2026
HESI RN Exit Exam 2026 Advanced
Medical-Surgical, Pharmacology, and
Critical Care Review
A nurse is caring for a postoperative client who suddenly reports shortness of breath and chest
pain. Which action should the nurse take first?
A.
Administer prescribed pain medication
B.
Assess oxygen saturation
C.
Encourage deep breathing
D.
Notify the healthcare provider
Correct Answer: B
Rationale: Sudden shortness of breath and chest pain may indicate a pulmonary embolism. The
nurse must first assess oxygenation status before implementing or escalating care.
The nurse is preparing to administer eye drops to a client. Which action is correct?
A.
Apply pressure to the cornea after instillation
B.
Drop medication directly onto the iris
C.
Pull the lower eyelid down to form a conjunctival sac
D.
Ask the client to blink rapidly after instillation
Correct Answer: C
Rationale: Eye drops should be placed into the conjunctival sac to avoid corneal injury and
ensure proper absorption.
The nurse is caring for a client with a new diagnosis of type 1 diabetes. Which finding requires
immediate intervention?
A.
,2026
Blood glucose of 220 mg/dL
B.
Fruity breath odor
C.
Polyuria
D.
Increased thirst
Correct Answer: B
Rationale: Fruity breath odor suggests diabetic ketoacidosis, a life-threatening condition
requiring immediate intervention.
A nurse is caring for a client receiving morphine IV. Which assessment finding indicates a
serious adverse effect?
A.
Constipation
B.
Urinary retention
C.
Respiratory rate of 10 breaths per minute
D.
Drowsiness
Correct Answer: C
Rationale: Respiratory depression is a life-threatening side effect of opioids and requires
immediate intervention.
The nurse is caring for a client with a suspected stroke. Which assessment finding should the
nurse report immediately?
A.
Blood pressure 150/88 mm Hg
B.
Unequal pupils
C.
Blood glucose of 110 mg/dL
D.
Headache rated 3/10
Correct Answer: B
Rationale: Unequal pupils may indicate increased intracranial pressure or brain injury and
requires urgent evaluation.
,2026
The nurse is teaching a client about proper hand hygiene. Which statement indicates
understanding?
A.
“I only need to wash my hands if they look dirty.”
B.
“I should wash my hands for at least 20 seconds.”
C.
“Hand sanitizer works better than soap and water.”
D.
“I can wear gloves instead of washing my hands.”
Correct Answer: B
Rationale: Proper handwashing should last at least 20 seconds to effectively remove
microorganisms.
A nurse is caring for a client with a nasogastric tube. Which action confirms correct tube
placement?
A.
Injecting air and listening over the stomach
B.
Observing the color of aspirated contents
C.
Measuring tube length
D.
Obtaining an x-ray
Correct Answer: D
Rationale: X-ray confirmation is the most accurate method to verify correct placement of an NG
tube.
The nurse is caring for a client with urinary retention. Which assessment finding supports this
diagnosis?
A.
Frequent urination
B.
Bladder distention
C.
Dark yellow urine
D.
Decreased urine specific gravity
, 2026
Correct Answer: B
Rationale: Bladder distention indicates accumulation of urine and supports urinary retention.
A nurse is caring for a client receiving enteral feedings. Which intervention helps prevent
aspiration?
A.
Place the client supine
B.
Check residuals every 12 hours
C.
Keep the head of the bed elevated
D.
Flush the tube with air
Correct Answer: C
Rationale: Elevating the head of the bed at least 30–45 degrees reduces aspiration risk.
The nurse is caring for a client with hypokalemia. Which food should the nurse recommend?
A.
Rice
B.
Apples
C.
Bananas
D.
White bread
Correct Answer: C
Rationale: Bananas are high in potassium and help correct hypokalemia.
The nurse is caring for a client with a pressure injury. Which intervention is most effective in
preventing further skin breakdown?
A.
Massage reddened areas
B.
Reposition the client every 2 hours
C.
Limit fluid intake
D.
Apply heat to the area
HESI RN Exit Exam 2026 Advanced
Medical-Surgical, Pharmacology, and
Critical Care Review
A nurse is caring for a postoperative client who suddenly reports shortness of breath and chest
pain. Which action should the nurse take first?
A.
Administer prescribed pain medication
B.
Assess oxygen saturation
C.
Encourage deep breathing
D.
Notify the healthcare provider
Correct Answer: B
Rationale: Sudden shortness of breath and chest pain may indicate a pulmonary embolism. The
nurse must first assess oxygenation status before implementing or escalating care.
The nurse is preparing to administer eye drops to a client. Which action is correct?
A.
Apply pressure to the cornea after instillation
B.
Drop medication directly onto the iris
C.
Pull the lower eyelid down to form a conjunctival sac
D.
Ask the client to blink rapidly after instillation
Correct Answer: C
Rationale: Eye drops should be placed into the conjunctival sac to avoid corneal injury and
ensure proper absorption.
The nurse is caring for a client with a new diagnosis of type 1 diabetes. Which finding requires
immediate intervention?
A.
,2026
Blood glucose of 220 mg/dL
B.
Fruity breath odor
C.
Polyuria
D.
Increased thirst
Correct Answer: B
Rationale: Fruity breath odor suggests diabetic ketoacidosis, a life-threatening condition
requiring immediate intervention.
A nurse is caring for a client receiving morphine IV. Which assessment finding indicates a
serious adverse effect?
A.
Constipation
B.
Urinary retention
C.
Respiratory rate of 10 breaths per minute
D.
Drowsiness
Correct Answer: C
Rationale: Respiratory depression is a life-threatening side effect of opioids and requires
immediate intervention.
The nurse is caring for a client with a suspected stroke. Which assessment finding should the
nurse report immediately?
A.
Blood pressure 150/88 mm Hg
B.
Unequal pupils
C.
Blood glucose of 110 mg/dL
D.
Headache rated 3/10
Correct Answer: B
Rationale: Unequal pupils may indicate increased intracranial pressure or brain injury and
requires urgent evaluation.
,2026
The nurse is teaching a client about proper hand hygiene. Which statement indicates
understanding?
A.
“I only need to wash my hands if they look dirty.”
B.
“I should wash my hands for at least 20 seconds.”
C.
“Hand sanitizer works better than soap and water.”
D.
“I can wear gloves instead of washing my hands.”
Correct Answer: B
Rationale: Proper handwashing should last at least 20 seconds to effectively remove
microorganisms.
A nurse is caring for a client with a nasogastric tube. Which action confirms correct tube
placement?
A.
Injecting air and listening over the stomach
B.
Observing the color of aspirated contents
C.
Measuring tube length
D.
Obtaining an x-ray
Correct Answer: D
Rationale: X-ray confirmation is the most accurate method to verify correct placement of an NG
tube.
The nurse is caring for a client with urinary retention. Which assessment finding supports this
diagnosis?
A.
Frequent urination
B.
Bladder distention
C.
Dark yellow urine
D.
Decreased urine specific gravity
, 2026
Correct Answer: B
Rationale: Bladder distention indicates accumulation of urine and supports urinary retention.
A nurse is caring for a client receiving enteral feedings. Which intervention helps prevent
aspiration?
A.
Place the client supine
B.
Check residuals every 12 hours
C.
Keep the head of the bed elevated
D.
Flush the tube with air
Correct Answer: C
Rationale: Elevating the head of the bed at least 30–45 degrees reduces aspiration risk.
The nurse is caring for a client with hypokalemia. Which food should the nurse recommend?
A.
Rice
B.
Apples
C.
Bananas
D.
White bread
Correct Answer: C
Rationale: Bananas are high in potassium and help correct hypokalemia.
The nurse is caring for a client with a pressure injury. Which intervention is most effective in
preventing further skin breakdown?
A.
Massage reddened areas
B.
Reposition the client every 2 hours
C.
Limit fluid intake
D.
Apply heat to the area
