HESI RN EXIT EXAM COMPREHENSIVE
REVIEW 2025/2026 VERSIONS 1 - 7 COMPLETE
PRACTICE EXAMINATION QUESTIONS WITH
ANSWERS AND RATIONALES 100%
GUARANTEED PASS | COMPLETE A+ GUIDE
EXAMINATION TITLE: HESI RN Exit Exam Comprehensive Review
2025/2026 — All Versions 1-7 Practice Questions with Verified Answers and
Rationales
DOMAINS COVERED:
• Domain 1: Fundamentals of Nursing (Questions 1-40)
• Domain 2: Medical-Surgical Nursing (Questions 41-80)
• Domain 3: Maternal-Newborn Nursing (Questions 81-110)
• Domain 4: Pediatric Nursing (Questions 111-140)
• Domain 5: Mental Health Nursing (Questions 141-170)
• Domain 6: Pharmacology (Questions 171-200)
• Domain 7: Leadership, Management, and Priority Setting (Questions 201-
250)
DOMAIN 1: FUNDAMENTALS OF NURSING
Questions 1-40
Question 1:
The nurse enters the room of a client with Parkinson's disease who is taking
carbidopa-levodopa. The client is rising slowly from a chair while assistive
personnel stands next to the chair. Which action should the nurse take?
,A) Offer a PRN analgesic to reduce painful movement
B) Tell the UAP to assess the client and move more quickly
C) Affirm that the client should arise slowly from the chair
D) Demonstrate how to help the client move more efficiently
Rationale: Clients with Parkinson's disease experience rigidity and bradykinesia
(slow movement). Rising slowly helps prevent orthostatic hypotension and falls.
The nurse should affirm the client's appropriate behavior. Moving quickly could
cause falls or injury.
Question 2:
The healthcare provider prescribes 500 mL IV bolus of 0.9% normal saline to be
infused over 30 minutes. How many milliliters per hour should the client receive?
A) 250 mL/hr
B) 500 mL/hr
C) 1000 mL/hr
D) 1500 mL/hr
Rationale: To calculate mL/hr: 500 mL ÷ 0.5 hours = 1000 mL/hr. The infusion
must be completed in 30 minutes (0.5 hours), requiring a rate of 1000 mL per hour.
Question 3:
The nurse observes an unlicensed assistive personnel (UAP) removing gloves after
emptying a bedpan containing feces. The UAP slides the fingers under the glove
edge and begins to roll the glove off. Which action should the nurse take?
A) Advise the UAP that the technique being used will result in hand
contamination
B) Suggest that the UAP roll both of the gloves off and inside out
C) Instruct the UAP to use two pairs of gloves when fecal contamination occurs
D) Remind the UAP to discard the gloves in the biohazard container
Rationale: The correct glove removal technique involves touching only the
outside of the glove with the gloved hand. Sliding fingers under the glove edge and
rolling off creates contamination risk. The nurse should correct this technique
immediately.
,Question 4:
The healthcare provider prescribes a medication that, when given orally, has a high
first-pass effect. The provider changes the route of administration and doubles the
dose. Which action should the nurse implement?
A) Administer the medication as prescribed and monitor for therapeutic
effect
B) Call the provider to clarify the rationale for doubling the dose
C) Hold the medication and notify the pharmacy
D) Administer the medication and document the dose change
Rationale: Medications with high first-pass effect are extensively metabolized in
the liver before reaching systemic circulation. When changing to a route that
bypasses first-pass metabolism (IV, sublingual, etc.), the dose is often adjusted.
The nurse should administer as prescribed and monitor response.
Question 5:
A client is receiving a blood transfusion and reports chills, low back pain, and
shortness of breath. What is the nurse's priority action?
A) Slow the transfusion rate
B) Stop the transfusion immediately
C) Administer diphenhydramine
D) Notify the healthcare provider
Rationale: These symptoms indicate a possible acute hemolytic transfusion
reaction, which is life-threatening. The priority action is to stop the transfusion
immediately, maintain IV access with normal saline, and notify the provider.
Question 6:
The nurse is preparing to insert a nasogastric tube. Which position should the client
be placed in to facilitate insertion?
A) Supine with head flat
B) Sitting in high Fowler's position with head tilted forward
, C) Left lateral recumbent position
D) Trendelenburg position
Rationale: High Fowler's position with head tilted forward allows the natural
curvature of the oropharynx to align with the esophagus, making tube passage
easier and reducing the risk of tracheal insertion.
Question 7:
A client with an indwelling urinary catheter has output of 50 mL over the past 4
hours. What is the nurse's priority action?
A) Increase the client's fluid intake
B) Assess for bladder distention and catheter patency
C) Notify the healthcare provider immediately
D) Irrigate the catheter with normal saline
Rationale: Low urine output may indicate a blocked catheter, dehydration, or renal
impairment. The nurse should first assess for bladder distention and ensure the
catheter is patent before notifying the provider or taking other actions.
Question 8:
The nurse is providing wound care for a client with a pressure injury. Which
finding indicates wound healing?
A) Increased wound drainage
B) Pink granulation tissue in the wound bed
C) Foul odor from the wound
D) Separation of wound edges
Rationale: Pink granulation tissue indicates new capillary growth and collagen
formation, which are signs of healing. Increased drainage, foul odor, and wound
separation indicate complications.
Question 9:
The nurse is preparing to administer an enteral feeding through a nasogastric tube.
Which action should be taken first?
REVIEW 2025/2026 VERSIONS 1 - 7 COMPLETE
PRACTICE EXAMINATION QUESTIONS WITH
ANSWERS AND RATIONALES 100%
GUARANTEED PASS | COMPLETE A+ GUIDE
EXAMINATION TITLE: HESI RN Exit Exam Comprehensive Review
2025/2026 — All Versions 1-7 Practice Questions with Verified Answers and
Rationales
DOMAINS COVERED:
• Domain 1: Fundamentals of Nursing (Questions 1-40)
• Domain 2: Medical-Surgical Nursing (Questions 41-80)
• Domain 3: Maternal-Newborn Nursing (Questions 81-110)
• Domain 4: Pediatric Nursing (Questions 111-140)
• Domain 5: Mental Health Nursing (Questions 141-170)
• Domain 6: Pharmacology (Questions 171-200)
• Domain 7: Leadership, Management, and Priority Setting (Questions 201-
250)
DOMAIN 1: FUNDAMENTALS OF NURSING
Questions 1-40
Question 1:
The nurse enters the room of a client with Parkinson's disease who is taking
carbidopa-levodopa. The client is rising slowly from a chair while assistive
personnel stands next to the chair. Which action should the nurse take?
,A) Offer a PRN analgesic to reduce painful movement
B) Tell the UAP to assess the client and move more quickly
C) Affirm that the client should arise slowly from the chair
D) Demonstrate how to help the client move more efficiently
Rationale: Clients with Parkinson's disease experience rigidity and bradykinesia
(slow movement). Rising slowly helps prevent orthostatic hypotension and falls.
The nurse should affirm the client's appropriate behavior. Moving quickly could
cause falls or injury.
Question 2:
The healthcare provider prescribes 500 mL IV bolus of 0.9% normal saline to be
infused over 30 minutes. How many milliliters per hour should the client receive?
A) 250 mL/hr
B) 500 mL/hr
C) 1000 mL/hr
D) 1500 mL/hr
Rationale: To calculate mL/hr: 500 mL ÷ 0.5 hours = 1000 mL/hr. The infusion
must be completed in 30 minutes (0.5 hours), requiring a rate of 1000 mL per hour.
Question 3:
The nurse observes an unlicensed assistive personnel (UAP) removing gloves after
emptying a bedpan containing feces. The UAP slides the fingers under the glove
edge and begins to roll the glove off. Which action should the nurse take?
A) Advise the UAP that the technique being used will result in hand
contamination
B) Suggest that the UAP roll both of the gloves off and inside out
C) Instruct the UAP to use two pairs of gloves when fecal contamination occurs
D) Remind the UAP to discard the gloves in the biohazard container
Rationale: The correct glove removal technique involves touching only the
outside of the glove with the gloved hand. Sliding fingers under the glove edge and
rolling off creates contamination risk. The nurse should correct this technique
immediately.
,Question 4:
The healthcare provider prescribes a medication that, when given orally, has a high
first-pass effect. The provider changes the route of administration and doubles the
dose. Which action should the nurse implement?
A) Administer the medication as prescribed and monitor for therapeutic
effect
B) Call the provider to clarify the rationale for doubling the dose
C) Hold the medication and notify the pharmacy
D) Administer the medication and document the dose change
Rationale: Medications with high first-pass effect are extensively metabolized in
the liver before reaching systemic circulation. When changing to a route that
bypasses first-pass metabolism (IV, sublingual, etc.), the dose is often adjusted.
The nurse should administer as prescribed and monitor response.
Question 5:
A client is receiving a blood transfusion and reports chills, low back pain, and
shortness of breath. What is the nurse's priority action?
A) Slow the transfusion rate
B) Stop the transfusion immediately
C) Administer diphenhydramine
D) Notify the healthcare provider
Rationale: These symptoms indicate a possible acute hemolytic transfusion
reaction, which is life-threatening. The priority action is to stop the transfusion
immediately, maintain IV access with normal saline, and notify the provider.
Question 6:
The nurse is preparing to insert a nasogastric tube. Which position should the client
be placed in to facilitate insertion?
A) Supine with head flat
B) Sitting in high Fowler's position with head tilted forward
, C) Left lateral recumbent position
D) Trendelenburg position
Rationale: High Fowler's position with head tilted forward allows the natural
curvature of the oropharynx to align with the esophagus, making tube passage
easier and reducing the risk of tracheal insertion.
Question 7:
A client with an indwelling urinary catheter has output of 50 mL over the past 4
hours. What is the nurse's priority action?
A) Increase the client's fluid intake
B) Assess for bladder distention and catheter patency
C) Notify the healthcare provider immediately
D) Irrigate the catheter with normal saline
Rationale: Low urine output may indicate a blocked catheter, dehydration, or renal
impairment. The nurse should first assess for bladder distention and ensure the
catheter is patent before notifying the provider or taking other actions.
Question 8:
The nurse is providing wound care for a client with a pressure injury. Which
finding indicates wound healing?
A) Increased wound drainage
B) Pink granulation tissue in the wound bed
C) Foul odor from the wound
D) Separation of wound edges
Rationale: Pink granulation tissue indicates new capillary growth and collagen
formation, which are signs of healing. Increased drainage, foul odor, and wound
separation indicate complications.
Question 9:
The nurse is preparing to administer an enteral feeding through a nasogastric tube.
Which action should be taken first?
