HESI RN Exit Exam V5: Questions & Correct
Answers (100% VERIFIED) Questions with
Correct Answers & Rationales | Latest 2025/2026
Update Grade A+ | Pass on First Try | RN
Compass Exit Exam Prep
1. A patient has serum potassium of 6.2 mEq/L. Which intervention is MOST
important?
A. Administer potassium supplement
B. Restrict potassium and monitor for arrhythmias
C. Give sodium supplement
D. Increase potassium intake
Correct answer: B
Rationale: Potassium 6.2 mEq/L indicates hyperkalemia (normal 3.5–5.0); risk of
cardiac arrhythmias; restrict potassium, give insulin/glucose, Kayexalate, or
dialysis; monitor EKG for peaked T waves.
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%; switch to anticoagulant like argatroban.
3. A patient has sodium level of 152 mEq/L. What is the priority nursing
action?
,A. Administer sodium supplement
B. Restrict fluids and monitor neuro status
C. Give potassium
D. Encourage fluid intake
Correct answer: D
Rationale: Sodium 152 mEq/L indicates hypernatremia (normal 135–145); caused
by fluid deficit; encourage fluid intake, monitor neuro status (lethargy, seizures),
treat underlying cause.
4. Which IV solution is hypotonic?
A. 0.9% NaCl (Normal Saline)
B. 3% NaCl
C. 0.45% NaCl
D. D5W in bag
Correct answer: C
Rationale: 0.45% NaCl is hypotonic (lower osmolarity than blood); used for
hypernatremia, dehydration; risk of fluid overload, cell swelling; use cautiously.
5. A patient on warfarin has INR of 1.5. What is the appropriate action?
A. Continue warfarin
B. Increase warfarin dose
C. Stop warfarin and give vitamin K
D. Give aspirin
Correct answer: B
Rationale: INR 1.5 is below therapeutic range (2.0–3.0); indicates inadequate
anticoagulation; increase warfarin dose, monitor INR weekly until therapeutic.
6. Which electrolyte imbalance causes tetany and Trousseau's sign?
A. Hyperkalemia
B. Hypocalcemia
,C. Hypernatremia
D. Hyponatremia
Correct answer: B
Rationale: Hypocalcemia (low calcium) causes neuromuscular irritability: tetany,
Trousseau's sign (carpal spasm with BP cuff), Chvostek's sign (facial twitching);
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), potassium, and renal function
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, potatoes) or potassium
supplement.
9. A patient has chloride level of 112 mEq/L. What does this indicate?
A. Normal chloride
B. Hypochloremia
, C. Hyperchloremia
D. Hypernatremia
Correct answer: C
Rationale: Chloride 112 mEq/L indicates hyperchloremia (normal 96–106);
associated with hypernatremia, metabolic acidosis, dehydration; treat underlying
cause, encourage fluids.
10. Which IV solution is used for metabolic acidosis?
A. 0.9% NaCl
B. D5W
C. Lactated Ringer's
D. 3% NaCl
Correct answer: C
Rationale: Lactated Ringer's is used for metabolic acidosis; contains lactate that
converts to bicarbonate in liver; also 0.9% NaCl can help; avoid bicarbonate unless
severe.
11. A patient is taking ACE inhibitor. Which electrolyte requires monitoring?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Correct answer: A
Rationale: ACE inhibitors (lisinopril, enalapril) cause hyperkalemia by decreasing
aldosterone; monitor potassium regularly; avoid potassium supplements and high-
potassium foods.
12. Which electrolyte imbalance causes arrhythmias and flattened T waves on
EKG?
A. Hypokalemia
B. Hyperkalemia
Answers (100% VERIFIED) Questions with
Correct Answers & Rationales | Latest 2025/2026
Update Grade A+ | Pass on First Try | RN
Compass Exit Exam Prep
1. A patient has serum potassium of 6.2 mEq/L. Which intervention is MOST
important?
A. Administer potassium supplement
B. Restrict potassium and monitor for arrhythmias
C. Give sodium supplement
D. Increase potassium intake
Correct answer: B
Rationale: Potassium 6.2 mEq/L indicates hyperkalemia (normal 3.5–5.0); risk of
cardiac arrhythmias; restrict potassium, give insulin/glucose, Kayexalate, or
dialysis; monitor EKG for peaked T waves.
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%; switch to anticoagulant like argatroban.
3. A patient has sodium level of 152 mEq/L. What is the priority nursing
action?
,A. Administer sodium supplement
B. Restrict fluids and monitor neuro status
C. Give potassium
D. Encourage fluid intake
Correct answer: D
Rationale: Sodium 152 mEq/L indicates hypernatremia (normal 135–145); caused
by fluid deficit; encourage fluid intake, monitor neuro status (lethargy, seizures),
treat underlying cause.
4. Which IV solution is hypotonic?
A. 0.9% NaCl (Normal Saline)
B. 3% NaCl
C. 0.45% NaCl
D. D5W in bag
Correct answer: C
Rationale: 0.45% NaCl is hypotonic (lower osmolarity than blood); used for
hypernatremia, dehydration; risk of fluid overload, cell swelling; use cautiously.
5. A patient on warfarin has INR of 1.5. What is the appropriate action?
A. Continue warfarin
B. Increase warfarin dose
C. Stop warfarin and give vitamin K
D. Give aspirin
Correct answer: B
Rationale: INR 1.5 is below therapeutic range (2.0–3.0); indicates inadequate
anticoagulation; increase warfarin dose, monitor INR weekly until therapeutic.
6. Which electrolyte imbalance causes tetany and Trousseau's sign?
A. Hyperkalemia
B. Hypocalcemia
,C. Hypernatremia
D. Hyponatremia
Correct answer: B
Rationale: Hypocalcemia (low calcium) causes neuromuscular irritability: tetany,
Trousseau's sign (carpal spasm with BP cuff), Chvostek's sign (facial twitching);
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), potassium, and renal function
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, potatoes) or potassium
supplement.
9. A patient has chloride level of 112 mEq/L. What does this indicate?
A. Normal chloride
B. Hypochloremia
, C. Hyperchloremia
D. Hypernatremia
Correct answer: C
Rationale: Chloride 112 mEq/L indicates hyperchloremia (normal 96–106);
associated with hypernatremia, metabolic acidosis, dehydration; treat underlying
cause, encourage fluids.
10. Which IV solution is used for metabolic acidosis?
A. 0.9% NaCl
B. D5W
C. Lactated Ringer's
D. 3% NaCl
Correct answer: C
Rationale: Lactated Ringer's is used for metabolic acidosis; contains lactate that
converts to bicarbonate in liver; also 0.9% NaCl can help; avoid bicarbonate unless
severe.
11. A patient is taking ACE inhibitor. Which electrolyte requires monitoring?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Correct answer: A
Rationale: ACE inhibitors (lisinopril, enalapril) cause hyperkalemia by decreasing
aldosterone; monitor potassium regularly; avoid potassium supplements and high-
potassium foods.
12. Which electrolyte imbalance causes arrhythmias and flattened T waves on
EKG?
A. Hypokalemia
B. Hyperkalemia
