HESI RN EXIT EXAM PRACTICE
QUESTIONS WITH CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
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1. A nurse is caring for a client who suddenly develops crushing substernal chest
pain radiating to the left arm. Which action should the nurse take first?
A. Assess the client's vital signs and pain characteristics.
B. Obtain a diet history.
C. Encourage the client to ambulate.
D. Offer oral fluids.
CORRECT ANSWER: A — Assess the client's vital signs and pain characteristics.
RATIONALE: The priority is to assess the client's status to determine the severity of the event
and guide immediate interventions for a suspected myocardial infarction.
2. A client with heart failure has gained 2.5 kg (5.5 lb) in 3 days. Which action
should the nurse take?
A. Notify the healthcare provider.
B. Encourage increased fluid intake.
C. Reassure the client that this is expected.
D. Encourage a high-sodium diet.
CORRECT ANSWER: A — Notify the healthcare provider.
RATIONALE: Rapid weight gain indicates fluid retention and worsening heart failure.
3. Which client should the nurse assess first?
A. A client with oxygen saturation of 84% and increasing confusion.
B. A client requesting pain medication for arthritis.
,C. A client asking for discharge instructions.
D. A client requesting assistance with hygiene.
CORRECT ANSWER: A — A client with oxygen saturation of 84% and increasing
confusion.
RATIONALE: Hypoxemia with altered mental status indicates impaired oxygenation and
requires immediate intervention.
4. A client receiving insulin becomes diaphoretic, shaky, and confused. What is
the nurse's priority action?
A. Check the client's blood glucose level.
B. Administer the scheduled insulin dose.
C. Encourage exercise.
D. Restrict oral intake.
CORRECT ANSWER: A — Check the client's blood glucose level.
RATIONALE: These findings suggest hypoglycemia and require immediate assessment.
5. A client is receiving a blood transfusion and reports chills and low back pain.
Which action should the nurse take first?
A. Stop the blood transfusion.
B. Slow the infusion rate.
C. Administer acetaminophen.
D. Continue the transfusion.
CORRECT ANSWER: A — Stop the blood transfusion.
RATIONALE: These findings suggest an acute hemolytic transfusion reaction.
6. Which laboratory value requires immediate intervention?
A. Potassium 6.7 mEq/L
B. Sodium 139 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 2.0 mg/dL
, CORRECT ANSWER: A — Potassium 6.7 mEq/L
RATIONALE: Severe hyperkalemia can rapidly cause fatal cardiac dysrhythmias.
7. A nurse is caring for a postoperative client who suddenly becomes restless and
anxious. Which assessment should the nurse perform first?
A. Measure oxygen saturation.
B. Assess bowel sounds.
C. Encourage ambulation.
D. Offer oral fluids.
CORRECT ANSWER: A — Measure oxygen saturation.
RATIONALE: Restlessness may be an early sign of hypoxemia.
8. A client taking warfarin has an INR of 5.6. Which action should the nurse
anticipate?
A. Hold the medication and notify the healthcare provider.
B. Increase the warfarin dose.
C. Administer aspirin.
D. Encourage foods low in vitamin K.
CORRECT ANSWER: A — Hold the medication and notify the healthcare provider.
RATIONALE: An elevated INR significantly increases the risk of bleeding.
9. Which assessment finding indicates digoxin toxicity?
A. Yellow-green halos around lights.
B. Increased appetite.
C. Frequent urination.
D. Excessive thirst.
CORRECT ANSWER: A — Yellow-green halos around lights.
RATIONALE: Visual disturbances are classic manifestations of digoxin toxicity.
QUESTIONS WITH CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
1. A nurse is caring for a client who suddenly develops crushing substernal chest
pain radiating to the left arm. Which action should the nurse take first?
A. Assess the client's vital signs and pain characteristics.
B. Obtain a diet history.
C. Encourage the client to ambulate.
D. Offer oral fluids.
CORRECT ANSWER: A — Assess the client's vital signs and pain characteristics.
RATIONALE: The priority is to assess the client's status to determine the severity of the event
and guide immediate interventions for a suspected myocardial infarction.
2. A client with heart failure has gained 2.5 kg (5.5 lb) in 3 days. Which action
should the nurse take?
A. Notify the healthcare provider.
B. Encourage increased fluid intake.
C. Reassure the client that this is expected.
D. Encourage a high-sodium diet.
CORRECT ANSWER: A — Notify the healthcare provider.
RATIONALE: Rapid weight gain indicates fluid retention and worsening heart failure.
3. Which client should the nurse assess first?
A. A client with oxygen saturation of 84% and increasing confusion.
B. A client requesting pain medication for arthritis.
,C. A client asking for discharge instructions.
D. A client requesting assistance with hygiene.
CORRECT ANSWER: A — A client with oxygen saturation of 84% and increasing
confusion.
RATIONALE: Hypoxemia with altered mental status indicates impaired oxygenation and
requires immediate intervention.
4. A client receiving insulin becomes diaphoretic, shaky, and confused. What is
the nurse's priority action?
A. Check the client's blood glucose level.
B. Administer the scheduled insulin dose.
C. Encourage exercise.
D. Restrict oral intake.
CORRECT ANSWER: A — Check the client's blood glucose level.
RATIONALE: These findings suggest hypoglycemia and require immediate assessment.
5. A client is receiving a blood transfusion and reports chills and low back pain.
Which action should the nurse take first?
A. Stop the blood transfusion.
B. Slow the infusion rate.
C. Administer acetaminophen.
D. Continue the transfusion.
CORRECT ANSWER: A — Stop the blood transfusion.
RATIONALE: These findings suggest an acute hemolytic transfusion reaction.
6. Which laboratory value requires immediate intervention?
A. Potassium 6.7 mEq/L
B. Sodium 139 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 2.0 mg/dL
, CORRECT ANSWER: A — Potassium 6.7 mEq/L
RATIONALE: Severe hyperkalemia can rapidly cause fatal cardiac dysrhythmias.
7. A nurse is caring for a postoperative client who suddenly becomes restless and
anxious. Which assessment should the nurse perform first?
A. Measure oxygen saturation.
B. Assess bowel sounds.
C. Encourage ambulation.
D. Offer oral fluids.
CORRECT ANSWER: A — Measure oxygen saturation.
RATIONALE: Restlessness may be an early sign of hypoxemia.
8. A client taking warfarin has an INR of 5.6. Which action should the nurse
anticipate?
A. Hold the medication and notify the healthcare provider.
B. Increase the warfarin dose.
C. Administer aspirin.
D. Encourage foods low in vitamin K.
CORRECT ANSWER: A — Hold the medication and notify the healthcare provider.
RATIONALE: An elevated INR significantly increases the risk of bleeding.
9. Which assessment finding indicates digoxin toxicity?
A. Yellow-green halos around lights.
B. Increased appetite.
C. Frequent urination.
D. Excessive thirst.
CORRECT ANSWER: A — Yellow-green halos around lights.
RATIONALE: Visual disturbances are classic manifestations of digoxin toxicity.
