HESI RN EXIT EXAM 2025 QUESTIONS, ANSWERS AND
RATIONALE
HESI RN EXIT EXAM QUESTIONS AND ANSWERS WITH RATIONALE Following discharge
teaching, a male client with a duodenal ulcer tells the nurse the he will drink plenty of dairy
products, such as milk, to help coat and protect his ulcer. What is the best follow-up action by
the nurse? a. Remind the client that switching to decaffeinated coffee and tea is also important.
b. I suggest that the client also plan to eat small meals frequently to reduce discomfort. c.
Review with the client the need to avoid foods that are rich in milk and cream. d. Reinforce this
teaching by asking the client to list a dairy food that he might select. Review with the client the
need to avoid foods that are rich in milk and cream Rationale: Diets rich in milk and cream
stimulate gastric acid secretion and should be avoided. A male client with hypertension, who
received new antihypertensive prescriptions at his last visit returns to the clinic two weeks later
to evaluate his blood pressure (BP). His BP is 158/106 and he admits that he has not been taking
the prescribed medication because the drugs make him.
1. Question:
A nurse is caring for a 50-year-old client with a history of chronic obstructive
pulmonary disease (COPD). The client is experiencing shortness of breath and a
productive cough. Which of the following is the priority nursing intervention?
A) Administer supplemental oxygen as ordered
B) Assess lung sounds for any changes
C) Increase fluid intake to help thin mucus
D) Perform chest physiotherapy to clear secretions
Answer: A) Administer supplemental oxygen as ordered
Rationale: The priority nursing intervention is to ensure adequate oxygenation. A
client with COPD who is experiencing shortness of breath may be hypoxic, and
administering supplemental oxygen will help improve oxygenation and prevent
complications such as respiratory failure.
2. Question:
A client is prescribed lisinopril (Zestril) for hypertension. Which of the following
assessments is most important for the nurse to perform before administering the
medication?
, A) Blood pressure
B) Electrocardiogram (ECG)
C) Serum potassium level
D) Respiratory rate
Answer: A) Blood pressure
Rationale: Lisinopril is an ACE inhibitor used to treat hypertension. The nurse
should assess the client's blood pressure to ensure it is within a safe range before
administering the medication. If the client's blood pressure is too low, the
medication should be withheld.
3. Question:
A nurse is providing discharge instructions to a client who has undergone a total
hip replacement. Which statement made by the client indicates a need for further
teaching?
A) "I will avoid crossing my legs to prevent dislocation."
B) "I can bend at the waist when I put on my shoes."
C) "I will use a raised toilet seat to prevent hip flexion."
D) "I should take pain medications as prescribed to prevent discomfort."
Answer: B) "I can bend at the waist when I put on my shoes."
Rationale: After a total hip replacement, the client should avoid hip flexion greater
than 90 degrees to prevent dislocation. Bending at the waist to put on shoes can
result in excessive hip flexion, which increases the risk of dislocation. The other
statements indicate appropriate postoperative care.
4. Question:
A client is receiving a blood transfusion and begins to experience chills, fever, and
back pain. Which of the following actions should the nurse take first?
A) Stop the transfusion immediately
B) Take the client's vital signs
, C) Administer acetaminophen for fever
D) Notify the healthcare provider
Answer: A) Stop the transfusion immediately
Rationale: Chills, fever, and back pain may indicate an acute hemolytic reaction,
which is a medical emergency. The first priority is to stop the blood transfusion to
prevent further complications. Once the transfusion is stopped, the nurse can
proceed with other interventions like taking vital signs and notifying the healthcare
provider.
5. Question:
A nurse is preparing to administer a dose of morphine sulfate to a postoperative
client who is experiencing moderate pain. Which of the following assessments
should the nurse perform before giving the medication?
A) Heart rate
B) Blood pressure
C) Respiratory rate
D) Temperature
Answer: C) Respiratory rate
Rationale: Morphine is an opioid analgesic that can depress the respiratory
system. It is important to assess the client's respiratory rate before administering
the medication to ensure the client is not at risk for respiratory depression.
6. Question:
A nurse is caring for a client with a history of congestive heart failure (CHF). The
client is receiving furosemide (Lasix). Which of the following laboratory results
should the nurse monitor regularly?
A) Sodium level
B) Potassium level
, C) Creatinine level
D) Hemoglobin level
Answer: B) Potassium level
Rationale: Furosemide is a loop diuretic that increases the excretion of potassium,
which can lead to hypokalemia. The nurse should monitor the client's potassium
level regularly to prevent potential complications associated with low potassium,
such as arrhythmias.
7. Question:
A nurse is caring for a client who is 36 weeks pregnant and reports sudden-onset
severe abdominal pain and vaginal bleeding. The nurse suspects placental
abruption. Which of the following is the priority action?
A) Perform a sterile vaginal exam to assess for cervical dilation
B) Initiate IV fluids to maintain hydration and blood volume
C) Monitor fetal heart tones for signs of distress
D) Administer magnesium sulfate to prevent seizures
Answer: B) Initiate IV fluids to maintain hydration and blood volume
Rationale: Placental abruption is a life-threatening condition that requires
immediate intervention. The priority action is to maintain the client's blood volume
and hydration by administering IV fluids, as this helps stabilize the client's
condition. Monitoring fetal heart tones is important, but addressing maternal
circulatory status is the first priority.
8. Question:
A nurse is caring for a 2-year-old child with a fever and rash. The child is
diagnosed with chickenpox (varicella). Which of the following nursing
interventions is appropriate for preventing the spread of the infection?
A) Place the child in a private room with airborne precautions
B) Encourage the child to wear a surgical mask while in the hospital
RATIONALE
HESI RN EXIT EXAM QUESTIONS AND ANSWERS WITH RATIONALE Following discharge
teaching, a male client with a duodenal ulcer tells the nurse the he will drink plenty of dairy
products, such as milk, to help coat and protect his ulcer. What is the best follow-up action by
the nurse? a. Remind the client that switching to decaffeinated coffee and tea is also important.
b. I suggest that the client also plan to eat small meals frequently to reduce discomfort. c.
Review with the client the need to avoid foods that are rich in milk and cream. d. Reinforce this
teaching by asking the client to list a dairy food that he might select. Review with the client the
need to avoid foods that are rich in milk and cream Rationale: Diets rich in milk and cream
stimulate gastric acid secretion and should be avoided. A male client with hypertension, who
received new antihypertensive prescriptions at his last visit returns to the clinic two weeks later
to evaluate his blood pressure (BP). His BP is 158/106 and he admits that he has not been taking
the prescribed medication because the drugs make him.
1. Question:
A nurse is caring for a 50-year-old client with a history of chronic obstructive
pulmonary disease (COPD). The client is experiencing shortness of breath and a
productive cough. Which of the following is the priority nursing intervention?
A) Administer supplemental oxygen as ordered
B) Assess lung sounds for any changes
C) Increase fluid intake to help thin mucus
D) Perform chest physiotherapy to clear secretions
Answer: A) Administer supplemental oxygen as ordered
Rationale: The priority nursing intervention is to ensure adequate oxygenation. A
client with COPD who is experiencing shortness of breath may be hypoxic, and
administering supplemental oxygen will help improve oxygenation and prevent
complications such as respiratory failure.
2. Question:
A client is prescribed lisinopril (Zestril) for hypertension. Which of the following
assessments is most important for the nurse to perform before administering the
medication?
, A) Blood pressure
B) Electrocardiogram (ECG)
C) Serum potassium level
D) Respiratory rate
Answer: A) Blood pressure
Rationale: Lisinopril is an ACE inhibitor used to treat hypertension. The nurse
should assess the client's blood pressure to ensure it is within a safe range before
administering the medication. If the client's blood pressure is too low, the
medication should be withheld.
3. Question:
A nurse is providing discharge instructions to a client who has undergone a total
hip replacement. Which statement made by the client indicates a need for further
teaching?
A) "I will avoid crossing my legs to prevent dislocation."
B) "I can bend at the waist when I put on my shoes."
C) "I will use a raised toilet seat to prevent hip flexion."
D) "I should take pain medications as prescribed to prevent discomfort."
Answer: B) "I can bend at the waist when I put on my shoes."
Rationale: After a total hip replacement, the client should avoid hip flexion greater
than 90 degrees to prevent dislocation. Bending at the waist to put on shoes can
result in excessive hip flexion, which increases the risk of dislocation. The other
statements indicate appropriate postoperative care.
4. Question:
A client is receiving a blood transfusion and begins to experience chills, fever, and
back pain. Which of the following actions should the nurse take first?
A) Stop the transfusion immediately
B) Take the client's vital signs
, C) Administer acetaminophen for fever
D) Notify the healthcare provider
Answer: A) Stop the transfusion immediately
Rationale: Chills, fever, and back pain may indicate an acute hemolytic reaction,
which is a medical emergency. The first priority is to stop the blood transfusion to
prevent further complications. Once the transfusion is stopped, the nurse can
proceed with other interventions like taking vital signs and notifying the healthcare
provider.
5. Question:
A nurse is preparing to administer a dose of morphine sulfate to a postoperative
client who is experiencing moderate pain. Which of the following assessments
should the nurse perform before giving the medication?
A) Heart rate
B) Blood pressure
C) Respiratory rate
D) Temperature
Answer: C) Respiratory rate
Rationale: Morphine is an opioid analgesic that can depress the respiratory
system. It is important to assess the client's respiratory rate before administering
the medication to ensure the client is not at risk for respiratory depression.
6. Question:
A nurse is caring for a client with a history of congestive heart failure (CHF). The
client is receiving furosemide (Lasix). Which of the following laboratory results
should the nurse monitor regularly?
A) Sodium level
B) Potassium level
, C) Creatinine level
D) Hemoglobin level
Answer: B) Potassium level
Rationale: Furosemide is a loop diuretic that increases the excretion of potassium,
which can lead to hypokalemia. The nurse should monitor the client's potassium
level regularly to prevent potential complications associated with low potassium,
such as arrhythmias.
7. Question:
A nurse is caring for a client who is 36 weeks pregnant and reports sudden-onset
severe abdominal pain and vaginal bleeding. The nurse suspects placental
abruption. Which of the following is the priority action?
A) Perform a sterile vaginal exam to assess for cervical dilation
B) Initiate IV fluids to maintain hydration and blood volume
C) Monitor fetal heart tones for signs of distress
D) Administer magnesium sulfate to prevent seizures
Answer: B) Initiate IV fluids to maintain hydration and blood volume
Rationale: Placental abruption is a life-threatening condition that requires
immediate intervention. The priority action is to maintain the client's blood volume
and hydration by administering IV fluids, as this helps stabilize the client's
condition. Monitoring fetal heart tones is important, but addressing maternal
circulatory status is the first priority.
8. Question:
A nurse is caring for a 2-year-old child with a fever and rash. The child is
diagnosed with chickenpox (varicella). Which of the following nursing
interventions is appropriate for preventing the spread of the infection?
A) Place the child in a private room with airborne precautions
B) Encourage the child to wear a surgical mask while in the hospital
