HESI Exit RN Exam Complete Test Bank 2025-2026 | 160
High-Yield Scenario-Based Questions & Rationales
1. A patient has sudden shortness of breath and a drop in oxygen saturation. What is
the priority intervention?
Correct Answer: Administer supplemental oxygen and assess airway patency.
Rationale: Airway and oxygenation are always the first priorities in acute respiratory
distress.
2. A post-op patient is complaining of incisional pain rated 8/10. What should the nurse
do first?
Correct Answer: Assess the pain characteristics and administer prescribed analgesic.
Rationale: Pain assessment guides appropriate analgesic administration.
3. A newborn has a heart rate of 85 bpm. What is the immediate action?
Correct Answer: Initiate neonatal resuscitation measures.
Rationale: Normal neonatal heart rate is 100–160 bpm; <100 requires intervention.
4. A patient receiving IV antibiotics develops a rash and difficulty breathing. What is the
first step?
Correct Answer: Stop the infusion and initiate emergency response (anaphylaxis
protocol).
Rationale: Immediate cessation of the allergen and emergency care is critical in
anaphylaxis.
5. A nurse delegates a stable patient’s routine vitals to a UAP. What is the nurse’s
responsibility?
Correct Answer: Ensure the UAP is competent and follow up on results.
Rationale: Delegation requires supervision and accountability for patient outcomes.
6. A patient with heart failure has 3+ pitting edema in the legs. What is the priority
nursing action?
,Correct Answer: Elevate the legs and assess fluid status.
Rationale: Elevation reduces edema; fluid status assessment guides further
interventions.
7. A patient reports new onset confusion and agitation. Vital signs: BP 180/100, HR 110.
What is the priority action?
Correct Answer: Assess for hypertensive encephalopathy and notify the provider.
Rationale: Acute confusion with high BP may indicate a hypertensive emergency.
8. A diabetic patient is found sweating, shaky, and anxious. Blood glucose is 55 mg/dL.
What is the immediate intervention?
Correct Answer: Administer fast-acting glucose orally if patient is alert.
Rationale: Hypoglycemia requires rapid glucose to prevent neurological damage.
9. A patient on anticoagulants develops sudden severe headache and vomiting. What
should the nurse do?
Correct Answer: Assess for intracranial hemorrhage and notify the provider.
Rationale: Severe headache in an anticoagulated patient may indicate bleeding.
10. A postoperative patient has a temp of 38.9°C and surgical site redness. What is the
priority action?
Correct Answer: Assess wound for infection and notify the provider.
Rationale: Early detection of infection is critical for postoperative patients.
11. A patient with COPD is using accessory muscles to breathe and has SpO₂ of 88%.
What is the priority action?
Correct Answer: Administer supplemental oxygen and position upright.
Rationale: Oxygenation and optimal positioning improve ventilation.
, 12. A patient refuses to take prescribed medication due to religious beliefs. What is the
nurse’s role?
Correct Answer: Respect the patient’s decision and document the refusal.
Rationale: Patient autonomy must be honored while ensuring informed decision-making.
13. A patient with chest pain has ST elevation on ECG. What is the immediate nursing
action?
Correct Answer: Notify the provider and prepare for possible reperfusion therapy.
Rationale: ST elevation indicates acute myocardial infarction; rapid intervention is
critical.
14. A patient receiving morphine reports respiratory rate of 8/min. What is the priority
action?
Correct Answer: Stop the infusion and administer naloxone per protocol.
Rationale: Opioid overdose can cause respiratory depression; immediate reversal is
lifesaving.
15. A patient with chronic kidney disease has serum potassium of 6.5 mEq/L. What
should the nurse do first?
Correct Answer: Notify the provider and prepare for interventions to lower potassium.
Rationale: Hyperkalemia is life-threatening and requires urgent treatment.
16. A patient with acute asthma exacerbation wheezes and has difficulty speaking. What
is the priority intervention?
Correct Answer: Administer rapid-acting bronchodilator and assess airway.
Rationale: Severe asthma attack requires immediate airway management and
bronchodilation.
17. A patient is post-op day 1 with no urine output for 6 hours. What should the nurse do
first?
High-Yield Scenario-Based Questions & Rationales
1. A patient has sudden shortness of breath and a drop in oxygen saturation. What is
the priority intervention?
Correct Answer: Administer supplemental oxygen and assess airway patency.
Rationale: Airway and oxygenation are always the first priorities in acute respiratory
distress.
2. A post-op patient is complaining of incisional pain rated 8/10. What should the nurse
do first?
Correct Answer: Assess the pain characteristics and administer prescribed analgesic.
Rationale: Pain assessment guides appropriate analgesic administration.
3. A newborn has a heart rate of 85 bpm. What is the immediate action?
Correct Answer: Initiate neonatal resuscitation measures.
Rationale: Normal neonatal heart rate is 100–160 bpm; <100 requires intervention.
4. A patient receiving IV antibiotics develops a rash and difficulty breathing. What is the
first step?
Correct Answer: Stop the infusion and initiate emergency response (anaphylaxis
protocol).
Rationale: Immediate cessation of the allergen and emergency care is critical in
anaphylaxis.
5. A nurse delegates a stable patient’s routine vitals to a UAP. What is the nurse’s
responsibility?
Correct Answer: Ensure the UAP is competent and follow up on results.
Rationale: Delegation requires supervision and accountability for patient outcomes.
6. A patient with heart failure has 3+ pitting edema in the legs. What is the priority
nursing action?
,Correct Answer: Elevate the legs and assess fluid status.
Rationale: Elevation reduces edema; fluid status assessment guides further
interventions.
7. A patient reports new onset confusion and agitation. Vital signs: BP 180/100, HR 110.
What is the priority action?
Correct Answer: Assess for hypertensive encephalopathy and notify the provider.
Rationale: Acute confusion with high BP may indicate a hypertensive emergency.
8. A diabetic patient is found sweating, shaky, and anxious. Blood glucose is 55 mg/dL.
What is the immediate intervention?
Correct Answer: Administer fast-acting glucose orally if patient is alert.
Rationale: Hypoglycemia requires rapid glucose to prevent neurological damage.
9. A patient on anticoagulants develops sudden severe headache and vomiting. What
should the nurse do?
Correct Answer: Assess for intracranial hemorrhage and notify the provider.
Rationale: Severe headache in an anticoagulated patient may indicate bleeding.
10. A postoperative patient has a temp of 38.9°C and surgical site redness. What is the
priority action?
Correct Answer: Assess wound for infection and notify the provider.
Rationale: Early detection of infection is critical for postoperative patients.
11. A patient with COPD is using accessory muscles to breathe and has SpO₂ of 88%.
What is the priority action?
Correct Answer: Administer supplemental oxygen and position upright.
Rationale: Oxygenation and optimal positioning improve ventilation.
, 12. A patient refuses to take prescribed medication due to religious beliefs. What is the
nurse’s role?
Correct Answer: Respect the patient’s decision and document the refusal.
Rationale: Patient autonomy must be honored while ensuring informed decision-making.
13. A patient with chest pain has ST elevation on ECG. What is the immediate nursing
action?
Correct Answer: Notify the provider and prepare for possible reperfusion therapy.
Rationale: ST elevation indicates acute myocardial infarction; rapid intervention is
critical.
14. A patient receiving morphine reports respiratory rate of 8/min. What is the priority
action?
Correct Answer: Stop the infusion and administer naloxone per protocol.
Rationale: Opioid overdose can cause respiratory depression; immediate reversal is
lifesaving.
15. A patient with chronic kidney disease has serum potassium of 6.5 mEq/L. What
should the nurse do first?
Correct Answer: Notify the provider and prepare for interventions to lower potassium.
Rationale: Hyperkalemia is life-threatening and requires urgent treatment.
16. A patient with acute asthma exacerbation wheezes and has difficulty speaking. What
is the priority intervention?
Correct Answer: Administer rapid-acting bronchodilator and assess airway.
Rationale: Severe asthma attack requires immediate airway management and
bronchodilation.
17. A patient is post-op day 1 with no urine output for 6 hours. What should the nurse do
first?
