HESI RN EXIT EXAM (2026)
Comprehensive Questions and Verified Answers
1. A client who is admitted for primary hypothyroidism has early signs of myxedema coma. In
assessing the client, in which sequence should the nurse complete these actions? (descending order)
CORRECT ANSWER: 1. Observe breathing patterns; 2. Assess blood pressure; 3. Measure body
temperature; 4. Palpate for pedal edema
2. A client with type 2 diabetes mellitus arrives to the clinic reporting episodes of weakness and
palpitations. Which finding should the nurse identify may indicate an emerging situation? A. Potassium
3.5 mEq/L B. Fingertips feel numb C. Sodium 135 mEq/L D. Cervical spine stiffness
CORRECT ANSWER: B. Fingertips feel numb
3. An older client is brought to the ED with a sudden onset of confusion that occurred after
experiencing a fall at home. Which information should the nurse provide first when reporting to the
healthcare provider using SBAR communication? A. Currently prescribed medications B. Client's
healthcare power of attorney C. Increasing confusion of the client D. Fall at home as reason for
admission
CORRECT ANSWER: C. Increasing confusion of the client
4. The nurse identifies an electrolyte imbalance, a weight gain of 4.4lbs in 24 hours and an elevated
central venous pressure for a client with full thickness burns. Which intervention should the nurse
implement? A. Auscultate for irregular heart rate B. Review arterial blood gases results C. Measure
ankle circumference D. Document abdominal girth
CORRECT ANSWER: A. Auscultate for irregular heart rate
5. The nurse is caring for a group of clients with the help of a practical nurse (PN). Which nursing
actions should the nurse assign to the PN? (Select all that apply) A. Administer a dose of insulin per
sliding scale for a client with Type 2 DM B. Start the second blood transfusion for a client 12 hours
following a BKA C. Initiate patient controlled analgesia (PCA) pumps for two clients immediately
postoperatively D. Perform daily surgical dressing change for a client who had an abdominal
hysterectomy E. Obtain postoperative vital signs for a client one day following unilateral knee
arthroplasty
CORRECT ANSWER: A. Administer a dose of insulin per sliding scale for a client with Type 2 DM; D.
Perform daily surgical dressing change for a client who had an abdominal hysterectomy; E. Obtain
postoperative vital signs for a client one day following unilateral knee arthroplasty
6. The nurse is teaching a group of women about osteoporosis and exercise. The nurse should
emphasize the need for which type of regular activity? A. Core strengthening B. Aerobic exercise C.
Weight-bearing exercise D. Muscle stretching and toning
CORRECT ANSWER: B. Aerobic exercise
7. A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for
pulmonary embolism. Which information in the client's history requires follow-up by the nurse? A. CT
scan that was performed 6 months earlier B. Metal hip prosthesis was placed 20 years ago C. Report of
,client's sobriety for the last 5 years D. Takes metformin for type 2 diabetes mellitus
CORRECT ANSWER: D. Takes metformin for type 2 diabetes mellitus
8. A client with type 2 diabetes mellitus is admitted for frequent hyperglycemic episodes and a
glycosylated hemoglobin (A1C) of 10%. Insulin glargine 10 units subcutaneously once a day at bedtime
and a sliding scale of insulin aspart every 6h are prescribed. What actions should the nurse include in
this client's plan of care? (Select all that apply)
CORRECT ANSWER: B. Review with client proper foot care and prevention of injury; C. Teach
subcutaneous injection technique, site rotation, and insulin management; D. Coordinate carbohydrate
controlled meals at consistent times and intervals; F. Fingerstick glucose assessments every 6h with meals
9. The psychiatric nurse is caring for clients on an adolescent unit. Which client requires the nurse's
immediate attention? A. A 14yo client with anorexia nervosa who is refusing to eat the evening snack B.
A 16yo client diagnosed with major depression who refuses to participate in group C. A 17yo client
diagnosed with bipolar disorder who is pacing around the lobby D. An 18yo client with antisocial
behavior who is being yelled at by other clients
CORRECT ANSWER: D. An 18yo client with antisocial behavior who is being yelled at by other clients
10. A client at 12 weeks gestation is admitted to the antepartum unit with a diagnosis of hyperemesis
gravidarum. Which action is most important for the nurse to implement? A. Obtain the client's 24-hour
dietary recall B. Document mucosal membrane status C. Schedule a consult with a nutritionist D.
Initiate prescribed intravenous fluids
CORRECT ANSWER: D. Initiate prescribed intravenous fluids
11. A pediatric client is taking the beta-adrenergic blocking agent propranolol. In developing a teaching
plan, the nurse should teach the parents to report which sign of overdose? A. Bradycardia B.
Tachypnea C. Hypertension D. Coughing
CORRECT ANSWER: A. Bradycardia
12. Prior to obtaining a trapeze bar for a client with limited mobility, which client assessment is most
important for the nurse to obtain? A. Upper body muscle strength B. Balance and posture C. Risk for
disuse syndrome D. Pressure sore risk
CORRECT ANSWER: A. Upper body muscle strength
13. A 3-year-old boy was successfully toilet trained prior to his admission to the hospital for injuries
sustained from a fall. His parents are very concerned that the child has regressed in his toileting
behaviors. Which information should the nurse provide to the parents?
CORRECT ANSWER: D. Children usually resume their toileting behaviors when they leave the hospital
14. The nurse is managing the care of a client with Cushing's syndrome. Which interventions should
the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply) A. Report any
client complaint of pain or discomfort B. Evaluate the client for sleep disturbances C. Assess the client
for weakness and fatigue D. Weigh the client and report any weight gain E. Note and report the client's
food and liquid intake during meals and snacks
CORRECT ANSWER: A. Report any client complaint of pain or discomfort; D. Weigh the client and report
any weight gain; E. Note and report the client's food and liquid intake during meals and snacks
,15. A young adult visits the client reporting symptoms associated with gastritis. Which information in
the client's history is most important for the nurse to address in the teaching plan? A. Consumes 10 or
more drinks of alcohol every weekend B. Snacks on foods with very high salt content on a daily basis
C. Exercises vigorously every evening right before going to bed D. Recently became a vegetarian and
eats a lot of high fiber foods
CORRECT ANSWER: A. Consumes 10 or more drinks of alcohol every weekend
16. After administering a proton pump inhibitor (PPI), which action should the nurse take to evaluate
the effectiveness of the medication? A. Auscultate for bowel sounds in all quadrants B. Ask the client
about gastrointestinal pain C. Monitor the client's serum electrolyte levels D. Measure the client's fluid
intake and output
CORRECT ANSWER: B. Ask the client about gastrointestinal pain
17. When assessing a recently delivered, multigravida client, the nurse finds that her vaginal bleeding is
more than expected. Which factor in this client's history is related to this finding? A. The second stage
of labor lasted 10 minutes B. She received butorphanol 2mg IVP during labor C. She is over 35 years of
age D. She is a gravida 6, para 5
CORRECT ANSWER: D. She is a gravida 6, para 5
18. When assessing an IV site that is used for fluid replacement and medication administration, the
client complains of tenderness when the arm is touched above the site. Which additional assessment
finding warrants immediate intervention by the nurse? A. Client uses the arm cautiously B. Red streak
tracking the vein C. A sluggish blood return D. Spot of dried blood at insertion site
CORRECT ANSWER: B. Red streaks tracking the vein
19. An older adult male reporting abdominal pain is admitted to the hospital from a long-term care
facility. It has been 7 days since his last bowel movement, his abdomen is distended, and he just
vomited 150mL of dark brown emesis. In what order should the nurse implement these interventions?
(Highest to lowest priority)
CORRECT ANSWER: 1. Send emesis sample to the lab; 2. Elevate the head of the bed; 3. Complete
focused assessment; 4. Offer PRN pain medication
20. When taking a health history, which information collected by the nurse correlates most directly to a
diagnosis of chronic peripheral arterial insufficiency? A. History of intermittent claudication B. A
positive Brodie-Trendelenburg test C. Ankle ulceration and edema D. A serum cholesterol level of
250mg/dl
CORRECT ANSWER: A. History of intermittent claudication
21. The nurse is providing discharge teaching to the parents of a 13 month old child who underwent
repair for an atrial septal defect. The healthcare provider prescribes aspirin and an antibiotic for the
first 6 months postoperatively to prevent infective endocarditis (IE). What information is most important
for the nurse discuss with the parents? A. Refer the mother to the healthcare provider to discuss
infective endocarditis B. Brush the child's teeth every day and ensure the child receives regular dental
follow-up C. Give the child acetaminophen for pain or fever and visit the surgeon for follow-up D.
Monitor the child for regular bowel movements and urine output that exceeds intake
CORRECT ANSWER: B. Brush the child's teeth every day and ensure the child receives regular dental
follow-up
, 22. An unlicensed assistive personnel (UAP) is assigned to ambulate a client with influenza who has
droplet precautions implemented. The UAP requests a change in assignment, stating the reason of
having not been fitted yet for a N95 respirator mask. Which action should the nurse take? A. Send the
UAP to be fitted for a particulate filter mask immediately B. Instruct the UAP that a standard face mask
is sufficient C. Before changing assignments, determine which staff members have fitted particulate
filter masks D. Advise the UAP to wear a standard face mask to take vital signs, and then get fitted
before providing personal care
CORRECT ANSWER: B. Instruct the UAP that a standard face mask is sufficient for the provision of care
for the assigned client
23. The nurse implements a tertiary prevention program for type 2 diabetes in a rural health clinic.
Which outcome indicates that the program was effective? A. Only 30% of clients did not attend
self-management education sessions B. More than 50% of at-risk clients were diagnosed early in their
disease process C. Clients who developed disease complications promptly received rehabilitation D.
Average client scores improved on specific risk factor knowledge tests
CORRECT ANSWER: C. Clients who developed disease complications promptly received rehabilitation
24. The nurse identifies several nursing problems for a client who is immobile and who has been
experiencing fecal incontinence and diarrhea for several days. The client's spouse is the primary
caregiver. In planning care, which problem has the highest priority? A. Impaired bed mobility B.
Caregiver role strain C. Fluid volume deficit D. Bowel incontinence
CORRECT ANSWER: D. Bowel incontinence
25. The nurse is feeding an older adult who was admitted with aspiration pneumonia. The client is weak
and begins coughing while attempting to drink through a straw. Which intervention should the nurse
implement? A. Teach coughing and deep breathing exercises B. Assess the client's oral cavity for
ulcerations C. Request thick nectar liquids for the client D. Monitor the client when using a straw for
liquids
CORRECT ANSWER: A. Teach coughing and deep breathing exercises
26. An adult client is admitted to the emergency department after falling from the ladder. While waiting
to have a computed tomography (CT) scan, the client requests something for a severe headache. When
the nurse offers a prescribed dose of acetaminophen, the client asks for something stronger. Which
intervention should the nurse implement? A. Review client's history for use of illicit drugs B. Explain
the reason for using only non-narcotics C. Assess client's pupils for their reaction to light D. Request
that the CT scan be done immediately
CORRECT ANSWER: B. Explain the reason for using only non-narcotics
27. The nurse is caring for a client who has chronic obstructive pulmonary disease (COPD) and chest
pain related to a recent fall. What nursing intervention requires the greatest caution when caring for a
client with COPD? A. Monitoring telemetry and cardiac rhythm B. Assisting client to cough and deep
breath C. Administering narcotics for pain relief D. Increasing the client's fluid intake
CORRECT ANSWER: C. Administering narcotics for pain relief
28. The nurse is providing care for a client with schizophrenia who receives haloperidol decanoate
75mg IM every 4 weeks. The client begins developing a puckering and smacking of the lips and facial
grimacing. Which intervention should the nurse implement? A. Monitor lying, sitting, and standing
blood pressures B. Provide coaching in relaxation techniques C. Complete abnormal involuntary
Comprehensive Questions and Verified Answers
1. A client who is admitted for primary hypothyroidism has early signs of myxedema coma. In
assessing the client, in which sequence should the nurse complete these actions? (descending order)
CORRECT ANSWER: 1. Observe breathing patterns; 2. Assess blood pressure; 3. Measure body
temperature; 4. Palpate for pedal edema
2. A client with type 2 diabetes mellitus arrives to the clinic reporting episodes of weakness and
palpitations. Which finding should the nurse identify may indicate an emerging situation? A. Potassium
3.5 mEq/L B. Fingertips feel numb C. Sodium 135 mEq/L D. Cervical spine stiffness
CORRECT ANSWER: B. Fingertips feel numb
3. An older client is brought to the ED with a sudden onset of confusion that occurred after
experiencing a fall at home. Which information should the nurse provide first when reporting to the
healthcare provider using SBAR communication? A. Currently prescribed medications B. Client's
healthcare power of attorney C. Increasing confusion of the client D. Fall at home as reason for
admission
CORRECT ANSWER: C. Increasing confusion of the client
4. The nurse identifies an electrolyte imbalance, a weight gain of 4.4lbs in 24 hours and an elevated
central venous pressure for a client with full thickness burns. Which intervention should the nurse
implement? A. Auscultate for irregular heart rate B. Review arterial blood gases results C. Measure
ankle circumference D. Document abdominal girth
CORRECT ANSWER: A. Auscultate for irregular heart rate
5. The nurse is caring for a group of clients with the help of a practical nurse (PN). Which nursing
actions should the nurse assign to the PN? (Select all that apply) A. Administer a dose of insulin per
sliding scale for a client with Type 2 DM B. Start the second blood transfusion for a client 12 hours
following a BKA C. Initiate patient controlled analgesia (PCA) pumps for two clients immediately
postoperatively D. Perform daily surgical dressing change for a client who had an abdominal
hysterectomy E. Obtain postoperative vital signs for a client one day following unilateral knee
arthroplasty
CORRECT ANSWER: A. Administer a dose of insulin per sliding scale for a client with Type 2 DM; D.
Perform daily surgical dressing change for a client who had an abdominal hysterectomy; E. Obtain
postoperative vital signs for a client one day following unilateral knee arthroplasty
6. The nurse is teaching a group of women about osteoporosis and exercise. The nurse should
emphasize the need for which type of regular activity? A. Core strengthening B. Aerobic exercise C.
Weight-bearing exercise D. Muscle stretching and toning
CORRECT ANSWER: B. Aerobic exercise
7. A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for
pulmonary embolism. Which information in the client's history requires follow-up by the nurse? A. CT
scan that was performed 6 months earlier B. Metal hip prosthesis was placed 20 years ago C. Report of
,client's sobriety for the last 5 years D. Takes metformin for type 2 diabetes mellitus
CORRECT ANSWER: D. Takes metformin for type 2 diabetes mellitus
8. A client with type 2 diabetes mellitus is admitted for frequent hyperglycemic episodes and a
glycosylated hemoglobin (A1C) of 10%. Insulin glargine 10 units subcutaneously once a day at bedtime
and a sliding scale of insulin aspart every 6h are prescribed. What actions should the nurse include in
this client's plan of care? (Select all that apply)
CORRECT ANSWER: B. Review with client proper foot care and prevention of injury; C. Teach
subcutaneous injection technique, site rotation, and insulin management; D. Coordinate carbohydrate
controlled meals at consistent times and intervals; F. Fingerstick glucose assessments every 6h with meals
9. The psychiatric nurse is caring for clients on an adolescent unit. Which client requires the nurse's
immediate attention? A. A 14yo client with anorexia nervosa who is refusing to eat the evening snack B.
A 16yo client diagnosed with major depression who refuses to participate in group C. A 17yo client
diagnosed with bipolar disorder who is pacing around the lobby D. An 18yo client with antisocial
behavior who is being yelled at by other clients
CORRECT ANSWER: D. An 18yo client with antisocial behavior who is being yelled at by other clients
10. A client at 12 weeks gestation is admitted to the antepartum unit with a diagnosis of hyperemesis
gravidarum. Which action is most important for the nurse to implement? A. Obtain the client's 24-hour
dietary recall B. Document mucosal membrane status C. Schedule a consult with a nutritionist D.
Initiate prescribed intravenous fluids
CORRECT ANSWER: D. Initiate prescribed intravenous fluids
11. A pediatric client is taking the beta-adrenergic blocking agent propranolol. In developing a teaching
plan, the nurse should teach the parents to report which sign of overdose? A. Bradycardia B.
Tachypnea C. Hypertension D. Coughing
CORRECT ANSWER: A. Bradycardia
12. Prior to obtaining a trapeze bar for a client with limited mobility, which client assessment is most
important for the nurse to obtain? A. Upper body muscle strength B. Balance and posture C. Risk for
disuse syndrome D. Pressure sore risk
CORRECT ANSWER: A. Upper body muscle strength
13. A 3-year-old boy was successfully toilet trained prior to his admission to the hospital for injuries
sustained from a fall. His parents are very concerned that the child has regressed in his toileting
behaviors. Which information should the nurse provide to the parents?
CORRECT ANSWER: D. Children usually resume their toileting behaviors when they leave the hospital
14. The nurse is managing the care of a client with Cushing's syndrome. Which interventions should
the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply) A. Report any
client complaint of pain or discomfort B. Evaluate the client for sleep disturbances C. Assess the client
for weakness and fatigue D. Weigh the client and report any weight gain E. Note and report the client's
food and liquid intake during meals and snacks
CORRECT ANSWER: A. Report any client complaint of pain or discomfort; D. Weigh the client and report
any weight gain; E. Note and report the client's food and liquid intake during meals and snacks
,15. A young adult visits the client reporting symptoms associated with gastritis. Which information in
the client's history is most important for the nurse to address in the teaching plan? A. Consumes 10 or
more drinks of alcohol every weekend B. Snacks on foods with very high salt content on a daily basis
C. Exercises vigorously every evening right before going to bed D. Recently became a vegetarian and
eats a lot of high fiber foods
CORRECT ANSWER: A. Consumes 10 or more drinks of alcohol every weekend
16. After administering a proton pump inhibitor (PPI), which action should the nurse take to evaluate
the effectiveness of the medication? A. Auscultate for bowel sounds in all quadrants B. Ask the client
about gastrointestinal pain C. Monitor the client's serum electrolyte levels D. Measure the client's fluid
intake and output
CORRECT ANSWER: B. Ask the client about gastrointestinal pain
17. When assessing a recently delivered, multigravida client, the nurse finds that her vaginal bleeding is
more than expected. Which factor in this client's history is related to this finding? A. The second stage
of labor lasted 10 minutes B. She received butorphanol 2mg IVP during labor C. She is over 35 years of
age D. She is a gravida 6, para 5
CORRECT ANSWER: D. She is a gravida 6, para 5
18. When assessing an IV site that is used for fluid replacement and medication administration, the
client complains of tenderness when the arm is touched above the site. Which additional assessment
finding warrants immediate intervention by the nurse? A. Client uses the arm cautiously B. Red streak
tracking the vein C. A sluggish blood return D. Spot of dried blood at insertion site
CORRECT ANSWER: B. Red streaks tracking the vein
19. An older adult male reporting abdominal pain is admitted to the hospital from a long-term care
facility. It has been 7 days since his last bowel movement, his abdomen is distended, and he just
vomited 150mL of dark brown emesis. In what order should the nurse implement these interventions?
(Highest to lowest priority)
CORRECT ANSWER: 1. Send emesis sample to the lab; 2. Elevate the head of the bed; 3. Complete
focused assessment; 4. Offer PRN pain medication
20. When taking a health history, which information collected by the nurse correlates most directly to a
diagnosis of chronic peripheral arterial insufficiency? A. History of intermittent claudication B. A
positive Brodie-Trendelenburg test C. Ankle ulceration and edema D. A serum cholesterol level of
250mg/dl
CORRECT ANSWER: A. History of intermittent claudication
21. The nurse is providing discharge teaching to the parents of a 13 month old child who underwent
repair for an atrial septal defect. The healthcare provider prescribes aspirin and an antibiotic for the
first 6 months postoperatively to prevent infective endocarditis (IE). What information is most important
for the nurse discuss with the parents? A. Refer the mother to the healthcare provider to discuss
infective endocarditis B. Brush the child's teeth every day and ensure the child receives regular dental
follow-up C. Give the child acetaminophen for pain or fever and visit the surgeon for follow-up D.
Monitor the child for regular bowel movements and urine output that exceeds intake
CORRECT ANSWER: B. Brush the child's teeth every day and ensure the child receives regular dental
follow-up
, 22. An unlicensed assistive personnel (UAP) is assigned to ambulate a client with influenza who has
droplet precautions implemented. The UAP requests a change in assignment, stating the reason of
having not been fitted yet for a N95 respirator mask. Which action should the nurse take? A. Send the
UAP to be fitted for a particulate filter mask immediately B. Instruct the UAP that a standard face mask
is sufficient C. Before changing assignments, determine which staff members have fitted particulate
filter masks D. Advise the UAP to wear a standard face mask to take vital signs, and then get fitted
before providing personal care
CORRECT ANSWER: B. Instruct the UAP that a standard face mask is sufficient for the provision of care
for the assigned client
23. The nurse implements a tertiary prevention program for type 2 diabetes in a rural health clinic.
Which outcome indicates that the program was effective? A. Only 30% of clients did not attend
self-management education sessions B. More than 50% of at-risk clients were diagnosed early in their
disease process C. Clients who developed disease complications promptly received rehabilitation D.
Average client scores improved on specific risk factor knowledge tests
CORRECT ANSWER: C. Clients who developed disease complications promptly received rehabilitation
24. The nurse identifies several nursing problems for a client who is immobile and who has been
experiencing fecal incontinence and diarrhea for several days. The client's spouse is the primary
caregiver. In planning care, which problem has the highest priority? A. Impaired bed mobility B.
Caregiver role strain C. Fluid volume deficit D. Bowel incontinence
CORRECT ANSWER: D. Bowel incontinence
25. The nurse is feeding an older adult who was admitted with aspiration pneumonia. The client is weak
and begins coughing while attempting to drink through a straw. Which intervention should the nurse
implement? A. Teach coughing and deep breathing exercises B. Assess the client's oral cavity for
ulcerations C. Request thick nectar liquids for the client D. Monitor the client when using a straw for
liquids
CORRECT ANSWER: A. Teach coughing and deep breathing exercises
26. An adult client is admitted to the emergency department after falling from the ladder. While waiting
to have a computed tomography (CT) scan, the client requests something for a severe headache. When
the nurse offers a prescribed dose of acetaminophen, the client asks for something stronger. Which
intervention should the nurse implement? A. Review client's history for use of illicit drugs B. Explain
the reason for using only non-narcotics C. Assess client's pupils for their reaction to light D. Request
that the CT scan be done immediately
CORRECT ANSWER: B. Explain the reason for using only non-narcotics
27. The nurse is caring for a client who has chronic obstructive pulmonary disease (COPD) and chest
pain related to a recent fall. What nursing intervention requires the greatest caution when caring for a
client with COPD? A. Monitoring telemetry and cardiac rhythm B. Assisting client to cough and deep
breath C. Administering narcotics for pain relief D. Increasing the client's fluid intake
CORRECT ANSWER: C. Administering narcotics for pain relief
28. The nurse is providing care for a client with schizophrenia who receives haloperidol decanoate
75mg IM every 4 weeks. The client begins developing a puckering and smacking of the lips and facial
grimacing. Which intervention should the nurse implement? A. Monitor lying, sitting, and standing
blood pressures B. Provide coaching in relaxation techniques C. Complete abnormal involuntary
