HESI EXIT V3 EXAM 2026–2027 | (150
QUESTIONS AND CORRECT ANSWERS) |
ALREADY GRADED A+ | 100% VERIFIED
Nursing, NCLEX NGN | Key Domains: Medical-Surgical Nursing, Maternity, Pediatrics, Mental Health,
Pharmacology, Nursing Fundamentals, Leadership & Management, Clinical Judgment, and Patient Safety |
Expert-Aligned Structure | Exam-Ready Format
Introduction
This structured HESI Exit V3 practice exam for 2026–2027 provides an original set of exam-style
questions with correct answers and concise rationales. It emphasizes clinical judgment, patient safety,
NCLEX NGN competencies, and evidence-based nursing principles critical to professional nursing practice
and successful licensure preparation.
Answer Format
All correct answers appear in bold cyan, followed by concise rationales that highlight safety, clinical
reasoning, and why alternative options are less appropriate.
File Format Requirement
This final document has been generated strictly as a .docx (Microsoft Word) file.
Medical-Surgical Nursing
1. Which finding should the nurse identify as an early sign of fluid volume overload in a client with
heart failure?
A. A weight gain of 2 kg in 48 hours
B. Dry mucous membranes
C. Sinus bradycardia at 54/min
D. Urine specific gravity of 1.030
Correct Answer: A. A weight gain of 2 kg in 48 hours
Rationale: Rapid weight gain is a sensitive indicator of fluid retention in heart failure and often
appears before severe respiratory distress.
2. A client with COPD is receiving low-flow oxygen. Which oxygen saturation target is generally
appropriate unless otherwise prescribed?
A. 88% to 92%
B. 96% to 100%
, C. 80% to 84%
D. 100% with a nonrebreather mask
Correct Answer: A. 88% to 92%
Rationale: Many clients with COPD are titrated to an SpO2 of about 88% to 92% to improve
oxygenation while reducing risk of worsening CO2 retention.
3. A client arrives with diabetic ketoacidosis. Which prescription should the nurse implement
first?
A. Start 0.9% normal saline
B. Administer IV regular insulin
C. Give potassium chloride
D. Provide dextrose 50% IV push
Correct Answer: A. Start 0.9% normal saline
Rationale: Initial management of DKA begins with isotonic fluid replacement to restore circulating
volume before other therapies are adjusted.
4. Which ECG change is most consistent with hyperkalemia?
A. Peaked T waves
B. U waves
C. ST-segment depression only
D. Prolonged PR interval with narrow T waves
Correct Answer: A. Peaked T waves
Rationale: Peaked T waves are a classic early ECG sign of hyperkalemia and may precede more
dangerous rhythm changes.
5. A client with chest pain and suspected myocardial infarction has no aspirin allergy. Which
action is a priority?
A. Administer chewable aspirin as prescribed
B. Encourage the client to ambulate
C. Place the client flat in bed
D. Offer a full meal
Correct Answer: A. Administer chewable aspirin as prescribed
, Rationale: Early aspirin reduces platelet aggregation and is a priority intervention in suspected acute
coronary syndrome when not contraindicated.
6. After a thyroidectomy, which assessment finding requires immediate intervention?
A. Stridor
B. Mild incisional pain
C. Hoarse voice for a few hours
D. Small amount of serosanguineous drainage
Correct Answer: A. Stridor
Rationale: Stridor suggests airway obstruction from edema or bleeding and requires immediate
action to protect ventilation.
7. Which laboratory finding is expected in a client with syndrome of inappropriate antidiuretic
hormone secretion (SIADH)?
A. Low serum osmolality
B. High serum sodium
C. Elevated hematocrit
D. Low urine specific gravity
Correct Answer: A. Low serum osmolality
Rationale: SIADH causes water retention that dilutes serum sodium and lowers serum osmolality
while urine remains concentrated.
8. A client with an acute stroke coughs when sipping water. Which nursing action is most
appropriate?
A. Keep the client NPO until a swallow screen is completed
B. Encourage fluids through a straw
C. Administer thickened water immediately without assessment
D. Document the finding as expected after stroke
Correct Answer: A. Keep the client NPO until a swallow screen is completed
Rationale: Coughing with swallowing suggests dysphagia and aspiration risk, so oral intake should be
held until swallowing is evaluated.
9. A client receiving gentamicin has a rising creatinine level and reduced urine output. What is the
nurse's best action?
A. Notify the provider about possible nephrotoxicity
, B. Give the next dose early
C. Increase the infusion rate
D. Encourage a high-protein meal only
Correct Answer: A. Notify the provider about possible nephrotoxicity
Rationale: Gentamicin can cause nephrotoxicity, and worsening renal function should be reported
promptly before additional doses are given.
10. A client with cirrhosis is receiving lactulose for hepatic encephalopathy. Which outcome
indicates the medication is effective?
A. The client has 2 to 3 soft stools per day
B. The client's urine output decreases
C. The client reports severe constipation
D. The client's blood pressure rises
Correct Answer: A. The client has 2 to 3 soft stools per day
Rationale: Lactulose works by lowering ammonia through bowel elimination, and the usual goal is
several soft stools daily.
11. Which position often helps relieve pain in a client with acute pancreatitis?
A. Sitting up and leaning forward
B. Supine with legs flat
C. Trendelenburg position
D. Prone with head turned to one side
Correct Answer: A. Sitting up and leaning forward
Rationale: Leaning forward can decrease abdominal pressure and commonly provides pain relief in
pancreatitis.
12. Which medication should the nurse anticipate giving for heparin overdose?
A. Protamine sulfate
B. Vitamin K
C. Naloxone
D. Acetylcysteine
Correct Answer: A. Protamine sulfate
QUESTIONS AND CORRECT ANSWERS) |
ALREADY GRADED A+ | 100% VERIFIED
Nursing, NCLEX NGN | Key Domains: Medical-Surgical Nursing, Maternity, Pediatrics, Mental Health,
Pharmacology, Nursing Fundamentals, Leadership & Management, Clinical Judgment, and Patient Safety |
Expert-Aligned Structure | Exam-Ready Format
Introduction
This structured HESI Exit V3 practice exam for 2026–2027 provides an original set of exam-style
questions with correct answers and concise rationales. It emphasizes clinical judgment, patient safety,
NCLEX NGN competencies, and evidence-based nursing principles critical to professional nursing practice
and successful licensure preparation.
Answer Format
All correct answers appear in bold cyan, followed by concise rationales that highlight safety, clinical
reasoning, and why alternative options are less appropriate.
File Format Requirement
This final document has been generated strictly as a .docx (Microsoft Word) file.
Medical-Surgical Nursing
1. Which finding should the nurse identify as an early sign of fluid volume overload in a client with
heart failure?
A. A weight gain of 2 kg in 48 hours
B. Dry mucous membranes
C. Sinus bradycardia at 54/min
D. Urine specific gravity of 1.030
Correct Answer: A. A weight gain of 2 kg in 48 hours
Rationale: Rapid weight gain is a sensitive indicator of fluid retention in heart failure and often
appears before severe respiratory distress.
2. A client with COPD is receiving low-flow oxygen. Which oxygen saturation target is generally
appropriate unless otherwise prescribed?
A. 88% to 92%
B. 96% to 100%
, C. 80% to 84%
D. 100% with a nonrebreather mask
Correct Answer: A. 88% to 92%
Rationale: Many clients with COPD are titrated to an SpO2 of about 88% to 92% to improve
oxygenation while reducing risk of worsening CO2 retention.
3. A client arrives with diabetic ketoacidosis. Which prescription should the nurse implement
first?
A. Start 0.9% normal saline
B. Administer IV regular insulin
C. Give potassium chloride
D. Provide dextrose 50% IV push
Correct Answer: A. Start 0.9% normal saline
Rationale: Initial management of DKA begins with isotonic fluid replacement to restore circulating
volume before other therapies are adjusted.
4. Which ECG change is most consistent with hyperkalemia?
A. Peaked T waves
B. U waves
C. ST-segment depression only
D. Prolonged PR interval with narrow T waves
Correct Answer: A. Peaked T waves
Rationale: Peaked T waves are a classic early ECG sign of hyperkalemia and may precede more
dangerous rhythm changes.
5. A client with chest pain and suspected myocardial infarction has no aspirin allergy. Which
action is a priority?
A. Administer chewable aspirin as prescribed
B. Encourage the client to ambulate
C. Place the client flat in bed
D. Offer a full meal
Correct Answer: A. Administer chewable aspirin as prescribed
, Rationale: Early aspirin reduces platelet aggregation and is a priority intervention in suspected acute
coronary syndrome when not contraindicated.
6. After a thyroidectomy, which assessment finding requires immediate intervention?
A. Stridor
B. Mild incisional pain
C. Hoarse voice for a few hours
D. Small amount of serosanguineous drainage
Correct Answer: A. Stridor
Rationale: Stridor suggests airway obstruction from edema or bleeding and requires immediate
action to protect ventilation.
7. Which laboratory finding is expected in a client with syndrome of inappropriate antidiuretic
hormone secretion (SIADH)?
A. Low serum osmolality
B. High serum sodium
C. Elevated hematocrit
D. Low urine specific gravity
Correct Answer: A. Low serum osmolality
Rationale: SIADH causes water retention that dilutes serum sodium and lowers serum osmolality
while urine remains concentrated.
8. A client with an acute stroke coughs when sipping water. Which nursing action is most
appropriate?
A. Keep the client NPO until a swallow screen is completed
B. Encourage fluids through a straw
C. Administer thickened water immediately without assessment
D. Document the finding as expected after stroke
Correct Answer: A. Keep the client NPO until a swallow screen is completed
Rationale: Coughing with swallowing suggests dysphagia and aspiration risk, so oral intake should be
held until swallowing is evaluated.
9. A client receiving gentamicin has a rising creatinine level and reduced urine output. What is the
nurse's best action?
A. Notify the provider about possible nephrotoxicity
, B. Give the next dose early
C. Increase the infusion rate
D. Encourage a high-protein meal only
Correct Answer: A. Notify the provider about possible nephrotoxicity
Rationale: Gentamicin can cause nephrotoxicity, and worsening renal function should be reported
promptly before additional doses are given.
10. A client with cirrhosis is receiving lactulose for hepatic encephalopathy. Which outcome
indicates the medication is effective?
A. The client has 2 to 3 soft stools per day
B. The client's urine output decreases
C. The client reports severe constipation
D. The client's blood pressure rises
Correct Answer: A. The client has 2 to 3 soft stools per day
Rationale: Lactulose works by lowering ammonia through bowel elimination, and the usual goal is
several soft stools daily.
11. Which position often helps relieve pain in a client with acute pancreatitis?
A. Sitting up and leaning forward
B. Supine with legs flat
C. Trendelenburg position
D. Prone with head turned to one side
Correct Answer: A. Sitting up and leaning forward
Rationale: Leaning forward can decrease abdominal pressure and commonly provides pain relief in
pancreatitis.
12. Which medication should the nurse anticipate giving for heparin overdose?
A. Protamine sulfate
B. Vitamin K
C. Naloxone
D. Acetylcysteine
Correct Answer: A. Protamine sulfate
