2025/2026 HESI Exit RN Exam Complete
Bundle V1-V7 by Elsevier – Latest NGN
Question Bank with Detailed Rationales
for Guaranteed First-Attempt Success
1. A nurse is assessing a patient with suspected pulmonary
embolism. Which finding is most consistent with this
diagnosis?
A) Bradycardia and hypotension
B) Sudden onset of pleuritic chest pain and dyspnea
C) Productive cough with green sputum
D) Bilateral crackles in lung bases
Answer: B
Rationale: Pulmonary embolism often presents with sudden
pleuritic chest pain, dyspnea, tachypnea, and tachycardia. Option
A (bradycardia) is not typical; PE usually causes tachycardia.
Option C suggests pneumonia. Option D suggests heart failure or
atelectasis.
,2. A patient with major depressive disorder is started on
phenelzine (an MAOI). Which food should the nurse instruct
the patient to avoid?
A) Broiled chicken
B) Aged cheddar cheese
C) White rice
D) Apple juice
Answer: B
Rationale: MAOIs interact with tyramine-rich foods (aged
cheeses, cured meats, fermented products) to cause hypertensive
crisis. Chicken, rice, and apple juice are low in tyramine.
3. A nurse is caring for a patient receiving oxytocin for
induction of labor. The contractions are lasting 110 seconds
with a frequency of every 1.5 minutes. What is the priority
action?
A) Increase the oxytocin infusion rate.
B) Stop the oxytocin infusion.
C) Reposition the patient onto her left side.
D) Administer oxygen via non-rebreather mask.
Answer: B
Rationale: Contractions lasting >90 seconds or frequency <2
minutes indicate uterine hyperstimulation, which risks fetal
distress and uterine rupture. The first action is to stop the
,oxytocin. Repositioning and oxygen may follow but are not the
priority over stopping the infusion.
4. A patient is being discharged after a myocardial infarction.
Which statement indicates a need for further teaching?
A) “I will wait at least 1 hour after eating before exercising.”
B) “I will stop smoking using nicotine patches as prescribed.”
C) “I will take my metoprolol even if my heart rate is 52 bpm.”
D) “I can resume sexual activity once I can climb two flights of
stairs without chest pain.”
Answer: C
Rationale: Metoprolol (a beta-blocker) may cause bradycardia. A
heart rate of 52 bpm is near the threshold (usually hold if <50–55
bpm depending on order). The patient should check with the
provider before taking it with a low HR. Option D is correct (sexual
activity can be resumed when able to climb two flights
comfortably). Option A (wait after eating) is correct. Option B
(nicotine patch) is fine.
5. A nurse is preparing to administer packed red blood cells.
Which IV solution can be infused with the blood product?
A) 0.9% normal saline
B) Lactated Ringer’s solution
, C) 5% dextrose in water
D) 0.45% normal saline
Answer: A
Rationale: Only 0.9% normal saline is compatible with PRBCs.
Dextrose solutions cause hemolysis. Lactated Ringer’s contains
calcium which can cause clotting in the tubing. Hypotonic saline
causes RBC swelling.
6. A patient is on a heparin infusion. The nurse notes
petechiae on the patient’s arms and a drop in platelet count
from 250,000 to 80,000. What should the nurse suspect?
A) Heparin overdose
B) Heparin-induced thrombocytopenia (HIT)
C) Allergic reaction to heparin
D) Disseminated intravascular coagulation (DIC)
Answer: B
Rationale: HIT is suspected with a >50% drop in platelets, often
with thrombosis or bleeding manifestations (petechiae). Stop
heparin immediately and notify provider. Option A would show
elevated aPTT but not isolated thrombocytopenia. Option C is
rare. DIC usually has other signs.
Bundle V1-V7 by Elsevier – Latest NGN
Question Bank with Detailed Rationales
for Guaranteed First-Attempt Success
1. A nurse is assessing a patient with suspected pulmonary
embolism. Which finding is most consistent with this
diagnosis?
A) Bradycardia and hypotension
B) Sudden onset of pleuritic chest pain and dyspnea
C) Productive cough with green sputum
D) Bilateral crackles in lung bases
Answer: B
Rationale: Pulmonary embolism often presents with sudden
pleuritic chest pain, dyspnea, tachypnea, and tachycardia. Option
A (bradycardia) is not typical; PE usually causes tachycardia.
Option C suggests pneumonia. Option D suggests heart failure or
atelectasis.
,2. A patient with major depressive disorder is started on
phenelzine (an MAOI). Which food should the nurse instruct
the patient to avoid?
A) Broiled chicken
B) Aged cheddar cheese
C) White rice
D) Apple juice
Answer: B
Rationale: MAOIs interact with tyramine-rich foods (aged
cheeses, cured meats, fermented products) to cause hypertensive
crisis. Chicken, rice, and apple juice are low in tyramine.
3. A nurse is caring for a patient receiving oxytocin for
induction of labor. The contractions are lasting 110 seconds
with a frequency of every 1.5 minutes. What is the priority
action?
A) Increase the oxytocin infusion rate.
B) Stop the oxytocin infusion.
C) Reposition the patient onto her left side.
D) Administer oxygen via non-rebreather mask.
Answer: B
Rationale: Contractions lasting >90 seconds or frequency <2
minutes indicate uterine hyperstimulation, which risks fetal
distress and uterine rupture. The first action is to stop the
,oxytocin. Repositioning and oxygen may follow but are not the
priority over stopping the infusion.
4. A patient is being discharged after a myocardial infarction.
Which statement indicates a need for further teaching?
A) “I will wait at least 1 hour after eating before exercising.”
B) “I will stop smoking using nicotine patches as prescribed.”
C) “I will take my metoprolol even if my heart rate is 52 bpm.”
D) “I can resume sexual activity once I can climb two flights of
stairs without chest pain.”
Answer: C
Rationale: Metoprolol (a beta-blocker) may cause bradycardia. A
heart rate of 52 bpm is near the threshold (usually hold if <50–55
bpm depending on order). The patient should check with the
provider before taking it with a low HR. Option D is correct (sexual
activity can be resumed when able to climb two flights
comfortably). Option A (wait after eating) is correct. Option B
(nicotine patch) is fine.
5. A nurse is preparing to administer packed red blood cells.
Which IV solution can be infused with the blood product?
A) 0.9% normal saline
B) Lactated Ringer’s solution
, C) 5% dextrose in water
D) 0.45% normal saline
Answer: A
Rationale: Only 0.9% normal saline is compatible with PRBCs.
Dextrose solutions cause hemolysis. Lactated Ringer’s contains
calcium which can cause clotting in the tubing. Hypotonic saline
causes RBC swelling.
6. A patient is on a heparin infusion. The nurse notes
petechiae on the patient’s arms and a drop in platelet count
from 250,000 to 80,000. What should the nurse suspect?
A) Heparin overdose
B) Heparin-induced thrombocytopenia (HIT)
C) Allergic reaction to heparin
D) Disseminated intravascular coagulation (DIC)
Answer: B
Rationale: HIT is suspected with a >50% drop in platelets, often
with thrombosis or bleeding manifestations (petechiae). Stop
heparin immediately and notify provider. Option A would show
elevated aPTT but not isolated thrombocytopenia. Option C is
rare. DIC usually has other signs.
