RN HESI EXIT EXAM V1
Latest Update 2026
With Detailed Explanations
and Rationales Verified Latest
Edition | Best Clinical Study
Guide 2026/2027 Update
Detail Information
Title RN HESI EXIT EXAM V1
Update Latest 2026
Total Questions 160
Format Multiple Choice with Rationales
Feature Correct answers highlighted with
detailed explanations
Page 1
,1. Aclient with acute pancreatitis is admitted with severe, piercing
abdominal pain and an elevated serum amylase. Which additional
information is the client most likely to report to the nurse?
A. Abdominal pain decreases when lying supine.
B. Pain lasts an hour and leaves the abdomen tender.
C. Right upper quadrant pain refers to right scapula.
D. Drinks alcohol until intoxicated at least twice weekly.
Rationale: Alcohol abuse is one of the leading causes of acute pancreatitis,
along with gallstones. A history of heavy, recurrent alcohol consumption is
strongly associated with pancreatic inflammation and is the most likely
additional finding the client would report. Pancreatitis pain typically worsens
when lying supine and is relieved by sitting up and leaning forward, making
option A incorrect. Option B describes pain more consistent with peptic ulcer
disease. Option C describes pain referral typical of gallbladder pathology, not
pancreatitis.
2. Thenurse is completing the admission assessment of a 3-year-old
who is admitted with bacterial meningitis and hydrocephalus. Which
assessment finding is evidence that the child is experiencing
increased intracranial pressure (ICP)?
A. Tachycardia and tachypnea.
B. Sluggish and unequal pupillary responses.
C. Increased head circumference and bulging fontanels.
D. Blood pressure fluctuations and syncope.
Rationale: In a 3-year-old with hydrocephalus, increased head circumference
and bulging fontanels are classic signs of increased ICP. Although the
anterior fontanel typically closes by 18 months, children with hydrocephalus
may have delayed closure or reopened sutures. Tachycardia and tachypnea
are nonspecific findings. Sluggish and unequal pupillary responses are late
signs of increased ICP and indicate brainstem herniation. Blood pressure
fluctuations and syncope are not typical early indicators in pediatric patients
with hydrocephalus.
Page 2
,3. Achild newly diagnosed with sickle cell anemia (SCA) is being
discharged from the hospital. Which information is most important for
the nurse to provide the parents prior to discharge?
A. Instructions about how much fluid the child should drink daily.
B. Signs of addiction to opioid pain medications.
C. Information about non-pharmaceutical pain relief measures.
D. Referral for social services for the child and family.
Rationale: Adequate hydration is the single most important intervention to
prevent sickling crises in children with sickle cell anemia. Dehydration
increases blood viscosity and promotes sickling of red blood cells, which
can trigger vaso-occlusive crises. While pain management is important, the
priority at discharge is preventing crises through hydration. Concerns about
opioid addiction are less critical than preventing sickling episodes. Non-
pharmaceutical measures and social services are supportive but not the
highest priority.
4. To
auscultate for a carotid bruit, the nurse places the stethoscope at
what location?
A. Base of the neck on the right side.
B. Chest wall near the sternum.
C. Subclavian area below the clavicle.
D. Suprasternal notch at the top of the sternum.
Rationale: A carotid bruit is an abnormal sound caused by turbulent blood
flow through a narrowed carotid artery. To auscultate for a bruit, the nurse
places the bell of the stethoscope at the base of the neck on the right or left
side over the carotid artery. The chest wall, subclavian area, and
suprasternal notch are not appropriate locations for carotid
Page 3
, auscultation. The nurse should never press firmly on the carotid artery, as this
can stimulate the carotid sinus and cause bradycardia or syncope.
5. After
receiving report on an inpatient acute care unit, which client should
the nurse assess first?
A. The client with an obstruction of the large intestine who is
experiencing abdominal distention.
B. The client who had surgery yesterday and is experiencing a paralytic
ileus with absent bowel sounds.
C. The client with a small bowel obstruction who has a nasogastric tube
that is draining greenish fluid.
D. The client with a bowel obstruction due to a volvulus who is
experiencing abdominal rigidity.
Rationale: Abdominal rigidity in a client with a volvulus indicates peritonitis,
which is a surgical emergency requiring immediate intervention. Peritonitis
can rapidly progress to sepsis and shock. Abdominal distention with a large
bowel obstruction is concerning but less acute. A paralytic ileus with absent
bowel sounds is expected postoperatively and is being managed
conservatively. A small bowel obstruction with a functioning nasogastric tube
draining greenish fluid indicates the tube is working properly and the condition
is being managed.
6. Ateenager presents to the emergency department with palpitations
after vaping at a party. The client is anxious, fearful, and hyperventilating.
The nurse anticipates the client developing which acid-base imbalance?
A. Respiratory acidosis.
B. Metabolic alkalosis.
C. Metabolic acidosis.
D. Respiratory alkalosis.
Rationale: Hyperventilation causes excessive blowing off of carbon dioxide
(CO2), which leads to respiratory alkalosis. When a person breathes too
rapidly and deeply, the reduction in arterial CO2 (hypocapnia) shifts the acid-
base balance toward alkalosis. Respiratory acidosis would result from
Page 4
Latest Update 2026
With Detailed Explanations
and Rationales Verified Latest
Edition | Best Clinical Study
Guide 2026/2027 Update
Detail Information
Title RN HESI EXIT EXAM V1
Update Latest 2026
Total Questions 160
Format Multiple Choice with Rationales
Feature Correct answers highlighted with
detailed explanations
Page 1
,1. Aclient with acute pancreatitis is admitted with severe, piercing
abdominal pain and an elevated serum amylase. Which additional
information is the client most likely to report to the nurse?
A. Abdominal pain decreases when lying supine.
B. Pain lasts an hour and leaves the abdomen tender.
C. Right upper quadrant pain refers to right scapula.
D. Drinks alcohol until intoxicated at least twice weekly.
Rationale: Alcohol abuse is one of the leading causes of acute pancreatitis,
along with gallstones. A history of heavy, recurrent alcohol consumption is
strongly associated with pancreatic inflammation and is the most likely
additional finding the client would report. Pancreatitis pain typically worsens
when lying supine and is relieved by sitting up and leaning forward, making
option A incorrect. Option B describes pain more consistent with peptic ulcer
disease. Option C describes pain referral typical of gallbladder pathology, not
pancreatitis.
2. Thenurse is completing the admission assessment of a 3-year-old
who is admitted with bacterial meningitis and hydrocephalus. Which
assessment finding is evidence that the child is experiencing
increased intracranial pressure (ICP)?
A. Tachycardia and tachypnea.
B. Sluggish and unequal pupillary responses.
C. Increased head circumference and bulging fontanels.
D. Blood pressure fluctuations and syncope.
Rationale: In a 3-year-old with hydrocephalus, increased head circumference
and bulging fontanels are classic signs of increased ICP. Although the
anterior fontanel typically closes by 18 months, children with hydrocephalus
may have delayed closure or reopened sutures. Tachycardia and tachypnea
are nonspecific findings. Sluggish and unequal pupillary responses are late
signs of increased ICP and indicate brainstem herniation. Blood pressure
fluctuations and syncope are not typical early indicators in pediatric patients
with hydrocephalus.
Page 2
,3. Achild newly diagnosed with sickle cell anemia (SCA) is being
discharged from the hospital. Which information is most important for
the nurse to provide the parents prior to discharge?
A. Instructions about how much fluid the child should drink daily.
B. Signs of addiction to opioid pain medications.
C. Information about non-pharmaceutical pain relief measures.
D. Referral for social services for the child and family.
Rationale: Adequate hydration is the single most important intervention to
prevent sickling crises in children with sickle cell anemia. Dehydration
increases blood viscosity and promotes sickling of red blood cells, which
can trigger vaso-occlusive crises. While pain management is important, the
priority at discharge is preventing crises through hydration. Concerns about
opioid addiction are less critical than preventing sickling episodes. Non-
pharmaceutical measures and social services are supportive but not the
highest priority.
4. To
auscultate for a carotid bruit, the nurse places the stethoscope at
what location?
A. Base of the neck on the right side.
B. Chest wall near the sternum.
C. Subclavian area below the clavicle.
D. Suprasternal notch at the top of the sternum.
Rationale: A carotid bruit is an abnormal sound caused by turbulent blood
flow through a narrowed carotid artery. To auscultate for a bruit, the nurse
places the bell of the stethoscope at the base of the neck on the right or left
side over the carotid artery. The chest wall, subclavian area, and
suprasternal notch are not appropriate locations for carotid
Page 3
, auscultation. The nurse should never press firmly on the carotid artery, as this
can stimulate the carotid sinus and cause bradycardia or syncope.
5. After
receiving report on an inpatient acute care unit, which client should
the nurse assess first?
A. The client with an obstruction of the large intestine who is
experiencing abdominal distention.
B. The client who had surgery yesterday and is experiencing a paralytic
ileus with absent bowel sounds.
C. The client with a small bowel obstruction who has a nasogastric tube
that is draining greenish fluid.
D. The client with a bowel obstruction due to a volvulus who is
experiencing abdominal rigidity.
Rationale: Abdominal rigidity in a client with a volvulus indicates peritonitis,
which is a surgical emergency requiring immediate intervention. Peritonitis
can rapidly progress to sepsis and shock. Abdominal distention with a large
bowel obstruction is concerning but less acute. A paralytic ileus with absent
bowel sounds is expected postoperatively and is being managed
conservatively. A small bowel obstruction with a functioning nasogastric tube
draining greenish fluid indicates the tube is working properly and the condition
is being managed.
6. Ateenager presents to the emergency department with palpitations
after vaping at a party. The client is anxious, fearful, and hyperventilating.
The nurse anticipates the client developing which acid-base imbalance?
A. Respiratory acidosis.
B. Metabolic alkalosis.
C. Metabolic acidosis.
D. Respiratory alkalosis.
Rationale: Hyperventilation causes excessive blowing off of carbon dioxide
(CO2), which leads to respiratory alkalosis. When a person breathes too
rapidly and deeply, the reduction in arterial CO2 (hypocapnia) shifts the acid-
base balance toward alkalosis. Respiratory acidosis would result from
Page 4
