1
HESI Exit RN Exam ACTUAL EXAM
2026/2027 | Volume 1 (V1) Latest |
Verified Questions and Answers | Pass
Guaranteed - A+ Graded
1. The nurse receives report on four clients. Which client should the nurse assess first?
A. 68-year-old 2 hours post-PCI with BP 118/76 and groin dressing dry
B. 55-year-old on hemodialysis with K⁺ 5.8 mEq/L and peaked T waves
C. 72-year-old 1 day post-CABG with chest tube output 80 mL/h
D. 60-year-old with COPD on 2 L O₂ via NC with SpO₂ 94 %
Correct Answer: B
Rationale: Hyperkalemia with peaked T waves is potentially lethal (ventricular
fibrillation risk). Follows ABC framework → cardiac stability first.
Test-Taking Tip: Always choose the option with life-threatening arrhythmia potential.
2. (SATA) A 7-year-old with sickle-cell disease is admitted with vaso-occlusive crisis.
Which nursing actions are priority? (Select all that apply.)
A. Administer morphine 0.05 mg/kg IV q4h PRN
B. Apply warm compresses to painful joints
C. Encourage oral fluids to 1.5× maintenance
D. Provide incentive spirometer q2h while awake
E. Order CBC with retic count daily
Correct Answer: A, B, C, D
Rationale: Pain control, hydration, and preventing hypoxia/acidosis are crisis
cornerstones. Daily CBC is provider order, not independent nursing action.
3. The nurse is caring for a client receiving heparin 1200 units/h for DVT. aPTT is 110
seconds (control 32). Which order should the nurse question?
A. Decrease heparin to 1000 units/h
B. Obtain PT/INR now
C. Continue current rate and recheck in 6 h
D. Notify house officer if aPTT >150
Correct Answer: C
,2
Rationale: aPTT >2.5–3× control (≈80–96 s) increases bleeding risk; continuing current
rate without reduction is unsafe.
4. A client with DM-1 reports waking with night sweats and morning headache. Which
additional finding supports Somogyi phenomenon?
A. Bedtime BG 180 mg/dL, 3 AM BG 76 mg/dL, morning BG 220 mg/dL
B. Bedtime BG 110 mg/dL, 3 AM BG 210 mg/dL, morning BG 160 mg/dL
C. Bedtime BG 95 mg/dL, 3 AM BG 88 mg/dL, morning BG 92 mg/dL
D. Bedtime BG 200 mg/dL, 3 AM BG 205 mg/dL, morning BG 198 mg/dL
Correct Answer: A
Rationale: Hypoglycemia at 3 AM triggers counter-regulatory hormones → rebound
hyperglycemia by morning.
5. The nurse notes late decelerations on the fetal monitor of a laboring client at 6 cm. Which
first action is indicated?
A. Stop Pitocin if infusing
B. Turn client to lateral position
C. Apply O₂ 10 L via non-rebreather
D. Increase IV fluid rate
Correct Answer: A
Rationale: Uterine hyper-stimulation is common cause; stopping Pitocin removes
stimulus rapidly.
6. (OR) Place the steps for donning PPE for contact precautions in correct order:
7. Apply gown
8. Perform hand hygiene
9. Apply mask/respirator
10. Apply goggles/face shield
11. Apply gloves over gown cuffs
Correct Order: 2-3-4-1-5
Rationale: CDC sequence: clean hands first, protect airway/mucosa, then body, then
gloves last.
12. A client with cirrhosis develops asterixis. Which initial nursing action is priority?
A. Restrict dietary protein
B. Measure abdominal girth
C. Institute fall precautions
D. Administer lactulose
Correct Answer: C
, 3
Rationale: Asterixis indicates hepatic encephalopathy → altered LOC & motor control →
fall risk is immediate safety threat.
13. The nurse is teaching a 16-year-old with new asthma. Which patient statement indicates
understanding?
A. “I will use my albuterol 2 puffs every morning to prevent attacks.”
B. “I should rinse my mouth after my fostair inhaler.”
C. “I can keep my cat if I vacuum weekly.”
D. “I will call if peak flow is in yellow zone.”
Correct Answer: D
Rationale: Zone system (green/yellow/red) is self-management cornerstone; yellow zone
= reduce dose or call, showing correct use.
14. A client receiving cisplatin reports tinnitus. Which lab value is most important to
check?
A. Serum creatinine
B. Serum magnesium
C. AST
D. WBC
Correct Answer: A
Rationale: Cisplatin is nephrotoxic; tinnitus may signal ototoxicity related to renal
excretion issues.
15. (SATA) A client with COPD is being discharged. Which health-promotion teachings are
appropriate? (Select all that apply.)
A. Receive pneumococcal conjugate vaccine if not had
B. Use pursed-lip breathing during exertion
C. Increase fluid intake to 3 L/day
D. Schedule flu vaccine annually
E. Avoid high-flow O₂ at home
Correct Answer: A, B, D, E
Rationale: 3 L/day may overload and cause hyponatremia; otherwise all reduce
exacerbation risk.
16. The nurse is reviewing morning labs for a client with acute pancreatitis. Which finding
requires immediate intervention?
A. Glucose 220 mg/dL
B. Ca²⁺ 7.2 mg/dL (ionized 0.9 mmol/L)
C. WBC 14 000 mm³
D. Amylase 500 U/L
Correct Answer: B
HESI Exit RN Exam ACTUAL EXAM
2026/2027 | Volume 1 (V1) Latest |
Verified Questions and Answers | Pass
Guaranteed - A+ Graded
1. The nurse receives report on four clients. Which client should the nurse assess first?
A. 68-year-old 2 hours post-PCI with BP 118/76 and groin dressing dry
B. 55-year-old on hemodialysis with K⁺ 5.8 mEq/L and peaked T waves
C. 72-year-old 1 day post-CABG with chest tube output 80 mL/h
D. 60-year-old with COPD on 2 L O₂ via NC with SpO₂ 94 %
Correct Answer: B
Rationale: Hyperkalemia with peaked T waves is potentially lethal (ventricular
fibrillation risk). Follows ABC framework → cardiac stability first.
Test-Taking Tip: Always choose the option with life-threatening arrhythmia potential.
2. (SATA) A 7-year-old with sickle-cell disease is admitted with vaso-occlusive crisis.
Which nursing actions are priority? (Select all that apply.)
A. Administer morphine 0.05 mg/kg IV q4h PRN
B. Apply warm compresses to painful joints
C. Encourage oral fluids to 1.5× maintenance
D. Provide incentive spirometer q2h while awake
E. Order CBC with retic count daily
Correct Answer: A, B, C, D
Rationale: Pain control, hydration, and preventing hypoxia/acidosis are crisis
cornerstones. Daily CBC is provider order, not independent nursing action.
3. The nurse is caring for a client receiving heparin 1200 units/h for DVT. aPTT is 110
seconds (control 32). Which order should the nurse question?
A. Decrease heparin to 1000 units/h
B. Obtain PT/INR now
C. Continue current rate and recheck in 6 h
D. Notify house officer if aPTT >150
Correct Answer: C
,2
Rationale: aPTT >2.5–3× control (≈80–96 s) increases bleeding risk; continuing current
rate without reduction is unsafe.
4. A client with DM-1 reports waking with night sweats and morning headache. Which
additional finding supports Somogyi phenomenon?
A. Bedtime BG 180 mg/dL, 3 AM BG 76 mg/dL, morning BG 220 mg/dL
B. Bedtime BG 110 mg/dL, 3 AM BG 210 mg/dL, morning BG 160 mg/dL
C. Bedtime BG 95 mg/dL, 3 AM BG 88 mg/dL, morning BG 92 mg/dL
D. Bedtime BG 200 mg/dL, 3 AM BG 205 mg/dL, morning BG 198 mg/dL
Correct Answer: A
Rationale: Hypoglycemia at 3 AM triggers counter-regulatory hormones → rebound
hyperglycemia by morning.
5. The nurse notes late decelerations on the fetal monitor of a laboring client at 6 cm. Which
first action is indicated?
A. Stop Pitocin if infusing
B. Turn client to lateral position
C. Apply O₂ 10 L via non-rebreather
D. Increase IV fluid rate
Correct Answer: A
Rationale: Uterine hyper-stimulation is common cause; stopping Pitocin removes
stimulus rapidly.
6. (OR) Place the steps for donning PPE for contact precautions in correct order:
7. Apply gown
8. Perform hand hygiene
9. Apply mask/respirator
10. Apply goggles/face shield
11. Apply gloves over gown cuffs
Correct Order: 2-3-4-1-5
Rationale: CDC sequence: clean hands first, protect airway/mucosa, then body, then
gloves last.
12. A client with cirrhosis develops asterixis. Which initial nursing action is priority?
A. Restrict dietary protein
B. Measure abdominal girth
C. Institute fall precautions
D. Administer lactulose
Correct Answer: C
, 3
Rationale: Asterixis indicates hepatic encephalopathy → altered LOC & motor control →
fall risk is immediate safety threat.
13. The nurse is teaching a 16-year-old with new asthma. Which patient statement indicates
understanding?
A. “I will use my albuterol 2 puffs every morning to prevent attacks.”
B. “I should rinse my mouth after my fostair inhaler.”
C. “I can keep my cat if I vacuum weekly.”
D. “I will call if peak flow is in yellow zone.”
Correct Answer: D
Rationale: Zone system (green/yellow/red) is self-management cornerstone; yellow zone
= reduce dose or call, showing correct use.
14. A client receiving cisplatin reports tinnitus. Which lab value is most important to
check?
A. Serum creatinine
B. Serum magnesium
C. AST
D. WBC
Correct Answer: A
Rationale: Cisplatin is nephrotoxic; tinnitus may signal ototoxicity related to renal
excretion issues.
15. (SATA) A client with COPD is being discharged. Which health-promotion teachings are
appropriate? (Select all that apply.)
A. Receive pneumococcal conjugate vaccine if not had
B. Use pursed-lip breathing during exertion
C. Increase fluid intake to 3 L/day
D. Schedule flu vaccine annually
E. Avoid high-flow O₂ at home
Correct Answer: A, B, D, E
Rationale: 3 L/day may overload and cause hyponatremia; otherwise all reduce
exacerbation risk.
16. The nurse is reviewing morning labs for a client with acute pancreatitis. Which finding
requires immediate intervention?
A. Glucose 220 mg/dL
B. Ca²⁺ 7.2 mg/dL (ionized 0.9 mmol/L)
C. WBC 14 000 mm³
D. Amylase 500 U/L
Correct Answer: B
