1
HESI RN Exit Exam Bundle 2025/2026
– Verified Questions & Real Answer
Keys | Updated A+ Version with Full
Rationales
1. A nurse is caring for a patient with chest pain radiating to the left arm. What is the
priority action?
a) Administer aspirin
b) Obtain a 12-lead ECG
c) Check blood pressure
d) Encourage deep breathing
Rationale: Chest pain radiating to the left arm suggests a possible myocardial infarction,
a medical emergency. Obtaining a 12-lead ECG is the priority to assess cardiac function
and guide treatment. Aspirin may be given after ECG confirmation, blood pressure is
secondary, and deep breathing is not indicated for cardiac chest pain.
2. A patient is prescribed furosemide 40 mg IV for heart failure. What indicates
effectiveness?
a) Weight gain
b) Increased urine output
c) Increased blood pressure
d) Decreased heart rate
Rationale: Furosemide, a loop diuretic, reduces fluid overload in heart failure, increasing
urine output as a sign of effectiveness. Weight gain indicates worsening fluid retention,
increased blood pressure is not expected, and heart rate is not directly affected.
3. A nurse is administering insulin lispro 10 units subcutaneous before meals. When should
it be given?
a) At bedtime
b) 15 minutes before meals
c) With meals
d) Every 12 hours
Rationale: Insulin lispro, a rapid-acting insulin, is administered 15 minutes before meals
to control postprandial glucose spikes. Bedtime or every 12 hours is incorrect for rapid -
acting insulin, and with meals may delay its action.
4. A patient with a history of seizures is prescribed phenytoin 100 mg PO three times daily.
What should the nurse teach?
a) Stop if seizures decrease
b) Report gingival hyperplasia
c) Take with grapefruit juice
d) Take at bedtime only
Rationale: Phenytoin commonly causes gingival hyperplasia, which should be reported
, 2
for dental management. Stopping the medication abruptly can trigger seizures, grapefruit
juice may affect metabolism, and bedtime-only dosing is incorrect.
5. A nurse is assessing a patient’s respiratory status and notes crackles in the lung bases.
What condition might this indicate?
a) Asthma
b) Pulmonary edema
c) Pneumothorax
d) Bronchitis
Rationale: Crackles in the lung bases indicate fluid in the alveoli, commonly associated
with pulmonary edema in heart failure. Asthma causes wheezing, pneumothorax causes
absent breath sounds, and bronchitis may cause rhonchi.
6. A patient is receiving warfarin 5 mg PO daily. Which laboratory value should the nurse
monitor?
a) Platelet count
b) INR
c) Hemoglobin
d) Blood glucose
Rationale: Warfarin, an anticoagulant, requires monitoring of the International
Normalized Ratio (INR) to ensure therapeutic anticoagulation and prevent bleeding or
clotting. Platelet count, hemoglobin, and blood glucose are not directly related.
7. A nurse is preparing to administer morphine 4 mg IV for pain. What is the priority
monitoring parameter?
a) Blood pressure
b) Respiratory rate
c) Blood glucose
d) Temperature
Rationale: Morphine, an opioid, can cause respiratory depression, making respiratory
rate the priority to monitor for patient safety. Blood pressure, glucose, and temperature
are secondary concerns.
8. A patient with diabetes is prescribed metformin 500 mg PO twice daily. What should the
nurse teach?
a) Take at bedtime only
b) Take with meals
c) Stop if glucose normalizes
d) Take with grapefruit juice
Rationale: Metformin is taken with meals to reduce gastrointestinal side effects like
nausea. Bedtime-only dosing is incorrect, stopping abruptly risks hyperglycemia, and
grapefruit juice is not contraindicated but unnecessary.
9. A nurse is caring for a patient with a blood pressure of 180/100 mmHg. What is the
priority action?
a) Encourage fluid intake
b) Notify the provider
c) Reassess in 1 hour
d) Administer oxygen
Rationale: A blood pressure of 180/100 mmHg indicates hypertensive crisis, requiring
, 3
immediate provider notification for antihypertensive therapy. Reassessing later delays
care, and fluids or oxygen are not indicated.
10. A patient is prescribed levothyroxine 100 mcg PO daily for hypothyroidism. What
indicates a therapeutic effect?
a) Weight gain
b) Increased energy levels
c) Hypotension
d) Bradycardia
Rationale: Levothyroxine corrects hypothyroidism, improving metabolism and
increasing energy levels. Weight gain, hypotension, and bradycardia are signs of
undertreatment or unrelated issues.
11. A nurse is assessing a patient’s cranial nerve II. Which test should be performed?
a) Weber test
b) Snellen chart test
c) Romberg test
d) Gag reflex test
Rationale: Cranial nerve II (optic nerve) is assessed using the Snellen chart to evaluate
visual acuity. Weber tests hearing, Romberg tests balance, and gag reflex tests cranial
nerves IX and X.
12. A patient with heart failure reports shortness of breath. What finding indicates worsening
condition?
a) Clear lung sounds
b) Bilateral crackles
c) Heart rate 80 bpm
d) Blood pressure 120/80 mmHg
Rationale: Bilateral crackles indicate fluid in the lungs, a sign of worsening heart failure
due to pulmonary edema. Clear lung sounds, normal heart rate, and blood pressure do not
suggest deterioration.
13. A nurse is administering enoxaparin 40 mg subcutaneous daily. What is the correct
administration site?
a) Deltoid muscle
b) Subcutaneous abdominal tissue
c) Gluteal muscle
d) Intravenous line
Rationale: Enoxaparin, a low-molecular-weight heparin, is administered in the
abdominal subcutaneous tissue to ensure proper absorption and minimize bruising. Other
sites are incorrect for subcutaneous injection, and IV administration is not indicated.
14. A patient is prescribed prednisone 20 mg PO daily for asthma. What should the nurse
teach?
a) Stop abruptly if side effects occur
b) Taper dose when discontinuing
c) Take with grapefruit juice
d) Take at bedtime only
Rationale: Prednisone requires tapering to prevent adrenal insufficiency due to
hypothalamic-pituitary-adrenal axis suppression. Abrupt cessation, grapefruit juice, and
bedtime-only dosing are incorrect.
HESI RN Exit Exam Bundle 2025/2026
– Verified Questions & Real Answer
Keys | Updated A+ Version with Full
Rationales
1. A nurse is caring for a patient with chest pain radiating to the left arm. What is the
priority action?
a) Administer aspirin
b) Obtain a 12-lead ECG
c) Check blood pressure
d) Encourage deep breathing
Rationale: Chest pain radiating to the left arm suggests a possible myocardial infarction,
a medical emergency. Obtaining a 12-lead ECG is the priority to assess cardiac function
and guide treatment. Aspirin may be given after ECG confirmation, blood pressure is
secondary, and deep breathing is not indicated for cardiac chest pain.
2. A patient is prescribed furosemide 40 mg IV for heart failure. What indicates
effectiveness?
a) Weight gain
b) Increased urine output
c) Increased blood pressure
d) Decreased heart rate
Rationale: Furosemide, a loop diuretic, reduces fluid overload in heart failure, increasing
urine output as a sign of effectiveness. Weight gain indicates worsening fluid retention,
increased blood pressure is not expected, and heart rate is not directly affected.
3. A nurse is administering insulin lispro 10 units subcutaneous before meals. When should
it be given?
a) At bedtime
b) 15 minutes before meals
c) With meals
d) Every 12 hours
Rationale: Insulin lispro, a rapid-acting insulin, is administered 15 minutes before meals
to control postprandial glucose spikes. Bedtime or every 12 hours is incorrect for rapid -
acting insulin, and with meals may delay its action.
4. A patient with a history of seizures is prescribed phenytoin 100 mg PO three times daily.
What should the nurse teach?
a) Stop if seizures decrease
b) Report gingival hyperplasia
c) Take with grapefruit juice
d) Take at bedtime only
Rationale: Phenytoin commonly causes gingival hyperplasia, which should be reported
, 2
for dental management. Stopping the medication abruptly can trigger seizures, grapefruit
juice may affect metabolism, and bedtime-only dosing is incorrect.
5. A nurse is assessing a patient’s respiratory status and notes crackles in the lung bases.
What condition might this indicate?
a) Asthma
b) Pulmonary edema
c) Pneumothorax
d) Bronchitis
Rationale: Crackles in the lung bases indicate fluid in the alveoli, commonly associated
with pulmonary edema in heart failure. Asthma causes wheezing, pneumothorax causes
absent breath sounds, and bronchitis may cause rhonchi.
6. A patient is receiving warfarin 5 mg PO daily. Which laboratory value should the nurse
monitor?
a) Platelet count
b) INR
c) Hemoglobin
d) Blood glucose
Rationale: Warfarin, an anticoagulant, requires monitoring of the International
Normalized Ratio (INR) to ensure therapeutic anticoagulation and prevent bleeding or
clotting. Platelet count, hemoglobin, and blood glucose are not directly related.
7. A nurse is preparing to administer morphine 4 mg IV for pain. What is the priority
monitoring parameter?
a) Blood pressure
b) Respiratory rate
c) Blood glucose
d) Temperature
Rationale: Morphine, an opioid, can cause respiratory depression, making respiratory
rate the priority to monitor for patient safety. Blood pressure, glucose, and temperature
are secondary concerns.
8. A patient with diabetes is prescribed metformin 500 mg PO twice daily. What should the
nurse teach?
a) Take at bedtime only
b) Take with meals
c) Stop if glucose normalizes
d) Take with grapefruit juice
Rationale: Metformin is taken with meals to reduce gastrointestinal side effects like
nausea. Bedtime-only dosing is incorrect, stopping abruptly risks hyperglycemia, and
grapefruit juice is not contraindicated but unnecessary.
9. A nurse is caring for a patient with a blood pressure of 180/100 mmHg. What is the
priority action?
a) Encourage fluid intake
b) Notify the provider
c) Reassess in 1 hour
d) Administer oxygen
Rationale: A blood pressure of 180/100 mmHg indicates hypertensive crisis, requiring
, 3
immediate provider notification for antihypertensive therapy. Reassessing later delays
care, and fluids or oxygen are not indicated.
10. A patient is prescribed levothyroxine 100 mcg PO daily for hypothyroidism. What
indicates a therapeutic effect?
a) Weight gain
b) Increased energy levels
c) Hypotension
d) Bradycardia
Rationale: Levothyroxine corrects hypothyroidism, improving metabolism and
increasing energy levels. Weight gain, hypotension, and bradycardia are signs of
undertreatment or unrelated issues.
11. A nurse is assessing a patient’s cranial nerve II. Which test should be performed?
a) Weber test
b) Snellen chart test
c) Romberg test
d) Gag reflex test
Rationale: Cranial nerve II (optic nerve) is assessed using the Snellen chart to evaluate
visual acuity. Weber tests hearing, Romberg tests balance, and gag reflex tests cranial
nerves IX and X.
12. A patient with heart failure reports shortness of breath. What finding indicates worsening
condition?
a) Clear lung sounds
b) Bilateral crackles
c) Heart rate 80 bpm
d) Blood pressure 120/80 mmHg
Rationale: Bilateral crackles indicate fluid in the lungs, a sign of worsening heart failure
due to pulmonary edema. Clear lung sounds, normal heart rate, and blood pressure do not
suggest deterioration.
13. A nurse is administering enoxaparin 40 mg subcutaneous daily. What is the correct
administration site?
a) Deltoid muscle
b) Subcutaneous abdominal tissue
c) Gluteal muscle
d) Intravenous line
Rationale: Enoxaparin, a low-molecular-weight heparin, is administered in the
abdominal subcutaneous tissue to ensure proper absorption and minimize bruising. Other
sites are incorrect for subcutaneous injection, and IV administration is not indicated.
14. A patient is prescribed prednisone 20 mg PO daily for asthma. What should the nurse
teach?
a) Stop abruptly if side effects occur
b) Taper dose when discontinuing
c) Take with grapefruit juice
d) Take at bedtime only
Rationale: Prednisone requires tapering to prevent adrenal insufficiency due to
hypothalamic-pituitary-adrenal axis suppression. Abrupt cessation, grapefruit juice, and
bedtime-only dosing are incorrect.
