2026
HESI RN Exit Exam 2026 Complete
Exam Prep Resource: Detailed Content
Review, Practice Quizzes, and Rationales
The nurse is planning care for a client who admits having suicidal thoughts. Which client
behavior indicates the highest risk for the client acting on these suicidal thoughts?
a. Express feelings of sadness and loneliness
b. Neglects personal hygiene and has no appetite
c. Lacks interest in the activity of the family and friends
d. Begin to show signs of improvement in affect
Correct Answer: d. Begin to show signs of improvement in affect
Rationale:
A sudden improvement in mood may indicate the client has made a decision to commit suicide
and feels relieved. The other behaviors indicate depression but not immediate suicide risk.
When assessing a multigravida on the first postpartum day, the nurse finds a moderate amount of
lochia rubra, with the uterus firm and three fingerbreadths above the umbilicus. What action
should the nurse implement first?
a. Massage the uterus to decrease atony
b. Check for a distended bladder
c. Increase intravenous infusion
d. Review the hemoglobin to determine hemorrhage
Correct Answer: c. Increase intravenous infusion
Rationale:
An elevated uterus with normal lochia suggests increased blood volume needs. Increasing IV
fluids supports circulation. A firm uterus rules out atony.
A 12-year-old client who had an appendectomy two days ago is receiving 0.9% normal saline at
50 mL/hour. The client's urine specific gravity is 1.035. What action should the nurse
implement?
a. Evaluate postural blood pressure measurements
b. Obtain specimen for urinalysis
,2026
c. Encourage popsicles and fluids of choice
d. Assess bowel sounds in all quadrants
Correct Answer: c. Encourage popsicles and fluids of choice
Rationale:
A high urine specific gravity indicates dehydration. Encouraging oral fluids is the most
appropriate intervention.
An older male client complains of weak urine flow, dribbling, nocturia, and difficulty initiating
urination. Which action should the nurse implement?
a. Obtain a urine specimen for culture and sensitivity
b. Palpate the client's suprapubic area for distention
c. Advise the client to maintain a voiding diary
d. Instruct in cleansing of the glans penis
Correct Answer: b. Palpate the client's suprapubic area for distention
Rationale:
These symptoms suggest urinary retention, commonly from prostatic enlargement. Assessing
bladder distention is the priority.
The nurse is preparing to administer 1.6 mL of medication IM to a 4-month-old infant. Which
action should the nurse include?
a. Use a 22-gauge 1½-inch needle
b. Inject into the deltoid muscle
c. Divide the medication into two injections under 1 mL
d. Inject into the dorsogluteal site
Correct Answer: c. Divide the medication into two injections under 1 mL
Rationale:
Infants cannot safely tolerate IM volumes greater than 1 mL per site. Dorsogluteal and deltoid
sites are unsafe for infants.
A client with a below-the-knee amputation asks if mirror therapy will stop phantom limb pain.
Which response is most helpful?
a. Research indicates that mirror therapy is effective in reducing phantom limb pain
b. You can try mirror therapy but should not expect complete relief
,2026
c. TENS therapy is more effective
d. Where did you learn about mirror therapy?
Correct Answer: a. Research indicates that mirror therapy is effective in reducing
phantom limb pain
Rationale:
This response provides evidence-based reassurance and supports use of a proven
nonpharmacologic therapy.
An older adult with heart failure develops cardiac tamponade. After oxygen and IV fluids, which
intervention is most important?
a. Observe for jugular vein distention
b. Notify the provider to prepare for pericardiocentesis
c. Assess for paradoxical blood pressure
d. Monitor oxygen saturation continuously
Correct Answer: b. Notify the provider to prepare for pericardiocentesis
Rationale:
Cardiac tamponade is life-threatening and requires immediate removal of pericardial fluid.
A new team member spreads belongings, forcing others to move. What action should the nurse
leader take?
a. Welcome and accommodate the new member
b. Ask the new person to move belongings
c. Tell the new person to move belongings
d. Bring in additional chairs
Correct Answer: b. Ask the new person to move belongings
Rationale:
This response is assertive, respectful, and maintains group harmony without being
confrontational.
In monitoring tissue perfusion after an above-the-knee amputation, which action should the nurse
include?
a. Evaluate closest proximal pulse
b. Assess skin elasticity of stump
, 2026
c. Observe swelling around stump
d. Note amount and color of drainage
Correct Answer: a. Evaluate closest proximal pulse
Rationale:
Assessing the proximal pulse provides the most direct evaluation of blood flow to the remaining
limb.
A client post gastric bypass has difficulty managing diet. What instruction is most important?
a. Chew food slowly
b. Plan volume-controlled, evenly spaced meals
c. Sip fluids with meals
d. Eliminate fatty foods
Correct Answer: b. Plan volume-controlled, evenly spaced meals
Rationale:
Small, frequent meals prevent dumping syndrome and ensure adequate nutrition after bariatric
surgery.
The legs of a hospice client appear mottled. A UAP applies a heating pad. What should the nurse
do?
a. Remove heating pad and apply a soft blanket
b. Monitor skin under heating pad
c. Elevate feet and monitor pulses
d. Reposition heating pads
Correct Answer: a. Remove heating pad and apply a soft blanket
Rationale:
Mottled skin is fragile and at high risk for burns. Heating pads should not be used.
A child with fever, dehydration, and sodium level of 156 mEq/L is receiving IV fluids. What
mechanism caused this finding?
a. Hypertonic IV fluids
b. Reduced blood viscosity
c. Insensible fluid loss causing hemoconcentration
d. Hypothalamic temperature resetting
HESI RN Exit Exam 2026 Complete
Exam Prep Resource: Detailed Content
Review, Practice Quizzes, and Rationales
The nurse is planning care for a client who admits having suicidal thoughts. Which client
behavior indicates the highest risk for the client acting on these suicidal thoughts?
a. Express feelings of sadness and loneliness
b. Neglects personal hygiene and has no appetite
c. Lacks interest in the activity of the family and friends
d. Begin to show signs of improvement in affect
Correct Answer: d. Begin to show signs of improvement in affect
Rationale:
A sudden improvement in mood may indicate the client has made a decision to commit suicide
and feels relieved. The other behaviors indicate depression but not immediate suicide risk.
When assessing a multigravida on the first postpartum day, the nurse finds a moderate amount of
lochia rubra, with the uterus firm and three fingerbreadths above the umbilicus. What action
should the nurse implement first?
a. Massage the uterus to decrease atony
b. Check for a distended bladder
c. Increase intravenous infusion
d. Review the hemoglobin to determine hemorrhage
Correct Answer: c. Increase intravenous infusion
Rationale:
An elevated uterus with normal lochia suggests increased blood volume needs. Increasing IV
fluids supports circulation. A firm uterus rules out atony.
A 12-year-old client who had an appendectomy two days ago is receiving 0.9% normal saline at
50 mL/hour. The client's urine specific gravity is 1.035. What action should the nurse
implement?
a. Evaluate postural blood pressure measurements
b. Obtain specimen for urinalysis
,2026
c. Encourage popsicles and fluids of choice
d. Assess bowel sounds in all quadrants
Correct Answer: c. Encourage popsicles and fluids of choice
Rationale:
A high urine specific gravity indicates dehydration. Encouraging oral fluids is the most
appropriate intervention.
An older male client complains of weak urine flow, dribbling, nocturia, and difficulty initiating
urination. Which action should the nurse implement?
a. Obtain a urine specimen for culture and sensitivity
b. Palpate the client's suprapubic area for distention
c. Advise the client to maintain a voiding diary
d. Instruct in cleansing of the glans penis
Correct Answer: b. Palpate the client's suprapubic area for distention
Rationale:
These symptoms suggest urinary retention, commonly from prostatic enlargement. Assessing
bladder distention is the priority.
The nurse is preparing to administer 1.6 mL of medication IM to a 4-month-old infant. Which
action should the nurse include?
a. Use a 22-gauge 1½-inch needle
b. Inject into the deltoid muscle
c. Divide the medication into two injections under 1 mL
d. Inject into the dorsogluteal site
Correct Answer: c. Divide the medication into two injections under 1 mL
Rationale:
Infants cannot safely tolerate IM volumes greater than 1 mL per site. Dorsogluteal and deltoid
sites are unsafe for infants.
A client with a below-the-knee amputation asks if mirror therapy will stop phantom limb pain.
Which response is most helpful?
a. Research indicates that mirror therapy is effective in reducing phantom limb pain
b. You can try mirror therapy but should not expect complete relief
,2026
c. TENS therapy is more effective
d. Where did you learn about mirror therapy?
Correct Answer: a. Research indicates that mirror therapy is effective in reducing
phantom limb pain
Rationale:
This response provides evidence-based reassurance and supports use of a proven
nonpharmacologic therapy.
An older adult with heart failure develops cardiac tamponade. After oxygen and IV fluids, which
intervention is most important?
a. Observe for jugular vein distention
b. Notify the provider to prepare for pericardiocentesis
c. Assess for paradoxical blood pressure
d. Monitor oxygen saturation continuously
Correct Answer: b. Notify the provider to prepare for pericardiocentesis
Rationale:
Cardiac tamponade is life-threatening and requires immediate removal of pericardial fluid.
A new team member spreads belongings, forcing others to move. What action should the nurse
leader take?
a. Welcome and accommodate the new member
b. Ask the new person to move belongings
c. Tell the new person to move belongings
d. Bring in additional chairs
Correct Answer: b. Ask the new person to move belongings
Rationale:
This response is assertive, respectful, and maintains group harmony without being
confrontational.
In monitoring tissue perfusion after an above-the-knee amputation, which action should the nurse
include?
a. Evaluate closest proximal pulse
b. Assess skin elasticity of stump
, 2026
c. Observe swelling around stump
d. Note amount and color of drainage
Correct Answer: a. Evaluate closest proximal pulse
Rationale:
Assessing the proximal pulse provides the most direct evaluation of blood flow to the remaining
limb.
A client post gastric bypass has difficulty managing diet. What instruction is most important?
a. Chew food slowly
b. Plan volume-controlled, evenly spaced meals
c. Sip fluids with meals
d. Eliminate fatty foods
Correct Answer: b. Plan volume-controlled, evenly spaced meals
Rationale:
Small, frequent meals prevent dumping syndrome and ensure adequate nutrition after bariatric
surgery.
The legs of a hospice client appear mottled. A UAP applies a heating pad. What should the nurse
do?
a. Remove heating pad and apply a soft blanket
b. Monitor skin under heating pad
c. Elevate feet and monitor pulses
d. Reposition heating pads
Correct Answer: a. Remove heating pad and apply a soft blanket
Rationale:
Mottled skin is fragile and at high risk for burns. Heating pads should not be used.
A child with fever, dehydration, and sodium level of 156 mEq/L is receiving IV fluids. What
mechanism caused this finding?
a. Hypertonic IV fluids
b. Reduced blood viscosity
c. Insensible fluid loss causing hemoconcentration
d. Hypothalamic temperature resetting
