lOMoAR cPSD| 18634763
lOMoAR cPSD| 1863476
HESI EXIT EXAM 2 FINAL - Exit Practice Exam 2026
1. Following discharge teaching, a male client with duodenal ulcer tells the nurse the he will drink plenty
ofdairy products, such as milk, to help coat and protect his ulcer. What is the best follow-up action
by the nurse?
Review with the client the need to avoid foods that are rich in milk and cream
2. A male client with hypertension, who received new antihypertensive prescriptions at his last visit
returns to the clinic two weeks later to evaluate his blood pressure (BP). His BP is 158/106 and he
admits that he has not been taking the prescribed medication because the drugs make him “feel
bad”. In explaining the need for hypertension control, the nurse should stress that an elevated BP
places the client at risk for which pathophysiological condition?
Stroke secondary to hemorrhage
3. The nurse observes an unlicensed assistive personnel (UAP) positioning a newly admitted
client who has a seizure disorder. The client is supine and the UAP is placing soft pillows along
the side rails. What action should the nurse implement?
Instruct the UAP to obtain soft blankets to secure to the side rails instead of
pillows.
4. An adolescent with major depressive disorder has been taking duloxetine (Cymbalta) for the past
12 days. Which assessment finding requires immediate follow-up?
Describes life without purpose
5. A 60-year-old female client with a positive family history of ovarian cancer has developed an
abdominal mass and is being evaluated for possible ovarian cancer. Her Papanicolau (Pap) smear
results are negative. What information should the nurse include in the client’s teaching plan?
Further evaluation involving surgery may be needed
6. A client who recently underwear a tracheostomy is being prepared for discharge to home. Which
instructions is most important for the nurse to include in the discharge plan?
Teach tracheal suctioning techniques
7. In assessing an adult client with a partial rebreather mask, the nurse notes that the oxygen
reservoir bag does not deflate completely during inspiration and the client’s respiratory rate is 14
breaths / minute. What action should the nurse implement?
Document the assessment data
Rational: reservoir bag should not deflate completely during inspiration and the client’s
respiratory rate is within normal limits.
8. During shift report, the central electrocardiogram (EKG) monitoring system alarms. Which
client alarm should the nurse investigate firs?
Respiratory apnea of 30 seconds
9. During a home visit, the nurse observed an elderly client with diabetes slip and fall. What action
should the nurse take first?
Check the client for lacerations or fractures
10. At 0600 while admitting a woman for a schedule repeat cesarean section (C-Section), the client
tells the nurse that she drank a cup a coffee at 0400 because she wanted to avoid
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, lOMoAR cPSD| 18634763
getting a headache. Which action should the nurse take first?
Inform the anesthesia care provider
11. After placing a stethoscope as seen in the picture, the nurse auscultates S1 and S2 heart
sounds. To determine if an S3 heart sound is present, what action should the nurse take first?
Listen with the bell at the same location
12. A 66-year-old woman is retiring and will no longer have a health insurance through her place of
employment. Which agency should the client be referred to by the employee health nurse for
health insurance needs?
Medicare
13. A client who is taking an oral dose of a tetracycline complains of gastrointestinal upset. What
snack should the nurse instruct the client to take with the tetracycline?
Toasted wheat bread and jelly
14. Following a lumbar puncture, a client voices several complaints. What complaint
indicated to the nurse that the client is experiencing a complication?
“I have a headache that gets worse when I sit up”
“I am having pain in my lower back when I move my legs”
“My throat hurts when I swallow”
“I feel sick to my stomach and am going to throw up”
15. An elderly client seems confused and reports the onset of nausea, dysuria, and urgency with
incontinence. Which action should the nurse implement?
Obtain a clean catch mid-stream specimen
16. The nurse is assisting the mother of a child with phenylketonuria (PKU) to select foods that are
in keeping with the child’s dietary restrictions. Which foods are contraindicated for this child?
Foods sweetened with aspartame
17. Before preparing a client for the first surgical case of the day, a part-time scrub nurse asks
the circulating nurse if a 3 minute surgical hand scrub is adequate preparation for this client.
Which response should the circulating nurse provide?
Direct the nurse to continue the surgical hand scrub for a 5 minute duration
18. Which breakfast selection indicates that the client understands the nurse’s instructions about
the dietary management of osteoporosis?
Bagel with jelly and skim milk
19. The charge nurse of a critical care unit is informed at the beginning of the shift that less than the
optimal number of registered nurses will be working that shift. In planning assignments, which
client should receive the most care hours by a registered nurse (RN)?
An 82-year-old client with Alzheimer’s disease newly-fractures femur who has a Foley
catheter and soft wrist restrains applied
2|Page
, lOMoAR cPSD| 18634763
20. A mother brings her 6-year-old child, who has just stepped on a rusty nail, to the pediatrician’s
office. Upon inspection, the nurse notes that the nail went through the shoe and pierced the
bottom of the child’s foot. Which action should the nurse implement first?
Cleanse the foot with soap and water and apply an antibiotic ointment
Provide teaching about the need for a tetanus booster within the next 72 hours.
have the mother check the child's temperature q4h for the next 24 hours
transfer the child to the emergency department to receive a gamma globulin
injection
21. The mother of an adolescent tells the clinic nurse, “My son has athlete’s foot, I have been applying
triple antibiotic ointment for two days, but there has been no improvement.” What instruction
should the nurse provide?
Stop using the ointment and encourage complete drying of the feet and wearing clean
socks.
22. A 26-year-old female client is admitted to the hospital for treatment of a simple goiter, and
levothyroxine sodium (Synthroid) is prescribed. Which symptoms indicate to the nurse that the
prescribed dosage is too high for this client? The client experiences
Bradycardia and constipation
Lethargy and lack of appetite
Muscle cramping and dry, flushed skin
Palpitations and shortness of breath
23. A client with a history of heart failure presents to the clinic with a nausea, vomiting, yellow vision
and palpitations. Which finding is most important for the nurse to assess to the client?
Obtain a list of medications taken for cardiac history
24. The healthcare provider prescribes an IV solution of isoproterenol (Isuprel) 1 mg in 250 ml of D5W
at 300 mcg/hour. The nurse should program the infusion pump to deliver how many ml/hour?
(Enter numeric value only.)
75
Rationale: Convert mg to mcg and use the formula D/H x Q. 300 mcg/hour / 1,000
mcg x 250 ml = 3/1 x 25 = 75 ml/hour
25. The pathophysiological mechanism are responsible for ascites related to liver failure? (Select
all that apply)
Fluid shifts from intravascular to interstitial area due to decreased serum protein
Increased hydrostatic pressure in portal circulation increases fluid shifts into
abdomen
Increased circulating aldosterone levels that increase sodium and water retention
26. The nurse is auscultating a client’s heart sounds. Which description should the nurse use to
document this sound? (Please listen to the audio first to select the option that applies)
Murmur
Rationale: A murmur is auscultated as a swishing sound that is associated with the blood
turbulence created by the heart or valvular defect.
3|Page
, lOMoAR cPSD| 18634763
27. The healthcare provider prescribes celtazidime (Fortax) 35 mg every 8 hours IM for an infant.
The 500 mg vial is labeled with the instruction to add 5.3 ml diluent to provide a concentration
of 100 mg/ml. How many ml should the nurse administered for each dose? (Enter numeric value
only. If rounding is required, round to the nearest tenth)
0.4
rationale: 35mg/100mg x 1 = 0.35 = 0.4 ml
28. The nurse notes that a client has been receiving hydromorphone (Dilaudid) every six hours
for four days. What assessment is most important for the nurse to complete?
Auscultate the client's bowel sounds
Observe for edema around the ankles
Measure the client’s capillary glucose level
Count the apical and radial pulses simultaneously
Rationale: hydromorphone is a potent opioid analgesic that slows peristalsis and
frequently causes constipation, so it is most important to Auscultate the client's bowel
sounds
29. A female client is admitted with end stage pulmonary disease is alert, oriented, and
complaining of shortness of breath. The client tells the nurse that she wants “no heroic
measures” taken if she stops breathing, and she asks the nurse to document this in her
medical record. What action should the nurse implement?
Ask the client to discuss “do not resuscitate” with her healthcare provider
30. A client is receiving a full strength continuous enteral tube feeding at 50 ml/hour and has
developed diarrhea. The client has a new prescription to change the feeding to half strength.
What intervention should the nurse implement?
Add equal amounts of water and feeding to a feeding bag and infuse at 50ml/hour
31. A female client reports that her hair is becoming coarse and breaking off, that the outer part of
her eyebrows have disappeared, and that her eyes are all puffy. Which follow-up question is
best for the nurse to ask?
Have you noticed any changes in your fingernails?
Rationale: The pattern of reported manifestations is suggestive of hypothyroidism
32. After a third hospitalization 6 months ago, a client is admitted to the hospital with ascites and
malnutrition. The client is drowsy but responding to verbal stimuli and reports recently spitting
up blood. What assessment finding warrants immediate intervention by the nurse?
Capillary refill of 8 seconds
bruises on arms and legs
round and tight abdomen
pitting edema in lower legs
33. After the nurse witnesses a preoperative client sign the surgical consent form, the nurse signs
the form as a witness. What are the legal implications of the nurse’s signature on the client’s
surgical consent form? (Select all that apply)
The client voluntarily grants permission for the procedure to be done
The client is competent to sign the consent without impairment of judgment
4|Page
lOMoAR cPSD| 1863476
HESI EXIT EXAM 2 FINAL - Exit Practice Exam 2026
1. Following discharge teaching, a male client with duodenal ulcer tells the nurse the he will drink plenty
ofdairy products, such as milk, to help coat and protect his ulcer. What is the best follow-up action
by the nurse?
Review with the client the need to avoid foods that are rich in milk and cream
2. A male client with hypertension, who received new antihypertensive prescriptions at his last visit
returns to the clinic two weeks later to evaluate his blood pressure (BP). His BP is 158/106 and he
admits that he has not been taking the prescribed medication because the drugs make him “feel
bad”. In explaining the need for hypertension control, the nurse should stress that an elevated BP
places the client at risk for which pathophysiological condition?
Stroke secondary to hemorrhage
3. The nurse observes an unlicensed assistive personnel (UAP) positioning a newly admitted
client who has a seizure disorder. The client is supine and the UAP is placing soft pillows along
the side rails. What action should the nurse implement?
Instruct the UAP to obtain soft blankets to secure to the side rails instead of
pillows.
4. An adolescent with major depressive disorder has been taking duloxetine (Cymbalta) for the past
12 days. Which assessment finding requires immediate follow-up?
Describes life without purpose
5. A 60-year-old female client with a positive family history of ovarian cancer has developed an
abdominal mass and is being evaluated for possible ovarian cancer. Her Papanicolau (Pap) smear
results are negative. What information should the nurse include in the client’s teaching plan?
Further evaluation involving surgery may be needed
6. A client who recently underwear a tracheostomy is being prepared for discharge to home. Which
instructions is most important for the nurse to include in the discharge plan?
Teach tracheal suctioning techniques
7. In assessing an adult client with a partial rebreather mask, the nurse notes that the oxygen
reservoir bag does not deflate completely during inspiration and the client’s respiratory rate is 14
breaths / minute. What action should the nurse implement?
Document the assessment data
Rational: reservoir bag should not deflate completely during inspiration and the client’s
respiratory rate is within normal limits.
8. During shift report, the central electrocardiogram (EKG) monitoring system alarms. Which
client alarm should the nurse investigate firs?
Respiratory apnea of 30 seconds
9. During a home visit, the nurse observed an elderly client with diabetes slip and fall. What action
should the nurse take first?
Check the client for lacerations or fractures
10. At 0600 while admitting a woman for a schedule repeat cesarean section (C-Section), the client
tells the nurse that she drank a cup a coffee at 0400 because she wanted to avoid
1|Page
, lOMoAR cPSD| 18634763
getting a headache. Which action should the nurse take first?
Inform the anesthesia care provider
11. After placing a stethoscope as seen in the picture, the nurse auscultates S1 and S2 heart
sounds. To determine if an S3 heart sound is present, what action should the nurse take first?
Listen with the bell at the same location
12. A 66-year-old woman is retiring and will no longer have a health insurance through her place of
employment. Which agency should the client be referred to by the employee health nurse for
health insurance needs?
Medicare
13. A client who is taking an oral dose of a tetracycline complains of gastrointestinal upset. What
snack should the nurse instruct the client to take with the tetracycline?
Toasted wheat bread and jelly
14. Following a lumbar puncture, a client voices several complaints. What complaint
indicated to the nurse that the client is experiencing a complication?
“I have a headache that gets worse when I sit up”
“I am having pain in my lower back when I move my legs”
“My throat hurts when I swallow”
“I feel sick to my stomach and am going to throw up”
15. An elderly client seems confused and reports the onset of nausea, dysuria, and urgency with
incontinence. Which action should the nurse implement?
Obtain a clean catch mid-stream specimen
16. The nurse is assisting the mother of a child with phenylketonuria (PKU) to select foods that are
in keeping with the child’s dietary restrictions. Which foods are contraindicated for this child?
Foods sweetened with aspartame
17. Before preparing a client for the first surgical case of the day, a part-time scrub nurse asks
the circulating nurse if a 3 minute surgical hand scrub is adequate preparation for this client.
Which response should the circulating nurse provide?
Direct the nurse to continue the surgical hand scrub for a 5 minute duration
18. Which breakfast selection indicates that the client understands the nurse’s instructions about
the dietary management of osteoporosis?
Bagel with jelly and skim milk
19. The charge nurse of a critical care unit is informed at the beginning of the shift that less than the
optimal number of registered nurses will be working that shift. In planning assignments, which
client should receive the most care hours by a registered nurse (RN)?
An 82-year-old client with Alzheimer’s disease newly-fractures femur who has a Foley
catheter and soft wrist restrains applied
2|Page
, lOMoAR cPSD| 18634763
20. A mother brings her 6-year-old child, who has just stepped on a rusty nail, to the pediatrician’s
office. Upon inspection, the nurse notes that the nail went through the shoe and pierced the
bottom of the child’s foot. Which action should the nurse implement first?
Cleanse the foot with soap and water and apply an antibiotic ointment
Provide teaching about the need for a tetanus booster within the next 72 hours.
have the mother check the child's temperature q4h for the next 24 hours
transfer the child to the emergency department to receive a gamma globulin
injection
21. The mother of an adolescent tells the clinic nurse, “My son has athlete’s foot, I have been applying
triple antibiotic ointment for two days, but there has been no improvement.” What instruction
should the nurse provide?
Stop using the ointment and encourage complete drying of the feet and wearing clean
socks.
22. A 26-year-old female client is admitted to the hospital for treatment of a simple goiter, and
levothyroxine sodium (Synthroid) is prescribed. Which symptoms indicate to the nurse that the
prescribed dosage is too high for this client? The client experiences
Bradycardia and constipation
Lethargy and lack of appetite
Muscle cramping and dry, flushed skin
Palpitations and shortness of breath
23. A client with a history of heart failure presents to the clinic with a nausea, vomiting, yellow vision
and palpitations. Which finding is most important for the nurse to assess to the client?
Obtain a list of medications taken for cardiac history
24. The healthcare provider prescribes an IV solution of isoproterenol (Isuprel) 1 mg in 250 ml of D5W
at 300 mcg/hour. The nurse should program the infusion pump to deliver how many ml/hour?
(Enter numeric value only.)
75
Rationale: Convert mg to mcg and use the formula D/H x Q. 300 mcg/hour / 1,000
mcg x 250 ml = 3/1 x 25 = 75 ml/hour
25. The pathophysiological mechanism are responsible for ascites related to liver failure? (Select
all that apply)
Fluid shifts from intravascular to interstitial area due to decreased serum protein
Increased hydrostatic pressure in portal circulation increases fluid shifts into
abdomen
Increased circulating aldosterone levels that increase sodium and water retention
26. The nurse is auscultating a client’s heart sounds. Which description should the nurse use to
document this sound? (Please listen to the audio first to select the option that applies)
Murmur
Rationale: A murmur is auscultated as a swishing sound that is associated with the blood
turbulence created by the heart or valvular defect.
3|Page
, lOMoAR cPSD| 18634763
27. The healthcare provider prescribes celtazidime (Fortax) 35 mg every 8 hours IM for an infant.
The 500 mg vial is labeled with the instruction to add 5.3 ml diluent to provide a concentration
of 100 mg/ml. How many ml should the nurse administered for each dose? (Enter numeric value
only. If rounding is required, round to the nearest tenth)
0.4
rationale: 35mg/100mg x 1 = 0.35 = 0.4 ml
28. The nurse notes that a client has been receiving hydromorphone (Dilaudid) every six hours
for four days. What assessment is most important for the nurse to complete?
Auscultate the client's bowel sounds
Observe for edema around the ankles
Measure the client’s capillary glucose level
Count the apical and radial pulses simultaneously
Rationale: hydromorphone is a potent opioid analgesic that slows peristalsis and
frequently causes constipation, so it is most important to Auscultate the client's bowel
sounds
29. A female client is admitted with end stage pulmonary disease is alert, oriented, and
complaining of shortness of breath. The client tells the nurse that she wants “no heroic
measures” taken if she stops breathing, and she asks the nurse to document this in her
medical record. What action should the nurse implement?
Ask the client to discuss “do not resuscitate” with her healthcare provider
30. A client is receiving a full strength continuous enteral tube feeding at 50 ml/hour and has
developed diarrhea. The client has a new prescription to change the feeding to half strength.
What intervention should the nurse implement?
Add equal amounts of water and feeding to a feeding bag and infuse at 50ml/hour
31. A female client reports that her hair is becoming coarse and breaking off, that the outer part of
her eyebrows have disappeared, and that her eyes are all puffy. Which follow-up question is
best for the nurse to ask?
Have you noticed any changes in your fingernails?
Rationale: The pattern of reported manifestations is suggestive of hypothyroidism
32. After a third hospitalization 6 months ago, a client is admitted to the hospital with ascites and
malnutrition. The client is drowsy but responding to verbal stimuli and reports recently spitting
up blood. What assessment finding warrants immediate intervention by the nurse?
Capillary refill of 8 seconds
bruises on arms and legs
round and tight abdomen
pitting edema in lower legs
33. After the nurse witnesses a preoperative client sign the surgical consent form, the nurse signs
the form as a witness. What are the legal implications of the nurse’s signature on the client’s
surgical consent form? (Select all that apply)
The client voluntarily grants permission for the procedure to be done
The client is competent to sign the consent without impairment of judgment
4|Page
