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HESI RN Exit Exam V – Expert-Level Practice Questions and Rationales for Final NCLEX Preparation

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This document features Version V of the HESI RN Exit Exam, designed for advanced NCLEX-RN preparation. It includes challenging, high-level practice questions that test critical thinking, clinical judgment, and nursing content mastery. Each question is supported by detailed rationales to enhance understanding and boost exam performance. Perfect for final-phase nursing students aiming to pass the NCLEX with confidence.

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Answer and Explanation
Question 1: Report an Issue


Report Wrong Answer
Choice A:

Improved visual acuity: Pregabalin is used
A client with diabetic peripheral to manage neuropathic pain, not visual
neuropathy has been taking acuity issues. Improved visual acuity would
pregabalin for 4 days. Which not be related to the effectiveness of
finding indicates to the nurse that pregabalin.
the medication is effective?

A. Improved visual acuity. 0%  Choice B:

B. Full volume of pedal pulses. 25% Full volume of pedal pulses: While
 monitoring pedal pulses is important for
assessing circulation, it is not an indicator
C. Granulating tissue in foot ulcer.
of pregabalin’s effectiveness in managing
0% 
diabetic peripheral neuropathy.
D. Reduced level of pain. 75%
Most selected  Choice C:

Granulating tissue in foot ulcer:
Granulating tissue indicates healing of a
wound, which is not directly related to the
effectiveness of pregabalin for pain relief.


Choice D:

Reduced level of pain: Pregabalin is
prescribed to relieve neuropathic pain. A
reduction in pain levels indicates that the
medication is having its intended effect on
managing symptoms of diabetic
peripheral neuropathy.

, Discussion Section


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Manhard: This is not correct..The questions given data na d one used on solution are
different (Pending)

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Answer and Explanation
Question 2: Report an Issue


Report Wrong Answer
Choice A:

Remind the UAP to wash hands frequently
The nurse observes an unlicensed while in the room: While hand hygiene is
assistive personnel (UAP) who is crucial, this action does not address the
preparing to provide personal care specific issue of how the gown and gloves
for a client who requires contact are being worn.
precautions. The UAP has applied a
gown and gloves and secured the Choice B:
tops of the gloves over the gown's
sleeves. Which action should the Confirm that the gown is tied securely at
nurse take? the neck and waist: Although important for
ensuring proper gown use, this action does
A. Remind the UAP to wash hands not address the issue with the gloves and
frequently while in the room. 0%  gown sleeves.
B. Confirm that the gown is tied
securely at the neck and waist. 50% Choice C:
Most selected 
Assist the UAP with application of a face
C. Assist the UAP with application of mask or face shield: The scenario
a face mask or face shield. 0%  describes issues with gown and gloves, not
with the face mask or face shield.
D. Help the UAP reposition the gown
sleeve over the glove edges. 50%
 Choice D:

Help the UAP reposition the gown sleeve
over the glove edges: In contact
precautions, gloves should cover the cuffs
of the gown to prevent contamination. The
UAP's current method leaves the gown
cuffs exposed, so adjusting this to cover
the gloves is necessary for proper infection
control practices.

, Discussion Section


M Share insights... 

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Answer and Explanation
Question 3: Report an Issue
Choice A:
Report Wrong Answer Weigh the client daily, in the morning: Daily
weights are crucial for monitoring fluid
A client is admitted for an status in clients with HF. Weighing at the
exacerbation of heart failure (HF) same time each day helps track fluid
and is being treated with diuretics retention or loss, which is essential for
for fluid volume excess. In planning adjusting diuretic therapy.
nursing care, what intervention(s)
Choice B:
should the nurse include? Select all
that apply. Monitor coagulation laboratory values:
While important in many clinical situations,
A. Weigh the client daily, in the
coagulation values are not directly related
morning. 0% 
to diuretic therapy or the management of
B. Monitor coagulation laboratory fluid volume excess in HF.
values. 0% 
Choice C:
C. Observe for evidence of
hypokalemia. 0%  Observe for evidence of hypokalemia:
Diuretics, especially loop diuretics, can
D. Teach the client how to restrict
cause hypokalemia. Monitoring for
dietary sodium. 0% 
symptoms of low potassium levels and
E. Encourage oral fluid intake of managing them is important for the safe
3,000 ml/day. 0%  administration of diuretics.

Choice D:

Teach the client how to restrict dietary
sodium: Sodium restriction is a key
component in managing fluid volume in
HF. Educating the client on sodium
restriction helps prevent exacerbations of
HF.

Choice E:

Encourage oral fluid intake of 3,000 ml/day:
In the context of HF and diuretic use, fluid
restriction is often necessary to manage
fluid overload. Encouraging a high fluid

, intake contradicts the goal of controlling
fluid volume.




Discussion Section


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Answer and Explanation
Question 4: Report an Issue


Report Wrong Answer
Choice A:

0800, 1200, 1600, 2000: This schedule
An intravenous (IV) antibiotic is distributes the doses evenly throughout the
prescribed for a client with a day while maintaining a consistent interval
postoperative infection. The between doses, which helps to maintain
medication is to be administered in effective drug levels in the body.
4 divided doses. Which schedule is
best for administering this Choice B:
prescription?
1000, 1600, 2200, 0400: This schedule
A. 0800, 1200, 1600, 2000. 75% includes a dose at 0400, which is outside of
Most selected  typical waking hours and can disrupt the
B. 1000, 1600, 2200, 0400. 25%  client’s rest and the nursing staff’s routine.

C. Administer with meals and a
Choice C:
bedtime snack. 0% 
Administer with meals and a bedtime
D. Give in equally divided doses
snack: The timing of doses with meals is
during waking hours. 0% 
not a standard method for IV antibiotic
administration and does not follow a
specific dosing schedule for antibiotics.


Choice D:

Give in equally divided doses during
waking hours: While this seems
appropriate, the specific time slots
provided in option A are better for
maintaining a consistent drug level and
practical for the client and nursing staff.

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