HESI RN Exit Exam Versions 1 - 7 Multiple Choice Questions
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||Complete A+
Pharmacology (Medication Safety & Side Effects)
Q1. A client with myasthenia gravis is prescribed pyridostigmine (Mestinon). The client
reports increased muscle weakness and difficulty swallowing 90 minutes after taking the
medication. Which action should the nurse take first?
• A. Administer the next dose early
• B. Assess for cholinergic crisis signs (muscle fasciculations, sweating)
• C. Hold the next dose and call the provider
• D. Encourage the client to rest
✅ Correct Answer: B
Rationale: The symptoms could indicate either cholinergic crisis (too much medication)
or myasthenic crisis (too little). The nurse must first assess for cholinergic signs
(fasciculations, salivation, sweating) to determine the next step.
Q2. A client is receiving a continuous heparin infusion for DVT. The aPTT result is 110
seconds (control 30 seconds). Which medication should the nurse prepare to
administer?
• A. Vitamin K
, • B. Protamine sulfate
• C. Naloxone
• D. Phytonadione
✅ Correct Answer: B
Rationale: The aPTT is >3x control, indicating bleeding risk. Protamine sulfate reverses
heparin. Vitamin K reverses warfarin.
Q3. A nurse administers digoxin 0.25 mg to a client with heart failure. One hour later,
the client reports nausea, vomiting, and sees yellow halos around lights. What is the
priority action?
• A. Administer metoclopramide for nausea
• B. Check the last potassium level
• C. Give another digoxin dose
• D. Prepare for cardioversion
✅ Correct Answer: B
Rationale: Yellow halos and GI symptoms indicate digoxin toxicity, often triggered by
hypokalemia. Check potassium; hold digoxin; notify provider.
Medical-Surgical Nursing
Q4. A client 6 hours post-gastrectomy has a nasogastric (NG) tube to low intermittent
suction. The nurse notes 300 mL of bright red drainage in the past hour. Which action is
most important?
• A. Increase the suction level
, • B. Irrigate the NG tube with saline
• C. Assess vital signs and notify the surgeon
• D. Clamp the NG tube for 30 minutes
✅ Correct Answer: C
Rationale: Bright red drainage post-gastrectomy suggests hemorrhage. Assess
hemodynamic status (HR, BP) and notify surgeon immediately.
Q5. A client with COPD has an oxygen saturation of 88% on room air. The nurse applies
2 L/min nasal cannula. Thirty minutes later, the client is lethargic and breathing 10
breaths/min. What is the most likely cause?
• A. Carbon dioxide narcosis
• B. Oxygen toxicity
• C. Pneumothorax
• D. Pulmonary embolism
✅ Correct Answer: A
Rationale: COPD clients may have chronic hypercapnia and rely on hypoxic drive.
Excessive oxygen can decrease respiratory drive, leading to CO₂ retention and narcosis.
Q6. A client with cirrhosis has jaundice, ascites, and asterixis (liver flap). Which breakfast
selection indicates effective teaching?
• A. Bacon and eggs with orange juice
• B. Ham sandwich with cheese
• C. Oatmeal with fruit and honey
& Answers (Verified Answers), 100% Guaranteed Pass
||Complete A+
Pharmacology (Medication Safety & Side Effects)
Q1. A client with myasthenia gravis is prescribed pyridostigmine (Mestinon). The client
reports increased muscle weakness and difficulty swallowing 90 minutes after taking the
medication. Which action should the nurse take first?
• A. Administer the next dose early
• B. Assess for cholinergic crisis signs (muscle fasciculations, sweating)
• C. Hold the next dose and call the provider
• D. Encourage the client to rest
✅ Correct Answer: B
Rationale: The symptoms could indicate either cholinergic crisis (too much medication)
or myasthenic crisis (too little). The nurse must first assess for cholinergic signs
(fasciculations, salivation, sweating) to determine the next step.
Q2. A client is receiving a continuous heparin infusion for DVT. The aPTT result is 110
seconds (control 30 seconds). Which medication should the nurse prepare to
administer?
• A. Vitamin K
, • B. Protamine sulfate
• C. Naloxone
• D. Phytonadione
✅ Correct Answer: B
Rationale: The aPTT is >3x control, indicating bleeding risk. Protamine sulfate reverses
heparin. Vitamin K reverses warfarin.
Q3. A nurse administers digoxin 0.25 mg to a client with heart failure. One hour later,
the client reports nausea, vomiting, and sees yellow halos around lights. What is the
priority action?
• A. Administer metoclopramide for nausea
• B. Check the last potassium level
• C. Give another digoxin dose
• D. Prepare for cardioversion
✅ Correct Answer: B
Rationale: Yellow halos and GI symptoms indicate digoxin toxicity, often triggered by
hypokalemia. Check potassium; hold digoxin; notify provider.
Medical-Surgical Nursing
Q4. A client 6 hours post-gastrectomy has a nasogastric (NG) tube to low intermittent
suction. The nurse notes 300 mL of bright red drainage in the past hour. Which action is
most important?
• A. Increase the suction level
, • B. Irrigate the NG tube with saline
• C. Assess vital signs and notify the surgeon
• D. Clamp the NG tube for 30 minutes
✅ Correct Answer: C
Rationale: Bright red drainage post-gastrectomy suggests hemorrhage. Assess
hemodynamic status (HR, BP) and notify surgeon immediately.
Q5. A client with COPD has an oxygen saturation of 88% on room air. The nurse applies
2 L/min nasal cannula. Thirty minutes later, the client is lethargic and breathing 10
breaths/min. What is the most likely cause?
• A. Carbon dioxide narcosis
• B. Oxygen toxicity
• C. Pneumothorax
• D. Pulmonary embolism
✅ Correct Answer: A
Rationale: COPD clients may have chronic hypercapnia and rely on hypoxic drive.
Excessive oxygen can decrease respiratory drive, leading to CO₂ retention and narcosis.
Q6. A client with cirrhosis has jaundice, ascites, and asterixis (liver flap). Which breakfast
selection indicates effective teaching?
• A. Bacon and eggs with orange juice
• B. Ham sandwich with cheese
• C. Oatmeal with fruit and honey
