EXIT HESI Comprehensive B Evolve Practice Questions 2026
A+
1. The nurse anticipates administering Rho(D) immune globulin (RhoGAM) to
which individual(s)? (Select all that apply.)
A. An Rh-negative woman who has had a miscarriage at 24 weeks
B. The father of a baby of an Rh-positive fetus
C. An Rh-negative mother after delivery of an Rh-positive infant with a
negative direct Coombs' test
D. An Rh-positive infant within 72 hours after birth
E. An Rh-negative mother with a negative antibody titer at 28 weeks
ANSWER: “A - An Rh-negative woman who has had a miscarriage at 24 weeks
C - An Rh-negative mother after delivery of an Rh-positive infant with a
negative direct Coombs' test
E - An Rh-negative mother with a negative antibody titer at 28 weeks.”
2. A client in the psychiatric setting with an anxiety disorder reports chest pain.
Which action should the nurse take first?
A. Administer an antianxiety medication PRN.
B. Assess the client's vital signs.
C. Notify the primary health care provider.
D. Determine coping mechanisms used in the past.
ANSWER: “B - Assess the client's vital signs.”
3. The nurse is caring for a client with deep vein thrombosis who is on a
continuous IV heparin infusion. The activated partial prothrombin time (aPTT)
is 120 seconds. Which action should the nurse take?
A. Increase the rate of the heparin infusion using a nomogram.
B. Decrease the heparin infusion rate and give vitamin K IM.
C. Continue the heparin infusion at the current prescribed rate.
D. Stop the heparin drip and prepare to administer protamine sulfate.
ANSWER: “D - Stop the heparin drip and prepare to administer protamine
sulfate.”
, 4. The nurse is caring for a client with an ischemic stroke who has a prescription
for tissue plasminogen activator (t-PA) IV. Which action(s) should the nurse
expect to implement? (Select all that apply.)
A. Administer aspirin with tissue plasminogen activator (t-PA).
B. Complete the National Institute of Health Stroke Scale (NIHSS).
C. Assess the client for signs of bleeding during and after the infusion.
D. Start t-PA within 6 hours after the onset of stroke symptoms.
E. Initiate multidisciplinary consult for potential rehabilitation.
ANSWER: “B - Complete the National Institute of Health Stroke Scale (NIHSS).
C - Assess the client for signs of bleeding during and after the infusion.
E - Initiate multidisciplinary consult for potential rehabilitation.”
5. Which data obtained during a respiratory assessment for a 78-year-old client is
most important to report to the primary health care provider?
A. Auscultation of vesicular breath sounds
B. Pulse oximetry reading of 89%
C. Arterial Pao2 of 86%
D. Resonance on percussion of the lungs
ANSWER: “B - Pulse oximetry reading of 89%”
6. A 12-year-old boy complains to the nurse that he is "short" (4'5" [53 inches]).
His twin sister is 5 inches taller than he is (4'10" [58 inches]). Based on these
findings, what conclusion should the nurse reach?
A. The boy is not growing as normally expected.
B. The girl is experiencing a period of unexpected growth.
C. A normal growth spurt occurs in girls 1 to 2 years earlier than boys.
D. Male-female twins are not identical; therefore, their growth cannot be
compared.
ANSWER: “C - A normal growth spurt occurs in girls 1 to 2 years earlier than
boys.”
7. The nurse is planning the care for a client who is admitted with syndrome of
inappropriate antidiuretic hormone secretion (SIADH). Which intervention(s)
should the nurse include in this client's plan of care? (Select all that apply.)
A+
1. The nurse anticipates administering Rho(D) immune globulin (RhoGAM) to
which individual(s)? (Select all that apply.)
A. An Rh-negative woman who has had a miscarriage at 24 weeks
B. The father of a baby of an Rh-positive fetus
C. An Rh-negative mother after delivery of an Rh-positive infant with a
negative direct Coombs' test
D. An Rh-positive infant within 72 hours after birth
E. An Rh-negative mother with a negative antibody titer at 28 weeks
ANSWER: “A - An Rh-negative woman who has had a miscarriage at 24 weeks
C - An Rh-negative mother after delivery of an Rh-positive infant with a
negative direct Coombs' test
E - An Rh-negative mother with a negative antibody titer at 28 weeks.”
2. A client in the psychiatric setting with an anxiety disorder reports chest pain.
Which action should the nurse take first?
A. Administer an antianxiety medication PRN.
B. Assess the client's vital signs.
C. Notify the primary health care provider.
D. Determine coping mechanisms used in the past.
ANSWER: “B - Assess the client's vital signs.”
3. The nurse is caring for a client with deep vein thrombosis who is on a
continuous IV heparin infusion. The activated partial prothrombin time (aPTT)
is 120 seconds. Which action should the nurse take?
A. Increase the rate of the heparin infusion using a nomogram.
B. Decrease the heparin infusion rate and give vitamin K IM.
C. Continue the heparin infusion at the current prescribed rate.
D. Stop the heparin drip and prepare to administer protamine sulfate.
ANSWER: “D - Stop the heparin drip and prepare to administer protamine
sulfate.”
, 4. The nurse is caring for a client with an ischemic stroke who has a prescription
for tissue plasminogen activator (t-PA) IV. Which action(s) should the nurse
expect to implement? (Select all that apply.)
A. Administer aspirin with tissue plasminogen activator (t-PA).
B. Complete the National Institute of Health Stroke Scale (NIHSS).
C. Assess the client for signs of bleeding during and after the infusion.
D. Start t-PA within 6 hours after the onset of stroke symptoms.
E. Initiate multidisciplinary consult for potential rehabilitation.
ANSWER: “B - Complete the National Institute of Health Stroke Scale (NIHSS).
C - Assess the client for signs of bleeding during and after the infusion.
E - Initiate multidisciplinary consult for potential rehabilitation.”
5. Which data obtained during a respiratory assessment for a 78-year-old client is
most important to report to the primary health care provider?
A. Auscultation of vesicular breath sounds
B. Pulse oximetry reading of 89%
C. Arterial Pao2 of 86%
D. Resonance on percussion of the lungs
ANSWER: “B - Pulse oximetry reading of 89%”
6. A 12-year-old boy complains to the nurse that he is "short" (4'5" [53 inches]).
His twin sister is 5 inches taller than he is (4'10" [58 inches]). Based on these
findings, what conclusion should the nurse reach?
A. The boy is not growing as normally expected.
B. The girl is experiencing a period of unexpected growth.
C. A normal growth spurt occurs in girls 1 to 2 years earlier than boys.
D. Male-female twins are not identical; therefore, their growth cannot be
compared.
ANSWER: “C - A normal growth spurt occurs in girls 1 to 2 years earlier than
boys.”
7. The nurse is planning the care for a client who is admitted with syndrome of
inappropriate antidiuretic hormone secretion (SIADH). Which intervention(s)
should the nurse include in this client's plan of care? (Select all that apply.)
