RN HESI EXIT EXAM 2026/2027
COMPREHENSIVE PRACTICE
QUESTIONS AND ANSWERS
1. A patient’s arterial blood gas results show pH 7.30, PaCO2 50 mmHg, and HCO3 24 mEq/L.
Which acid-base imbalance is the patient experiencing?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Answer: D
Conceptual Explanation: The pH is low (acidosis) and the PaCO2 is high (respiratory
component), while the HCO3 is normal, indicating respiratory acidosis.
2. A patient is prescribed Digoxin 0.25 mg daily. Which assessment finding should the nurse
prioritize as an early sign of toxicity?
A. Increased urine output
B. Anorexia and nausea
,C. Heart rate of 100 bpm
D. Tinnitus and hearing loss
Answer: B
Conceptual Explanation: Gastrointestinal symptoms like anorexia, nausea, and vomiting
are often the earliest signs of Digoxin toxicity.
3. The nurse is assigned four patients. Which patient should be assessed first?
A. A patient with a history of COPD reporting a cough
B. A patient with a blood glucose of 150 mg/dL
C. A patient scheduled for discharge requesting medication clarification
D. A patient post-op day 1 reporting sudden chest pain and dyspnea
Answer: D
Conceptual Explanation: Sudden chest pain and dyspnea post-operatively are red flags
for pulmonary embolism or MI, requiring immediate intervention
(Airway/Breathing/Circulation).
4. Which task can the RN safely delegate to a Licensed Practical Nurse (LPN)?
A. Creating a teaching plan for a newly diagnosed diabetic
B. Assessing a patient returning from surgery
C. Administering scheduled oral medications
, D. Administering IV push morphine for pain
Answer: C
Conceptual Explanation: LPNs can administer oral medications. RNs must handle initial
assessments, teaching plans, and complex IV push medications depending on state scope of
practice.
5. A patient taking Phenytoin (Dilantin) should be instructed by the nurse to perform which
action?
A. Avoid foods high in Vitamin K
B. Practice meticulous oral hygiene
C. Take the medication only when a seizure occurs
D. Increase sodium intake to prevent toxicity
Answer: B
Conceptual Explanation: Gingival hyperplasia is a common side effect of Phenytoin,
requiring frequent dental care and oral hygiene.
6. Which medication is the antidote for Magnesium Sulfate toxicity in a preeclamptic patient?
A. Protamine sulfate
B. Vitamin K
C. Naloxone
D. Calcium gluconate
COMPREHENSIVE PRACTICE
QUESTIONS AND ANSWERS
1. A patient’s arterial blood gas results show pH 7.30, PaCO2 50 mmHg, and HCO3 24 mEq/L.
Which acid-base imbalance is the patient experiencing?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Answer: D
Conceptual Explanation: The pH is low (acidosis) and the PaCO2 is high (respiratory
component), while the HCO3 is normal, indicating respiratory acidosis.
2. A patient is prescribed Digoxin 0.25 mg daily. Which assessment finding should the nurse
prioritize as an early sign of toxicity?
A. Increased urine output
B. Anorexia and nausea
,C. Heart rate of 100 bpm
D. Tinnitus and hearing loss
Answer: B
Conceptual Explanation: Gastrointestinal symptoms like anorexia, nausea, and vomiting
are often the earliest signs of Digoxin toxicity.
3. The nurse is assigned four patients. Which patient should be assessed first?
A. A patient with a history of COPD reporting a cough
B. A patient with a blood glucose of 150 mg/dL
C. A patient scheduled for discharge requesting medication clarification
D. A patient post-op day 1 reporting sudden chest pain and dyspnea
Answer: D
Conceptual Explanation: Sudden chest pain and dyspnea post-operatively are red flags
for pulmonary embolism or MI, requiring immediate intervention
(Airway/Breathing/Circulation).
4. Which task can the RN safely delegate to a Licensed Practical Nurse (LPN)?
A. Creating a teaching plan for a newly diagnosed diabetic
B. Assessing a patient returning from surgery
C. Administering scheduled oral medications
, D. Administering IV push morphine for pain
Answer: C
Conceptual Explanation: LPNs can administer oral medications. RNs must handle initial
assessments, teaching plans, and complex IV push medications depending on state scope of
practice.
5. A patient taking Phenytoin (Dilantin) should be instructed by the nurse to perform which
action?
A. Avoid foods high in Vitamin K
B. Practice meticulous oral hygiene
C. Take the medication only when a seizure occurs
D. Increase sodium intake to prevent toxicity
Answer: B
Conceptual Explanation: Gingival hyperplasia is a common side effect of Phenytoin,
requiring frequent dental care and oral hygiene.
6. Which medication is the antidote for Magnesium Sulfate toxicity in a preeclamptic patient?
A. Protamine sulfate
B. Vitamin K
C. Naloxone
D. Calcium gluconate
