HESI Exit RN Exam Prep: 200+ Verified Questions
with Answers & Rationales for NCLEX Success
2026 update /pdf.
Introduction
Congratulations on reaching this pivotal stage in your nursing education. The HESI Exit
Exam is more than just another test—it is a comprehensive predictor of your readiness for
the NCLEX-RN and a key milestone on your path to becoming a registered nurse. Success
on this exam requires not only clinical knowledge but also critical thinking, prioritization
skills, and the ability to apply nursing concepts in realistic patient care scenarios.
This study guide is designed to help you achieve that success. Inside, you will find over 200
practice questions that mirror the style, difficulty, and content areas of the actual HESI Exit
Exam. Each question is followed by the correct answer in italics and a detailed rationale that
explains the underlying principles, nursing interventions, and clinical reasoning behind
the answer. Reading and understanding the rationales is just as important as answering
the questions correctly—this is where true learning and retention occur
HESI Exit RN Exam Practice Questions
1. Following discharge teaching, a male client with a duodenal ulcer tells the nurse
he will drink plenty of dairy products, such as milk, to help coat and protect his
ulcer. What is the best follow-up action by the nurse?
A. Praise the client for understanding the teaching.
B. Remind the client to also increase his intake of water.
C. Review with the client the need to avoid foods that are rich in milk and cream.
D. Document the client's statement in the medical record.
Answer: C. Review with the client the need to avoid foods that are rich in milk and
cream.
, Rationale: While milk may provide temporary relief by coating the stomach lining, it is a
potent stimulator of gastric acid secretion, which can ultimately worsen a duodenal
ulcer. The nurse's best action is to provide corrective teaching to clarify this
misconception .
2. 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?
A. Report the UAP's behavior to the charge nurse.
B. Instruct the UAP to obtain soft blankets to secure to the side rails instead of pillows.
C. Praise the UAP for taking measures to keep the client safe.
D. Ask the UAP why pillows are being used instead of padding.
Answer: B. Instruct the UAP to obtain soft blankets to secure to the side rails
instead of pillows.
Rationale: Using pillows as padding during a seizure is dangerous because the client
could move and cause the pillow to obstruct their airway or become a suffocation
hazard. The correct safety measure is to pad the side rails with soft blankets or
commercial padding. The nurse must correct the UAP's action immediately .
3. A client who is taking an oral dose of tetracycline complains of gastrointestinal
upset. What snack should the nurse instruct the client to take with the
tetracycline?
A. A glass of milk.
B. A bowl of yogurt.
C. A slice of cheese pizza.
D. Toasted wheat bread and jelly.
Answer: D. Toasted wheat bread and jelly.
, Rationale: Tetracycline binds with calcium-rich foods (like milk, yogurt, and cheese),
which significantly reduces its absorption and effectiveness. To minimize GI upset
without affecting absorption, the client should take the medication with a non-dairy,
bland snack such as toast or crackers .
4. A 66-year-old woman is retiring and will no longer have health insurance
through her place of employment. Which agency should the client be referred to
by the employee health nurse for health insurance needs?
A. Medicaid
B. Medicare
C. COBRA
D. The Affordable Care Act marketplace
Answer: B. Medicare
Rationale: Medicare is the federal health insurance program for people who are 65 or
older, regardless of income. Since the client is 66, she is eligible for Medicare. While
COBRA and the ACA marketplace are options, Medicare is the most appropriate and
specific referral for her age .
5. A client with a history of heart failure presents to the clinic with nausea,
vomiting, yellow vision, and palpitations. Which finding is most important for the
nurse to assess?
A. The client's potassium level.
B. Obtain a list of medications taken for cardiac history.
C. The client's most recent weight.
D. The client's last bowel movement.
Answer: B. Obtain a list of medications taken for cardiac history.
Rationale: The symptoms described (nausea, vomiting, yellow vision, palpitations) are
classic signs of digoxin toxicity, a common medication for heart failure. The priority
, action is to assess the client's medications, including dose and last time taken, to
confirm digoxin use and potential toxicity .
6. The nurse is caring for a client with pneumonia who now develops initial signs
of septic shock and multi-organ failure. The healthcare provider prescribes a sepsis
protocol. Which intervention is most important for the nurse to include in the plan
of care?
A. Maintain strict intake and output.
B. Keep the head of bed raised 45 degrees.
C. Assess for excess warmth of extremities.
D. Monitor blood glucose level.
Answer: A. Maintain strict intake and output.
Rationale: In septic shock, a key goal is to maintain adequate tissue perfusion and
organ function by optimizing fluid volume. Strict intake and output monitoring allows
the nurse to accurately assess the patient's fluid status, guide fluid resuscitation, and
monitor for acute kidney injury, a common complication of multi-organ failure .
7. An infant is receiving digoxin for congestive heart failure. The apical heart rate
is assessed at 80 beats/min. What intervention should the nurse implement?
A. Call for a portable chest radiograph.
B. Obtain a therapeutic drug level.
C. Reassess the heart rate in 30 minutes.
D. Administer digoxin immune Fab stat.
Answer: B. Obtain a therapeutic drug level.
Rationale: For an infant, a normal apical heart rate is typically over 100-120 bpm. A rate
of 80 bpm is bradycardic and is a primary sign of digoxin toxicity. The priority action is
to withhold the medication and obtain a digoxin level to assess for toxicity .
with Answers & Rationales for NCLEX Success
2026 update /pdf.
Introduction
Congratulations on reaching this pivotal stage in your nursing education. The HESI Exit
Exam is more than just another test—it is a comprehensive predictor of your readiness for
the NCLEX-RN and a key milestone on your path to becoming a registered nurse. Success
on this exam requires not only clinical knowledge but also critical thinking, prioritization
skills, and the ability to apply nursing concepts in realistic patient care scenarios.
This study guide is designed to help you achieve that success. Inside, you will find over 200
practice questions that mirror the style, difficulty, and content areas of the actual HESI Exit
Exam. Each question is followed by the correct answer in italics and a detailed rationale that
explains the underlying principles, nursing interventions, and clinical reasoning behind
the answer. Reading and understanding the rationales is just as important as answering
the questions correctly—this is where true learning and retention occur
HESI Exit RN Exam Practice Questions
1. Following discharge teaching, a male client with a duodenal ulcer tells the nurse
he will drink plenty of dairy products, such as milk, to help coat and protect his
ulcer. What is the best follow-up action by the nurse?
A. Praise the client for understanding the teaching.
B. Remind the client to also increase his intake of water.
C. Review with the client the need to avoid foods that are rich in milk and cream.
D. Document the client's statement in the medical record.
Answer: C. Review with the client the need to avoid foods that are rich in milk and
cream.
, Rationale: While milk may provide temporary relief by coating the stomach lining, it is a
potent stimulator of gastric acid secretion, which can ultimately worsen a duodenal
ulcer. The nurse's best action is to provide corrective teaching to clarify this
misconception .
2. 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?
A. Report the UAP's behavior to the charge nurse.
B. Instruct the UAP to obtain soft blankets to secure to the side rails instead of pillows.
C. Praise the UAP for taking measures to keep the client safe.
D. Ask the UAP why pillows are being used instead of padding.
Answer: B. Instruct the UAP to obtain soft blankets to secure to the side rails
instead of pillows.
Rationale: Using pillows as padding during a seizure is dangerous because the client
could move and cause the pillow to obstruct their airway or become a suffocation
hazard. The correct safety measure is to pad the side rails with soft blankets or
commercial padding. The nurse must correct the UAP's action immediately .
3. A client who is taking an oral dose of tetracycline complains of gastrointestinal
upset. What snack should the nurse instruct the client to take with the
tetracycline?
A. A glass of milk.
B. A bowl of yogurt.
C. A slice of cheese pizza.
D. Toasted wheat bread and jelly.
Answer: D. Toasted wheat bread and jelly.
, Rationale: Tetracycline binds with calcium-rich foods (like milk, yogurt, and cheese),
which significantly reduces its absorption and effectiveness. To minimize GI upset
without affecting absorption, the client should take the medication with a non-dairy,
bland snack such as toast or crackers .
4. A 66-year-old woman is retiring and will no longer have health insurance
through her place of employment. Which agency should the client be referred to
by the employee health nurse for health insurance needs?
A. Medicaid
B. Medicare
C. COBRA
D. The Affordable Care Act marketplace
Answer: B. Medicare
Rationale: Medicare is the federal health insurance program for people who are 65 or
older, regardless of income. Since the client is 66, she is eligible for Medicare. While
COBRA and the ACA marketplace are options, Medicare is the most appropriate and
specific referral for her age .
5. A client with a history of heart failure presents to the clinic with nausea,
vomiting, yellow vision, and palpitations. Which finding is most important for the
nurse to assess?
A. The client's potassium level.
B. Obtain a list of medications taken for cardiac history.
C. The client's most recent weight.
D. The client's last bowel movement.
Answer: B. Obtain a list of medications taken for cardiac history.
Rationale: The symptoms described (nausea, vomiting, yellow vision, palpitations) are
classic signs of digoxin toxicity, a common medication for heart failure. The priority
, action is to assess the client's medications, including dose and last time taken, to
confirm digoxin use and potential toxicity .
6. The nurse is caring for a client with pneumonia who now develops initial signs
of septic shock and multi-organ failure. The healthcare provider prescribes a sepsis
protocol. Which intervention is most important for the nurse to include in the plan
of care?
A. Maintain strict intake and output.
B. Keep the head of bed raised 45 degrees.
C. Assess for excess warmth of extremities.
D. Monitor blood glucose level.
Answer: A. Maintain strict intake and output.
Rationale: In septic shock, a key goal is to maintain adequate tissue perfusion and
organ function by optimizing fluid volume. Strict intake and output monitoring allows
the nurse to accurately assess the patient's fluid status, guide fluid resuscitation, and
monitor for acute kidney injury, a common complication of multi-organ failure .
7. An infant is receiving digoxin for congestive heart failure. The apical heart rate
is assessed at 80 beats/min. What intervention should the nurse implement?
A. Call for a portable chest radiograph.
B. Obtain a therapeutic drug level.
C. Reassess the heart rate in 30 minutes.
D. Administer digoxin immune Fab stat.
Answer: B. Obtain a therapeutic drug level.
Rationale: For an infant, a normal apical heart rate is typically over 100-120 bpm. A rate
of 80 bpm is bradycardic and is a primary sign of digoxin toxicity. The priority action is
to withhold the medication and obtain a digoxin level to assess for toxicity .
