1
Page | 1
HESI Exit Exam Test Bank 2025-2026
NEWEST 2025 ACTUAL EXAM WITH
CORRECT DETAILED ANSWERS AND
RATIONALES (VERIFIED ANSWERS) |
ALREADY GRADED A+
, 2
Page | 2
Q1. A client receiving lisinopril develops a persistent dry cough. What is the most
appropriate nursing action?
A. Reassure the client and continue the medication
B. Recommend warm fluids for throat relief
C. Notify the healthcare provider to consider switching medication ✅
D. Instruct the client to take the medication at night
Rationale: A persistent dry cough is a common side effect of ACE inhibitors like lisinopril
due to increased bradykinin levels. It is not harmful but can be bothersome. The best
intervention is to notify the provider, who may consider switching to an angiotensin receptor
blocker (ARB), such as losartan, which does not cause this cough. Symptomatic relief won’t
address the root cause, and continuing the drug without evaluation may lead to poor
adherence. Nurses must recognize when common side effects warrant further evaluation and
potential medication adjustment.
, 3
Q2. A postoperative client reports calf pain, and the nurse notes swelling and redness in the
area. What is the priority action?
Page | 3 A. Elevate the leg
B. Apply warm compresses
C. Assess pedal pulses
D. Notify the provider immediately ✅
Rationale: The client shows signs of a deep vein thrombosis (DVT)—pain, redness, and
swelling in the calf. This is a medical emergency due to the risk of pulmonary embolism. The
priority action is to notify the healthcare provider. Interventions such as compression or
massage are contraindicated as they may dislodge the clot. Elevation can help reduce
swelling, but treatment decisions (e.g., anticoagulation) require provider orders. Prompt
recognition and response to potential thrombotic events is crucial for preventing life-
threatening complications.
Q3. A client with COPD is receiving oxygen at 4 L/min via nasal cannula. The client
becomes drowsy and difficult to arouse. What should the nurse do first?
A. Increase the oxygen flow
B. Place the client in a supine position
C. Lower the oxygen to 2 L/min ✅
D. Administer naloxone
Rationale: Clients with COPD may retain CO₂ due to their impaired gas exchange. Their
respiratory drive is often hypoxia-driven, not CO₂-driven like in healthy individuals.
, 4
Administering high levels of oxygen can reduce this drive, causing hypoventilation and CO₂
narcosis. The nurse should lower the O₂ to a safe level (typically 1–2 L/min) and monitor
respiratory status. Naloxone is not indicated unless opioids are involved. Early recognition of
Page | 4
oxygen toxicity in COPD is key to patient safety.
Q4. Which task can the RN delegate to the UAP when caring for a client with a stroke?
A. Assess for unilateral weakness
B. Teach how to use a walker
C. Feed the client prescribed pureed diet ✅
D. Monitor for facial drooping
Rationale: UAPs can perform non-invasive, routine tasks such as feeding, provided the client
is stable and not at risk for aspiration. Assessment, evaluation, and patient teaching are RN
responsibilities. The RN should confirm that the client is cleared for oral intake and
understands how to prevent aspiration before assigning the task. Delegation must always
align with the "5 Rights of Delegation" to ensure client safety.
Q5. A client on warfarin reports bleeding gums and dark stools. What is the nurse’s first
action?
A. Document the findings
B. Instruct the client to stop warfarin
C. Notify the provider ✅
D. Administer vitamin K immediately
Page | 1
HESI Exit Exam Test Bank 2025-2026
NEWEST 2025 ACTUAL EXAM WITH
CORRECT DETAILED ANSWERS AND
RATIONALES (VERIFIED ANSWERS) |
ALREADY GRADED A+
, 2
Page | 2
Q1. A client receiving lisinopril develops a persistent dry cough. What is the most
appropriate nursing action?
A. Reassure the client and continue the medication
B. Recommend warm fluids for throat relief
C. Notify the healthcare provider to consider switching medication ✅
D. Instruct the client to take the medication at night
Rationale: A persistent dry cough is a common side effect of ACE inhibitors like lisinopril
due to increased bradykinin levels. It is not harmful but can be bothersome. The best
intervention is to notify the provider, who may consider switching to an angiotensin receptor
blocker (ARB), such as losartan, which does not cause this cough. Symptomatic relief won’t
address the root cause, and continuing the drug without evaluation may lead to poor
adherence. Nurses must recognize when common side effects warrant further evaluation and
potential medication adjustment.
, 3
Q2. A postoperative client reports calf pain, and the nurse notes swelling and redness in the
area. What is the priority action?
Page | 3 A. Elevate the leg
B. Apply warm compresses
C. Assess pedal pulses
D. Notify the provider immediately ✅
Rationale: The client shows signs of a deep vein thrombosis (DVT)—pain, redness, and
swelling in the calf. This is a medical emergency due to the risk of pulmonary embolism. The
priority action is to notify the healthcare provider. Interventions such as compression or
massage are contraindicated as they may dislodge the clot. Elevation can help reduce
swelling, but treatment decisions (e.g., anticoagulation) require provider orders. Prompt
recognition and response to potential thrombotic events is crucial for preventing life-
threatening complications.
Q3. A client with COPD is receiving oxygen at 4 L/min via nasal cannula. The client
becomes drowsy and difficult to arouse. What should the nurse do first?
A. Increase the oxygen flow
B. Place the client in a supine position
C. Lower the oxygen to 2 L/min ✅
D. Administer naloxone
Rationale: Clients with COPD may retain CO₂ due to their impaired gas exchange. Their
respiratory drive is often hypoxia-driven, not CO₂-driven like in healthy individuals.
, 4
Administering high levels of oxygen can reduce this drive, causing hypoventilation and CO₂
narcosis. The nurse should lower the O₂ to a safe level (typically 1–2 L/min) and monitor
respiratory status. Naloxone is not indicated unless opioids are involved. Early recognition of
Page | 4
oxygen toxicity in COPD is key to patient safety.
Q4. Which task can the RN delegate to the UAP when caring for a client with a stroke?
A. Assess for unilateral weakness
B. Teach how to use a walker
C. Feed the client prescribed pureed diet ✅
D. Monitor for facial drooping
Rationale: UAPs can perform non-invasive, routine tasks such as feeding, provided the client
is stable and not at risk for aspiration. Assessment, evaluation, and patient teaching are RN
responsibilities. The RN should confirm that the client is cleared for oral intake and
understands how to prevent aspiration before assigning the task. Delegation must always
align with the "5 Rights of Delegation" to ensure client safety.
Q5. A client on warfarin reports bleeding gums and dark stools. What is the nurse’s first
action?
A. Document the findings
B. Instruct the client to stop warfarin
C. Notify the provider ✅
D. Administer vitamin K immediately
