HESI Comprehensive Review for the
NCLEX-RN Examination 7th Edition by
HESI: Ultimate 2025/2026 HESI EXIT
RN Prep (Versions V1-V7) with NGN
Questions & Rationales - Pass on First
Attempt
1. A nurse is caring for a client with heart failure who reports
sudden dyspnea, crackles in lung bases, and pink frothy
sputum. What action should the nurse take first?
A. Place the client in high-Fowler’s position
B. Administer furosemide IV push
C. Apply a non-rebreather mask at 100% O₂
D. Notify the provider
Answer: A
Rationale: High-Fowler’s position uses gravity to reduce venous
return and pulmonary congestion. Oxygen and diuretics follow,
but positioning is immediate.
2. A client with type 1 diabetes mellitus has a blood glucose
of 45 mg/dL and is unconscious. What should the nurse do
first?
A. Give 15 g of oral glucose gel
B. Administer glucagon 1 mg IM
C. Start an IV of D50W
D. Recheck glucose in 15 minutes
,Answer: B
Rationale: Unconscious client cannot swallow; glucagon IM raises
glucose rapidly. IV D50W requires IV access, which takes longer.
3. A nurse is providing discharge teaching for a client with a
new ileostomy. Which food should the client be instructed to
avoid to prevent obstruction?
A. Applesauce
B. Cooked carrots
C. Celery
D. White bread
Answer: C
Rationale: High-fiber foods like celery, corn, and nuts can cause
stomal obstruction. Low-fiber foods are safer.
4. The nurse is assessing a client with Cushing’s syndrome.
Which finding is expected?
A. Hypoglycemia
B. Weight loss
C. Buffalo hump
D. Hypotension
Answer: C
Rationale: Excess cortisol causes fat redistribution – buffalo
hump, moon face, truncal obesity, hyperglycemia, and
hypertension.
5. A nurse is caring for a client on warfarin with an INR of 4.5.
Which action is most important?
A. Hold the next dose of warfarin
B. Administer vitamin K IM
C. Check for signs of bleeding
,D. Give fresh frozen plasma
Answer: C
Rationale: INR 4.5 increases bleeding risk; first assess for active
bleeding (e.g., hematuria, bruising). Hold warfarin and notify
provider.
6. A postpartum client reports a foul-smelling lochia, fever,
and uterine tenderness. What condition does the nurse
suspect?
A. Endometritis
B. Cystitis
C. Mastitis
D. Normal involution
Answer: A
Rationale: Endometritis presents with fever, uterine pain, and
malodorous lochia; usually occurs within days after delivery.
7. The nurse is caring for a client with acute pancreatitis.
Which laboratory value is most specific for this condition?
A. Elevated amylase
B. Elevated lipase
C. Elevated ALT
D. Elevated bilirubin
Answer: B
Rationale: Lipase is more specific and remains elevated longer
than amylase in acute pancreatitis.
8. A client with major depressive disorder starts taking
phenelzine (MAOI). Which food should the nurse instruct the
client to avoid?
A. Broccoli
, B. Aged cheese
C. Apples
D. Rice
Answer: B
Rationale: MAOIs inhibit tyramine metabolism; aged cheese,
wine, smoked meats can cause hypertensive crisis.
9. A nurse is preparing to administer digoxin. The client’s
apical pulse is 52 bpm. What should the nurse do?
A. Give the digoxin as ordered
B. Hold the dose and recheck in 1 hour
C. Hold the dose and notify the provider
D. Give the digoxin with atropine
Answer: C
Rationale: Digoxin is held for HR <60 bpm in adults; provider
should be notified for possible toxicity or dose adjustment.
10. Which client should the nurse assign to an LPN?
A. Newly admitted with pneumonia
B. Post-op day 2 with stable vital signs needing a wound dressing
change
C. Client with chest tube and continuous bubbling
D. Client with new tracheostomy requiring suctioning every hour
Answer: B
Rationale: LPNs can perform stable, routine wound care.
Complex, unstable, or new admits require RN.
11. A child with sickle cell crisis is in severe pain. What is the
priority nursing intervention?
A. Administer morphine as ordered
B. Apply cold compresses to joints
NCLEX-RN Examination 7th Edition by
HESI: Ultimate 2025/2026 HESI EXIT
RN Prep (Versions V1-V7) with NGN
Questions & Rationales - Pass on First
Attempt
1. A nurse is caring for a client with heart failure who reports
sudden dyspnea, crackles in lung bases, and pink frothy
sputum. What action should the nurse take first?
A. Place the client in high-Fowler’s position
B. Administer furosemide IV push
C. Apply a non-rebreather mask at 100% O₂
D. Notify the provider
Answer: A
Rationale: High-Fowler’s position uses gravity to reduce venous
return and pulmonary congestion. Oxygen and diuretics follow,
but positioning is immediate.
2. A client with type 1 diabetes mellitus has a blood glucose
of 45 mg/dL and is unconscious. What should the nurse do
first?
A. Give 15 g of oral glucose gel
B. Administer glucagon 1 mg IM
C. Start an IV of D50W
D. Recheck glucose in 15 minutes
,Answer: B
Rationale: Unconscious client cannot swallow; glucagon IM raises
glucose rapidly. IV D50W requires IV access, which takes longer.
3. A nurse is providing discharge teaching for a client with a
new ileostomy. Which food should the client be instructed to
avoid to prevent obstruction?
A. Applesauce
B. Cooked carrots
C. Celery
D. White bread
Answer: C
Rationale: High-fiber foods like celery, corn, and nuts can cause
stomal obstruction. Low-fiber foods are safer.
4. The nurse is assessing a client with Cushing’s syndrome.
Which finding is expected?
A. Hypoglycemia
B. Weight loss
C. Buffalo hump
D. Hypotension
Answer: C
Rationale: Excess cortisol causes fat redistribution – buffalo
hump, moon face, truncal obesity, hyperglycemia, and
hypertension.
5. A nurse is caring for a client on warfarin with an INR of 4.5.
Which action is most important?
A. Hold the next dose of warfarin
B. Administer vitamin K IM
C. Check for signs of bleeding
,D. Give fresh frozen plasma
Answer: C
Rationale: INR 4.5 increases bleeding risk; first assess for active
bleeding (e.g., hematuria, bruising). Hold warfarin and notify
provider.
6. A postpartum client reports a foul-smelling lochia, fever,
and uterine tenderness. What condition does the nurse
suspect?
A. Endometritis
B. Cystitis
C. Mastitis
D. Normal involution
Answer: A
Rationale: Endometritis presents with fever, uterine pain, and
malodorous lochia; usually occurs within days after delivery.
7. The nurse is caring for a client with acute pancreatitis.
Which laboratory value is most specific for this condition?
A. Elevated amylase
B. Elevated lipase
C. Elevated ALT
D. Elevated bilirubin
Answer: B
Rationale: Lipase is more specific and remains elevated longer
than amylase in acute pancreatitis.
8. A client with major depressive disorder starts taking
phenelzine (MAOI). Which food should the nurse instruct the
client to avoid?
A. Broccoli
, B. Aged cheese
C. Apples
D. Rice
Answer: B
Rationale: MAOIs inhibit tyramine metabolism; aged cheese,
wine, smoked meats can cause hypertensive crisis.
9. A nurse is preparing to administer digoxin. The client’s
apical pulse is 52 bpm. What should the nurse do?
A. Give the digoxin as ordered
B. Hold the dose and recheck in 1 hour
C. Hold the dose and notify the provider
D. Give the digoxin with atropine
Answer: C
Rationale: Digoxin is held for HR <60 bpm in adults; provider
should be notified for possible toxicity or dose adjustment.
10. Which client should the nurse assign to an LPN?
A. Newly admitted with pneumonia
B. Post-op day 2 with stable vital signs needing a wound dressing
change
C. Client with chest tube and continuous bubbling
D. Client with new tracheostomy requiring suctioning every hour
Answer: B
Rationale: LPNs can perform stable, routine wound care.
Complex, unstable, or new admits require RN.
11. A child with sickle cell crisis is in severe pain. What is the
priority nursing intervention?
A. Administer morphine as ordered
B. Apply cold compresses to joints
