HESI EXIT RN EXAM V1-V7 WITH NGN 2025-2026
COMPLETE QUESTIONS WITH CORRECT
DETAILED ANSWERS AND RATIONALES
1. A client who has been in active labor for 12 hours suddenly tells the nurse
that she has a strong urge to have a bowel movement. What action should the
nurse take?
a) Allow the client to use a bedpan.
b) Assist the client to the bathroom.
c) Perform a sterile vaginal exam.
d) Explain the fetal head is descending.
Correct Answer & Rationale: c) Perform a sterile vaginal exam. The urge to
have a bowel movement during active labor indicates that the fetal head is
descending and pressing on the rectum. A sterile vaginal exam is necessary to
assess cervical dilation and fetal station to determine if delivery is imminent.
2. The nurse assesses a 78-year-old male client who has left-sided heart
failure. Which symptoms would the nurse expect this client to exhibit?
a) Dyspnea, cough, and fatigue.
b) Hepatomegaly and distended neck veins.
c) Pain over the pericardium and friction rub.
d) Narrowing pulse pressure and distant heart sounds.
Correct Answer & Rationale: a) Dyspnea, cough, and fatigue. Left-sided heart
failure results in pulmonary congestion due to blood backing up into the lungs.
Symptoms include dyspnea, crackles, cough (often frothy sputum), fatigue, and
orthopnea.
3. A female client comes to the clinic complaining of fatigue and inability to
sleep because she is the full-time caretaker for her 22-year-old son who was
paralyzed in a motor vehicle collision. She adds that her husband left her
,because he says he can't take her behavior anymore since all she does is care
for their son. What intervention should the nurse implement?
a) Schedule a home visit in the afternoon to assess the son and client's role as
caregiver.
b) Acknowledge the client's stress and suggest that she consider respite care.
c) Provide feedback to the client about her atonement for guilt about her son's
impairment.
d) Teach the client to problem-solve for herself and establish her own priorities.
Correct Answer & Rationale: b) Acknowledge the client's stress and suggest
that she consider respite care. The client is experiencing caregiver burnout.
Respite care would provide temporary relief, acknowledging her stress is
therapeutic, and this intervention addresses the immediate need for support.
4. The nurse plans to administer a scheduled dose of metoprolol (Toprol SR)
at 0900 to a client with hypertension. At 0800, the nurse notes that the client's
telemetry pattern shows a second-degree heart block with a ventricular rate of
50. What action should the nurse take?
a) Administer the Toprol immediately and monitor the client until the heart rate
increases.
b) Provide the dose of Toprol as scheduled and assign a UAP to monitor the
client's BP q30 minutes.
c) Give the Toprol as scheduled if the client's systolic blood pressure reading is
greater than 180.
d) Hold the scheduled dose of Toprol and notify the healthcare provider of the
telemetry pattern.
Correct Answer & Rationale: d) Hold the scheduled dose of Toprol and notify
the healthcare provider. Beta-blockers such as metoprolol are contraindicated in
second- or third-degree heart block because they decrease heart rate and can
worsen the block or cause asystole.
5. A client who developed syndrome of inappropriate antidiuretic hormone
(SIADH) associated with small cell carcinoma of the lung is preparing for
discharge. When teaching the client about self-management with
,demeclocycline (Declomycin), the nurse should instruct the client to report
which condition to the healthcare provider?
a) Insomnia
b) Muscle cramping
c) Increased appetite
d) Anxiety
Correct Answer & Rationale: b) Muscle cramping. Demeclocycline can cause
nephrotoxicity and electrolyte imbalances. Muscle cramping may indicate
hypokalemia or hyponatremia, which requires prompt evaluation. SIADH
management focuses on fluid and electrolyte balance.
6. A client with type 1 diabetes mellitus is brought to the emergency
department unconscious. Blood glucose is 650 mg/dL. Which finding should
the nurse expect?
a) Moist mucous membranes
b) Kussmaul respirations
c) Hypoventilation
d) Blood pressure 180/100
Correct Answer & Rationale: b) Kussmaul respirations. Diabetic ketoacidosis
(DKA) presents with hyperglycemia, metabolic acidosis, and Kussmaul
respirations (deep, rapid breathing) as a compensatory mechanism for acidosis.
7. The nurse is caring for a client receiving digoxin (Lanoxin). Which finding
indicates digoxin toxicity?
a) Heart rate of 72 bpm
b) Blood pressure 130/80
c) Serum potassium 4.0 mEq/L
d) Visual disturbances (yellow halos around lights)
Correct Answer & Rationale: d) Visual disturbances (yellow halos around
lights). Digoxin toxicity causes visual changes (yellow-green halos, blurred
vision), nausea, vomiting, bradycardia, and dysrhythmias. Early recognition is
critical.
, 8. A postoperative client reports sudden chest pain and shortness of breath.
The nurse notes tachycardia and oxygen saturation of 88%. What action
should the nurse take FIRST?
a) Administer oxygen via nasal cannula.
b) Notify the healthcare provider immediately.
c) Prepare for STAT chest x-ray.
d) Obtain an EKG.
Correct Answer & Rationale: a) Administer oxygen via nasal cannula. Airway
and breathing are priorities. The client is hypoxic (SpO2 88%), so oxygen
administration is the immediate intervention before further assessment or provider
notification.
9. A client with chronic obstructive pulmonary disease (COPD) has an arterial
blood gas (ABG) with pH 7.32, PaCO2 68, HCO3 30. Which interpretation is
correct?
a) Metabolic acidosis, uncompensated
b) Metabolic alkalosis, partially compensated
c) Respiratory alkalosis, fully compensated
d) Respiratory acidosis, partially compensated
Correct Answer & Rationale: d) Respiratory acidosis, partially
compensated. Low pH (acidosis), high PaCO2 (respiratory cause), elevated HCO3
indicates metabolic compensation. Compensation is partial because pH remains
abnormal.
10. A nurse is teaching a client with hypertension about limiting sodium
intake. Which food choice indicates understanding of teaching?
a) Canned vegetable soup
b) Dill pickles
c) Processed cheese slices
d) Baked chicken breast with steamed broccoli
COMPLETE QUESTIONS WITH CORRECT
DETAILED ANSWERS AND RATIONALES
1. A client who has been in active labor for 12 hours suddenly tells the nurse
that she has a strong urge to have a bowel movement. What action should the
nurse take?
a) Allow the client to use a bedpan.
b) Assist the client to the bathroom.
c) Perform a sterile vaginal exam.
d) Explain the fetal head is descending.
Correct Answer & Rationale: c) Perform a sterile vaginal exam. The urge to
have a bowel movement during active labor indicates that the fetal head is
descending and pressing on the rectum. A sterile vaginal exam is necessary to
assess cervical dilation and fetal station to determine if delivery is imminent.
2. The nurse assesses a 78-year-old male client who has left-sided heart
failure. Which symptoms would the nurse expect this client to exhibit?
a) Dyspnea, cough, and fatigue.
b) Hepatomegaly and distended neck veins.
c) Pain over the pericardium and friction rub.
d) Narrowing pulse pressure and distant heart sounds.
Correct Answer & Rationale: a) Dyspnea, cough, and fatigue. Left-sided heart
failure results in pulmonary congestion due to blood backing up into the lungs.
Symptoms include dyspnea, crackles, cough (often frothy sputum), fatigue, and
orthopnea.
3. A female client comes to the clinic complaining of fatigue and inability to
sleep because she is the full-time caretaker for her 22-year-old son who was
paralyzed in a motor vehicle collision. She adds that her husband left her
,because he says he can't take her behavior anymore since all she does is care
for their son. What intervention should the nurse implement?
a) Schedule a home visit in the afternoon to assess the son and client's role as
caregiver.
b) Acknowledge the client's stress and suggest that she consider respite care.
c) Provide feedback to the client about her atonement for guilt about her son's
impairment.
d) Teach the client to problem-solve for herself and establish her own priorities.
Correct Answer & Rationale: b) Acknowledge the client's stress and suggest
that she consider respite care. The client is experiencing caregiver burnout.
Respite care would provide temporary relief, acknowledging her stress is
therapeutic, and this intervention addresses the immediate need for support.
4. The nurse plans to administer a scheduled dose of metoprolol (Toprol SR)
at 0900 to a client with hypertension. At 0800, the nurse notes that the client's
telemetry pattern shows a second-degree heart block with a ventricular rate of
50. What action should the nurse take?
a) Administer the Toprol immediately and monitor the client until the heart rate
increases.
b) Provide the dose of Toprol as scheduled and assign a UAP to monitor the
client's BP q30 minutes.
c) Give the Toprol as scheduled if the client's systolic blood pressure reading is
greater than 180.
d) Hold the scheduled dose of Toprol and notify the healthcare provider of the
telemetry pattern.
Correct Answer & Rationale: d) Hold the scheduled dose of Toprol and notify
the healthcare provider. Beta-blockers such as metoprolol are contraindicated in
second- or third-degree heart block because they decrease heart rate and can
worsen the block or cause asystole.
5. A client who developed syndrome of inappropriate antidiuretic hormone
(SIADH) associated with small cell carcinoma of the lung is preparing for
discharge. When teaching the client about self-management with
,demeclocycline (Declomycin), the nurse should instruct the client to report
which condition to the healthcare provider?
a) Insomnia
b) Muscle cramping
c) Increased appetite
d) Anxiety
Correct Answer & Rationale: b) Muscle cramping. Demeclocycline can cause
nephrotoxicity and electrolyte imbalances. Muscle cramping may indicate
hypokalemia or hyponatremia, which requires prompt evaluation. SIADH
management focuses on fluid and electrolyte balance.
6. A client with type 1 diabetes mellitus is brought to the emergency
department unconscious. Blood glucose is 650 mg/dL. Which finding should
the nurse expect?
a) Moist mucous membranes
b) Kussmaul respirations
c) Hypoventilation
d) Blood pressure 180/100
Correct Answer & Rationale: b) Kussmaul respirations. Diabetic ketoacidosis
(DKA) presents with hyperglycemia, metabolic acidosis, and Kussmaul
respirations (deep, rapid breathing) as a compensatory mechanism for acidosis.
7. The nurse is caring for a client receiving digoxin (Lanoxin). Which finding
indicates digoxin toxicity?
a) Heart rate of 72 bpm
b) Blood pressure 130/80
c) Serum potassium 4.0 mEq/L
d) Visual disturbances (yellow halos around lights)
Correct Answer & Rationale: d) Visual disturbances (yellow halos around
lights). Digoxin toxicity causes visual changes (yellow-green halos, blurred
vision), nausea, vomiting, bradycardia, and dysrhythmias. Early recognition is
critical.
, 8. A postoperative client reports sudden chest pain and shortness of breath.
The nurse notes tachycardia and oxygen saturation of 88%. What action
should the nurse take FIRST?
a) Administer oxygen via nasal cannula.
b) Notify the healthcare provider immediately.
c) Prepare for STAT chest x-ray.
d) Obtain an EKG.
Correct Answer & Rationale: a) Administer oxygen via nasal cannula. Airway
and breathing are priorities. The client is hypoxic (SpO2 88%), so oxygen
administration is the immediate intervention before further assessment or provider
notification.
9. A client with chronic obstructive pulmonary disease (COPD) has an arterial
blood gas (ABG) with pH 7.32, PaCO2 68, HCO3 30. Which interpretation is
correct?
a) Metabolic acidosis, uncompensated
b) Metabolic alkalosis, partially compensated
c) Respiratory alkalosis, fully compensated
d) Respiratory acidosis, partially compensated
Correct Answer & Rationale: d) Respiratory acidosis, partially
compensated. Low pH (acidosis), high PaCO2 (respiratory cause), elevated HCO3
indicates metabolic compensation. Compensation is partial because pH remains
abnormal.
10. A nurse is teaching a client with hypertension about limiting sodium
intake. Which food choice indicates understanding of teaching?
a) Canned vegetable soup
b) Dill pickles
c) Processed cheese slices
d) Baked chicken breast with steamed broccoli
