HESI RN Exit Exam 2025/2026 Newest
Edition Test Bank by Elsevier | 150
Verified Questions & Answers for A+
Results
Medical-Surgical Nursing
1. A client with pneumonia is receiving oxygen at 2 L/min via nasal cannula. The
nurse should expect the oxygen saturation to be maintained at:
A. 80% to 85%
B. 86% to 88%
C. 92% or greater
D. 100% at all times
Answer: C. 92% or greater
Rationale: For a client with pneumonia, adequate oxygenation is essential for tissue
perfusion and healing. An oxygen saturation of 92% or greater indicates effective
oxygen delivery. Saturation below 90% indicates hypoxemia and requires intervention.
100% is not typically required or sustainable.
2. A nurse is caring for a client receiving IV potassium. The nurse should monitor
for:
A. Cardiac arrhythmias
B. Increased urine output
,C. Hypotension from fluid loss
D. Constipation
Answer: A. Cardiac arrhythmias
Rationale: IV potassium administration requires careful monitoring because
hyperkalemia can cause life-threatening cardiac arrhythmias, including peaked T waves,
widened QRS complexes, and cardiac arrest. Urine output should be monitored to
ensure adequate kidney function, but arrhythmias are the priority concern.
3. A client with COPD becomes short of breath while ambulating. The nurse should
first:
A. Have the client sit and use pursed-lip breathing
B. Administer IV fluids
C. Increase oxygen to 6 L/min
D. Apply a cooling blanket
Answer: A. Have the client sit and use pursed-lip breathing
Rationale: Pursed-lip breathing helps prolong exhalation, prevents airway collapse, and
reduces dyspnea. The priority is to stop activity and position the client for optimal
breathing. Increasing oxygen without assessment could lead to CO₂ retention in COPD
clients.
4. The nurse is caring for a client with a potassium level of 6.2 mEq/L. Which
assessment finding should the nurse expect?
A. Abdominal distension and hypoactive bowel sounds
B. Tall, peaked T waves on the ECG
,C. Muscle weakness and decreased deep tendon reflexes
D. Shallow respirations and respiratory acidosis
Answer: B. Tall, peaked T waves on the ECG
Rationale: Hyperkalemia (high potassium) often first presents with ECG changes,
including tall, peaked T waves, widened QRS, and prolonged PR intervals. Abdominal
distension and muscle weakness can occur but are later signs. Respiratory acidosis is
associated with hypokalemia.
5. The practical nurse (PN) is reinforcing discharge teaching with a client who has
a new diagnosis of heart failure. Which statement indicates a need for further
teaching?
A. "I will weigh myself every day and report a gain of 2 pounds in a day."
B. "I should limit my sodium intake to less than 2 grams per day."
C. "It's important to rest between activities to conserve my energy."
D. "If I feel short of breath, I will lie down flat with my feet elevated."
Answer: D. "If I feel short of breath, I will lie down flat with my feet elevated."
Rationale: Lying flat (supine) increases venous return to the heart, worsening pulmonary
congestion and shortness of breath. Clients with heart failure should sit upright
(orthopneic position) or in High Fowler's to ease breathing.
6. A client is receiving mesalamine 800 mg PO TID. Which assessment is most
important to evaluate the medication's effectiveness?
A. Pupillary response
B. Oxygen saturation
, C. Peripheral pulses
D. Bowel patterns
Answer: D. Bowel patterns
Rationale: Mesalamine is an anti-inflammatory medication used to treat ulcerative colitis.
Effectiveness is evaluated by assessing improvement in bowel patterns, including
decreased diarrhea, abdominal pain, and rectal bleeding.
7. The healthcare provider prescribes dalteparin 200 units per kilogram
subcutaneous once a day for a client who weighs 154 pounds. The medication is
available in 25,000 units per milliliter vial. How many milliliters should the nurse
administer? (Round to the nearest 10th.)
Answer: 0.6 mL
Rationale: First convert pounds to kilograms: 154 lbs ÷ 2.2 = 70 kg. Calculate dose: 200
units/kg × 70 kg = 14,000 units. Calculate volume: 14,000 units ÷ 25,000 units/mL =
0.56 mL, rounded to 0.6 mL.
8. A client with foul-smelling drainage from an incision on the upper left arm is
admitted with suspected MRSA. Which interventions should the nurse include?
(Select all that apply)
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 client's white blood cell count
E. Explain the purpose of a low bacteria diet
Edition Test Bank by Elsevier | 150
Verified Questions & Answers for A+
Results
Medical-Surgical Nursing
1. A client with pneumonia is receiving oxygen at 2 L/min via nasal cannula. The
nurse should expect the oxygen saturation to be maintained at:
A. 80% to 85%
B. 86% to 88%
C. 92% or greater
D. 100% at all times
Answer: C. 92% or greater
Rationale: For a client with pneumonia, adequate oxygenation is essential for tissue
perfusion and healing. An oxygen saturation of 92% or greater indicates effective
oxygen delivery. Saturation below 90% indicates hypoxemia and requires intervention.
100% is not typically required or sustainable.
2. A nurse is caring for a client receiving IV potassium. The nurse should monitor
for:
A. Cardiac arrhythmias
B. Increased urine output
,C. Hypotension from fluid loss
D. Constipation
Answer: A. Cardiac arrhythmias
Rationale: IV potassium administration requires careful monitoring because
hyperkalemia can cause life-threatening cardiac arrhythmias, including peaked T waves,
widened QRS complexes, and cardiac arrest. Urine output should be monitored to
ensure adequate kidney function, but arrhythmias are the priority concern.
3. A client with COPD becomes short of breath while ambulating. The nurse should
first:
A. Have the client sit and use pursed-lip breathing
B. Administer IV fluids
C. Increase oxygen to 6 L/min
D. Apply a cooling blanket
Answer: A. Have the client sit and use pursed-lip breathing
Rationale: Pursed-lip breathing helps prolong exhalation, prevents airway collapse, and
reduces dyspnea. The priority is to stop activity and position the client for optimal
breathing. Increasing oxygen without assessment could lead to CO₂ retention in COPD
clients.
4. The nurse is caring for a client with a potassium level of 6.2 mEq/L. Which
assessment finding should the nurse expect?
A. Abdominal distension and hypoactive bowel sounds
B. Tall, peaked T waves on the ECG
,C. Muscle weakness and decreased deep tendon reflexes
D. Shallow respirations and respiratory acidosis
Answer: B. Tall, peaked T waves on the ECG
Rationale: Hyperkalemia (high potassium) often first presents with ECG changes,
including tall, peaked T waves, widened QRS, and prolonged PR intervals. Abdominal
distension and muscle weakness can occur but are later signs. Respiratory acidosis is
associated with hypokalemia.
5. The practical nurse (PN) is reinforcing discharge teaching with a client who has
a new diagnosis of heart failure. Which statement indicates a need for further
teaching?
A. "I will weigh myself every day and report a gain of 2 pounds in a day."
B. "I should limit my sodium intake to less than 2 grams per day."
C. "It's important to rest between activities to conserve my energy."
D. "If I feel short of breath, I will lie down flat with my feet elevated."
Answer: D. "If I feel short of breath, I will lie down flat with my feet elevated."
Rationale: Lying flat (supine) increases venous return to the heart, worsening pulmonary
congestion and shortness of breath. Clients with heart failure should sit upright
(orthopneic position) or in High Fowler's to ease breathing.
6. A client is receiving mesalamine 800 mg PO TID. Which assessment is most
important to evaluate the medication's effectiveness?
A. Pupillary response
B. Oxygen saturation
, C. Peripheral pulses
D. Bowel patterns
Answer: D. Bowel patterns
Rationale: Mesalamine is an anti-inflammatory medication used to treat ulcerative colitis.
Effectiveness is evaluated by assessing improvement in bowel patterns, including
decreased diarrhea, abdominal pain, and rectal bleeding.
7. The healthcare provider prescribes dalteparin 200 units per kilogram
subcutaneous once a day for a client who weighs 154 pounds. The medication is
available in 25,000 units per milliliter vial. How many milliliters should the nurse
administer? (Round to the nearest 10th.)
Answer: 0.6 mL
Rationale: First convert pounds to kilograms: 154 lbs ÷ 2.2 = 70 kg. Calculate dose: 200
units/kg × 70 kg = 14,000 units. Calculate volume: 14,000 units ÷ 25,000 units/mL =
0.56 mL, rounded to 0.6 mL.
8. A client with foul-smelling drainage from an incision on the upper left arm is
admitted with suspected MRSA. Which interventions should the nurse include?
(Select all that apply)
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 client's white blood cell count
E. Explain the purpose of a low bacteria diet
