Page 1 of 123
Online HESI Exit Exam 2026 with All
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Solutions to Excel in the Actual HESI Exit Exam
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Question 1
Scenario: A nurse is assessing a patient with heart failure who
reports shortness of breath when walking to the bathroom. The
patient’s oxygen saturation is 89% on room air. What is the
priority intervention?
A) Administer oxygen via nasal cannula at 2 L/min
B) Place the patient in high-Fowler’s position
C) Notify the healthcare provider
D) Check the patient’s blood pressure
Answer: B
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Rationale: High-Fowler’s position maximizes lung expansion and
reduces venous return, improving oxygenation. This is an
immediate, non-invasive intervention that does not require an
order. Oxygen may be added after positioning.
Question 2
A patient with type 1 diabetes is admitted with diabetic
ketoacidosis (DKA). Which laboratory finding is most consistent
with this diagnosis?
A) Blood glucose 180 mg/dL
B) Serum bicarbonate 22 mEq/L
C) Serum pH 7.32
D) Anion gap 8
Answer: C
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Rationale: DKA presents with metabolic acidosis (pH <7.35), low
bicarbonate (<18), elevated glucose (>250), and anion gap
>12. A pH of 7.32 indicates acidosis.
Question 3
Scenario: A patient is receiving a continuous heparin infusion. The
aPTT is 110 seconds (normal 25-35). What is the priority action?
A) Continue the infusion as ordered
B) Stop the infusion and notify the provider
C) Reduce the infusion rate by half
D) Administer protamine sulfate
Answer: B
Rationale: An aPTT >100 seconds indicates excessive
anticoagulation. The infusion should be stopped immediately to
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reduce bleeding risk. Protamine sulfate may be ordered based
on clinical need.
Question 4
A nurse is caring for a patient with a chest tube after a
pneumothorax. The chest tube becomes disconnected from the
drainage system. What is the priority action?
A) Clamp the chest tube immediately
B) Submerge the end of the tube in sterile water
C) Call the healthcare provider
D) Apply a sterile dressing over the insertion site
Answer: B
Rationale: Submerging the open end in sterile water
re-establishes a water seal, preventing air from entering the
Online HESI Exit Exam 2026 with All
Questions & Answers and 100% Verified
Solutions to Excel in the Actual HESI Exit Exam
First Attempt Success
Question 1
Scenario: A nurse is assessing a patient with heart failure who
reports shortness of breath when walking to the bathroom. The
patient’s oxygen saturation is 89% on room air. What is the
priority intervention?
A) Administer oxygen via nasal cannula at 2 L/min
B) Place the patient in high-Fowler’s position
C) Notify the healthcare provider
D) Check the patient’s blood pressure
Answer: B
,Page 2 of 123
Rationale: High-Fowler’s position maximizes lung expansion and
reduces venous return, improving oxygenation. This is an
immediate, non-invasive intervention that does not require an
order. Oxygen may be added after positioning.
Question 2
A patient with type 1 diabetes is admitted with diabetic
ketoacidosis (DKA). Which laboratory finding is most consistent
with this diagnosis?
A) Blood glucose 180 mg/dL
B) Serum bicarbonate 22 mEq/L
C) Serum pH 7.32
D) Anion gap 8
Answer: C
,Page 3 of 123
Rationale: DKA presents with metabolic acidosis (pH <7.35), low
bicarbonate (<18), elevated glucose (>250), and anion gap
>12. A pH of 7.32 indicates acidosis.
Question 3
Scenario: A patient is receiving a continuous heparin infusion. The
aPTT is 110 seconds (normal 25-35). What is the priority action?
A) Continue the infusion as ordered
B) Stop the infusion and notify the provider
C) Reduce the infusion rate by half
D) Administer protamine sulfate
Answer: B
Rationale: An aPTT >100 seconds indicates excessive
anticoagulation. The infusion should be stopped immediately to
, Page 4 of 123
reduce bleeding risk. Protamine sulfate may be ordered based
on clinical need.
Question 4
A nurse is caring for a patient with a chest tube after a
pneumothorax. The chest tube becomes disconnected from the
drainage system. What is the priority action?
A) Clamp the chest tube immediately
B) Submerge the end of the tube in sterile water
C) Call the healthcare provider
D) Apply a sterile dressing over the insertion site
Answer: B
Rationale: Submerging the open end in sterile water
re-establishes a water seal, preventing air from entering the
