1
HESI RN Exit Exam 2025 Full Bundle
– Real Exam Scenarios, Prioritization
& 100% Verified Answers with
Rationales | Updated for 2024/2025
This document provides a comprehensive HESI RN Exit Exam 2025 practice bundle with
100 clinically relevant questions, emphasizing critical thinking, patient safety, prioritization
(ABCs, Maslow’s hierarchy), and interdisciplinary collaboration. Questions include
multiple-choice (MCQ), select-all-that-apply (SATA), and Next Generation NCLEX
(NGN)-style formats (matrix, drop-down, highlight, drag-and-drop), aligned with
2024/2025 standards. Correct answers are highlighted in yellow, followed by detailed
rationales in red. The layout is clean, editable, and watermark-free.
Critical Thinking (Questions 1–30)
Question 1 (MCQ)
Scenario: A client with chest pain is admitted to the ED. Vital signs: BP 160/90 mmHg, HR 110
bpm, RR 24 breaths/min, SpO2 94%.
Question: What is the nurse’s first action?
A. Administer nitroglycerin
B. Assess respiratory status
C. Notify the provider
D. Document vital signs
Correct Answer:
B. Assess respiratory status
Rationale: Using the ABCs (airway, breathing, circulation), assessing respiratory status is the
priority to ensure oxygenation, as chest pain and tachypnea suggest possible cardiac ischemia or
hypoxia. Nitroglycerin, notification, and documentation follow assessment.
Question 2 (SATA)
Scenario: A client with suspected myocardial infarction (MI) is receiving oxygen.
Question: Which interventions should the nurse include? Select all that apply.
A. Administer aspirin as prescribed
B. Monitor ECG continuously
C. Encourage ambulation
D. Assess pain level
E. Provide a high-fat meal
, 2
Correct Answers:
A. Administer aspirin as prescribed
B. Monitor ECG continuously
D. Assess pain level
Rationale: Aspirin prevents platelet aggregation, ECG monitoring detects arrhythmias, and pain
assessment guides treatment in MI. Ambulation risks worsening ischemia, and high-fat meals are
contraindicated.
Question 3 (NGN - Matrix)
Scenario: A client post-CABG has a CVP of 10 mmHg, MAP of 70 mmHg, and crackles in the
lungs.
Question: Match the finding to the appropriate nursing action.
Findings:
1. CVP 10 mmHg
2. MAP 70 mmHg
3. Crackles in lungs
Actions:
A. Administer furosemide
B. Monitor for hypoperfusion
C. Assess fluid status
Correct Answer:
1-C, 2-B, 3-A
Rationale: Elevated CVP suggests fluid overload, requiring fluid status assessment; low MAP
indicates potential hypoperfusion, needing monitoring; crackles suggest pulmonary edema,
requiring furosemide.
Question 4 (NGN - Drop-Down)
Scenario: A client with pneumonia reports dyspnea.
Question: Select the priority nursing diagnosis.
• Ineffective breathing pattern
• Risk for infection
• Acute pain
• Anxiety
Correct Answer:
Ineffective breathing pattern
Rationale: Dyspnea indicates impaired gas exchange, making ineffective breathing pattern the
priority per ABCs. Infection, pain, and anxiety are secondary.
, 3
Question 5 (NGN - Highlight)
Scenario: A client with heart failure has jugular vein distension (JVD).
Question: Highlight the priority intervention in the care plan.
• Encourage fluid intake
• Administer diuretics as prescribed
• Teach low-sodium diet
• Monitor daily weights
Correct Answer:
Administer diuretics as prescribed
Rationale: JVD indicates fluid overload, requiring diuretics to reduce preload. Fluid intake
worsens overload, while diet and weights are secondary.
Question 6 (MCQ)
Scenario: A client with diabetes reports shakiness and sweating. Blood glucose is 55 mg/dL.
Question: What is the nurse’s priority action?
A. Administer insulin
B. Provide a carbohydrate snack
C. Notify the provider
D. Document the glucose
Correct Answer:
B. Provide a carbohydrate snack
Rationale: Shakiness and sweating with low glucose indicate hypoglycemia, requiring a fast-
acting carbohydrate (e.g., juice). Insulin worsens hypoglycemia, and notification or
documentation follows treatment.
Question 7 (SATA)
Scenario: A client with a new tracheostomy is coughing.
Question: Which interventions should the nurse implement? Select all that apply.
A. Suction the airway
B. Assess airway patency
C. Administer a cough suppressant
D. Monitor oxygen saturation
E. Encourage deep breathing
Correct Answers:
A. Suction the airway
B. Assess airway patency
D. Monitor oxygen saturation
, 4
Rationale: Coughing suggests obstruction, requiring airway assessment and suctioning, with
SpO2 monitoring to ensure oxygenation. Cough suppressants risk secretion retention, and deep
breathing is secondary.
Question 8 (NGN - Drag and Drop)
Scenario: A client with sepsis requires urgent care.
Question: Place the following actions in the correct order.
1. Obtain blood cultures
2. Administer IV antibiotics
3. Initiate fluid bolus
4. Assess vital signs
Correct Answer:
4, 1, 3, 2
Rationale: Assessing vital signs determines urgency, blood cultures identify the pathogen, fluids
restore perfusion, and antibiotics treat infection, per sepsis protocols.
Question 9 (MCQ)
Scenario: A client post-stroke has dysphagia.
Question: What is the nurse’s priority action?
A. Provide thin liquids
B. Assess swallowing ability
C. Encourage rapid eating
D. Document the diet
Correct Answer:
B. Assess swallowing ability
Rationale: Dysphagia risks aspiration, requiring swallowing assessment to ensure safety. Thin
liquids and rapid eating increase risk, and documentation is secondary.
Question 10 (NGN - Matrix)
Scenario: A client with COPD has wheezing and SpO2 of 90%.
Question: Match the finding to the appropriate nursing action.
Findings:
1. Wheezing
2. SpO2 90%
3. Anxiety
Actions:
A. Administer oxygen
B. Administer bronchodilator
C. Provide reassurance
HESI RN Exit Exam 2025 Full Bundle
– Real Exam Scenarios, Prioritization
& 100% Verified Answers with
Rationales | Updated for 2024/2025
This document provides a comprehensive HESI RN Exit Exam 2025 practice bundle with
100 clinically relevant questions, emphasizing critical thinking, patient safety, prioritization
(ABCs, Maslow’s hierarchy), and interdisciplinary collaboration. Questions include
multiple-choice (MCQ), select-all-that-apply (SATA), and Next Generation NCLEX
(NGN)-style formats (matrix, drop-down, highlight, drag-and-drop), aligned with
2024/2025 standards. Correct answers are highlighted in yellow, followed by detailed
rationales in red. The layout is clean, editable, and watermark-free.
Critical Thinking (Questions 1–30)
Question 1 (MCQ)
Scenario: A client with chest pain is admitted to the ED. Vital signs: BP 160/90 mmHg, HR 110
bpm, RR 24 breaths/min, SpO2 94%.
Question: What is the nurse’s first action?
A. Administer nitroglycerin
B. Assess respiratory status
C. Notify the provider
D. Document vital signs
Correct Answer:
B. Assess respiratory status
Rationale: Using the ABCs (airway, breathing, circulation), assessing respiratory status is the
priority to ensure oxygenation, as chest pain and tachypnea suggest possible cardiac ischemia or
hypoxia. Nitroglycerin, notification, and documentation follow assessment.
Question 2 (SATA)
Scenario: A client with suspected myocardial infarction (MI) is receiving oxygen.
Question: Which interventions should the nurse include? Select all that apply.
A. Administer aspirin as prescribed
B. Monitor ECG continuously
C. Encourage ambulation
D. Assess pain level
E. Provide a high-fat meal
, 2
Correct Answers:
A. Administer aspirin as prescribed
B. Monitor ECG continuously
D. Assess pain level
Rationale: Aspirin prevents platelet aggregation, ECG monitoring detects arrhythmias, and pain
assessment guides treatment in MI. Ambulation risks worsening ischemia, and high-fat meals are
contraindicated.
Question 3 (NGN - Matrix)
Scenario: A client post-CABG has a CVP of 10 mmHg, MAP of 70 mmHg, and crackles in the
lungs.
Question: Match the finding to the appropriate nursing action.
Findings:
1. CVP 10 mmHg
2. MAP 70 mmHg
3. Crackles in lungs
Actions:
A. Administer furosemide
B. Monitor for hypoperfusion
C. Assess fluid status
Correct Answer:
1-C, 2-B, 3-A
Rationale: Elevated CVP suggests fluid overload, requiring fluid status assessment; low MAP
indicates potential hypoperfusion, needing monitoring; crackles suggest pulmonary edema,
requiring furosemide.
Question 4 (NGN - Drop-Down)
Scenario: A client with pneumonia reports dyspnea.
Question: Select the priority nursing diagnosis.
• Ineffective breathing pattern
• Risk for infection
• Acute pain
• Anxiety
Correct Answer:
Ineffective breathing pattern
Rationale: Dyspnea indicates impaired gas exchange, making ineffective breathing pattern the
priority per ABCs. Infection, pain, and anxiety are secondary.
, 3
Question 5 (NGN - Highlight)
Scenario: A client with heart failure has jugular vein distension (JVD).
Question: Highlight the priority intervention in the care plan.
• Encourage fluid intake
• Administer diuretics as prescribed
• Teach low-sodium diet
• Monitor daily weights
Correct Answer:
Administer diuretics as prescribed
Rationale: JVD indicates fluid overload, requiring diuretics to reduce preload. Fluid intake
worsens overload, while diet and weights are secondary.
Question 6 (MCQ)
Scenario: A client with diabetes reports shakiness and sweating. Blood glucose is 55 mg/dL.
Question: What is the nurse’s priority action?
A. Administer insulin
B. Provide a carbohydrate snack
C. Notify the provider
D. Document the glucose
Correct Answer:
B. Provide a carbohydrate snack
Rationale: Shakiness and sweating with low glucose indicate hypoglycemia, requiring a fast-
acting carbohydrate (e.g., juice). Insulin worsens hypoglycemia, and notification or
documentation follows treatment.
Question 7 (SATA)
Scenario: A client with a new tracheostomy is coughing.
Question: Which interventions should the nurse implement? Select all that apply.
A. Suction the airway
B. Assess airway patency
C. Administer a cough suppressant
D. Monitor oxygen saturation
E. Encourage deep breathing
Correct Answers:
A. Suction the airway
B. Assess airway patency
D. Monitor oxygen saturation
, 4
Rationale: Coughing suggests obstruction, requiring airway assessment and suctioning, with
SpO2 monitoring to ensure oxygenation. Cough suppressants risk secretion retention, and deep
breathing is secondary.
Question 8 (NGN - Drag and Drop)
Scenario: A client with sepsis requires urgent care.
Question: Place the following actions in the correct order.
1. Obtain blood cultures
2. Administer IV antibiotics
3. Initiate fluid bolus
4. Assess vital signs
Correct Answer:
4, 1, 3, 2
Rationale: Assessing vital signs determines urgency, blood cultures identify the pathogen, fluids
restore perfusion, and antibiotics treat infection, per sepsis protocols.
Question 9 (MCQ)
Scenario: A client post-stroke has dysphagia.
Question: What is the nurse’s priority action?
A. Provide thin liquids
B. Assess swallowing ability
C. Encourage rapid eating
D. Document the diet
Correct Answer:
B. Assess swallowing ability
Rationale: Dysphagia risks aspiration, requiring swallowing assessment to ensure safety. Thin
liquids and rapid eating increase risk, and documentation is secondary.
Question 10 (NGN - Matrix)
Scenario: A client with COPD has wheezing and SpO2 of 90%.
Question: Match the finding to the appropriate nursing action.
Findings:
1. Wheezing
2. SpO2 90%
3. Anxiety
Actions:
A. Administer oxygen
B. Administer bronchodilator
C. Provide reassurance
