HESI RN Exit Exam V1 | 2026 Q&A with
Rationale (HESI RN Exit Exam 2026)
1. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min
via nasal cannula. The nurse notes the client’s oxygen saturation is 88% and they are
experiencing increased dyspnea. Which action should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min.
B. Administer a PRN dose of an inhaled bronchodilator.
C. Contact the healthcare provider for an arterial blood gas (ABG) order.
D. Assist the client to a high-Fowler’s position.
Correct Answer: D
Rationale: Elevating the head of the bed to high-Fowler’s position promotes lung
expansion and facilitates easier breathing, which is the most immediate nursing
intervention for dyspnea. For COPD patients, oxygen should be titrated carefully as too
much can suppress the hypoxic drive, making B the safest first step. This intervention
provides immediate physical relief before moving to pharmacological or higher-level
medical interventions.
2. The nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which finding requires the most immediate intervention?
A. New onset of shortness of breath and chest pain.
,B. Pain level of 6 on a scale of 0 to 10.
C. Serosanguineous drainage on the surgical dressing.
D. A temperature of 99.4°F (37.4°C).
Correct Answer: A
Rationale: Shortness of breath and chest pain following a major orthopedic surgery are
classic signs of a pulmonary embolism, which is a life-threatening complication. While pain
and mild temperature elevations are common postoperatively, they do not take precedence
over respiratory and circulatory stability. Immediate assessment and notification of the
rapid response team are necessary in this scenario.
3. A client with type 1 diabetes mellitus is found unconscious and diaphoretic. What is the
nurse’s priority action?
A. Administer 15 grams of simple carbohydrates orally.
B. Administer intramuscular glucagon according to protocol.
C. Obtain a capillary blood glucose reading.
D. Start an intravenous infusion of Normal Saline.
Correct Answer: B
Rationale: Because the client is unconscious, oral carbohydrates are contraindicated due
to the risk of aspiration. Glucagon is the standard emergency treatment for severe
hypoglycemia in an unconscious patient without IV access. Although checking the blood
,glucose is important, treating the life-threatening hypoglycemia based on clinical
symptoms of diaphoresis and unconsciousness takes priority in an emergency protocol.
4. The nurse is preparing to administer digoxin to a client with heart failure. Which laboratory
value should the nurse review before administering the medication?
A. Serum potassium level.
B. Serum sodium level.
C. Serum calcium level.
D. Serum creatinine level.
Correct Answer: A
Rationale: Hypokalemia significantly increases the risk of digoxin toxicity, making the
monitoring of potassium levels essential. Digoxin competes with potassium for binding
sites on the sodium-potassium ATPase pump. Ensuring the potassium is within a normal
range (3.5–5.0 mEq/L) prevents life-threatening arrhythmias associated with digitalis
toxicity.
5. A nurse is teaching a client about a newly prescribed monoamine oxidase inhibitor (MAOI).
Which food should the nurse instruct the client to avoid? (Select All That Apply)
A. Aged cheddar cheese.
B. Fresh grilled chicken.
C. Cured pepperoni.
, D. Red wine.
E. Boiled potatoes.
F. Avocados.
Correct Answer: A, C, D, F
Rationale: MAOIs interact with tyramine-rich foods, which can lead to a hypertensive
crisis. Aged cheeses, cured meats, red wine, and certain fruits like avocados contain high
levels of tyramine. Fresh meats and most vegetables like potatoes do not typically pose a
risk and are safe to consume.
6. Which client should the nurse assess first after receiving the change-of-shift report?
A. A client with pneumonia who has a pulse oximetry of 91% on room air.
B. A client who is 4 hours post-appendectomy complaining of 8/10 abdominal pain.
C. A client with a head injury whose Glasgow Coma Scale score decreased from 13 to 11.
D. A client with a history of seizures who is scheduled for a routine EEG.
Correct Answer: C
Rationale: A decrease in the Glasgow Coma Scale (GCS) score indicates a deteriorating
neurological status and potential increase in intracranial pressure. This is an acute change
that requires immediate evaluation and intervention to prevent brain herniation. The other
clients, while requiring care, are more stable than a client with declining neurological
function.
Rationale (HESI RN Exit Exam 2026)
1. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min
via nasal cannula. The nurse notes the client’s oxygen saturation is 88% and they are
experiencing increased dyspnea. Which action should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min.
B. Administer a PRN dose of an inhaled bronchodilator.
C. Contact the healthcare provider for an arterial blood gas (ABG) order.
D. Assist the client to a high-Fowler’s position.
Correct Answer: D
Rationale: Elevating the head of the bed to high-Fowler’s position promotes lung
expansion and facilitates easier breathing, which is the most immediate nursing
intervention for dyspnea. For COPD patients, oxygen should be titrated carefully as too
much can suppress the hypoxic drive, making B the safest first step. This intervention
provides immediate physical relief before moving to pharmacological or higher-level
medical interventions.
2. The nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which finding requires the most immediate intervention?
A. New onset of shortness of breath and chest pain.
,B. Pain level of 6 on a scale of 0 to 10.
C. Serosanguineous drainage on the surgical dressing.
D. A temperature of 99.4°F (37.4°C).
Correct Answer: A
Rationale: Shortness of breath and chest pain following a major orthopedic surgery are
classic signs of a pulmonary embolism, which is a life-threatening complication. While pain
and mild temperature elevations are common postoperatively, they do not take precedence
over respiratory and circulatory stability. Immediate assessment and notification of the
rapid response team are necessary in this scenario.
3. A client with type 1 diabetes mellitus is found unconscious and diaphoretic. What is the
nurse’s priority action?
A. Administer 15 grams of simple carbohydrates orally.
B. Administer intramuscular glucagon according to protocol.
C. Obtain a capillary blood glucose reading.
D. Start an intravenous infusion of Normal Saline.
Correct Answer: B
Rationale: Because the client is unconscious, oral carbohydrates are contraindicated due
to the risk of aspiration. Glucagon is the standard emergency treatment for severe
hypoglycemia in an unconscious patient without IV access. Although checking the blood
,glucose is important, treating the life-threatening hypoglycemia based on clinical
symptoms of diaphoresis and unconsciousness takes priority in an emergency protocol.
4. The nurse is preparing to administer digoxin to a client with heart failure. Which laboratory
value should the nurse review before administering the medication?
A. Serum potassium level.
B. Serum sodium level.
C. Serum calcium level.
D. Serum creatinine level.
Correct Answer: A
Rationale: Hypokalemia significantly increases the risk of digoxin toxicity, making the
monitoring of potassium levels essential. Digoxin competes with potassium for binding
sites on the sodium-potassium ATPase pump. Ensuring the potassium is within a normal
range (3.5–5.0 mEq/L) prevents life-threatening arrhythmias associated with digitalis
toxicity.
5. A nurse is teaching a client about a newly prescribed monoamine oxidase inhibitor (MAOI).
Which food should the nurse instruct the client to avoid? (Select All That Apply)
A. Aged cheddar cheese.
B. Fresh grilled chicken.
C. Cured pepperoni.
, D. Red wine.
E. Boiled potatoes.
F. Avocados.
Correct Answer: A, C, D, F
Rationale: MAOIs interact with tyramine-rich foods, which can lead to a hypertensive
crisis. Aged cheeses, cured meats, red wine, and certain fruits like avocados contain high
levels of tyramine. Fresh meats and most vegetables like potatoes do not typically pose a
risk and are safe to consume.
6. Which client should the nurse assess first after receiving the change-of-shift report?
A. A client with pneumonia who has a pulse oximetry of 91% on room air.
B. A client who is 4 hours post-appendectomy complaining of 8/10 abdominal pain.
C. A client with a head injury whose Glasgow Coma Scale score decreased from 13 to 11.
D. A client with a history of seizures who is scheduled for a routine EEG.
Correct Answer: C
Rationale: A decrease in the Glasgow Coma Scale (GCS) score indicates a deteriorating
neurological status and potential increase in intracranial pressure. This is an acute change
that requires immediate evaluation and intervention to prevent brain herniation. The other
clients, while requiring care, are more stable than a client with declining neurological
function.
