HESI RN Exit Exam Legacy V2: Questions
& Correct Answers (100% COMPLETE)
Questions with Correct Answers &
Rationales | Latest 2026/2027 Update Grade
A+ | Pass on First Try
Domain Questions Key Concepts Covered
K+, Na+, Ca+, Mg+, Cl-, Phos, Bicarb;
Fluids & 1–4, 6–9, 12–15, 17–
hypo/hyper conditions; EKG changes;
Electrolytes 19, 21
IV solutions
2–5, 7–8, 11, 14–16, Warfarin, digoxin, heparin, ACE, beta-
Pharmacology 20, 23, 26, 28, 58, 60, blockers, diuretics, steroids, insulin,
62, 66, 70, 74, 78, 82 naloxone, antithyroid, pyridostigmine
4, 10, 16, 22, 26–28,
IV solutions, safety, infection control,
Nursing 86–90, 92–96, 98–
delegation, consent, documentation,
Fundamentals 100, 102, 104, 106,
PPE, patient education, transfer
108–110
Preeclampsia, RDS, placenta
29–32, 34–38, 41, 45, abruption/previa, newborn care,
Maternity
47–48, 51, 54, 56 vaccines, labor positions, cord prolapse,
SIDS prevention
Newborn resuscitation, weight
31, 33, 36–37, 39–40,
Pediatrics & conversion, vaccines, jaundice,
42–44, 46–47, 49, 52–
Neonatal dehydration, seizure, otitis media, SIDS,
53, 55
tachycardia, kernicterus
MI, COPD, DKA, stroke, pneumonia,
57, 59–61, 63–65, 67,
pancreatitis, hyper/hypothyroid,
Medical-Surgical 71, 73, 75–77, 79–81,
cirrhosis, gout, peritonitis,
83
thyroidectomy, RA
Serotonin syndrome, hyperthyroidism
Mental Health 62, 73
(anxiety), depression
, Domain Questions Key Concepts Covered
CHF diet, malnutrition, wound healing
Nutrition 65, 68, 76, 79, 84 protein, gout purines, fiber for
constipation
85–87, 89–90, 93–95, Prioritization, delegation, patient rights,
Leadership &
97, 101, 103, 105, reporting, triage, pain management,
Management
107, 109 palliative care, fall prevention
Questions 1–28: Fluids & Electrolytes, Pharmacology & Nursing
Fundamentals
1. A patient has serum potassium of 2.8 mEq/L. Which intervention is MOST
important?
A. Administer potassium supplement
B. Restrict potassium intake
C. Give sodium supplement
D. Monitor for hyperkalemia
Correct answer: A
Rationale: Potassium 2.8 mEq/L indicates hypokalemia (normal 3.5–5.0); requires
potassium replacement to prevent cardiac arrhythmias, muscle weakness, and
respiratory failure.
2. Which medication requires monitoring for thrombocytopenia?
A. Metoprolol
B. Heparin
C. Lisinopril
D. Furosemide
Correct answer: B
Rationale: Heparin can cause heparin-induced thrombocytopenia (HIT); monitor
platelet count regularly; discontinue if platelets drop <100,000/mm³ or decrease by
50%.
,3. A patient has sodium level of 118 mEq/L. What is the priority nursing
action?
A. Administer sodium supplement
B. Restrict fluids and monitor neuro status
C. Give potassium
D. Increase fluid intake
Correct answer: B
Rationale: Sodium 118 mEq/L indicates severe hyponatremia (normal 135–145);
risk of cerebral edema, seizures; restrict fluids, monitor neuro status, consider
sodium replacement cautiously.
4. Which IV solution is isotonic?
A. 0.9% NaCl (Normal Saline)
B. 3% NaCl
C. 0.45% NaCl
D. D5W
Correct answer: A
Rationale: 0.9% NaCl (Normal Saline) is isotonic (same osmolarity as blood);
used for fluid resuscitation, dehydration, and as IV flush. D5W is isotonic in bag
but hypotonic in body.
5. A patient on warfarin has INR of 5.0. What is the appropriate action?
A. Continue warfarin
B. Stop warfarin and give vitamin K
C. Increase warfarin dose
D. Give aspirin
Correct answer: B
Rationale: INR 5.0 is above therapeutic range (2.0–3.0); indicates bleeding risk;
stop warfarin, give vitamin K to reverse anticoagulation, and monitor for bleeding.
, 6. Which electrolyte imbalance causes tetany and Chvostek's sign?
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypomagnesemia
Correct answer: B
Rationale: Hypocalcemia (low calcium) causes neuromuscular irritability: tetany,
Chvostek's sign (facial twitching), Trousseau's sign (carpal spasm); treat with
calcium supplement.
7. A patient is prescribed digoxin. Which lab value is CRITICAL to monitor?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Correct answer: B
Rationale: Digoxin toxicity increases with hypokalemia; maintain potassium 4.0–
5.0 mEq/L; monitor digoxin level (0.5–2.0 ng/mL) and potassium regularly.
8. Which medication is a potassium-wasting diuretic?
A. Spironolactone
B. Furosemide (Lasix)
C. Lisinopril
D. Metoprolol
Correct answer: B
Rationale: Furosemide is a potassium-wasting diuretic; causes hypokalemia;
patient needs potassium-rich foods (bananas, oranges) or potassium supplement.
9. A patient has chloride level of 88 mEq/L. What does this indicate?
A. Normal chloride
B. Hypochloremia
& Correct Answers (100% COMPLETE)
Questions with Correct Answers &
Rationales | Latest 2026/2027 Update Grade
A+ | Pass on First Try
Domain Questions Key Concepts Covered
K+, Na+, Ca+, Mg+, Cl-, Phos, Bicarb;
Fluids & 1–4, 6–9, 12–15, 17–
hypo/hyper conditions; EKG changes;
Electrolytes 19, 21
IV solutions
2–5, 7–8, 11, 14–16, Warfarin, digoxin, heparin, ACE, beta-
Pharmacology 20, 23, 26, 28, 58, 60, blockers, diuretics, steroids, insulin,
62, 66, 70, 74, 78, 82 naloxone, antithyroid, pyridostigmine
4, 10, 16, 22, 26–28,
IV solutions, safety, infection control,
Nursing 86–90, 92–96, 98–
delegation, consent, documentation,
Fundamentals 100, 102, 104, 106,
PPE, patient education, transfer
108–110
Preeclampsia, RDS, placenta
29–32, 34–38, 41, 45, abruption/previa, newborn care,
Maternity
47–48, 51, 54, 56 vaccines, labor positions, cord prolapse,
SIDS prevention
Newborn resuscitation, weight
31, 33, 36–37, 39–40,
Pediatrics & conversion, vaccines, jaundice,
42–44, 46–47, 49, 52–
Neonatal dehydration, seizure, otitis media, SIDS,
53, 55
tachycardia, kernicterus
MI, COPD, DKA, stroke, pneumonia,
57, 59–61, 63–65, 67,
pancreatitis, hyper/hypothyroid,
Medical-Surgical 71, 73, 75–77, 79–81,
cirrhosis, gout, peritonitis,
83
thyroidectomy, RA
Serotonin syndrome, hyperthyroidism
Mental Health 62, 73
(anxiety), depression
, Domain Questions Key Concepts Covered
CHF diet, malnutrition, wound healing
Nutrition 65, 68, 76, 79, 84 protein, gout purines, fiber for
constipation
85–87, 89–90, 93–95, Prioritization, delegation, patient rights,
Leadership &
97, 101, 103, 105, reporting, triage, pain management,
Management
107, 109 palliative care, fall prevention
Questions 1–28: Fluids & Electrolytes, Pharmacology & Nursing
Fundamentals
1. A patient has serum potassium of 2.8 mEq/L. Which intervention is MOST
important?
A. Administer potassium supplement
B. Restrict potassium intake
C. Give sodium supplement
D. Monitor for hyperkalemia
Correct answer: A
Rationale: Potassium 2.8 mEq/L indicates hypokalemia (normal 3.5–5.0); requires
potassium replacement to prevent cardiac arrhythmias, muscle weakness, and
respiratory failure.
2. Which medication requires monitoring for thrombocytopenia?
A. Metoprolol
B. Heparin
C. Lisinopril
D. Furosemide
Correct answer: B
Rationale: Heparin can cause heparin-induced thrombocytopenia (HIT); monitor
platelet count regularly; discontinue if platelets drop <100,000/mm³ or decrease by
50%.
,3. A patient has sodium level of 118 mEq/L. What is the priority nursing
action?
A. Administer sodium supplement
B. Restrict fluids and monitor neuro status
C. Give potassium
D. Increase fluid intake
Correct answer: B
Rationale: Sodium 118 mEq/L indicates severe hyponatremia (normal 135–145);
risk of cerebral edema, seizures; restrict fluids, monitor neuro status, consider
sodium replacement cautiously.
4. Which IV solution is isotonic?
A. 0.9% NaCl (Normal Saline)
B. 3% NaCl
C. 0.45% NaCl
D. D5W
Correct answer: A
Rationale: 0.9% NaCl (Normal Saline) is isotonic (same osmolarity as blood);
used for fluid resuscitation, dehydration, and as IV flush. D5W is isotonic in bag
but hypotonic in body.
5. A patient on warfarin has INR of 5.0. What is the appropriate action?
A. Continue warfarin
B. Stop warfarin and give vitamin K
C. Increase warfarin dose
D. Give aspirin
Correct answer: B
Rationale: INR 5.0 is above therapeutic range (2.0–3.0); indicates bleeding risk;
stop warfarin, give vitamin K to reverse anticoagulation, and monitor for bleeding.
, 6. Which electrolyte imbalance causes tetany and Chvostek's sign?
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypomagnesemia
Correct answer: B
Rationale: Hypocalcemia (low calcium) causes neuromuscular irritability: tetany,
Chvostek's sign (facial twitching), Trousseau's sign (carpal spasm); treat with
calcium supplement.
7. A patient is prescribed digoxin. Which lab value is CRITICAL to monitor?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Correct answer: B
Rationale: Digoxin toxicity increases with hypokalemia; maintain potassium 4.0–
5.0 mEq/L; monitor digoxin level (0.5–2.0 ng/mL) and potassium regularly.
8. Which medication is a potassium-wasting diuretic?
A. Spironolactone
B. Furosemide (Lasix)
C. Lisinopril
D. Metoprolol
Correct answer: B
Rationale: Furosemide is a potassium-wasting diuretic; causes hypokalemia;
patient needs potassium-rich foods (bananas, oranges) or potassium supplement.
9. A patient has chloride level of 88 mEq/L. What does this indicate?
A. Normal chloride
B. Hypochloremia
