© Academic_Excellence
HESI RN Exit Exam V3 | Exam Practice Questions And
Correct Answers (Verified Answers) Plus Rationale 2026
Q&A | Instant Download Pdf
1. A nurse is assessing a client who is 1 hour post-cardiac catheterization via the
femoral artery. Which finding requires immediate action?
A. Pulse rate of 76 bpm
B. Hematoma at the insertion site
C. Capillary refill <2 seconds in the affected leg
D. Client reports mild groin discomfort
Correct Answer: B
Rationale: Expanding hematoma indicates bleeding or retroperitoneal bleed, a life-
threatening complication. Groin discomfort, normal pulse, and good cap refill are
expected findings.
2. A nurse is providing discharge teaching to a client with a new prescription for
warfarin. Which statement by the client indicates a need for further teaching?
A. "I will use a soft toothbrush."
B. "I will avoid eating large amounts of spinach and kale."
C. "I will take ibuprofen for my headaches."
D. "I will get my INR checked as scheduled."
Correct Answer: C
Rationale: NSAIDs (ibuprofen, naproxen, aspirin) increase bleeding risk with
warfarin. Acetaminophen is safer for pain. Consistent vitamin K intake
(spinach/kale) is advised, not complete avoidance.
,© Academic_Excellence
3. A nurse is caring for a client who is receiving a blood transfusion. Fifteen
minutes after the start, the client reports low back pain and chills. What is the
priority action?
A. Slow the transfusion rate.
B. Administer acetaminophen.
C. Stop the transfusion.
D. Notify the provider.
Correct Answer: C
Rationale: Low back pain and chills indicate a hemolytic transfusion reaction. Stop
the transfusion immediately, then disconnect tubing, keep IV line open with saline,
and notify the provider.
4. A nurse is assessing a client with diabetic ketoacidosis (DKA). Which laboratory
finding is most consistent?
A. Serum glucose 180 mg/dL
B. pH 7.32, HCO3 18 mEq/L
C. Potassium 2.8 mEq/L
D. Negative serum ketones
Correct Answer: B
Rationale: DKA presents with hyperglycemia (>250), metabolic acidosis (pH
<7.35, HCO3 <18), positive ketones, and often hyperkalemia
(pseudohypokalemia after treatment).
5. A nurse is providing discharge teaching to a client with a new colostomy. Which
statement indicates understanding?
,© Academic_Excellence
A. "I will expect my stool to be formed like before surgery."
B. "I will change my pouch every day."
C. "I will empty my pouch when it is one-third to one-half full."
D. "I will restrict fluids to reduce output."
Correct Answer: C
*Rationale: Empty pouch at 1/3 to 1/2 full to prevent leakage and skin
breakdown. Colostomy output is typically semi-formed; change pouch every 3-7
days; do not restrict fluids (risk of dehydration).*
6. A nurse is preparing to administer an intramuscular injection to an adult in the
ventrogluteal site. Which landmark identifies this site?
A. Acromion process
B. Greater trochanter and iliac crest
C. Two fingerbreadths below the acromion process
D. Midpoint of the rectus femoris
Correct Answer: B
Rationale: Ventrogluteal site is located using the greater trochanter and iliac crest.
It is the preferred IM site for adults due to lack of major nerves and vessels.
7. A nurse is caring for a client with a chest tube following a thoracotomy. Which
finding requires immediate intervention?
A. Tidaling in the water seal chamber with respirations.
B. 100 mL of bloody drainage in the first hour.
C. Continuous bubbling in the water seal chamber.
D. Suction control chamber has gentle bubbling.
, © Academic_Excellence
Correct Answer: C
*Rationale: Continuous bubbling in the water seal chamber indicates an air leak.
Tidaling is normal; >100 mL/hr drainage is high but not as urgent as an air leak;
gentle bubbling in suction chamber is normal.*
8. A nurse is assessing a client for signs of dehydration. Which finding is most
indicative?
A. Bounding pulse
B. Jugular vein distension
C. Poor skin turgor (tenting)
D. Crackles in the lungs
Correct Answer: C
Rationale: Dehydration causes poor skin turgor (tenting), dry mucous membranes,
tachycardia, and hypotension. Bounding pulse, JVD, and crackles indicate fluid
overload.
9. A nurse is providing teaching to a client with a new prescription for albuterol
metered-dose inhaler (MDI). Which instruction is correct?
A. "Shake the inhaler before each use."
B. "Inhale quickly and deeply."
C. "Hold your breath for 1 second after inhaling."
D. "Use this inhaler daily to prevent asthma attacks."
Correct Answer: A
Rationale: Shake MDI well. Inhale slowly and deeply (quick inhalation deposits in
HESI RN Exit Exam V3 | Exam Practice Questions And
Correct Answers (Verified Answers) Plus Rationale 2026
Q&A | Instant Download Pdf
1. A nurse is assessing a client who is 1 hour post-cardiac catheterization via the
femoral artery. Which finding requires immediate action?
A. Pulse rate of 76 bpm
B. Hematoma at the insertion site
C. Capillary refill <2 seconds in the affected leg
D. Client reports mild groin discomfort
Correct Answer: B
Rationale: Expanding hematoma indicates bleeding or retroperitoneal bleed, a life-
threatening complication. Groin discomfort, normal pulse, and good cap refill are
expected findings.
2. A nurse is providing discharge teaching to a client with a new prescription for
warfarin. Which statement by the client indicates a need for further teaching?
A. "I will use a soft toothbrush."
B. "I will avoid eating large amounts of spinach and kale."
C. "I will take ibuprofen for my headaches."
D. "I will get my INR checked as scheduled."
Correct Answer: C
Rationale: NSAIDs (ibuprofen, naproxen, aspirin) increase bleeding risk with
warfarin. Acetaminophen is safer for pain. Consistent vitamin K intake
(spinach/kale) is advised, not complete avoidance.
,© Academic_Excellence
3. A nurse is caring for a client who is receiving a blood transfusion. Fifteen
minutes after the start, the client reports low back pain and chills. What is the
priority action?
A. Slow the transfusion rate.
B. Administer acetaminophen.
C. Stop the transfusion.
D. Notify the provider.
Correct Answer: C
Rationale: Low back pain and chills indicate a hemolytic transfusion reaction. Stop
the transfusion immediately, then disconnect tubing, keep IV line open with saline,
and notify the provider.
4. A nurse is assessing a client with diabetic ketoacidosis (DKA). Which laboratory
finding is most consistent?
A. Serum glucose 180 mg/dL
B. pH 7.32, HCO3 18 mEq/L
C. Potassium 2.8 mEq/L
D. Negative serum ketones
Correct Answer: B
Rationale: DKA presents with hyperglycemia (>250), metabolic acidosis (pH
<7.35, HCO3 <18), positive ketones, and often hyperkalemia
(pseudohypokalemia after treatment).
5. A nurse is providing discharge teaching to a client with a new colostomy. Which
statement indicates understanding?
,© Academic_Excellence
A. "I will expect my stool to be formed like before surgery."
B. "I will change my pouch every day."
C. "I will empty my pouch when it is one-third to one-half full."
D. "I will restrict fluids to reduce output."
Correct Answer: C
*Rationale: Empty pouch at 1/3 to 1/2 full to prevent leakage and skin
breakdown. Colostomy output is typically semi-formed; change pouch every 3-7
days; do not restrict fluids (risk of dehydration).*
6. A nurse is preparing to administer an intramuscular injection to an adult in the
ventrogluteal site. Which landmark identifies this site?
A. Acromion process
B. Greater trochanter and iliac crest
C. Two fingerbreadths below the acromion process
D. Midpoint of the rectus femoris
Correct Answer: B
Rationale: Ventrogluteal site is located using the greater trochanter and iliac crest.
It is the preferred IM site for adults due to lack of major nerves and vessels.
7. A nurse is caring for a client with a chest tube following a thoracotomy. Which
finding requires immediate intervention?
A. Tidaling in the water seal chamber with respirations.
B. 100 mL of bloody drainage in the first hour.
C. Continuous bubbling in the water seal chamber.
D. Suction control chamber has gentle bubbling.
, © Academic_Excellence
Correct Answer: C
*Rationale: Continuous bubbling in the water seal chamber indicates an air leak.
Tidaling is normal; >100 mL/hr drainage is high but not as urgent as an air leak;
gentle bubbling in suction chamber is normal.*
8. A nurse is assessing a client for signs of dehydration. Which finding is most
indicative?
A. Bounding pulse
B. Jugular vein distension
C. Poor skin turgor (tenting)
D. Crackles in the lungs
Correct Answer: C
Rationale: Dehydration causes poor skin turgor (tenting), dry mucous membranes,
tachycardia, and hypotension. Bounding pulse, JVD, and crackles indicate fluid
overload.
9. A nurse is providing teaching to a client with a new prescription for albuterol
metered-dose inhaler (MDI). Which instruction is correct?
A. "Shake the inhaler before each use."
B. "Inhale quickly and deeply."
C. "Hold your breath for 1 second after inhaling."
D. "Use this inhaler daily to prevent asthma attacks."
Correct Answer: A
Rationale: Shake MDI well. Inhale slowly and deeply (quick inhalation deposits in
