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HESI RN Exit Exam 2025: Most Tested Questions
and Expert Answers | A+ Graded Review Guide for
Guaranteed Nursing School Success
1. Medication Dose Discrepancy Question: A homeless client at a community psychiatric clinic reports that the medication dose prescribed is different from what they usually take. What is the nurse’s best action? A) Inform the client that he may refuse the medication and document whether or not the client takes it. B) Withhold the medication until the dosage can be confirmed. C) Explain to the client that the dosage has been changed. D) Tell the client to take the medication then verify the dosage at the next healthcare team meeting. Correct Answer: B Rationale: Patient safety is the priority. If there is any discrepancy between what the client reports and the prescribed dose, the nurse must clarify the order before administration to avoid potential harm. Administering the medication without verification could result in overdose or underdose. 2. Delegation to Practical Nurse (PN) Question: Which neurologically compromised client is best to assign to a practical nurse (PN)? A) Subdural hematoma with BP change from 150/80 to 170/ B) Viral meningitis with a temperature increase from 101°F to 102°F C) Diabetic ketoacidosis with Glasgow Coma Scale change from 10 to 7 D) Myxedema with BP change from 80/50 to 70/ Correct Answer: B Rationale: Clients with significant neurologic deterioration, hemodynamic instability, or critical changes require RN care. A slight fever increase in viral meningitis is stable and appropriate for PN care under RN supervision.
3. Sepsis and Multi-Organ Failure Question: A pneumonia client develops signs of septic shock and multi-organ failure. Which intervention is most important? A) Maintain strict intake and output B) Keep the head of the bed raised 45° C) Assess for warmth of extremities D) Monitor blood glucose level Correct Answer: A Rationale: Monitoring intake and output helps detect renal involvement, which is crucial in managing multi-organ dysfunction. It assists in evaluating perfusion and fluid balance during sepsis protocol implementation. 4. Adolescent Post-Team Meeting Reaction Question: An adolescent hospitalized after a suicide note is found crying after a treatment team meeting. What is the nurse's best action? A) Let the client rest quietly B) Explore the client’s goals and desire for treatment C) Ask the treatment team about the client’s behavior D) Go to the client’s room and ask what happened Correct Answer: D Rationale: Timely therapeutic communication helps build trust and address emotional distress. The nurse should directly engage the client to explore and support emotional needs post-meeting. 5. Dalteparin Dose Calculation Question: A client weighing 154 pounds is prescribed dalteparin 200 units/kg subcutaneously. The medication is available as 25,000 units/mL. How many mL should the nurse administer?
F) Lamb’s wool G) Tape Correct Answers: D and E Rationale: A nasal cannula and flow meter are essential for administering low-flow oxygen. The other items are not necessary for basic oxygen delivery at 3 L/min.
8. NGN: Signs of Hypoxia by System Question: Identify the assessment findings that indicate hypoxia by system: Cardiovascular: - Heart rate 100 bpm - Capillary refill 4 seconds - Blood pressure 145/ Neurological: - Anxious - Awake and alert - Restless Respiratory: - Oxygen saturation 90% - Respiratory rate 28 bpm - Productive cough Rationale: Signs of hypoxia include delayed capillary refill, increased BP (early compensatory mechanism), anxiety/restlessness (neurologic), tachypnea, and low oxygen saturation. 9. NGN: Positioning for Lung Expansion Question: What position should the nurse place the client in to promote lung expansion? Answer: Semi-Fowler ✅
Rationale: Semi-Fowler’s position (head of bed elevated 30-45°) supports lung expansion by allowing diaphragmatic movement and improved oxygenation, especially in clients with respiratory compromise. NGN: Orders: 0330: place the client on a cardio respiratory monitor, NPO, sputum culture, start a PIV, start oxygen 3L via nasal cannula, normal saline 150 ML per hour, acetaminophen 350mg PO every six hours for temp greater than 101F, chest x-ray. 0500: Oxygen 8Lvia simple facemask, titrate to keep oxygen saturation greater than 94%. (mark whether the statements by the new grad nurse indicate understanding or no understanding of the use of facemask in the care of this client)
- I should clean the facemask once per shift.
- The client should take a 1 to 2 minute break from the facemask each hour.
- I should put gauze under the elastic straps over the ears.
- I can adjust the oxygen level on the flow meter to keep the clients oxygen saturation greater than 94%.
- The mask should cover only the mouth and leave the nose open for expiration.
- I should place the mask first over the nose and then cover the mouth. - - correct ans- --I should clean the facemask once per shift. (UNDERSTANDING)
- The client should take a 1 to 2 minute break from the facemask each hour. (NOT UNDERSTANDING)
- I should put gauze under the elastic straps over the ears. (NOT UNDERSTANDING ????)
- I can adjust the oxygen level on the flow meter to keep the clients oxygen saturation greater than 94%. (UNDERSTANDING)
- The mask should cover only the mouth and leave the nose open for expiration. (NOT UNDERSTANDING)
- I should place the mask first over the nose and then cover the mouth. (UNDERSTANDING)
A client with foul-smelling drainage from an incision on the upper left arm is admitted with a suspected MRSA. Which nursing intervention should the nurse include in the plan of care? SATA. A) Institute contact precautions for staff and visitors. B) Use standard precautions and wear a mask. C) Send wound drainage for culture and sensitivity. D) Monitor the clients white blood cell count. E) Explain the purpose of a low bacteria diet. - - correct ans- - A) Institute contact precautions for staff and visitors. C) Send wound drainage for culture and sensitivity. D) Monitor the clients white blood cell count. An adult client who is admitted to the mental health unit for treatment of bipolar disorder has a slightly slurred speech pattern and an unsteady gait. Which assessment finding is most important for the nurse to report to the healthcare provider? A) Weight loss of 10 pounds in the past month. B) Six hours of sleep in the past three days. C) Blood alcohol level of 0.09%. D) Serum lithium level of 1.6. - - correct ans- - D) Serum lithium level of 1.6. When conducting diet teaching for a client who is on a post operative full liquid diet, which foods should the nurse encouraged the client to eat? SATA. A) Clear beef broth. B) Vanilla frozen yogurt. C) Vegetable juice. D) Creamy peanut butter. E) Canned fruit cocktail. - - correct ans- - A) Clear beef broth.
B) Vanilla frozen yogurt. C) Vegetable juice. An infant born with esophageal atresia and tracheoesophageal fistula receives a prescription for internal feedings after corrective surgery. To promote normal growth and development of the infant, which action should the nurse include in the plan of care? - - correct ans- - Offer a pacifier for non-Nutritive sucking The nurse is preparing a four year-old client with a serum bilirubin level of 19 for discharge from the hospital. When teaching the parents about home photo therapy, which instruction should the nurse include in the discharge teaching plan? A) Cover with a receiving blanket. B) Perform diaper changes under the light. C) Feed the infant every four hours. D) Reposition the infant every two hours. - - correct ans- - D) Reposition the infant every two hours. The nurse initiate the procedure to remove a clients peripherally inserted central catheter when a code blue is called for another client in the unit who collapse in the hallway while ambulating with the unlicensed assistive personnel. Which action should the nurse take? A) Close the room door. B) Finish the procedure. C) Respond to the code. D) Call for an assistant. - - correct ans- - B) Finish the procedure. Which nursing intervention is most important for the nurse to include in the plan of care for a client with alcohol withdrawal delirium?
B) When the client has ankle edema. C) During admission to labor and delivery. D) If the client has an elevated blood pressure. - - correct ans- - D) If the client has an elevated blood pressure. NGN: The client has returned to work at in accounting firm and has started going to a grief support group. She reports she is seeking care from a healthcare professional because her father is worried about her. The client says she only gets 2 to 3 hours of sleep due to nightmares about the crash. She informed that exercising right after work helps her get better sleep and to relax. She feels that she is "jumpy" after the accident, especially when she is in the car. She also stated, "I feel so sad that I can't seem to feel anything at all". In addition to her father, the client has a large family and friend support system. She denies alcohol or drug use. (highlight areas in the above paragraph that the nurse should...) - - correct ans- --she only gets 2 to 3 hours of sleep due to nightmares about the crash.
- She feels that she is "jumpy" after the accident, especially when she is in the car.
- "I feel so sad that I can't seem to feel anything at all" The client is a 26 year old female who was in a car accident six months ago that killed her mother, husband, and two year old son. She and her father were the only survivors of the crash. She is seeking care for depression. The client is exhibiting symptoms of ________________________ related to ______________ and ___________________. - - correct ans- - Post traumatic stress disorder , experiencing a life-threatening event , losing a loved one. NGN: Orders, diagnosis, depression and posttraumatic stress disorder. Diphenhydramine 12.5 mg PO every night at sleep. BuspironeHydrochloride 7.5 mg PO twice a day. (how can the nurse build a therapeutic relationship with the client? Select all that apply) A) The nurse can show no emotion when talking to the client.
B) The nurse can be open honest and sincere. C) The nurse can talk as much as needed to get the client talking. D) The nurse can focus energy on the client. E) The nurse can communicate acceptance of the client as she is F) The nurse can establish a meaningful connection. - - correct ans- - B) the nurse can be open, honest and sincere. E) The nurse can communicate acceptance of the client as she is F) The nurse can establish a meaningful connection. NGN: The client has returned to work at in accounting firm and has started going to a grief support group. She reports she is seeking care from a healthcare professional because her father is worried about her. The client says she only gets 2 to 3 hours of sleep due to nightmares about the crash. She informed that exercising right after work helps her get better sleep and to relax. She feels that she is "jumpy" after the accident, especially when she is in the car. She also stated, "I feel so sad that I can't seem to feel anything at all". In addition to her father, the client has a large family and friend support system. She denies alcohol or drug use. The client states, "I don't want to kill myself, but sometimes I wish I had died in the crash." The statement by the client presents _______________ and should be followed up with _____________. - - correct ans- - Suicidal ideation, assessment of respecters for suicide. The client is a 26 year old female who was in a car accident six months ago that killed her mother, husband, and two year old son. She and her father were the only survivors of the crash. She is seeking care for depression. (what would be some affective strategies that the nurse could use to decrease the clients risk of suicide in the future? SATA.) A) Have the client remove any sharp objects from the home. B) Have the client sign a no suicide contract. C) Help the client unless the help of friends and family.
C) Self-reported glucose levels 120 to 150. D) Hemoglobin A1c readings less than 7%. - - correct ans- - D) Hemoglobin A1c readings less than 7%. After receiving report on an inpatient acute care unit which client should the nurse assess first? A) The client who had surgery yesterday and is experiencing a paralytic ileus with absent bowel sounds. B) The client with a small bowel obstruction who has a nasogastric tube that is draining greenish fluid. C) The client with an obstruction of the large intestine who is experiencing abdominal distention. D) The client with a bowel obstruction due to a volvulus who is experiencing abdominal rigidity. - - correct ans- - D) The client with a bowel obstruction due to a volvulus who is experiencing abdominal rigidity. Client presents at the emergency department reporting a raspy voice, cold intolerance, and fatigue. Laboratory tests indicate an elevated thyroid stimulating hormone and a low T3 and T4 levels. After the client is admitted to the telemetary unit, which intervention is most appropriate for the nurse to implement? A) administer prescribed dose of level thyroxine. B) Note clients most recent hemoglobin level. C) Offer additional blankets and a warm drink. D) Assess for the presence of nonpitting edema. - - correct ans- - A) administer prescribed dose of level thyroxine. While caring for a client post operative dressing, the nurse observes purulent wound drainage. Previously, the wound was inflamed and tender but without drainage. Which is the most important action for the nurse to take?
A) Determine if the drainage has an unpleasant odor. B) Cleanse the wound with a sterile saline solution. C) Monitor the clients white blood cell count. D) Request a culture and sensitivity of the wound. - - correct ans- - D) Request a culture and sensitivity of the wound. The school nurse is screening students for scoliosis and notes that one student has lordosis. Which finding should the nurse document in the student screening record? A) Lateral curvature that creates a symmetry of the shoulders. B) Posterior curvature that is convex in the thoracic area. C) Excessive concave curvature of the lumbar spine. D) Rounded spine from head to hips without concave curbs. - - correct ans- - C) Excessive concave curvature of the lumbar spine. The nurse is assigned to care for for surgical clients. After receiving report, which client should the nurse see first? A) An older client who is receiving packed red blood cells on the third day post operative for colon resection. B) An older client with continuous bladder irrigation who is two days post operative for bladder surgery. C) An adult who is in bucks traction, and scheduled for hip arthroplasty within the just 12 hours. D) An adult one day post operative laparoscopic cholecystectomy requesting pain medication. - - correct ans- - A) An older client who is receiving packed red blood cells on the third day post operative for colon resection. The nurse is providing education to a client who experiences recurrent levels of moderate anxiety to situation and perceived stress. In addition to information about prescribe medication and administration, which instruction should the nurse include in the teaching?
A) Side-lying with the head slightly elevated. B) Sitting up and leaning forward. C) Standing with the head leaning backwards. D) Supine with the legs raised. - - correct ans- - B) Sitting up and leaning forward. The nurse is auscultating a clients lung sounds. Which description should the nurse use to document this sound? Please listen to the audio file to select the option that applies. A) High pitch squeeze. B) Rhonchi. C) High-pitched or fine crackles. D) Stridor. - - correct ans- - C) High-pitched or fine crackles. NGN: Flow Sheet, vital signs, heart rate 104 bpm, respiratory rate 31 bpm. The client is experiencing __________________ and ____________________. - - correct ans-
- Tachypnea , tachycardia NGN: Orders, 1300 admit to the surgical unit, vital signs every four hours, advanced diet as tolerated, administer lactated ringers IV at 85 mL per hour, ibuprofen 800 mg PO every eight hours PRN for pain. (the nurse would anticipate which of the following could be affecting the clients current condition? SATA. A) stress. B) Medication. C) Anemia. D) Fever.
E) Hypothermia. F) Hypertension. G) Pain. - - correct ans- - A) stress. B) Medication. G) Pain. NGN: the client is a 34-year-old female who had a surgical procedure to remove a benign abdominal tumor. (Select which is understanding or not understanding)
- The tubing should be tucked under the chin and secured with the sliding adjustment piece.
- Humidification of oxygen is not needed for administration under 4 L per minute.
- The nasal cannula can deliver up to 10 L per minute of oxygen.
- A nasal cannula delivers 100% oxygen to the client. - - correct ans- --The tubing should be tucked under the chin and secured with the sliding adjustment piece. (UNDERSTANDING)
- Humidification of oxygen is not needed for administration under 4 L per minute. (UNDERSTANDING)
- The nasal cannula can deliver up to 10 L per minute of oxygen. (NOT UNDERSTANDING)
- A nasal cannula delivers 100% oxygen to the client. (NOT UNDERSTANDING) NGN: Orders, 1300 admit to the surgical unit, vital signs every four hours, advanced diet as tolerated, administer lactated ringers IV at 85 mL per hour, ibuprofen 800 mg PO every eight hours PRN for pain. 1310: supplemental oxygen at 2 (what diagnostic test would be appropriate for this client? SATA) A) Doppler. B) Blood gases.
- Provide mouth care.
- Document changes in respiratory status.
- Set up the oxygen administration system.
- Change the gauze under the nasal cannula. - - correct ans- --Provide mouth care. (UAP)
- Document changes in respiratory status. (RN/RT)
- Set up the oxygen administration system. (RN/RT)
- Change the gauze under the nasal cannula. (UAP) A client experiencing an acute dystonic reaction presents with a laryngeal spasm. Which treatment should the nurse prepare? A) IV administration of benztropine. B) IV administration of isotonic crystalloid fluid. C) PO administration of lorazepam. D) PO administration of divalproex. - - correct ans- - A) IV administration of benztropine. A client with heart failure become short of breath, anxious, and has audible reasoning with pink frothy sputum. The nurse sits the client upright and provides oxygen per nasal cannula. The nurse receives a prescription to administer a one time dose of morphine sulfate IV. Which action should the nurse take? A) Administer the dose of morphine sulfate as prescribed. B) Consult with the charge nurse regarding the morphine prescription. C) Review the need for the prescription with the healthcare provider. D) Withhold the morphine until the clients dyspnea resolves. - - correct ans- - A) Administer the dose of morphine sulfate as prescribed. A client with acute asthma exacerbation is manifesting inspiratory and expiratory wheezes and a decreased forced expiratory volume. Which prescribed drug class should the nurse administer first to the client?
A) Inhaled short acting beta two agonists. B) Inhaled corticosteroids. C) Anti-cholinergics. D) Leukotriene modifiers. - - correct ans- - B) Inhaled corticosteroids. The nurse enters a clients room to administer oral medication's and find an unlicensed assistive personnel providing personal care to the client, whose condition has obviously deteriorated. The client is lying in a supine position and is weak, pale, and diaphoretic. Which is the priority nursing action? A) Determine why the UAP did not notify the nurse of the change in the clients condition. B) Advised the UAP to stop providing care so the nurse can assess the clients condition. C) Explain to the UAP that changes in a clients condition should be reported immediately. D) Ask for UAP to position the client so the oral medication's can be administered. - - correct ans- - B) Advised the UAP to stop providing care so the nurse can assess the clients condition. The client who was admitted yesterday with severe dehydration is reporting pain where a 24 gauge IV catheter with 0.9% sodium chloride is infusing at a rate of 150 mL per hour. Which intervention should the nurse implement first? A) Discontinue the 24 gauge IV. B) Establish a second IV site. C) Stop the 0.9% sodium chloride infusion. D) Assess the IV for blood return. - - correct ans- - C) Stop the 0.9% sodium chloride infusion. Client should the nurse assess frequently because of the risk for overflow incontinence?
