--- complete 760-question HESI RN Exit Exam Test
Bank (
---
**1.** A client with heart failure is prescribed furosemide (Lasix) 40 mg IV push. Which finding indicates
the medication is having the desired effect?
A) Decreased blood pressure
B) Increased urine output and decreased dyspnea
C) Decreased jugular venous distension
D) Weight gain
🔍 **RATIONALE** 💡-- Furosemide reduces preload, promoting diuresis. Desired effects include
increased urine output, decreased dyspnea, and reduced edema.
ANSWER💫✔️-- **B) Increased urine output and decreased dyspnea**
---
**2.** A client with chronic obstructive pulmonary disease (COPD) has an SpO₂ of 88% on room air. The
nurse initiates oxygen at 2 L/min via nasal cannula. Why is this low flow rate used?
A) High flow can cause oxygen toxicity
B) Clients with COPD may have a hypoxic drive
C) Nasal cannula cannot deliver higher flows
D) The client’s lungs are too damaged
🔍 **RATIONALE** 💡-- Some COPD clients with chronic hypercapnia rely on a hypoxic drive; high
oxygen can suppress breathing.
,ANSWER💫✔️-- **B) Clients with COPD may have a hypoxic drive**
---
**3.** A client receiving a blood transfusion develops chills, fever, and low back pain. Which action
should the nurse take first?
A) Slow the infusion
B) Stop the transfusion and infuse normal saline with new tubing
C) Administer acetaminophen
D) Notify the provider
🔍 **RATIONALE** 💡-- Symptoms suggest a hemolytic reaction. Stop the transfusion immediately, keep
the line open with saline, and notify the provider.
ANSWER💫✔️-- **B) Stop the transfusion and infuse normal saline with new tubing**
---
**4.** A client with a traumatic brain injury has an ICP of 22 mm Hg and a MAP of 80 mm Hg. Calculate
the CPP.
A) 58 mm Hg
B) 62 mm Hg
C) 68 mm Hg
D) 72 mm Hg
🔍 **RATIONALE** 💡-- CPP = MAP – ICP = 80 – 22 = 58 mm Hg.
ANSWER💫✔️-- **A) 58 mm Hg**
,---
**5.** A client with a spinal cord injury at T6 develops a severe headache, diaphoresis, and bradycardia
with BP 210/110 mm Hg. What is the priority action?
A) Administer hydralazine
B) Place the client supine
C) Check for a distended bladder or fecal impaction
D) Notify the provider
🔍 **RATIONALE** 💡-- Autonomic dysreflexia – identify and remove the noxious stimulus.
ANSWER💫✔️-- **C) Check for a distended bladder or fecal impaction**
---
**6.** A client with type 2 diabetes is prescribed metformin. Which symptom requires immediate
reporting?
A) Nausea and diarrhea
B) Metallic taste
C) Muscle pain or weakness with fatigue
D) Headache
🔍 **RATIONALE** 💡-- Muscle pain/weakness may indicate lactic acidosis.
ANSWER💫✔️-- **C) Muscle pain or weakness with fatigue**
---
**7.** A client with a new ileostomy asks, “What foods should I avoid to prevent blockage?”
, A) Avoid high‑fiber foods like corn, nuts, and popcorn
B) Avoid all fruits and vegetables for 6 months
C) Limit fluid intake
D) Eat only white bread and pasta
🔍 **RATIONALE** 💡-- Ileostomies are prone to blockage from poorly chewed, high‑fiber foods.
ANSWER💫✔️-- **A) Avoid high‑fiber foods like corn, nuts, and popcorn**
---
**8.** A client with a chest tube has continuous bubbling in the water seal chamber. What is the
priority action?
A) Clamp the chest tube
B) Increase suction
C) Assess for an air leak and notify the provider
D) Strip the tube
🔍 **RATIONALE** 💡-- Continuous bubbling indicates an air leak; assess system and notify provider.
ANSWER💫✔️-- **C) Assess for an air leak and notify the provider**
---
**9.** A client with chronic kidney disease has a serum phosphorus of 6.5 mg/dL. Which medication
does the nurse anticipate?
A) Calcium acetate (PhosLo)
B) Ferrous sulfate
C) Epoetin alfa
Bank (
---
**1.** A client with heart failure is prescribed furosemide (Lasix) 40 mg IV push. Which finding indicates
the medication is having the desired effect?
A) Decreased blood pressure
B) Increased urine output and decreased dyspnea
C) Decreased jugular venous distension
D) Weight gain
🔍 **RATIONALE** 💡-- Furosemide reduces preload, promoting diuresis. Desired effects include
increased urine output, decreased dyspnea, and reduced edema.
ANSWER💫✔️-- **B) Increased urine output and decreased dyspnea**
---
**2.** A client with chronic obstructive pulmonary disease (COPD) has an SpO₂ of 88% on room air. The
nurse initiates oxygen at 2 L/min via nasal cannula. Why is this low flow rate used?
A) High flow can cause oxygen toxicity
B) Clients with COPD may have a hypoxic drive
C) Nasal cannula cannot deliver higher flows
D) The client’s lungs are too damaged
🔍 **RATIONALE** 💡-- Some COPD clients with chronic hypercapnia rely on a hypoxic drive; high
oxygen can suppress breathing.
,ANSWER💫✔️-- **B) Clients with COPD may have a hypoxic drive**
---
**3.** A client receiving a blood transfusion develops chills, fever, and low back pain. Which action
should the nurse take first?
A) Slow the infusion
B) Stop the transfusion and infuse normal saline with new tubing
C) Administer acetaminophen
D) Notify the provider
🔍 **RATIONALE** 💡-- Symptoms suggest a hemolytic reaction. Stop the transfusion immediately, keep
the line open with saline, and notify the provider.
ANSWER💫✔️-- **B) Stop the transfusion and infuse normal saline with new tubing**
---
**4.** A client with a traumatic brain injury has an ICP of 22 mm Hg and a MAP of 80 mm Hg. Calculate
the CPP.
A) 58 mm Hg
B) 62 mm Hg
C) 68 mm Hg
D) 72 mm Hg
🔍 **RATIONALE** 💡-- CPP = MAP – ICP = 80 – 22 = 58 mm Hg.
ANSWER💫✔️-- **A) 58 mm Hg**
,---
**5.** A client with a spinal cord injury at T6 develops a severe headache, diaphoresis, and bradycardia
with BP 210/110 mm Hg. What is the priority action?
A) Administer hydralazine
B) Place the client supine
C) Check for a distended bladder or fecal impaction
D) Notify the provider
🔍 **RATIONALE** 💡-- Autonomic dysreflexia – identify and remove the noxious stimulus.
ANSWER💫✔️-- **C) Check for a distended bladder or fecal impaction**
---
**6.** A client with type 2 diabetes is prescribed metformin. Which symptom requires immediate
reporting?
A) Nausea and diarrhea
B) Metallic taste
C) Muscle pain or weakness with fatigue
D) Headache
🔍 **RATIONALE** 💡-- Muscle pain/weakness may indicate lactic acidosis.
ANSWER💫✔️-- **C) Muscle pain or weakness with fatigue**
---
**7.** A client with a new ileostomy asks, “What foods should I avoid to prevent blockage?”
, A) Avoid high‑fiber foods like corn, nuts, and popcorn
B) Avoid all fruits and vegetables for 6 months
C) Limit fluid intake
D) Eat only white bread and pasta
🔍 **RATIONALE** 💡-- Ileostomies are prone to blockage from poorly chewed, high‑fiber foods.
ANSWER💫✔️-- **A) Avoid high‑fiber foods like corn, nuts, and popcorn**
---
**8.** A client with a chest tube has continuous bubbling in the water seal chamber. What is the
priority action?
A) Clamp the chest tube
B) Increase suction
C) Assess for an air leak and notify the provider
D) Strip the tube
🔍 **RATIONALE** 💡-- Continuous bubbling indicates an air leak; assess system and notify provider.
ANSWER💫✔️-- **C) Assess for an air leak and notify the provider**
---
**9.** A client with chronic kidney disease has a serum phosphorus of 6.5 mg/dL. Which medication
does the nurse anticipate?
A) Calcium acetate (PhosLo)
B) Ferrous sulfate
C) Epoetin alfa
