1
Page | 1
DESCRIPTION – HESI RN EXIT
EXAM 2025–2026 | VERIFIED
QUESTIONS WITH RATIONALES |
GRADED A+ COMPLETE STUDY
PACK
, 2
Page | 2 1. A nurse is caring for a patient with heart failure who is receiving
furosemide. Which laboratory value should be monitored closely?
A. Sodium
B. Potassium ✔ Correct Answer
C. Calcium
D. Hemoglobin
Explanation
Furosemide is a loop diuretic that increases the excretion of water, sodium, and
potassium through the kidneys. Hypokalemia (low potassium) is a common side
effect and can lead to life-threatening cardiac arrhythmias. Therefore, potassium
levels must be closely monitored in patients on furosemide. Low potassium
levels can present as muscle weakness, cramps, or ECG changes. Monitoring
and replacing potassium as needed prevents complications. Sodium and calcium
may also be affected but are secondary concerns compared to potassium.
Hemoglobin is unrelated to furosemide therapy unless there is concurrent
anemia. Thus, potassium monitoring is the priority.
2. A patient with type 1 diabetes presents with Kussmaul respirations.
What is the nurse's priority action?
A. Administer oxygen
B. Encourage fluid intake
C. Check blood glucose and ketones ✔ Correct Answer
D. Raise the head of the bed
Explanation
Kussmaul respirations are deep, rapid breaths typically seen in diabetic
ketoacidosis (DKA), where the body attempts to blow off CO₂ to correct
metabolic acidosis. The priority is to assess the blood glucose level and ketones
to confirm DKA. Administering oxygen does not address the underlying cause.
Fluid intake may be helpful but not before evaluating glucose and ketone levels.
Elevating the head of the bed might improve comfort but doesn’t address the
metabolic crisis. Early identification of DKA is critical to prevent coma or
death. Therefore, prompt assessment of glucose and ketones is the most
important nursing intervention.
, 3
3. Which finding indicates the effectiveness of a diuretic in a patient with
fluid volume excess?
Page | 3 A. Decreased heart rate
B. Increased urine output ✔ Correct Answer
C. Increased blood pressure
D. Decreased oxygen saturation
Explanation (100 words):
Diuretics promote the excretion of excess fluid, so increased urine output is the
most direct indicator that the medication is working. In fluid volume excess,
signs like edema, shortness of breath, and high blood pressure are present.
Effective diuretic therapy reduces these symptoms by eliminating fluid. While
other changes may occur—such as a drop in BP or HR—increased urine output
is the clearest and most immediate sign of therapeutic effect. A decrease in
oxygen saturation would actually suggest worsening pulmonary edema.
Therefore, monitoring urine output helps determine the effectiveness of diuretic
therapy in patients with fluid overload.
4. A nurse is assessing a post-operative patient. Which assessment finding
requires immediate intervention?
A. Pain level of 7/10
B. Urine output of 30 mL/hour
C. Sudden onset of restlessness and confusion ✔ Correct Answer
D. Heart rate of 102 bpm
Explanation (100 words):
Sudden restlessness and confusion in a post-op patient can signal hypoxia,
internal bleeding, or other life-threatening complications. These neurological
signs often precede changes in vital signs and should be treated as an
emergency. Pain and mild tachycardia are expected postoperatively and can be
managed accordingly. A urine output of 30 mL/hour is borderline but
acceptable. However, a change in mental status indicates a potentially severe
issue that could worsen rapidly if not addressed. Immediate assessment of
oxygen saturation, airway, and potential sources of bleeding is warranted.
Prompt intervention can prevent deterioration into shock or respiratory failure.
Page | 1
DESCRIPTION – HESI RN EXIT
EXAM 2025–2026 | VERIFIED
QUESTIONS WITH RATIONALES |
GRADED A+ COMPLETE STUDY
PACK
, 2
Page | 2 1. A nurse is caring for a patient with heart failure who is receiving
furosemide. Which laboratory value should be monitored closely?
A. Sodium
B. Potassium ✔ Correct Answer
C. Calcium
D. Hemoglobin
Explanation
Furosemide is a loop diuretic that increases the excretion of water, sodium, and
potassium through the kidneys. Hypokalemia (low potassium) is a common side
effect and can lead to life-threatening cardiac arrhythmias. Therefore, potassium
levels must be closely monitored in patients on furosemide. Low potassium
levels can present as muscle weakness, cramps, or ECG changes. Monitoring
and replacing potassium as needed prevents complications. Sodium and calcium
may also be affected but are secondary concerns compared to potassium.
Hemoglobin is unrelated to furosemide therapy unless there is concurrent
anemia. Thus, potassium monitoring is the priority.
2. A patient with type 1 diabetes presents with Kussmaul respirations.
What is the nurse's priority action?
A. Administer oxygen
B. Encourage fluid intake
C. Check blood glucose and ketones ✔ Correct Answer
D. Raise the head of the bed
Explanation
Kussmaul respirations are deep, rapid breaths typically seen in diabetic
ketoacidosis (DKA), where the body attempts to blow off CO₂ to correct
metabolic acidosis. The priority is to assess the blood glucose level and ketones
to confirm DKA. Administering oxygen does not address the underlying cause.
Fluid intake may be helpful but not before evaluating glucose and ketone levels.
Elevating the head of the bed might improve comfort but doesn’t address the
metabolic crisis. Early identification of DKA is critical to prevent coma or
death. Therefore, prompt assessment of glucose and ketones is the most
important nursing intervention.
, 3
3. Which finding indicates the effectiveness of a diuretic in a patient with
fluid volume excess?
Page | 3 A. Decreased heart rate
B. Increased urine output ✔ Correct Answer
C. Increased blood pressure
D. Decreased oxygen saturation
Explanation (100 words):
Diuretics promote the excretion of excess fluid, so increased urine output is the
most direct indicator that the medication is working. In fluid volume excess,
signs like edema, shortness of breath, and high blood pressure are present.
Effective diuretic therapy reduces these symptoms by eliminating fluid. While
other changes may occur—such as a drop in BP or HR—increased urine output
is the clearest and most immediate sign of therapeutic effect. A decrease in
oxygen saturation would actually suggest worsening pulmonary edema.
Therefore, monitoring urine output helps determine the effectiveness of diuretic
therapy in patients with fluid overload.
4. A nurse is assessing a post-operative patient. Which assessment finding
requires immediate intervention?
A. Pain level of 7/10
B. Urine output of 30 mL/hour
C. Sudden onset of restlessness and confusion ✔ Correct Answer
D. Heart rate of 102 bpm
Explanation (100 words):
Sudden restlessness and confusion in a post-op patient can signal hypoxia,
internal bleeding, or other life-threatening complications. These neurological
signs often precede changes in vital signs and should be treated as an
emergency. Pain and mild tachycardia are expected postoperatively and can be
managed accordingly. A urine output of 30 mL/hour is borderline but
acceptable. However, a change in mental status indicates a potentially severe
issue that could worsen rapidly if not addressed. Immediate assessment of
oxygen saturation, airway, and potential sources of bleeding is warranted.
Prompt intervention can prevent deterioration into shock or respiratory failure.
