1
HESI RN Exit Exam Full Bundle –
Questions with Highlighted Answers
and Expert Rationales (2025/2026) |
A+ Grade
1. A client with chest pain is admitted to the emergency department. Which diagnostic test
should the nurse prioritize?
a) Complete blood count (CBC)
b) Electrocardiogram (ECG)
c) Chest X-ray
d) Blood glucose
Rationale: An ECG is the priority to assess for myocardial ischemia or infarction, critical
in chest pain evaluation.
2. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
appropriate?
a) Administering oral medications
b) Taking vital signs
c) Performing a sterile dressing change
d) Developing a care plan
Rationale: Taking vital signs is within the UAP’s scope, while medication
administration, sterile procedures, and care planning require a licensed nurse.
3. A client with diabetes receives insulin lispro. When should the nurse expect the peak
effect?
a) 6–8 hours
b) 1–2 hours
c) 12–14 hours
d) 24 hours
Rationale: Insulin lispro, a rapid-acting insulin, peaks in 1–2 hours, requiring monitoring
for hypoglycemia during this time.
4. (SATA) A nurse is assessing a client with heart failure. Which findings indicate
worsening condition? (Select all that apply.)
a) Weight gain of 3 pounds in 24 hours
b) Bilateral crackles in lungs
c) Stable blood pressure
d) Jugular vein distention
e) Increased energy levels
Rationale: Weight gain, crackles, and jugular vein distention indicate fluid overload, a
sign of worsening heart failure. Stable blood pressure and increased energy are not
typically associated.
, 2
5. A client is receiving heparin. Which laboratory value should the nurse monitor?
a) Prothrombin time (PT)
b) Activated partial thromboplastin time (aPTT)
c) International normalized ratio (INR)
d) Platelet count
Rationale: Heparin’s anticoagulant effect is monitored via aPTT to ensure therapeutic
levels and prevent bleeding.
6. A nurse is prioritizing care for multiple clients. Which client should be assessed first?
a) A client with a blood pressure of 120/80 mmHg
b) A client reporting shortness of breath
c) A client awaiting discharge instructions
d) A client requesting pain medication
Rationale: Shortness of breath indicates a potential airway or oxygenation issue,
requiring immediate assessment per ABC prioritization.
7. A client with pneumonia is prescribed azithromycin. What should the nurse teach the
client?
a) Take with grapefruit juice
b) Take on an empty stomach
c) Avoid sunlight exposure
d) Double the dose if missed
Rationale: Azithromycin is best absorbed on an empty stomach to maximize efficacy.
8. A nurse is planning care for a client with a new colostomy. Which intervention is
priority?
a) Teach stoma care
b) Assess stoma appearance
c) Encourage ambulation
d) Administer pain medication
Rationale: Assessing stoma appearance ensures proper function and detects
complications like ischemia early.
9. (SATA) A client is at risk for falls. Which interventions should the nurse implement?
(Select all that apply.)
a) Keep the bed in the lowest position
b) Use a bed alarm
c) Place the call light out of reach
d) Ensure adequate lighting
e) Encourage independent ambulation
Rationale: Low bed position, bed alarms, and adequate lighting reduce fall risk. Placing
the call light out of reach and encouraging independent ambulation increase risk.
10. A client with hypertension is prescribed lisinopril. What should the nurse monitor?
a) Blood glucose
b) Blood pressure
c) Respiratory rate
d) Oxygen saturation
Rationale: Lisinopril, an ACE inhibitor, lowers blood pressure, requiring regular
monitoring for hypotension.
, 3
11. A nurse is assessing a client with suspected appendicitis. Which finding requires
immediate action?
a) Mild abdominal pain
b) Rebound tenderness
c) Normal bowel sounds
d) Stable vital signs
Rationale: Rebound tenderness suggests peritoneal inflammation, indicating possible
appendicitis rupture, requiring urgent intervention.
12. A client is receiving morphine for pain. What is the priority nursing assessment?
a) Blood pressure
b) Respiratory rate
c) Temperature
d) Pulse rate
Rationale: Morphine can cause respiratory depression, making respiratory rate the
priority assessment.
13. A nurse is delegating tasks to a licensed practical nurse (LPN). Which task is
appropriate?
a) Developing a care plan
b) Administering oral medications
c) Performing a central line dressing change
d) Evaluating client outcomes
Rationale: Administering oral medications is within the LPN’s scope, while care
planning, central line care, and evaluation are RN responsibilities.
14. A client with a history of seizures is prescribed phenytoin. What should the nurse teach?
a) Skip doses if feeling well
b) Report gingival hyperplasia
c) Take with grapefruit juice
d) Stop if a rash develops
Rationale: Gingival hyperplasia is a side effect of phenytoin, requiring monitoring and
reporting to the provider.
15. A nurse is caring for a client with a chest tube. What indicates a complication?
a) Continuous bubbling in the water seal chamber
b) Sudden cessation of bubbling
c) Tidaling in the water seal chamber
d) Clear drainage
Rationale: Sudden cessation of bubbling may indicate a blockage or disconnection,
requiring immediate intervention.
16. A client with COPD is prescribed albuterol. What is the primary action of this
medication?
a) Anti-inflammatory
b) Bronchodilator
c) Antihistamine
d) Expectorant
Rationale: Albuterol is a bronchodilator that relaxes airway muscles to improve
breathing in COPD.
, 4
17. (SATA) A nurse is planning care for a client with diabetic ketoacidosis (DKA). Which
interventions are appropriate? (Select all that apply.)
a) Administer IV insulin
b) Monitor blood glucose hourly
c) Restrict all fluids
d) Administer IV fluids
e) Encourage oral intake
Rationale: DKA requires IV insulin, frequent glucose monitoring, and IV fluids to
correct hyperglycemia and dehydration. Fluid restriction and oral intake are
inappropriate.
18. A nurse is prioritizing care in the emergency department. Which client should be seen
first?
a) A client with a sprained ankle
b) A client with chest pain and diaphoresis
c) A client with a fever of 100.4°F
d) A client with a laceration
Rationale: Chest pain with diaphoresis suggests a myocardial infarction, requiring
immediate assessment per ABC prioritization.
19. A client is receiving furosemide. Which electrolyte imbalance should the nurse monitor?
a) Hypernatremia
b) Hypokalemia
c) Hypercalcemia
d) Hypermagnesemia
Rationale: Furosemide, a loop diuretic, can cause hypokalemia due to potassium loss in
urine.
20. A nurse is assessing a client post-thyroidectomy. What is a priority assessment?
a) Blood pressure
b) Airway patency
c) Pain level
d) Temperature
Rationale: Airway patency is critical post-thyroidectomy due to the risk of swelling or
hematoma compromising the airway.
21. A client with atrial fibrillation is prescribed warfarin. What should the nurse teach the
client?
a) Avoid foods high in vitamin C
b) Monitor for bleeding
c) Take with grapefruit juice
d) Skip doses if feeling well
Rationale: Warfarin increases bleeding risk, requiring monitoring for signs like bruising
or epistaxis.
22. A nurse is caring for a client with a nasogastric tube. What is the priority intervention?
a) Administer medications orally
b) Verify tube placement
c) Encourage ambulation
d) Change the dressing
HESI RN Exit Exam Full Bundle –
Questions with Highlighted Answers
and Expert Rationales (2025/2026) |
A+ Grade
1. A client with chest pain is admitted to the emergency department. Which diagnostic test
should the nurse prioritize?
a) Complete blood count (CBC)
b) Electrocardiogram (ECG)
c) Chest X-ray
d) Blood glucose
Rationale: An ECG is the priority to assess for myocardial ischemia or infarction, critical
in chest pain evaluation.
2. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
appropriate?
a) Administering oral medications
b) Taking vital signs
c) Performing a sterile dressing change
d) Developing a care plan
Rationale: Taking vital signs is within the UAP’s scope, while medication
administration, sterile procedures, and care planning require a licensed nurse.
3. A client with diabetes receives insulin lispro. When should the nurse expect the peak
effect?
a) 6–8 hours
b) 1–2 hours
c) 12–14 hours
d) 24 hours
Rationale: Insulin lispro, a rapid-acting insulin, peaks in 1–2 hours, requiring monitoring
for hypoglycemia during this time.
4. (SATA) A nurse is assessing a client with heart failure. Which findings indicate
worsening condition? (Select all that apply.)
a) Weight gain of 3 pounds in 24 hours
b) Bilateral crackles in lungs
c) Stable blood pressure
d) Jugular vein distention
e) Increased energy levels
Rationale: Weight gain, crackles, and jugular vein distention indicate fluid overload, a
sign of worsening heart failure. Stable blood pressure and increased energy are not
typically associated.
, 2
5. A client is receiving heparin. Which laboratory value should the nurse monitor?
a) Prothrombin time (PT)
b) Activated partial thromboplastin time (aPTT)
c) International normalized ratio (INR)
d) Platelet count
Rationale: Heparin’s anticoagulant effect is monitored via aPTT to ensure therapeutic
levels and prevent bleeding.
6. A nurse is prioritizing care for multiple clients. Which client should be assessed first?
a) A client with a blood pressure of 120/80 mmHg
b) A client reporting shortness of breath
c) A client awaiting discharge instructions
d) A client requesting pain medication
Rationale: Shortness of breath indicates a potential airway or oxygenation issue,
requiring immediate assessment per ABC prioritization.
7. A client with pneumonia is prescribed azithromycin. What should the nurse teach the
client?
a) Take with grapefruit juice
b) Take on an empty stomach
c) Avoid sunlight exposure
d) Double the dose if missed
Rationale: Azithromycin is best absorbed on an empty stomach to maximize efficacy.
8. A nurse is planning care for a client with a new colostomy. Which intervention is
priority?
a) Teach stoma care
b) Assess stoma appearance
c) Encourage ambulation
d) Administer pain medication
Rationale: Assessing stoma appearance ensures proper function and detects
complications like ischemia early.
9. (SATA) A client is at risk for falls. Which interventions should the nurse implement?
(Select all that apply.)
a) Keep the bed in the lowest position
b) Use a bed alarm
c) Place the call light out of reach
d) Ensure adequate lighting
e) Encourage independent ambulation
Rationale: Low bed position, bed alarms, and adequate lighting reduce fall risk. Placing
the call light out of reach and encouraging independent ambulation increase risk.
10. A client with hypertension is prescribed lisinopril. What should the nurse monitor?
a) Blood glucose
b) Blood pressure
c) Respiratory rate
d) Oxygen saturation
Rationale: Lisinopril, an ACE inhibitor, lowers blood pressure, requiring regular
monitoring for hypotension.
, 3
11. A nurse is assessing a client with suspected appendicitis. Which finding requires
immediate action?
a) Mild abdominal pain
b) Rebound tenderness
c) Normal bowel sounds
d) Stable vital signs
Rationale: Rebound tenderness suggests peritoneal inflammation, indicating possible
appendicitis rupture, requiring urgent intervention.
12. A client is receiving morphine for pain. What is the priority nursing assessment?
a) Blood pressure
b) Respiratory rate
c) Temperature
d) Pulse rate
Rationale: Morphine can cause respiratory depression, making respiratory rate the
priority assessment.
13. A nurse is delegating tasks to a licensed practical nurse (LPN). Which task is
appropriate?
a) Developing a care plan
b) Administering oral medications
c) Performing a central line dressing change
d) Evaluating client outcomes
Rationale: Administering oral medications is within the LPN’s scope, while care
planning, central line care, and evaluation are RN responsibilities.
14. A client with a history of seizures is prescribed phenytoin. What should the nurse teach?
a) Skip doses if feeling well
b) Report gingival hyperplasia
c) Take with grapefruit juice
d) Stop if a rash develops
Rationale: Gingival hyperplasia is a side effect of phenytoin, requiring monitoring and
reporting to the provider.
15. A nurse is caring for a client with a chest tube. What indicates a complication?
a) Continuous bubbling in the water seal chamber
b) Sudden cessation of bubbling
c) Tidaling in the water seal chamber
d) Clear drainage
Rationale: Sudden cessation of bubbling may indicate a blockage or disconnection,
requiring immediate intervention.
16. A client with COPD is prescribed albuterol. What is the primary action of this
medication?
a) Anti-inflammatory
b) Bronchodilator
c) Antihistamine
d) Expectorant
Rationale: Albuterol is a bronchodilator that relaxes airway muscles to improve
breathing in COPD.
, 4
17. (SATA) A nurse is planning care for a client with diabetic ketoacidosis (DKA). Which
interventions are appropriate? (Select all that apply.)
a) Administer IV insulin
b) Monitor blood glucose hourly
c) Restrict all fluids
d) Administer IV fluids
e) Encourage oral intake
Rationale: DKA requires IV insulin, frequent glucose monitoring, and IV fluids to
correct hyperglycemia and dehydration. Fluid restriction and oral intake are
inappropriate.
18. A nurse is prioritizing care in the emergency department. Which client should be seen
first?
a) A client with a sprained ankle
b) A client with chest pain and diaphoresis
c) A client with a fever of 100.4°F
d) A client with a laceration
Rationale: Chest pain with diaphoresis suggests a myocardial infarction, requiring
immediate assessment per ABC prioritization.
19. A client is receiving furosemide. Which electrolyte imbalance should the nurse monitor?
a) Hypernatremia
b) Hypokalemia
c) Hypercalcemia
d) Hypermagnesemia
Rationale: Furosemide, a loop diuretic, can cause hypokalemia due to potassium loss in
urine.
20. A nurse is assessing a client post-thyroidectomy. What is a priority assessment?
a) Blood pressure
b) Airway patency
c) Pain level
d) Temperature
Rationale: Airway patency is critical post-thyroidectomy due to the risk of swelling or
hematoma compromising the airway.
21. A client with atrial fibrillation is prescribed warfarin. What should the nurse teach the
client?
a) Avoid foods high in vitamin C
b) Monitor for bleeding
c) Take with grapefruit juice
d) Skip doses if feeling well
Rationale: Warfarin increases bleeding risk, requiring monitoring for signs like bruising
or epistaxis.
22. A nurse is caring for a client with a nasogastric tube. What is the priority intervention?
a) Administer medications orally
b) Verify tube placement
c) Encourage ambulation
d) Change the dressing
