RN HESI EXIT EXAM COMPREHENSIVE
PRACTICE QUESTIONS AND ANSWERS
2026/2027
1. A client with chronic kidney disease (CKD) is scheduled for hemodialysis. Which medication
should the nurse withhold until after the procedure?
A. Lisinopril
B. Epoetin alfa
C. Calcium carbonate
D. Sevelamer
Answer: A
Conceptual Explanation: Antihypertensives like Lisinopril are typically withheld prior to
dialysis to prevent hypotension during the fluid removal process.
2. The nurse is caring for a client with a suspected diagnosis of Guillain-Barre Syndrome.
Which assessment is the priority?
A. Respiratory rate and effort
B. Lower extremity muscle strength
,C. Bowel sounds and abdominal distension
D. Deep tendon reflexes
Answer: A
Conceptual Explanation: Ascending paralysis in Guillain-Barre can reach the diaphragm,
leading to respiratory failure; monitoring breathing is the highest priority.
3. A client is receiving a continuous intravenous infusion of Heparin. The nurse notes the
client’s aPTT is 95 seconds (control is 25 seconds). What is the priority action?
A. Notify the healthcare provider for a Protamine Sulfate order
B. Administer Vitamin K intramuscularly
C. Decrease the infusion rate by half
D. Stop the Heparin infusion
Answer: D
Conceptual Explanation: The aPTT is significantly above the therapeutic range (typically
1.5 to 2.5 times the control). The infusion must be stopped first to prevent hemorrhage.
4. A nurse is caring for a client post-thyroidectomy. The client complains of tingling in the
fingers and around the mouth. Which action should the nurse take first?
A. Apply a cold pack to the neck
B. Check the surgical dressing for bleeding
C. Administer a dose of levothyroxine
, D. Assess for Chvostek’s sign
Answer: D
Conceptual Explanation: Tingling indicates hypocalcemia, which can occur if the
parathyroid glands are damaged. Chvostek’s sign confirms neuromuscular irritability
associated with low calcium.
5. Which electrolyte imbalance is a client with Addison’s disease most likely to exhibit?
A. Hypernatremia and hypokalemia
B. Hypercalcemia and hypophosphatemia
C. Hyponatremia and hyperkalemia
D. Hypomagnesemia and hypernatremia
Answer: C
Conceptual Explanation: Addison’s disease involves a lack of aldosterone, leading to
sodium loss (hyponatremia) and potassium retention (hyperkalemia).
6. The nurse provides discharge instructions for a client taking Warfarin. Which statement by
the client indicates a need for further teaching?
A. I will use a soft-bristled toothbrush.
B. I will report any dark, tarry stools to my doctor.
C. I will increase my intake of spinach and kale to stay healthy.
D. I will avoid taking aspirin or ibuprofen.
PRACTICE QUESTIONS AND ANSWERS
2026/2027
1. A client with chronic kidney disease (CKD) is scheduled for hemodialysis. Which medication
should the nurse withhold until after the procedure?
A. Lisinopril
B. Epoetin alfa
C. Calcium carbonate
D. Sevelamer
Answer: A
Conceptual Explanation: Antihypertensives like Lisinopril are typically withheld prior to
dialysis to prevent hypotension during the fluid removal process.
2. The nurse is caring for a client with a suspected diagnosis of Guillain-Barre Syndrome.
Which assessment is the priority?
A. Respiratory rate and effort
B. Lower extremity muscle strength
,C. Bowel sounds and abdominal distension
D. Deep tendon reflexes
Answer: A
Conceptual Explanation: Ascending paralysis in Guillain-Barre can reach the diaphragm,
leading to respiratory failure; monitoring breathing is the highest priority.
3. A client is receiving a continuous intravenous infusion of Heparin. The nurse notes the
client’s aPTT is 95 seconds (control is 25 seconds). What is the priority action?
A. Notify the healthcare provider for a Protamine Sulfate order
B. Administer Vitamin K intramuscularly
C. Decrease the infusion rate by half
D. Stop the Heparin infusion
Answer: D
Conceptual Explanation: The aPTT is significantly above the therapeutic range (typically
1.5 to 2.5 times the control). The infusion must be stopped first to prevent hemorrhage.
4. A nurse is caring for a client post-thyroidectomy. The client complains of tingling in the
fingers and around the mouth. Which action should the nurse take first?
A. Apply a cold pack to the neck
B. Check the surgical dressing for bleeding
C. Administer a dose of levothyroxine
, D. Assess for Chvostek’s sign
Answer: D
Conceptual Explanation: Tingling indicates hypocalcemia, which can occur if the
parathyroid glands are damaged. Chvostek’s sign confirms neuromuscular irritability
associated with low calcium.
5. Which electrolyte imbalance is a client with Addison’s disease most likely to exhibit?
A. Hypernatremia and hypokalemia
B. Hypercalcemia and hypophosphatemia
C. Hyponatremia and hyperkalemia
D. Hypomagnesemia and hypernatremia
Answer: C
Conceptual Explanation: Addison’s disease involves a lack of aldosterone, leading to
sodium loss (hyponatremia) and potassium retention (hyperkalemia).
6. The nurse provides discharge instructions for a client taking Warfarin. Which statement by
the client indicates a need for further teaching?
A. I will use a soft-bristled toothbrush.
B. I will report any dark, tarry stools to my doctor.
C. I will increase my intake of spinach and kale to stay healthy.
D. I will avoid taking aspirin or ibuprofen.
