HESI RN Exit Exam 2025/2026 (V1–V3
Update) – Verified Questions, Correct
Answers, and Expert Rationales
Question 1
A client with heart failure is prescribed enalapril (Vasotec). Which assessment should the nurse
prioritize before administering the medication?
A. Checking the client’s peripheral pulses
B. Monitoring the client’s potassium levels
C. Assessing the client’s blood pressure
D. Reviewing the client’s intake and output
Rationale: Enalapril, an ACE inhibitor, is used to treat heart failure and hypertension by
reducing blood pressure. Checking the client’s blood pressure before administration is critical to
prevent hypotension, a common side effect. Peripheral pulses, potassium levels, and
intake/output are important but not the priority in this context.
Question 2
A nurse is teaching a client newly diagnosed with type 1 diabetes mellitus about insulin storage.
Which client statement indicates understanding?
A. “I’ll keep my insulin in the freezer to maintain potency.”
B. “I can store my open insulin vial at room temperature for up to 28 days.”
C. “I’ll store my insulin on the windowsill for easy access.”
D. “I need to refrigerate my insulin pens at all times.”
Rationale: Open insulin vials or pens can be stored at room temperature (15–30°C) for up to 28
days without losing potency, making this the correct client statement. Freezing insulin damages
it, windowsill storage risks temperature fluctuations, and refrigeration is not required for open
vials/pens.
Question 3
A 34-week pregnant client presents with painless bright red vaginal bleeding. What is the most
likely diagnosis?
,A. Placental abruption
B. Placenta previa
C. Preterm labor
D. Uterine rupture
Rationale: Placenta previa is characterized by painless bright red vaginal bleeding in the third
trimester due to the placenta covering the cervical os. Placental abruption causes painful
bleeding, preterm labor involves contractions, and uterine rupture is rare and associated with
severe pain and fetal distress.
Question 4
A client with bipolar disorder on lithium presents with slurred speech. Which laboratory result
should the nurse report immediately?
A. Sodium level of 140 mEq/L
B. Creatinine level of 1.0 mg/dL
C. Lithium level of 1.8 mEq/L
D. Potassium level of 4.2 mEq/L
Rationale: A lithium level of 1.8 mEq/L is above the therapeutic range (0.6–1.2 mEq/L),
indicating potential toxicity, which can cause slurred speech, tremors, or seizures. The other
laboratory results are within normal limits and do not explain the symptoms.
Question 5
A nurse is preparing to administer a metered-dose inhaler (MDI) with a spacer to a client with
asthma. What is the correct technique?
A. Inhale quickly and hold the breath for 2 seconds.
B. Inhale slowly and deeply, holding the breath for 10 seconds.
C. Exhale into the spacer before inhaling.
D. Activate the MDI after starting to inhale.
Rationale: For an MDI with a spacer, the client should inhale slowly and deeply after activating
the inhaler, holding the breath for 10 seconds to allow medication deposition in the lungs. Quick
inhalation, exhaling into the spacer, or mistiming activation reduces effectiveness.
Question 6
A client with a history of peptic ulcer disease is prescribed sucralfate (Carafate). When should
the nurse administer this medication?
, A. 1 hour before meals on an empty stomach
B. With meals to enhance absorption
C. Immediately after meals
D. At bedtime only
Rationale: Sucralfate forms a protective barrier over the ulcer and should be taken 1 hour before
meals on an empty stomach to maximize its effect. Taking it with or after meals or only at
bedtime reduces its efficacy.
Question 7
A postoperative client has a prescription for morphine sulfate 2 mg IV every 2 hours as needed
for pain. What should the nurse assess first?
A. Respiratory rate
B. Pain level
C. Blood pressure
D. Temperature
Rationale: Morphine is an opioid for pain relief, so assessing the client’s pain level first ensures
the medication is needed and guides dosing. Respiratory rate is critical before administration but
follows pain assessment.
Question 8
A client with chronic kidney disease is prescribed epoetin alfa (Epogen). What laboratory value
should the nurse monitor?
A. Platelet count
B. Hemoglobin level
C. Serum creatinine
D. Blood urea nitrogen
Rationale: Epoetin alfa stimulates red blood cell production, so monitoring hemoglobin levels is
essential to evaluate effectiveness and prevent complications like hypertension from
overcorrection. Other values are relevant but not primary.
Question 9
A nurse is caring for a client with a new colostomy. Which client statement indicates a need for
further teaching?
Update) – Verified Questions, Correct
Answers, and Expert Rationales
Question 1
A client with heart failure is prescribed enalapril (Vasotec). Which assessment should the nurse
prioritize before administering the medication?
A. Checking the client’s peripheral pulses
B. Monitoring the client’s potassium levels
C. Assessing the client’s blood pressure
D. Reviewing the client’s intake and output
Rationale: Enalapril, an ACE inhibitor, is used to treat heart failure and hypertension by
reducing blood pressure. Checking the client’s blood pressure before administration is critical to
prevent hypotension, a common side effect. Peripheral pulses, potassium levels, and
intake/output are important but not the priority in this context.
Question 2
A nurse is teaching a client newly diagnosed with type 1 diabetes mellitus about insulin storage.
Which client statement indicates understanding?
A. “I’ll keep my insulin in the freezer to maintain potency.”
B. “I can store my open insulin vial at room temperature for up to 28 days.”
C. “I’ll store my insulin on the windowsill for easy access.”
D. “I need to refrigerate my insulin pens at all times.”
Rationale: Open insulin vials or pens can be stored at room temperature (15–30°C) for up to 28
days without losing potency, making this the correct client statement. Freezing insulin damages
it, windowsill storage risks temperature fluctuations, and refrigeration is not required for open
vials/pens.
Question 3
A 34-week pregnant client presents with painless bright red vaginal bleeding. What is the most
likely diagnosis?
,A. Placental abruption
B. Placenta previa
C. Preterm labor
D. Uterine rupture
Rationale: Placenta previa is characterized by painless bright red vaginal bleeding in the third
trimester due to the placenta covering the cervical os. Placental abruption causes painful
bleeding, preterm labor involves contractions, and uterine rupture is rare and associated with
severe pain and fetal distress.
Question 4
A client with bipolar disorder on lithium presents with slurred speech. Which laboratory result
should the nurse report immediately?
A. Sodium level of 140 mEq/L
B. Creatinine level of 1.0 mg/dL
C. Lithium level of 1.8 mEq/L
D. Potassium level of 4.2 mEq/L
Rationale: A lithium level of 1.8 mEq/L is above the therapeutic range (0.6–1.2 mEq/L),
indicating potential toxicity, which can cause slurred speech, tremors, or seizures. The other
laboratory results are within normal limits and do not explain the symptoms.
Question 5
A nurse is preparing to administer a metered-dose inhaler (MDI) with a spacer to a client with
asthma. What is the correct technique?
A. Inhale quickly and hold the breath for 2 seconds.
B. Inhale slowly and deeply, holding the breath for 10 seconds.
C. Exhale into the spacer before inhaling.
D. Activate the MDI after starting to inhale.
Rationale: For an MDI with a spacer, the client should inhale slowly and deeply after activating
the inhaler, holding the breath for 10 seconds to allow medication deposition in the lungs. Quick
inhalation, exhaling into the spacer, or mistiming activation reduces effectiveness.
Question 6
A client with a history of peptic ulcer disease is prescribed sucralfate (Carafate). When should
the nurse administer this medication?
, A. 1 hour before meals on an empty stomach
B. With meals to enhance absorption
C. Immediately after meals
D. At bedtime only
Rationale: Sucralfate forms a protective barrier over the ulcer and should be taken 1 hour before
meals on an empty stomach to maximize its effect. Taking it with or after meals or only at
bedtime reduces its efficacy.
Question 7
A postoperative client has a prescription for morphine sulfate 2 mg IV every 2 hours as needed
for pain. What should the nurse assess first?
A. Respiratory rate
B. Pain level
C. Blood pressure
D. Temperature
Rationale: Morphine is an opioid for pain relief, so assessing the client’s pain level first ensures
the medication is needed and guides dosing. Respiratory rate is critical before administration but
follows pain assessment.
Question 8
A client with chronic kidney disease is prescribed epoetin alfa (Epogen). What laboratory value
should the nurse monitor?
A. Platelet count
B. Hemoglobin level
C. Serum creatinine
D. Blood urea nitrogen
Rationale: Epoetin alfa stimulates red blood cell production, so monitoring hemoglobin levels is
essential to evaluate effectiveness and prevent complications like hypertension from
overcorrection. Other values are relevant but not primary.
Question 9
A nurse is caring for a client with a new colostomy. Which client statement indicates a need for
further teaching?
