MEDSTUDY.COM
HESI FUNDAMENTALS EXIT EXAM
(VERSION 1, VERSION 2, VERSION 3)
FOR RN & PN NURSING STUDENTS
QUESTIONS AND CORRECT ANSWERS
WITH RATIONALES GRADED A+
LATEST
Version 1 – RN
1. A client with congestive heart failure reports shortness of breath and
increasing fatigue. The nurse notes bilateral crackles and 2+ pitting edema.
Which action should the nurse take first?
A. Encourage the client to increase fluid intake
B. Administer the prescribed diuretic
C. Place the client in high-Fowler’s position
D. Document the findings and reassess in 2 hours
Answer: C
Rationale: High-Fowler’s position improves ventilation and oxygenation
immediately. Diuretics can be administered next, but positioning is the priority to
relieve respiratory distress.
,MEDSTUDY.COM
2.
A client is scheduled for a colonoscopy. Which instruction should the nurse
provide?
A. “You may continue your aspirin daily.”
B. “Drink clear liquids only the day before.”
C. “You should not fast before the procedure.”
D. “You can take your diabetic insulin as usual.”
Answer: B
Rationale: Clear liquids help empty the bowel and reduce the risk of aspiration.
Aspirin is usually stopped prior; insulin is often adjusted.
3.
A client with pneumonia is receiving oxygen at 2 L/min via nasal cannula. The
client becomes confused and sleepy. What is the priority nursing action?
A. Increase oxygen to 4 L/min
B. Check oxygen saturation and respiratory rate
C. Administer a sedative to calm the client
D. Encourage the client to drink fluids
Answer: B
Rationale: Confusion and drowsiness may indicate hypoxia or CO2 retention.
Assessing oxygenation and respiratory status is the priority.
4.
A client with newly diagnosed diabetes asks how to prevent hypoglycemia. The
nurse should advise:
A. “Skip meals when you feel tired.”
B. “Eat a snack before exercise.”
C. “Take your insulin only on weekdays.”
D. “Reduce your carbohydrate intake to zero.”
,MEDSTUDY.COM
Answer: B
Rationale: Exercise lowers blood glucose, so a snack before activity helps prevent
hypoglycemia.
5.
A client with a nasogastric tube reports nausea and abdominal distention. The
nurse notes the NG tube is clogged. What is the nurse’s priority action?
A. Remove the tube immediately
B. Attempt to irrigate with sterile water
C. Notify the provider
D. Increase the suction setting
Answer: B
Rationale: Irrigation may restore patency and relieve gastric distention. Removing
the tube should be done only if irrigation fails.
6.
A postoperative client is complaining of severe pain despite receiving scheduled
analgesics. The nurse notes tachycardia and increased blood pressure. What is the
most appropriate nursing action?
A. Document the findings and wait
B. Administer the next dose early
C. Assess the surgical site and vital signs
D. Encourage the client to rest
Answer: C
Rationale: Increased pain with vital sign changes may indicate complications such
as bleeding or infection. Assess first.
, MEDSTUDY.COM
7.
A client with chronic kidney disease has a serum potassium of 6.2 mEq/L. Which
intervention should the nurse implement first?
A. Administer insulin with dextrose as ordered
B. Restrict dietary potassium
C. Notify the provider
D. Start a potassium-wasting diuretic
Answer: C
Rationale: Hyperkalemia is life-threatening. Notify the provider immediately
while preparing for treatment.
8.
A client with COPD is receiving oxygen at 2 L/min. The client becomes lethargic
and respiratory rate drops. The nurse suspects:
A. Hypoxia
B. Oxygen toxicity
C. CO2 retention
D. Pulmonary embolism
Answer: C
Rationale: COPD patients may rely on hypoxic drive. Too much oxygen can cause
CO2 retention and decreased respiratory drive.
9.
A client is scheduled for surgery and is anxious. Which nursing action is most
effective?
A. Provide detailed medical terminology
B. Encourage the client to ask questions
C. Tell the client not to worry
D. Avoid discussing the procedure
HESI FUNDAMENTALS EXIT EXAM
(VERSION 1, VERSION 2, VERSION 3)
FOR RN & PN NURSING STUDENTS
QUESTIONS AND CORRECT ANSWERS
WITH RATIONALES GRADED A+
LATEST
Version 1 – RN
1. A client with congestive heart failure reports shortness of breath and
increasing fatigue. The nurse notes bilateral crackles and 2+ pitting edema.
Which action should the nurse take first?
A. Encourage the client to increase fluid intake
B. Administer the prescribed diuretic
C. Place the client in high-Fowler’s position
D. Document the findings and reassess in 2 hours
Answer: C
Rationale: High-Fowler’s position improves ventilation and oxygenation
immediately. Diuretics can be administered next, but positioning is the priority to
relieve respiratory distress.
,MEDSTUDY.COM
2.
A client is scheduled for a colonoscopy. Which instruction should the nurse
provide?
A. “You may continue your aspirin daily.”
B. “Drink clear liquids only the day before.”
C. “You should not fast before the procedure.”
D. “You can take your diabetic insulin as usual.”
Answer: B
Rationale: Clear liquids help empty the bowel and reduce the risk of aspiration.
Aspirin is usually stopped prior; insulin is often adjusted.
3.
A client with pneumonia is receiving oxygen at 2 L/min via nasal cannula. The
client becomes confused and sleepy. What is the priority nursing action?
A. Increase oxygen to 4 L/min
B. Check oxygen saturation and respiratory rate
C. Administer a sedative to calm the client
D. Encourage the client to drink fluids
Answer: B
Rationale: Confusion and drowsiness may indicate hypoxia or CO2 retention.
Assessing oxygenation and respiratory status is the priority.
4.
A client with newly diagnosed diabetes asks how to prevent hypoglycemia. The
nurse should advise:
A. “Skip meals when you feel tired.”
B. “Eat a snack before exercise.”
C. “Take your insulin only on weekdays.”
D. “Reduce your carbohydrate intake to zero.”
,MEDSTUDY.COM
Answer: B
Rationale: Exercise lowers blood glucose, so a snack before activity helps prevent
hypoglycemia.
5.
A client with a nasogastric tube reports nausea and abdominal distention. The
nurse notes the NG tube is clogged. What is the nurse’s priority action?
A. Remove the tube immediately
B. Attempt to irrigate with sterile water
C. Notify the provider
D. Increase the suction setting
Answer: B
Rationale: Irrigation may restore patency and relieve gastric distention. Removing
the tube should be done only if irrigation fails.
6.
A postoperative client is complaining of severe pain despite receiving scheduled
analgesics. The nurse notes tachycardia and increased blood pressure. What is the
most appropriate nursing action?
A. Document the findings and wait
B. Administer the next dose early
C. Assess the surgical site and vital signs
D. Encourage the client to rest
Answer: C
Rationale: Increased pain with vital sign changes may indicate complications such
as bleeding or infection. Assess first.
, MEDSTUDY.COM
7.
A client with chronic kidney disease has a serum potassium of 6.2 mEq/L. Which
intervention should the nurse implement first?
A. Administer insulin with dextrose as ordered
B. Restrict dietary potassium
C. Notify the provider
D. Start a potassium-wasting diuretic
Answer: C
Rationale: Hyperkalemia is life-threatening. Notify the provider immediately
while preparing for treatment.
8.
A client with COPD is receiving oxygen at 2 L/min. The client becomes lethargic
and respiratory rate drops. The nurse suspects:
A. Hypoxia
B. Oxygen toxicity
C. CO2 retention
D. Pulmonary embolism
Answer: C
Rationale: COPD patients may rely on hypoxic drive. Too much oxygen can cause
CO2 retention and decreased respiratory drive.
9.
A client is scheduled for surgery and is anxious. Which nursing action is most
effective?
A. Provide detailed medical terminology
B. Encourage the client to ask questions
C. Tell the client not to worry
D. Avoid discussing the procedure
