RN HESI Exit Exam
Comprehensive Practice Question Bank
84 NCLEX-style practice questions covering the major HESI Exit Exam content areas:
• Medical-Surgical Nursing (12 questions)
• Pharmacology (12 questions)
• Maternal-Newborn Nursing (12 questions)
• Pediatric Nursing (12 questions)
• Mental Health Nursing (12 questions)
• Leadership & Prioritization (12 questions)
• Fundamentals & Safety (12 questions)
How to use this guide:
1. Answer each question in Part 1 before checking the Answer Key.
2. Part 2 contains the full answer key with detailed rationales explaining why the correct answer is right and why
the other options are incorrect.
3. Pay close attention to questions you miss — review the underlying concept, not just the correct letter.
4. Use these questions to identify content areas that need further review before your exam.
Note: This is a study/practice resource created to support exam preparation. It is not an official HESI product.
, PART 1: PRACTICE QUESTIONS
Medical-Surgical Nursing
1. A client with heart failure is prescribed furosemide (Lasix). Which assessment finding requires
the nurse to notify the health care provider immediately?
A. Serum potassium of 3.0 mEq/L
B. Blood pressure of 128/78 mmHg
C. Weight loss of 1 lb in 24 hours
D. Urine output of 40 mL/hour
2. The nurse is caring for a client immediately after a thyroidectomy. Which finding is the priority
for the nurse to monitor?
A. Hoarseness when speaking
B. Tingling around the mouth and fingers
C. Mild incisional pain rated 3/10
D. Slight edema at the incision site
3. A client with chronic kidney disease has a potassium level of 6.8 mEq/L. Which prescription
should the nurse anticipate first?
A. Sodium polystyrene sulfonate (Kayexalate)
B. IV calcium gluconate
C. Oral potassium chloride supplement
D. Scheduled hemodialysis in 24 hours
4. The nurse is assessing a client 4 hours after a cardiac catheterization performed via the right
femoral artery. Which finding requires immediate action?
A. Right pedal pulse weaker than the left
B. Client reports needing to void
C. Small ecchymosis at the puncture site
D. Heart rate of 88 beats/min
5. A client with a chest tube connected to a water-seal drainage system has continuous bubbling
in the water-seal chamber. What should the nurse do first?
A. Check all tubing connections for an air leak
B. Clamp the chest tube immediately
C. Increase the suction pressure
D. Notify the health care provider immediately
6. The nurse is caring for a client with suspected increased intracranial pressure (ICP). Which
position is most appropriate?
A. Head of bed elevated 30 degrees with head in neutral alignment
B. Trendelenburg position
C. Flat with the head turned to the side
D. Prone position
, 7. A client with diabetic ketoacidosis (DKA) is receiving an IV insulin infusion. Which laboratory
finding indicates the treatment is effective?
A. Serum glucose decreasing from 450 to 250 mg/dL
B. Serum potassium increasing from 3.2 to 5.9 mEq/L
C. Arterial pH decreasing from 7.30 to 7.10
D. Serum bicarbonate decreasing from 18 to 10 mEq/L
8. The nurse notes clear fluid draining from the nose of a client following a head injury. Which
action should the nurse take first?
A. Test the drainage for glucose using a reagent strip
B. Have the client blow their nose gently
C. Insert nasal packing to stop the drainage
D. Position the client supine with the head lowered
9. A client with a new colostomy asks the nurse when the stoma will stop looking swollen. Which
response is most accurate?
A. "Some swelling is normal and should decrease over 6 to 8 weeks."
B. "The swelling means the stoma is infected."
C. "The stoma will need to be surgically revised."
D. "Swelling indicates the stoma is prolapsing."
10. The nurse is caring for a client receiving a blood transfusion who develops chills, low back
pain, and a temperature of 102.2°F (39°C) 15 minutes after the transfusion started. What is the
nurse's first action?
A. Stop the transfusion and keep the IV line open with normal saline
B. Slow the transfusion rate and monitor closely
C. Administer an antipyretic and continue the transfusion
D. Document the findings and reassess in 15 minutes
11. A client with cirrhosis has ascites and is prescribed spironolactone. What is the priority
nursing assessment while the client is on this medication?
A. Serum potassium level
B. Serum sodium level
C. Blood glucose level
D. Serum calcium level
12. The nurse is teaching a client newly diagnosed with Addison's disease about the importance
of corticosteroid therapy. Which statement by the client indicates a need for further teaching?
A. "I can stop taking the medication once I feel better."
B. "I should carry medical identification stating I take steroids."
C. "I need to increase my dose during times of stress or illness."
D. "I should not stop this medication abruptly."
Pharmacology
13. A client is receiving IV heparin therapy. Which laboratory value should the nurse monitor to
evaluate the effectiveness of therapy?
Comprehensive Practice Question Bank
84 NCLEX-style practice questions covering the major HESI Exit Exam content areas:
• Medical-Surgical Nursing (12 questions)
• Pharmacology (12 questions)
• Maternal-Newborn Nursing (12 questions)
• Pediatric Nursing (12 questions)
• Mental Health Nursing (12 questions)
• Leadership & Prioritization (12 questions)
• Fundamentals & Safety (12 questions)
How to use this guide:
1. Answer each question in Part 1 before checking the Answer Key.
2. Part 2 contains the full answer key with detailed rationales explaining why the correct answer is right and why
the other options are incorrect.
3. Pay close attention to questions you miss — review the underlying concept, not just the correct letter.
4. Use these questions to identify content areas that need further review before your exam.
Note: This is a study/practice resource created to support exam preparation. It is not an official HESI product.
, PART 1: PRACTICE QUESTIONS
Medical-Surgical Nursing
1. A client with heart failure is prescribed furosemide (Lasix). Which assessment finding requires
the nurse to notify the health care provider immediately?
A. Serum potassium of 3.0 mEq/L
B. Blood pressure of 128/78 mmHg
C. Weight loss of 1 lb in 24 hours
D. Urine output of 40 mL/hour
2. The nurse is caring for a client immediately after a thyroidectomy. Which finding is the priority
for the nurse to monitor?
A. Hoarseness when speaking
B. Tingling around the mouth and fingers
C. Mild incisional pain rated 3/10
D. Slight edema at the incision site
3. A client with chronic kidney disease has a potassium level of 6.8 mEq/L. Which prescription
should the nurse anticipate first?
A. Sodium polystyrene sulfonate (Kayexalate)
B. IV calcium gluconate
C. Oral potassium chloride supplement
D. Scheduled hemodialysis in 24 hours
4. The nurse is assessing a client 4 hours after a cardiac catheterization performed via the right
femoral artery. Which finding requires immediate action?
A. Right pedal pulse weaker than the left
B. Client reports needing to void
C. Small ecchymosis at the puncture site
D. Heart rate of 88 beats/min
5. A client with a chest tube connected to a water-seal drainage system has continuous bubbling
in the water-seal chamber. What should the nurse do first?
A. Check all tubing connections for an air leak
B. Clamp the chest tube immediately
C. Increase the suction pressure
D. Notify the health care provider immediately
6. The nurse is caring for a client with suspected increased intracranial pressure (ICP). Which
position is most appropriate?
A. Head of bed elevated 30 degrees with head in neutral alignment
B. Trendelenburg position
C. Flat with the head turned to the side
D. Prone position
, 7. A client with diabetic ketoacidosis (DKA) is receiving an IV insulin infusion. Which laboratory
finding indicates the treatment is effective?
A. Serum glucose decreasing from 450 to 250 mg/dL
B. Serum potassium increasing from 3.2 to 5.9 mEq/L
C. Arterial pH decreasing from 7.30 to 7.10
D. Serum bicarbonate decreasing from 18 to 10 mEq/L
8. The nurse notes clear fluid draining from the nose of a client following a head injury. Which
action should the nurse take first?
A. Test the drainage for glucose using a reagent strip
B. Have the client blow their nose gently
C. Insert nasal packing to stop the drainage
D. Position the client supine with the head lowered
9. A client with a new colostomy asks the nurse when the stoma will stop looking swollen. Which
response is most accurate?
A. "Some swelling is normal and should decrease over 6 to 8 weeks."
B. "The swelling means the stoma is infected."
C. "The stoma will need to be surgically revised."
D. "Swelling indicates the stoma is prolapsing."
10. The nurse is caring for a client receiving a blood transfusion who develops chills, low back
pain, and a temperature of 102.2°F (39°C) 15 minutes after the transfusion started. What is the
nurse's first action?
A. Stop the transfusion and keep the IV line open with normal saline
B. Slow the transfusion rate and monitor closely
C. Administer an antipyretic and continue the transfusion
D. Document the findings and reassess in 15 minutes
11. A client with cirrhosis has ascites and is prescribed spironolactone. What is the priority
nursing assessment while the client is on this medication?
A. Serum potassium level
B. Serum sodium level
C. Blood glucose level
D. Serum calcium level
12. The nurse is teaching a client newly diagnosed with Addison's disease about the importance
of corticosteroid therapy. Which statement by the client indicates a need for further teaching?
A. "I can stop taking the medication once I feel better."
B. "I should carry medical identification stating I take steroids."
C. "I need to increase my dose during times of stress or illness."
D. "I should not stop this medication abruptly."
Pharmacology
13. A client is receiving IV heparin therapy. Which laboratory value should the nurse monitor to
evaluate the effectiveness of therapy?
