HESI RN EXIT EXAM / NGN HESI RN ACTUAL EXIT EXAM 2026/2027
COMPLETE ACCURATE EXAM APPROVED QUESTIONS AND CORRECT
VERIFIED ANSWERS WITH DETAILED RATIONALES (A NEW UPDATED
VERSION 2026 EDITION |GUARANTEED PASS A+ (BRAND NEW!) FULL
REVISED RN HESI EXIT EXAM
1. A client with heart failure is prescribed furosemide. Which assessment finding
indicates the medication is effective?
A. Decreased peripheral edema
B. Increased blood pressure
C. Jugular vein distention
D. Crackles in lung bases
Correct Answer: A
Rationale: Furosemide is a loop diuretic used to reduce fluid volume overload in
heart failure. A decrease in peripheral edema, dyspnea, and crackles indicates
effective diuresis. Increased blood pressure, jugular vein distention, and crackles
indicate worsening fluid overload.
2. A nurse is caring for a client with a chest tube. Which finding requires
immediate intervention?
A. Continuous bubbling in the suction control chamber
B. Intermittent bubbling in the water seal chamber
C. Tidaling in the water seal chamber
D. Sudden cessation of bubbling in the water seal chamber
Correct Answer: D
Rationale: Sudden cessation of bubbling in the water seal chamber indicates a
possible obstruction or disconnection of the chest tube system, leading to a
tension pneumothorax. Continuous bubbling in the suction control chamber is
expected. Intermittent bubbling in the water seal chamber indicates an air leak.
Tidaling is a normal finding indicating respiratory fluctuation.
,3. A client with diabetes mellitus is prescribed regular insulin. When is the peak
action time for this insulin?
A. 1-2 hours
B. 2-4 hours
C. 4-8 hours
D. 10-16 hours
Correct Answer: B
Rationale: Regular insulin has an onset of 30-60 minutes, a peak of 2-4 hours,
and a duration of 5-8 hours. The peak time is the period when the risk of
hypoglycemia is highest. Rapid-acting insulin peaks in 1-2 hours, NPH in 4-8
hours, and long-acting has no distinct peak.
4. A client is receiving a blood transfusion and develops chills, fever, and low back
pain. What is the nurse's priority action?
A. Slow the transfusion rate
B. Stop the transfusion
C. Administer an antihistamine
D. Notify the healthcare provider
Correct Answer: B
Rationale: The client is exhibiting signs of an acute hemolytic transfusion
reaction. The priority action is to stop the transfusion immediately to prevent
further complications. After stopping the transfusion, the nurse should maintain
IV access with normal saline, notify the healthcare provider, and send the blood
bag and tubing to the lab.
5. A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 88%. The nurse should administer oxygen at which flow rate?
A. 1-2 L/min via nasal cannula
,B. 4-6 L/min via nasal cannula
C. 8-10 L/min via face mask
D. 10-15 L/min via non-rebreather mask
Correct Answer: A
Rationale: Clients with COPD are often chronic carbon dioxide retainers and
rely on a hypoxic drive to breathe. High-flow oxygen can eliminate this drive
and cause respiratory depression. Oxygen should be administered at a low
flow rate of 1-2 L/min via nasal cannula to maintain a target SpO2 of 88-92%.
6. A client is scheduled for a colonoscopy. Which instruction should the nurse
provide regarding the preparation?
A. Eat a light breakfast the morning of the procedure
B. Drink clear liquids only the day before the procedure
C. Take all oral medications as usual the morning of the procedure
D. Administer a tap water enema the night before the procedure
Correct Answer: B
Rationale: For a colonoscopy, the colon must be completely clear. The client
should consume only clear liquids the day before the procedure. NPO status is
typically required 6-8 hours before the procedure. A specific bowel prep (e.g.,
polyethylene glycol) is prescribed, not just a tap water enema.
7. A client is experiencing status epilepticus. Which medication should the nurse
anticipate administering first?
A. Lorazepam
B. Phenytoin
C. Valproic acid
D. Carbamazepine
Correct Answer: A
, Rationale: Status epilepticus is a medical emergency characterized by
continuous seizure activity. The first-line treatment is a benzodiazepine, such as
lorazepam or diazepam, to rapidly stop seizure activity. Phenytoin, valproic acid,
and carbamazepine are used for long-term seizure control.
8. A nurse is assessing a client who is 24 hours post-operative from a total hip
arthroplasty. Which finding requires immediate action?
A. Pain rating of 4 on a scale of 0-10
B. Slight redness at the incision site
C. The client's operative leg is shorter than the other leg
D. The client is unable to flex the foot on the operative side
Correct Answer: D
Rationale: Inability to dorsiflex the foot or move the toes on the operative side
indicates possible nerve damage or impaired circulation, which is a critical
finding requiring immediate notification of the healthcare provider. Pain, slight
redness, and leg length discrepancy are expected or less emergent findings post-
operatively.
9. A client with cirrhosis is exhibiting signs of hepatic encephalopathy. Which
dietary modification is most important?
A. Low-sodium diet
B. High-protein diet
C. Low-protein diet
D. High-carbohydrate diet
Correct Answer: C
Rationale: Hepatic encephalopathy is caused by the accumulation of ammonia
in the blood due to the liver's inability to convert it to urea. Protein breakdown
produces ammonia; therefore, a low-protein diet is implemented to reduce
ammonia levels. Lactulose is also administered to promote ammonia excretion.
COMPLETE ACCURATE EXAM APPROVED QUESTIONS AND CORRECT
VERIFIED ANSWERS WITH DETAILED RATIONALES (A NEW UPDATED
VERSION 2026 EDITION |GUARANTEED PASS A+ (BRAND NEW!) FULL
REVISED RN HESI EXIT EXAM
1. A client with heart failure is prescribed furosemide. Which assessment finding
indicates the medication is effective?
A. Decreased peripheral edema
B. Increased blood pressure
C. Jugular vein distention
D. Crackles in lung bases
Correct Answer: A
Rationale: Furosemide is a loop diuretic used to reduce fluid volume overload in
heart failure. A decrease in peripheral edema, dyspnea, and crackles indicates
effective diuresis. Increased blood pressure, jugular vein distention, and crackles
indicate worsening fluid overload.
2. A nurse is caring for a client with a chest tube. Which finding requires
immediate intervention?
A. Continuous bubbling in the suction control chamber
B. Intermittent bubbling in the water seal chamber
C. Tidaling in the water seal chamber
D. Sudden cessation of bubbling in the water seal chamber
Correct Answer: D
Rationale: Sudden cessation of bubbling in the water seal chamber indicates a
possible obstruction or disconnection of the chest tube system, leading to a
tension pneumothorax. Continuous bubbling in the suction control chamber is
expected. Intermittent bubbling in the water seal chamber indicates an air leak.
Tidaling is a normal finding indicating respiratory fluctuation.
,3. A client with diabetes mellitus is prescribed regular insulin. When is the peak
action time for this insulin?
A. 1-2 hours
B. 2-4 hours
C. 4-8 hours
D. 10-16 hours
Correct Answer: B
Rationale: Regular insulin has an onset of 30-60 minutes, a peak of 2-4 hours,
and a duration of 5-8 hours. The peak time is the period when the risk of
hypoglycemia is highest. Rapid-acting insulin peaks in 1-2 hours, NPH in 4-8
hours, and long-acting has no distinct peak.
4. A client is receiving a blood transfusion and develops chills, fever, and low back
pain. What is the nurse's priority action?
A. Slow the transfusion rate
B. Stop the transfusion
C. Administer an antihistamine
D. Notify the healthcare provider
Correct Answer: B
Rationale: The client is exhibiting signs of an acute hemolytic transfusion
reaction. The priority action is to stop the transfusion immediately to prevent
further complications. After stopping the transfusion, the nurse should maintain
IV access with normal saline, notify the healthcare provider, and send the blood
bag and tubing to the lab.
5. A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 88%. The nurse should administer oxygen at which flow rate?
A. 1-2 L/min via nasal cannula
,B. 4-6 L/min via nasal cannula
C. 8-10 L/min via face mask
D. 10-15 L/min via non-rebreather mask
Correct Answer: A
Rationale: Clients with COPD are often chronic carbon dioxide retainers and
rely on a hypoxic drive to breathe. High-flow oxygen can eliminate this drive
and cause respiratory depression. Oxygen should be administered at a low
flow rate of 1-2 L/min via nasal cannula to maintain a target SpO2 of 88-92%.
6. A client is scheduled for a colonoscopy. Which instruction should the nurse
provide regarding the preparation?
A. Eat a light breakfast the morning of the procedure
B. Drink clear liquids only the day before the procedure
C. Take all oral medications as usual the morning of the procedure
D. Administer a tap water enema the night before the procedure
Correct Answer: B
Rationale: For a colonoscopy, the colon must be completely clear. The client
should consume only clear liquids the day before the procedure. NPO status is
typically required 6-8 hours before the procedure. A specific bowel prep (e.g.,
polyethylene glycol) is prescribed, not just a tap water enema.
7. A client is experiencing status epilepticus. Which medication should the nurse
anticipate administering first?
A. Lorazepam
B. Phenytoin
C. Valproic acid
D. Carbamazepine
Correct Answer: A
, Rationale: Status epilepticus is a medical emergency characterized by
continuous seizure activity. The first-line treatment is a benzodiazepine, such as
lorazepam or diazepam, to rapidly stop seizure activity. Phenytoin, valproic acid,
and carbamazepine are used for long-term seizure control.
8. A nurse is assessing a client who is 24 hours post-operative from a total hip
arthroplasty. Which finding requires immediate action?
A. Pain rating of 4 on a scale of 0-10
B. Slight redness at the incision site
C. The client's operative leg is shorter than the other leg
D. The client is unable to flex the foot on the operative side
Correct Answer: D
Rationale: Inability to dorsiflex the foot or move the toes on the operative side
indicates possible nerve damage or impaired circulation, which is a critical
finding requiring immediate notification of the healthcare provider. Pain, slight
redness, and leg length discrepancy are expected or less emergent findings post-
operatively.
9. A client with cirrhosis is exhibiting signs of hepatic encephalopathy. Which
dietary modification is most important?
A. Low-sodium diet
B. High-protein diet
C. Low-protein diet
D. High-carbohydrate diet
Correct Answer: C
Rationale: Hepatic encephalopathy is caused by the accumulation of ammonia
in the blood due to the liver's inability to convert it to urea. Protein breakdown
produces ammonia; therefore, a low-protein diet is implemented to reduce
ammonia levels. Lactulose is also administered to promote ammonia excretion.
