admitted with suspected pulmonary tuberculosis (TB). The nurse must implement appropriate
infection control precautions while awaiting confirmation of diagnosis. Which intervention is most
appropriate?
A. Place the patient in a private room and require all visitors to wear surgical masks
B. Place the patient in a negative-pressure room and require staff to wear N95 respirators
C. Implement contact precautions and ensure the use of gowns and gloves for all interactions
D. Allow the patient to remain in a semi-private room if a curtain divider is used
Correct Answer: B
Rationale: TB requires airborne precautions, including negative pressure room and N95 masks.
6. Cardiac Emergency (MI Management)
A 59-year-old male presents to the emergency department with severe chest pain radiating to his left arm
and jaw. He appears diaphoretic and anxious. Vital signs are BP 150/92 mmHg, HR 110 bpm, RR 24/min.
Which action should the nurse take first?
A. Administer sublingual nitroglycerin as prescribed to relieve chest pain
B. Obtain a 12-lead ECG to confirm myocardial infarction
C. Apply oxygen via nasal cannula to improve myocardial oxygenation
D. Administer morphine sulfate to decrease pain and anxiety
, Correct Answer: C
Rationale: Oxygen improves tissue perfusion immediately. Other actions follow quickly but
airway/oxygenation is priority.
7. Pediatric – Fluid & Electrolyte Imbalance
A 2-year-old child is brought to the emergency department with a history of vomiting and diarrhea for 48
hours. Assessment findings include dry mucous membranes, sunken eyes, decreased urine output, and
lethargy. Which finding indicates severe dehydration requiring immediate intervention?
A. Slight irritability and thirst
B. Capillary refill time of 2 seconds
C. Sunken fontanelle and weak peripheral pulses
D. Mild decrease in urine output
Correct Answer: C
Rationale: Indicates severe dehydration and possible shock.
8. Obstetrics – Preeclampsia Complications
A pregnant client at 34 weeks gestation presents with elevated blood pressure (150/96 mmHg), +2
proteinuria, and complaints of severe headache and blurred vision. Which assessment finding is most
concerning and requires immediate action?
A. Mild swelling of the ankles and feet
B. Blood pressure reading of 150/96 mmHg
C. Complaint of persistent headache and visual disturbances
D. Presence of protein in the urine
Correct Answer: C
Rationale: Indicates risk of eclampsia (seizures).
9. Neurological Emergency – Stroke
A patient arrives at the emergency department with sudden onset right-sided weakness, slurred speech,
and facial drooping. The nurse suspects an acute ischemic stroke. What is the priority nursing
intervention?
A. Administer aspirin immediately to prevent clot progression
B. Maintain airway patency and ensure adequate oxygenation
C. Obtain a complete health history from the patient’s family
D. Prepare the patient for immediate physical therapy
Correct Answer: B
Rationale: Airway and oxygenation always come first before diagnostics or medications.
10. Renal/Electrolyte Emergency
