HESI Exit Exam 2024 Comprehensive
Review
100% Updated Questions & Rationales with Full Grading
Assurance
Instructions
This review contains 80 high-yield, non-repeating multiple-choice questions designed
for the HESI Exit Exam 2024. Questions align with 2024 clinical guidelines, ethical
scenarios, and safety protocols. Each includes four answer options, with the correct
answer marked and an expert-level rationale. The document is formatted for profes-
sional PDF export. Use this resource to prepare effectively.
Question 1: A nurse is caring for a client with heart failure experiencing dyspnea. Which
position should the nurse place the client in to relieve symptoms?
A. Supine with legs elevated
B. Fowlers position (Correct)
C. Prone position
D. Trendelenburg position
Rationale: Fowlers position (semi-sitting, 4560 degrees) promotes lung expan-
sion and reduces preload, easing dyspnea in heart failure. Supine worsens symp-
toms, prone is impractical, and Trendelenburg increases venous return, exac-
erbating congestion. Reference: Ignatavicius, D. D., & Workman, M. L. (2024).
Medical-Surgical Nursing.
Question 2: A nurse is administering insulin lispro to a client with type 1 diabetes. When
should the nurse expect the onset of action?
A. 510 minutes
B. 1530 minutes (Correct)
C. 12 hours
D. 34 hours
Rationale: Insulin lispro, a rapid-acting insulin, has an onset of 1530 minutes.
Options A, C, and D correspond to other insulin types (e.g., regular, NPH, long-
acting). Reference: 2024 ADA Standards of Care.
Question 3: A nurse is assessing a client with suspected appendicitis. Which finding should
the nurse report immediately?
A. Rebound tenderness (Correct)
B. Mild fever
1
, C. Nausea
D. Soft abdomen
Rationale: Rebound tenderness indicates peritoneal irritation, a critical sign of
appendicitis requiring urgent surgical evaluation. Mild fever and nausea are
common but less urgent, and a soft abdomen is normal.
Question 4: A nurse is teaching a client about warfarin therapy. Which food should the client
limit to maintain therapeutic INR levels?
A. Broccoli (Correct)
B. Chicken breast
C. White rice
D. Apples
Rationale: Broccoli, high in vitamin K, can decrease warfarins anticoagulant ef-
fect, affecting INR. Chicken, rice, and apples have minimal impact on INR. Ref-
erence: 2024 ACCP Antithrombotic Guidelines.
Question 5: A nurse is caring for a client with a new colostomy. Which observation indicates
a complication?
A. Pink stoma
B. Liquid stool
C. Dusky stoma (Correct)
D. Mild peristomal redness
Rationale: A dusky stoma suggests ischemia, a serious complication requiring
immediate intervention. Pink stoma is normal, liquid stool is expected initially,
and mild redness is common.
Question 6: A nurse is prioritizing care for four clients. Which client should the nurse assess
first?
A. Client with chest pain and diaphoresis (Correct)
B. Client with a blood glucose of 180 mg/dL
C. Client with a temperature of 100.4řF
D. Client awaiting discharge teaching
Rationale: Chest pain and diaphoresis suggest acute coronary syndrome, a life-
threatening condition requiring immediate assessment. The other clients condi-
tions are less urgent.
Question 7: A nurse is administering a blood transfusion. The client reports itching and
hives. What should the nurse do first?
A. Slow the transfusion rate
B. Stop the transfusion (Correct)
2
, C. Administer diphenhydramine
D. Notify the provider
Rationale: Itching and hives indicate an allergic reaction. Stopping the transfu-
sion prevents further exposure. Slowing the rate is insufficient, and medications
or notification follow stopping the infusion.
Question 8: A nurse is caring for a client with pneumonia. Which laboratory result requires
immediate intervention?
A. Oxygen saturation 88% (Correct)
B. White blood cell count 12,000/mmş
C. Sodium 138 mEq/L
D. Hemoglobin 13 g/dL
Rationale: An oxygen saturation of 88% indicates hypoxia, requiring immediate
oxygen administration. Other results are within normal or expected ranges for
pneumonia.
Question 9: A nurse is teaching a client with hypertension about lifestyle modifications. Which
recommendation should the nurse include?
A. Limit sodium to 2,300 mg/day (Correct)
B. Consume 34 alcoholic drinks daily
C. Avoid aerobic exercise
D. Increase saturated fat intake
Rationale: Limiting sodium to 2,300 mg/day reduces blood pressure per 2024
AHA guidelines. Alcohol should be limited, exercise encouraged, and saturated
fats reduced.
Question 10: A nurse is assessing a client with suspected hypokalemia. Which symptom
should the nurse expect?
A. Muscle cramps (Correct)
B. Hypertension
C. Bradycardia
D. Hyperreflexia
Rationale: Hypokalemia causes muscle cramps due to impaired muscle contrac-
tion. Hypertension, bradycardia, and hyperreflexia are not typical symptoms.
Question 11: A nurse is caring for a client post-myocardial infarction. Which medication
should the nurse expect to administer?
A. Aspirin (Correct)
B. Digoxin
C. Furosemide
3
Review
100% Updated Questions & Rationales with Full Grading
Assurance
Instructions
This review contains 80 high-yield, non-repeating multiple-choice questions designed
for the HESI Exit Exam 2024. Questions align with 2024 clinical guidelines, ethical
scenarios, and safety protocols. Each includes four answer options, with the correct
answer marked and an expert-level rationale. The document is formatted for profes-
sional PDF export. Use this resource to prepare effectively.
Question 1: A nurse is caring for a client with heart failure experiencing dyspnea. Which
position should the nurse place the client in to relieve symptoms?
A. Supine with legs elevated
B. Fowlers position (Correct)
C. Prone position
D. Trendelenburg position
Rationale: Fowlers position (semi-sitting, 4560 degrees) promotes lung expan-
sion and reduces preload, easing dyspnea in heart failure. Supine worsens symp-
toms, prone is impractical, and Trendelenburg increases venous return, exac-
erbating congestion. Reference: Ignatavicius, D. D., & Workman, M. L. (2024).
Medical-Surgical Nursing.
Question 2: A nurse is administering insulin lispro to a client with type 1 diabetes. When
should the nurse expect the onset of action?
A. 510 minutes
B. 1530 minutes (Correct)
C. 12 hours
D. 34 hours
Rationale: Insulin lispro, a rapid-acting insulin, has an onset of 1530 minutes.
Options A, C, and D correspond to other insulin types (e.g., regular, NPH, long-
acting). Reference: 2024 ADA Standards of Care.
Question 3: A nurse is assessing a client with suspected appendicitis. Which finding should
the nurse report immediately?
A. Rebound tenderness (Correct)
B. Mild fever
1
, C. Nausea
D. Soft abdomen
Rationale: Rebound tenderness indicates peritoneal irritation, a critical sign of
appendicitis requiring urgent surgical evaluation. Mild fever and nausea are
common but less urgent, and a soft abdomen is normal.
Question 4: A nurse is teaching a client about warfarin therapy. Which food should the client
limit to maintain therapeutic INR levels?
A. Broccoli (Correct)
B. Chicken breast
C. White rice
D. Apples
Rationale: Broccoli, high in vitamin K, can decrease warfarins anticoagulant ef-
fect, affecting INR. Chicken, rice, and apples have minimal impact on INR. Ref-
erence: 2024 ACCP Antithrombotic Guidelines.
Question 5: A nurse is caring for a client with a new colostomy. Which observation indicates
a complication?
A. Pink stoma
B. Liquid stool
C. Dusky stoma (Correct)
D. Mild peristomal redness
Rationale: A dusky stoma suggests ischemia, a serious complication requiring
immediate intervention. Pink stoma is normal, liquid stool is expected initially,
and mild redness is common.
Question 6: A nurse is prioritizing care for four clients. Which client should the nurse assess
first?
A. Client with chest pain and diaphoresis (Correct)
B. Client with a blood glucose of 180 mg/dL
C. Client with a temperature of 100.4řF
D. Client awaiting discharge teaching
Rationale: Chest pain and diaphoresis suggest acute coronary syndrome, a life-
threatening condition requiring immediate assessment. The other clients condi-
tions are less urgent.
Question 7: A nurse is administering a blood transfusion. The client reports itching and
hives. What should the nurse do first?
A. Slow the transfusion rate
B. Stop the transfusion (Correct)
2
, C. Administer diphenhydramine
D. Notify the provider
Rationale: Itching and hives indicate an allergic reaction. Stopping the transfu-
sion prevents further exposure. Slowing the rate is insufficient, and medications
or notification follow stopping the infusion.
Question 8: A nurse is caring for a client with pneumonia. Which laboratory result requires
immediate intervention?
A. Oxygen saturation 88% (Correct)
B. White blood cell count 12,000/mmş
C. Sodium 138 mEq/L
D. Hemoglobin 13 g/dL
Rationale: An oxygen saturation of 88% indicates hypoxia, requiring immediate
oxygen administration. Other results are within normal or expected ranges for
pneumonia.
Question 9: A nurse is teaching a client with hypertension about lifestyle modifications. Which
recommendation should the nurse include?
A. Limit sodium to 2,300 mg/day (Correct)
B. Consume 34 alcoholic drinks daily
C. Avoid aerobic exercise
D. Increase saturated fat intake
Rationale: Limiting sodium to 2,300 mg/day reduces blood pressure per 2024
AHA guidelines. Alcohol should be limited, exercise encouraged, and saturated
fats reduced.
Question 10: A nurse is assessing a client with suspected hypokalemia. Which symptom
should the nurse expect?
A. Muscle cramps (Correct)
B. Hypertension
C. Bradycardia
D. Hyperreflexia
Rationale: Hypokalemia causes muscle cramps due to impaired muscle contrac-
tion. Hypertension, bradycardia, and hyperreflexia are not typical symptoms.
Question 11: A nurse is caring for a client post-myocardial infarction. Which medication
should the nurse expect to administer?
A. Aspirin (Correct)
B. Digoxin
C. Furosemide
3
