HESI EXIT FINAL EXAM
(NIGHTINGALE COLLEGE) 2026/2027
QUESTIONS AND CORRECT DETAILED
ANSWERS
1. A client with a history of heart failure is prescribed digoxin 0.25 mg daily. Which
assessment finding should the nurse prioritize as a sign of digoxin toxicity?
A. Visual disturbances such as seeing yellow-green halos
B. Hyperkalemia and increased urinary output
C. Tachycardia and sudden hypertension
D. Increased appetite and improved exercise tolerance
Answer: A
Conceptual Explanation: Visual disturbances, such as yellow-green halos, are classic signs
of digoxin toxicity, alongside bradycardia, nausea, and vomiting.
2. An adult client is admitted with suspected acute pancreatitis. Which laboratory value
should the nurse expect to be significantly elevated?
A. Serum Amylase
B. Serum Creatinine
C. Hemoglobin A1C
,D. Prothrombin Time
Answer: A
Conceptual Explanation: Serum amylase and lipase are the primary markers for acute
pancreatitis; they rise significantly during an acute inflammatory response of the pancreas.
3. The nurse is caring for a client who is 2 hours post-op after a thyroidectomy. The nurse
notes the client is experiencing frequent swallowing and has a hoarse voice. What is the
priority nursing action?
A. Encourage the client to cough and deep breathe
B. Check the back of the neck for bleeding
C. Administer prescribed oral pain medication
D. Position the client flat in bed
Answer: B
Conceptual Explanation: Frequent swallowing can indicate bleeding in the throat. After a
thyroidectomy, blood may drain to the back of the neck due to gravity, making it the
priority site to assess for hemorrhage.
4. A client diagnosed with schizophrenia is prescribed Clozapine. Which laboratory result
must be monitored weekly?
A. White Blood Cell (WBC) count
B. Serum Glucose
, C. Blood Urea Nitrogen (BUN)
D. Platelet Count
Answer: A
Conceptual Explanation: Clozapine carries a risk of agranulocytosis, which is a severe
decrease in white blood cell count. Regular monitoring of the absolute neutrophil count
(ANC) is mandatory.
5. A pregnant client at 34 weeks gestation presents with painless, bright red vaginal bleeding.
Which condition does the nurse suspect?
A. Abruptio Placentae
B. Preterm Labor
C. Ectopic Pregnancy
D. Placenta Previa
Answer: D
Conceptual Explanation: Placenta previa is characterized by painless, bright red vaginal
bleeding in the third trimester. Abruptio placentae is typically painful.
6. The nurse is caring for a client with a chest tube. The nurse notices continuous bubbling in
the water-seal chamber. What does this finding indicate?
A. The chest tube is functioning correctly
B. The client has an active pneumothorax
(NIGHTINGALE COLLEGE) 2026/2027
QUESTIONS AND CORRECT DETAILED
ANSWERS
1. A client with a history of heart failure is prescribed digoxin 0.25 mg daily. Which
assessment finding should the nurse prioritize as a sign of digoxin toxicity?
A. Visual disturbances such as seeing yellow-green halos
B. Hyperkalemia and increased urinary output
C. Tachycardia and sudden hypertension
D. Increased appetite and improved exercise tolerance
Answer: A
Conceptual Explanation: Visual disturbances, such as yellow-green halos, are classic signs
of digoxin toxicity, alongside bradycardia, nausea, and vomiting.
2. An adult client is admitted with suspected acute pancreatitis. Which laboratory value
should the nurse expect to be significantly elevated?
A. Serum Amylase
B. Serum Creatinine
C. Hemoglobin A1C
,D. Prothrombin Time
Answer: A
Conceptual Explanation: Serum amylase and lipase are the primary markers for acute
pancreatitis; they rise significantly during an acute inflammatory response of the pancreas.
3. The nurse is caring for a client who is 2 hours post-op after a thyroidectomy. The nurse
notes the client is experiencing frequent swallowing and has a hoarse voice. What is the
priority nursing action?
A. Encourage the client to cough and deep breathe
B. Check the back of the neck for bleeding
C. Administer prescribed oral pain medication
D. Position the client flat in bed
Answer: B
Conceptual Explanation: Frequent swallowing can indicate bleeding in the throat. After a
thyroidectomy, blood may drain to the back of the neck due to gravity, making it the
priority site to assess for hemorrhage.
4. A client diagnosed with schizophrenia is prescribed Clozapine. Which laboratory result
must be monitored weekly?
A. White Blood Cell (WBC) count
B. Serum Glucose
, C. Blood Urea Nitrogen (BUN)
D. Platelet Count
Answer: A
Conceptual Explanation: Clozapine carries a risk of agranulocytosis, which is a severe
decrease in white blood cell count. Regular monitoring of the absolute neutrophil count
(ANC) is mandatory.
5. A pregnant client at 34 weeks gestation presents with painless, bright red vaginal bleeding.
Which condition does the nurse suspect?
A. Abruptio Placentae
B. Preterm Labor
C. Ectopic Pregnancy
D. Placenta Previa
Answer: D
Conceptual Explanation: Placenta previa is characterized by painless, bright red vaginal
bleeding in the third trimester. Abruptio placentae is typically painful.
6. The nurse is caring for a client with a chest tube. The nurse notices continuous bubbling in
the water-seal chamber. What does this finding indicate?
A. The chest tube is functioning correctly
B. The client has an active pneumothorax
