RN HESI EXIT EXAM VERSION 7
2026/2027 QUESTIONS AND ANSWERS.
VERIFIED
1. A patient with heart failure is receiving digoxin. The nurse notes the patient is complaining
of nausea and seeing yellow halos around lights. Which action should the nurse take first?
A. Check the patient’s serum digoxin level.
B. Assess the patient’s apical pulse for one full minute.
C. Administer an antiemetic as prescribed.
D. Increase the patient’s potassium intake.
Answer: B
Conceptual Explanation: Nausea and visual changes are classic signs of digoxin toxicity.
The nurse must first assess the apical pulse to check for bradycardia or arrhythmias before
notifying the provider and checking levels.
2. Which arterial blood gas (ABG) result is most indicative of a patient in respiratory acidosis?
A. pH 7.30, PaCO2 52 mmHg, HCO3 24 mEq/L
B. pH 7.48, PaCO2 30 mmHg, HCO3 22 mEq/L
C. pH 7.32, PaCO2 38 mmHg, HCO3 18 mEq/L
,D. pH 7.50, PaCO2 40 mmHg, HCO3 32 mEq/L
Answer: A
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (below 7.35)
and an elevated PaCO2 (above 45 mmHg) with a normal or compensating bicarbonate
level.
3. A nurse is caring for a client with a history of lithium carbonate use for bipolar disorder.
The client reports blurred vision and tremors. The serum lithium level is 1.8 mEq/L. What is
the priority nursing action?
A. Hold the medication and notify the healthcare provider.
B. Encourage the client to increase fluid intake.
C. Administer the next scheduled dose of lithium.
D. Place the client on seizure precautions.
Answer: A
Conceptual Explanation: The therapeutic range for lithium is 0.6 to 1.2 mEq/L. A level of
1.8 mEq/L indicates toxicity, and the medication must be held to prevent further
neurological damage.
4. A nurse is triaging patients in the emergency department. Which patient should be seen
first?
A. A 10-year-old with a laceration to the arm and controlled bleeding.
, B. A 45-year-old reporting sudden onset of ‘crushing’ chest pain and diaphoresis.
C. A 65-year-old with a temperature of 101.5°F and a cough.
D. A 30-year-old with a possible ankle fracture and pain rated 8/10.
Answer: B
Conceptual Explanation: Chest pain with diaphoresis suggests a myocardial infarction,
which is a life-threatening emergency requiring immediate intervention over non-urgent
issues.
5. The nurse is monitoring a client receiving Magnesium Sulfate for preeclampsia. Which
finding requires immediate intervention?
A. Urine output of 20 mL/hour
B. Deep tendon reflexes 2+
C. Respiratory rate of 16 breaths/min
D. Fetal heart rate of 140 bpm
Answer: A
Conceptual Explanation: Magnesium sulfate is excreted by the kidneys. Low urine output
(less than 30 mL/hr) can lead to toxic accumulation, which may lead to respiratory arrest.
6. Which instruction should the nurse provide to a client prescribed Alendronate for
osteoporosis?
A. Take the medication with a glass of milk.
2026/2027 QUESTIONS AND ANSWERS.
VERIFIED
1. A patient with heart failure is receiving digoxin. The nurse notes the patient is complaining
of nausea and seeing yellow halos around lights. Which action should the nurse take first?
A. Check the patient’s serum digoxin level.
B. Assess the patient’s apical pulse for one full minute.
C. Administer an antiemetic as prescribed.
D. Increase the patient’s potassium intake.
Answer: B
Conceptual Explanation: Nausea and visual changes are classic signs of digoxin toxicity.
The nurse must first assess the apical pulse to check for bradycardia or arrhythmias before
notifying the provider and checking levels.
2. Which arterial blood gas (ABG) result is most indicative of a patient in respiratory acidosis?
A. pH 7.30, PaCO2 52 mmHg, HCO3 24 mEq/L
B. pH 7.48, PaCO2 30 mmHg, HCO3 22 mEq/L
C. pH 7.32, PaCO2 38 mmHg, HCO3 18 mEq/L
,D. pH 7.50, PaCO2 40 mmHg, HCO3 32 mEq/L
Answer: A
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (below 7.35)
and an elevated PaCO2 (above 45 mmHg) with a normal or compensating bicarbonate
level.
3. A nurse is caring for a client with a history of lithium carbonate use for bipolar disorder.
The client reports blurred vision and tremors. The serum lithium level is 1.8 mEq/L. What is
the priority nursing action?
A. Hold the medication and notify the healthcare provider.
B. Encourage the client to increase fluid intake.
C. Administer the next scheduled dose of lithium.
D. Place the client on seizure precautions.
Answer: A
Conceptual Explanation: The therapeutic range for lithium is 0.6 to 1.2 mEq/L. A level of
1.8 mEq/L indicates toxicity, and the medication must be held to prevent further
neurological damage.
4. A nurse is triaging patients in the emergency department. Which patient should be seen
first?
A. A 10-year-old with a laceration to the arm and controlled bleeding.
, B. A 45-year-old reporting sudden onset of ‘crushing’ chest pain and diaphoresis.
C. A 65-year-old with a temperature of 101.5°F and a cough.
D. A 30-year-old with a possible ankle fracture and pain rated 8/10.
Answer: B
Conceptual Explanation: Chest pain with diaphoresis suggests a myocardial infarction,
which is a life-threatening emergency requiring immediate intervention over non-urgent
issues.
5. The nurse is monitoring a client receiving Magnesium Sulfate for preeclampsia. Which
finding requires immediate intervention?
A. Urine output of 20 mL/hour
B. Deep tendon reflexes 2+
C. Respiratory rate of 16 breaths/min
D. Fetal heart rate of 140 bpm
Answer: A
Conceptual Explanation: Magnesium sulfate is excreted by the kidneys. Low urine output
(less than 30 mL/hr) can lead to toxic accumulation, which may lead to respiratory arrest.
6. Which instruction should the nurse provide to a client prescribed Alendronate for
osteoporosis?
A. Take the medication with a glass of milk.
