RN HESI EXIT EXAM VERSION 1
QUESTIONS AND ANSWERS 2026/2027
1. A nurse is caring for a client who is 2 hours postoperative following a subtotal
thyroidectomy. The client reports a feeling of ‘fullness’ in the neck and is experiencing stridor.
Which action should the nurse take first?
A. Notify the Rapid Response Team and prepare for emergency intubation.
B. Administer an oral analgesic for pain relief.
C. Assess the client’s surgical dressing for bleeding.
D. Place the client in a high-Fowler’s position to facilitate breathing.
Answer: A
Conceptual Explanation: Stridor indicates laryngeal edema and potential airway
obstruction, which is a medical emergency. Notifying the Rapid Response Team and
preparing for intubation or tracheostomy is the priority to maintain airway patency.
2. A client with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L. Which
of the following cardiac rhythm changes is the nurse most likely to observe on the EKG?
A. Presence of U waves
,B. Prolonged PR interval
C. Tall, peaked T waves
D. ST-segment depression
Answer: C
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically causes tall,
peaked T waves, widened QRS complexes, and potentially cardiac arrest. U waves are seen
in hypokalemia.
3. A nurse is preparing to administer digoxin to a client with heart failure. Which of the
following findings should lead the nurse to withhold the medication and notify the provider?
A. Respiratory rate of 18 breaths per minute
B. Blood pressure of 100/60 mmHg
C. Heart rate of 52 beats per minute
D. Digoxin level of 1.2 ng/mL
Answer: C
Conceptual Explanation: Digoxin is a cardiac glycoside that slows the heart rate. It should
be withheld if the apical pulse is less than 60 bpm in adults to avoid severe bradycardia.
, 4. A client is admitted to the psychiatric unit with a diagnosis of bipolar disorder, manic
phase. Which of the following interventions is most appropriate for the nurse to include in
the plan of care?
A. Provide high-calorie, portable snacks (finger foods).
B. Encourage the client to participate in a group volleyball game.
C. Place the client in a room with a talkative roommate.
D. Engage the client in a long, detailed discussion about therapy goals.
Answer: A
Conceptual Explanation: Clients in a manic state often have high energy and cannot sit
still for meals. Finger foods allow them to maintain nutrition while moving. Low-
stimulation environments are preferred over group activities.
5. Which of the following signs is an early indication of increased intracranial pressure (ICP) in
a client who sustained a head injury?
A. Decerebrate posturing
B. Decrease in the level of consciousness
C. Fixed and dilated pupils
D. Cushing’s triad
Answer: B
QUESTIONS AND ANSWERS 2026/2027
1. A nurse is caring for a client who is 2 hours postoperative following a subtotal
thyroidectomy. The client reports a feeling of ‘fullness’ in the neck and is experiencing stridor.
Which action should the nurse take first?
A. Notify the Rapid Response Team and prepare for emergency intubation.
B. Administer an oral analgesic for pain relief.
C. Assess the client’s surgical dressing for bleeding.
D. Place the client in a high-Fowler’s position to facilitate breathing.
Answer: A
Conceptual Explanation: Stridor indicates laryngeal edema and potential airway
obstruction, which is a medical emergency. Notifying the Rapid Response Team and
preparing for intubation or tracheostomy is the priority to maintain airway patency.
2. A client with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L. Which
of the following cardiac rhythm changes is the nurse most likely to observe on the EKG?
A. Presence of U waves
,B. Prolonged PR interval
C. Tall, peaked T waves
D. ST-segment depression
Answer: C
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically causes tall,
peaked T waves, widened QRS complexes, and potentially cardiac arrest. U waves are seen
in hypokalemia.
3. A nurse is preparing to administer digoxin to a client with heart failure. Which of the
following findings should lead the nurse to withhold the medication and notify the provider?
A. Respiratory rate of 18 breaths per minute
B. Blood pressure of 100/60 mmHg
C. Heart rate of 52 beats per minute
D. Digoxin level of 1.2 ng/mL
Answer: C
Conceptual Explanation: Digoxin is a cardiac glycoside that slows the heart rate. It should
be withheld if the apical pulse is less than 60 bpm in adults to avoid severe bradycardia.
, 4. A client is admitted to the psychiatric unit with a diagnosis of bipolar disorder, manic
phase. Which of the following interventions is most appropriate for the nurse to include in
the plan of care?
A. Provide high-calorie, portable snacks (finger foods).
B. Encourage the client to participate in a group volleyball game.
C. Place the client in a room with a talkative roommate.
D. Engage the client in a long, detailed discussion about therapy goals.
Answer: A
Conceptual Explanation: Clients in a manic state often have high energy and cannot sit
still for meals. Finger foods allow them to maintain nutrition while moving. Low-
stimulation environments are preferred over group activities.
5. Which of the following signs is an early indication of increased intracranial pressure (ICP) in
a client who sustained a head injury?
A. Decerebrate posturing
B. Decrease in the level of consciousness
C. Fixed and dilated pupils
D. Cushing’s triad
Answer: B
