HESI RN EXIT EXAM 2026
COMPREHENSIVE
STUDY GUIDE
SECTION 1: MEDICATIONS & PHARMACOLOGY
QUESTION 1
Enalapril maleate (Vasotec) is prescribed for a hospitalized client. Which assessment does
the nurse perform as priority BEFORE administering?
ANSWER
A. Checking the client's blood pressure
RATIONALE / EXPLANATION
Enalapril is an ACE inhibitor used for hypertension. Common side effect is postural hypotension.
Check BP immediately before each dose.
QUESTION 2
Medication dose is higher than normal. Physician is off for the night. Nurse should:
ANSWER
B. Ask the answering service to contact the on-call physician
RATIONALE / EXPLANATION
Never administer a medication you question. Contact on-call physician for clarification. Don't wait
until morning or give without verification.
QUESTION 3
Client scheduled for ECT at 1 PM is NPO but takes oral antihypertensive each morning.
Nurse should:
ANSWER
A. Administer the antihypertensive with a small sip of water
RATIONALE / EXPLANATION
Page 1 of 13
, Essential medications (antihypertensives, cardiac meds, seizure meds) are given with small sip
of water even when NPO for procedures.
QUESTION 4
Atropine sulfate ophthalmic drops given preoperatively to right eye for cataract surgery.
Which response indicates effectiveness?
ANSWER
D. The right pupil dilates after drop instillation
RATIONALE / EXPLANATION
Atropine is a mydriatic (dilates pupils) and cycloplegic (paralyzes ciliary muscle). Pupil dilation
indicates drug is working.
QUESTION 5
Client with HIV develops painful blistering skin rash on right lateral abdominal area. Which
drug should nurse expect?
ANSWER
B. Acyclovir sodium
RATIONALE / EXPLANATION
Description is herpes zoster (shingles) - reactivation of varicella-zoster virus common in
immunocompromised patients. Acyclovir treats herpes viruses.
QUESTION 6
Client with TB taking rifampin. Which finding to report immediately?
ANSWER
C. Elevated liver enzyme levels
RATIONALE / EXPLANATION
Rifampin is HEPATOTOXIC. Elevated liver enzymes indicate liver damage - must be reported
immediately. Orange urine is expected side effect.
Page 2 of 13
COMPREHENSIVE
STUDY GUIDE
SECTION 1: MEDICATIONS & PHARMACOLOGY
QUESTION 1
Enalapril maleate (Vasotec) is prescribed for a hospitalized client. Which assessment does
the nurse perform as priority BEFORE administering?
ANSWER
A. Checking the client's blood pressure
RATIONALE / EXPLANATION
Enalapril is an ACE inhibitor used for hypertension. Common side effect is postural hypotension.
Check BP immediately before each dose.
QUESTION 2
Medication dose is higher than normal. Physician is off for the night. Nurse should:
ANSWER
B. Ask the answering service to contact the on-call physician
RATIONALE / EXPLANATION
Never administer a medication you question. Contact on-call physician for clarification. Don't wait
until morning or give without verification.
QUESTION 3
Client scheduled for ECT at 1 PM is NPO but takes oral antihypertensive each morning.
Nurse should:
ANSWER
A. Administer the antihypertensive with a small sip of water
RATIONALE / EXPLANATION
Page 1 of 13
, Essential medications (antihypertensives, cardiac meds, seizure meds) are given with small sip
of water even when NPO for procedures.
QUESTION 4
Atropine sulfate ophthalmic drops given preoperatively to right eye for cataract surgery.
Which response indicates effectiveness?
ANSWER
D. The right pupil dilates after drop instillation
RATIONALE / EXPLANATION
Atropine is a mydriatic (dilates pupils) and cycloplegic (paralyzes ciliary muscle). Pupil dilation
indicates drug is working.
QUESTION 5
Client with HIV develops painful blistering skin rash on right lateral abdominal area. Which
drug should nurse expect?
ANSWER
B. Acyclovir sodium
RATIONALE / EXPLANATION
Description is herpes zoster (shingles) - reactivation of varicella-zoster virus common in
immunocompromised patients. Acyclovir treats herpes viruses.
QUESTION 6
Client with TB taking rifampin. Which finding to report immediately?
ANSWER
C. Elevated liver enzyme levels
RATIONALE / EXPLANATION
Rifampin is HEPATOTOXIC. Elevated liver enzymes indicate liver damage - must be reported
immediately. Orange urine is expected side effect.
Page 2 of 13
