---
**HESI Exit Exam Fundamentals 2026 Test Bank: Real
Questions & Verified Answers for Grade A Success**
1. A nurse is caring for a client with heart failure who reports sudden onset of dyspnea and coughing up
pink, frothy sputum. Which action should the nurse take first?
A) Administer oxygen via nasal cannula
B) Place the client in high Fowler’s position
C) Notify the healthcare provider
D) Check the oxygen saturation
🔍 **RATIONALE** 💡-- High Fowler’s position reduces venous return to the heart and helps decrease
pulmonary congestion, which is the priority in acute pulmonary edema. Oxygen (A) is important but
positioning is the immediate action. Notifying the provider (C) and checking SpO₂ (D) follow after
positioning and oxygen.
ANSWER💫✔️-- **B) Place the client in high Fowler’s position**
---
2. A nurse is assessing a client who is 1 day postoperative following abdominal surgery. Which finding
requires immediate intervention?
A) Pain rating of 6 on a 0–10 scale
B) Absent bowel sounds
C) Oxygen saturation of 88% on room air
D) Serosanguineous drainage on the dressing
,🔍 **RATIONALE** 💡-- Oxygen saturation <90% indicates hypoxemia, a life‑threatening
airway/breathing priority. Pain (A) is important but not immediate; absent bowel sounds (B) are
expected post‑op; serosanguineous drainage (D) is normal.
ANSWER💫✔️-- **C) Oxygen saturation of 88% on room air**
---
3. A client with type 1 diabetes mellitus has a blood glucose level of 45 mg/dL and is unconscious. What
should the nurse administer first?
A) ½ cup of orange juice
B) 15 g of carbohydrates via nasogastric tube
C) Glucagon 1 mg intramuscularly
D) 50 mL of 50% dextrose IV push
🔍 **RATIONALE** 💡-- For an unconscious hypoglycemic client, IV dextrose is the fastest and most
effective treatment to restore blood glucose. Glucagon (C) is an alternative if IV access is unavailable but
is slower. Oral options (A, B) are unsafe due to aspiration risk.
ANSWER💫✔️-- **D) 50 mL of 50% dextrose IV push**
---
4. A nurse is assessing a postoperative client for deep vein thrombosis (DVT). Which finding is most
indicative?
A) Bilateral calf swelling
B) Pain in the calf with dorsiflexion of the foot
C) Warm, erythematous area on the lower leg
D) Report of leg fatigue after ambulation
,🔍 **RATIONALE** 💡-- Unilateral warmth, erythema, and tenderness are classic signs of DVT. Bilateral
swelling (A) suggests other causes like heart failure. Homan’s sign (B) is unreliable and no longer
recommended. Leg fatigue (D) is nonspecific.
ANSWER💫✔️-- **C) Warm, erythematous area on the lower leg**
---
5. A client receiving morphine sulfate for pain has a respiratory rate of 8 breaths/minute. Which
medication should the nurse prepare to administer?
A) Naloxone
B) Flumazenil
C) Acetylcysteine
D) Protamine sulfate
🔍 **RATIONALE** 💡-- Naloxone is an opioid antagonist that reverses respiratory depression caused by
morphine. Flumazenil (B) reverses benzodiazepines; acetylcysteine (C) treats acetaminophen overdose;
protamine sulfate (D) reverses heparin.
ANSWER💫✔️-- **A) Naloxone**
---
6. A nurse is preparing to insert an indwelling urinary catheter for a female client. Which action best
maintains sterile technique?
A) Opening the catheter kit facing away from the nurse
B) Placing the sterile drape with the waterproof side down
C) Using sterile gloves to handle the catheter and securing with tape after insertion
D) Pouring antiseptic solution onto the sterile field before donning sterile gloves
, 🔍 **RATIONALE** 💡-- Sterile gloves must be worn to maintain the sterile field when handling the
catheter. Tape is applied after insertion. The waterproof side of the drape should face up to protect the
field from moisture. Antiseptic solution should be poured after sterile gloves are on.
ANSWER💫✔️-- **C) Using sterile gloves to handle the catheter and securing with tape after insertion**
---
7. A policy requiring the removal of acrylic nails by all nursing personnel was implemented 6 months
ago. Which assessment measure best determines if the intended outcome is being achieved?
A) Number of staff‑induced injuries
B) Client satisfaction survey
C) Health care‑associated infection rate
D) Rate of needle‑stick injuries by nurses
🔍 **RATIONALE** 💡-- Acrylic nails carry bacteria and increase the risk of healthcare‑associated
infections. Removing them would be expected to lower infection rates. They are not linked to staff
injuries, needle‑stick injuries, or patient satisfaction.
ANSWER💫✔️-- **C) Health care‑associated infection rate**
---
8. Which assessment data would provide the most accurate determination of proper placement of a
nasogastric tube?
A) Aspirating gastric contents to assure a pH value of 4 or less
B) Hearing air pass in the stomach after injecting air into the tubing
C) Examining a chest x‑ray obtained after the tubing was inserted
D) Checking the remaining length of tubing to ensure that the correct length was inserted
**HESI Exit Exam Fundamentals 2026 Test Bank: Real
Questions & Verified Answers for Grade A Success**
1. A nurse is caring for a client with heart failure who reports sudden onset of dyspnea and coughing up
pink, frothy sputum. Which action should the nurse take first?
A) Administer oxygen via nasal cannula
B) Place the client in high Fowler’s position
C) Notify the healthcare provider
D) Check the oxygen saturation
🔍 **RATIONALE** 💡-- High Fowler’s position reduces venous return to the heart and helps decrease
pulmonary congestion, which is the priority in acute pulmonary edema. Oxygen (A) is important but
positioning is the immediate action. Notifying the provider (C) and checking SpO₂ (D) follow after
positioning and oxygen.
ANSWER💫✔️-- **B) Place the client in high Fowler’s position**
---
2. A nurse is assessing a client who is 1 day postoperative following abdominal surgery. Which finding
requires immediate intervention?
A) Pain rating of 6 on a 0–10 scale
B) Absent bowel sounds
C) Oxygen saturation of 88% on room air
D) Serosanguineous drainage on the dressing
,🔍 **RATIONALE** 💡-- Oxygen saturation <90% indicates hypoxemia, a life‑threatening
airway/breathing priority. Pain (A) is important but not immediate; absent bowel sounds (B) are
expected post‑op; serosanguineous drainage (D) is normal.
ANSWER💫✔️-- **C) Oxygen saturation of 88% on room air**
---
3. A client with type 1 diabetes mellitus has a blood glucose level of 45 mg/dL and is unconscious. What
should the nurse administer first?
A) ½ cup of orange juice
B) 15 g of carbohydrates via nasogastric tube
C) Glucagon 1 mg intramuscularly
D) 50 mL of 50% dextrose IV push
🔍 **RATIONALE** 💡-- For an unconscious hypoglycemic client, IV dextrose is the fastest and most
effective treatment to restore blood glucose. Glucagon (C) is an alternative if IV access is unavailable but
is slower. Oral options (A, B) are unsafe due to aspiration risk.
ANSWER💫✔️-- **D) 50 mL of 50% dextrose IV push**
---
4. A nurse is assessing a postoperative client for deep vein thrombosis (DVT). Which finding is most
indicative?
A) Bilateral calf swelling
B) Pain in the calf with dorsiflexion of the foot
C) Warm, erythematous area on the lower leg
D) Report of leg fatigue after ambulation
,🔍 **RATIONALE** 💡-- Unilateral warmth, erythema, and tenderness are classic signs of DVT. Bilateral
swelling (A) suggests other causes like heart failure. Homan’s sign (B) is unreliable and no longer
recommended. Leg fatigue (D) is nonspecific.
ANSWER💫✔️-- **C) Warm, erythematous area on the lower leg**
---
5. A client receiving morphine sulfate for pain has a respiratory rate of 8 breaths/minute. Which
medication should the nurse prepare to administer?
A) Naloxone
B) Flumazenil
C) Acetylcysteine
D) Protamine sulfate
🔍 **RATIONALE** 💡-- Naloxone is an opioid antagonist that reverses respiratory depression caused by
morphine. Flumazenil (B) reverses benzodiazepines; acetylcysteine (C) treats acetaminophen overdose;
protamine sulfate (D) reverses heparin.
ANSWER💫✔️-- **A) Naloxone**
---
6. A nurse is preparing to insert an indwelling urinary catheter for a female client. Which action best
maintains sterile technique?
A) Opening the catheter kit facing away from the nurse
B) Placing the sterile drape with the waterproof side down
C) Using sterile gloves to handle the catheter and securing with tape after insertion
D) Pouring antiseptic solution onto the sterile field before donning sterile gloves
, 🔍 **RATIONALE** 💡-- Sterile gloves must be worn to maintain the sterile field when handling the
catheter. Tape is applied after insertion. The waterproof side of the drape should face up to protect the
field from moisture. Antiseptic solution should be poured after sterile gloves are on.
ANSWER💫✔️-- **C) Using sterile gloves to handle the catheter and securing with tape after insertion**
---
7. A policy requiring the removal of acrylic nails by all nursing personnel was implemented 6 months
ago. Which assessment measure best determines if the intended outcome is being achieved?
A) Number of staff‑induced injuries
B) Client satisfaction survey
C) Health care‑associated infection rate
D) Rate of needle‑stick injuries by nurses
🔍 **RATIONALE** 💡-- Acrylic nails carry bacteria and increase the risk of healthcare‑associated
infections. Removing them would be expected to lower infection rates. They are not linked to staff
injuries, needle‑stick injuries, or patient satisfaction.
ANSWER💫✔️-- **C) Health care‑associated infection rate**
---
8. Which assessment data would provide the most accurate determination of proper placement of a
nasogastric tube?
A) Aspirating gastric contents to assure a pH value of 4 or less
B) Hearing air pass in the stomach after injecting air into the tubing
C) Examining a chest x‑ray obtained after the tubing was inserted
D) Checking the remaining length of tubing to ensure that the correct length was inserted
