HESI RN Exit Exam V2 | 2026 Q&A with
Rationale (HESI RN Exit Exam 2026)
1. A client with heart failure is receiving digoxin 0.25 mg daily. Which assessment finding
should the nurse identify as a primary indicator of digoxin toxicity?
A. Increased appetite and thirst
B. Sudden onset of hypertension
C. Heart rate of 88 beats per minute
D. Blurred vision with yellow-green halos
Correct Answer: D
Rationale: Digoxin toxicity commonly manifests as gastrointestinal distress and visual
disturbances, such as seeing yellow-green halos around objects. The therapeutic range for
digoxin is narrow, typically 0.5 to 2.0 ng/mL, requiring frequent monitoring. Bradycardia is
also a common sign, while tachycardia or hypertension are less characteristic of this
toxicity.
2. The nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which intervention should the nurse prioritize to prevent deep vein thrombosis
(DVT)?
A. Maintain the client on strict bed rest for the first 48 hours
B. Perform passive range-of-motion exercises every 8 hours
,C. Apply sequential compression devices (SCDs) while the client is in bed
D. Massage the client’s calves twice daily
Correct Answer: C
Rationale: SCDs provide intermittent pressure to the legs, promoting venous return and
preventing stasis, which is the primary cause of DVT after major surgery. Early ambulation
is also critical, but while in bed, mechanical prophylaxis is a standard of care. Massaging the
calves is strictly contraindicated because it could dislodge an existing clot, leading to a
pulmonary embolism.
3. A client with Type 1 Diabetes Mellitus is admitted with a blood glucose of 560 mg/dL and
positive ketonuria. Which physician order should the nurse implement first?
A. Administer 10 units of regular insulin subcutaneously
B. Obtain an arterial blood gas (ABG) sample
C. Infuse 0.9% Normal Saline at 1000 mL/hr
D. Check the client’s serum potassium level
Correct Answer: C
Rationale: In Diabetic Ketoacidosis (DKA), the priority is fluid resuscitation to address
severe dehydration and hypovolemia. Normal saline is typically the initial fluid of choice to
restore circulatory volume before starting insulin therapy. Although insulin and labs are
necessary, stabilizing the hemodynamic status through rehydration takes precedence to
prevent cardiovascular collapse.
,4. Which laboratory value should the nurse monitor most closely for a client receiving a
continuous heparin infusion for a pulmonary embolism?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
Correct Answer: C
Rationale: The aPTT is used to monitor the effectiveness of unfractionated heparin and to
adjust the dosage to maintain a therapeutic level. The PT and INR are used primarily to
monitor warfarin therapy rather than heparin. While the platelet count is important to
monitor for Heparin-Induced Thrombocytopenia (HIT), the aPTT is the primary indicator
of anticoagulation status.
5. A nurse is assessing a 4-year-old child with a suspected diagnosis of epiglottitis. Which
action is most important for the nurse to avoid?
A. Placing the child in a tripod position
B. Providing humidified oxygen via mask
C. Monitoring oxygen saturation levels
D. Examining the throat with a tongue blade
Correct Answer: D
, Rationale: Examining the throat of a child with epiglottitis can trigger a laryngospasm,
which can lead to complete airway obstruction. The nurse should keep the child calm and
avoid any invasive procedures until an artificial airway is ready. Epiglottitis is a medical
emergency that requires immediate attention from an experienced team to secure the
airway.
6. A client is admitted to the psychiatric unit with a diagnosis of major depressive disorder
and reports feeling ‘worthless’ and ‘having no reason to live.’ Which is the priority nursing
intervention?
A. Encourage the client to participate in group therapy sessions
B. Assign a staff member to provide one-to-one observation
C. Administer prescribed antidepressant medications
D. Help the client identify positive coping mechanisms
Correct Answer: B
Rationale: The client’s statements indicate a high risk for suicide, making safety the
absolute priority. One-to-one observation ensures that the client is never left alone and
provides the highest level of safety monitoring. While medication and therapy are
important for long-term recovery, they do not address the immediate safety risk posed by
suicidal ideation.
Rationale (HESI RN Exit Exam 2026)
1. A client with heart failure is receiving digoxin 0.25 mg daily. Which assessment finding
should the nurse identify as a primary indicator of digoxin toxicity?
A. Increased appetite and thirst
B. Sudden onset of hypertension
C. Heart rate of 88 beats per minute
D. Blurred vision with yellow-green halos
Correct Answer: D
Rationale: Digoxin toxicity commonly manifests as gastrointestinal distress and visual
disturbances, such as seeing yellow-green halos around objects. The therapeutic range for
digoxin is narrow, typically 0.5 to 2.0 ng/mL, requiring frequent monitoring. Bradycardia is
also a common sign, while tachycardia or hypertension are less characteristic of this
toxicity.
2. The nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which intervention should the nurse prioritize to prevent deep vein thrombosis
(DVT)?
A. Maintain the client on strict bed rest for the first 48 hours
B. Perform passive range-of-motion exercises every 8 hours
,C. Apply sequential compression devices (SCDs) while the client is in bed
D. Massage the client’s calves twice daily
Correct Answer: C
Rationale: SCDs provide intermittent pressure to the legs, promoting venous return and
preventing stasis, which is the primary cause of DVT after major surgery. Early ambulation
is also critical, but while in bed, mechanical prophylaxis is a standard of care. Massaging the
calves is strictly contraindicated because it could dislodge an existing clot, leading to a
pulmonary embolism.
3. A client with Type 1 Diabetes Mellitus is admitted with a blood glucose of 560 mg/dL and
positive ketonuria. Which physician order should the nurse implement first?
A. Administer 10 units of regular insulin subcutaneously
B. Obtain an arterial blood gas (ABG) sample
C. Infuse 0.9% Normal Saline at 1000 mL/hr
D. Check the client’s serum potassium level
Correct Answer: C
Rationale: In Diabetic Ketoacidosis (DKA), the priority is fluid resuscitation to address
severe dehydration and hypovolemia. Normal saline is typically the initial fluid of choice to
restore circulatory volume before starting insulin therapy. Although insulin and labs are
necessary, stabilizing the hemodynamic status through rehydration takes precedence to
prevent cardiovascular collapse.
,4. Which laboratory value should the nurse monitor most closely for a client receiving a
continuous heparin infusion for a pulmonary embolism?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
Correct Answer: C
Rationale: The aPTT is used to monitor the effectiveness of unfractionated heparin and to
adjust the dosage to maintain a therapeutic level. The PT and INR are used primarily to
monitor warfarin therapy rather than heparin. While the platelet count is important to
monitor for Heparin-Induced Thrombocytopenia (HIT), the aPTT is the primary indicator
of anticoagulation status.
5. A nurse is assessing a 4-year-old child with a suspected diagnosis of epiglottitis. Which
action is most important for the nurse to avoid?
A. Placing the child in a tripod position
B. Providing humidified oxygen via mask
C. Monitoring oxygen saturation levels
D. Examining the throat with a tongue blade
Correct Answer: D
, Rationale: Examining the throat of a child with epiglottitis can trigger a laryngospasm,
which can lead to complete airway obstruction. The nurse should keep the child calm and
avoid any invasive procedures until an artificial airway is ready. Epiglottitis is a medical
emergency that requires immediate attention from an experienced team to secure the
airway.
6. A client is admitted to the psychiatric unit with a diagnosis of major depressive disorder
and reports feeling ‘worthless’ and ‘having no reason to live.’ Which is the priority nursing
intervention?
A. Encourage the client to participate in group therapy sessions
B. Assign a staff member to provide one-to-one observation
C. Administer prescribed antidepressant medications
D. Help the client identify positive coping mechanisms
Correct Answer: B
Rationale: The client’s statements indicate a high risk for suicide, making safety the
absolute priority. One-to-one observation ensures that the client is never left alone and
provides the highest level of safety monitoring. While medication and therapy are
important for long-term recovery, they do not address the immediate safety risk posed by
suicidal ideation.
