1
RN HESI Exit Exam 2025 –
Versions 1, 2 & 3 | 200
Updated Questions, 100%
Verified Answers &
Rationales
1. A patient with heart failure is prescribed furosemide. Which laboratory value
should the nurse monitor closely?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Correct Answer: B. Potassium
Rationale: Furosemide, a loop diuretic, increases potassium excretion, risking
hypokalemia. Monitoring potassium levels is critical to prevent arrhythmias. Sodium,
calcium, and magnesium are less directly affected.
2. A patient with diabetic ketoacidosis (DKA) has a blood glucose of 450 mg/dL. What
is the priority nursing action?
A. Administer oral glucose
B. Initiate IV insulin
C. Restrict all fluids
D. Give glucagon
Correct Answer: B. Initiate IV insulin
Rationale: DKA requires IV insulin to lower blood glucose and halt ketone production.
Oral glucose and glucagon worsen hyperglycemia, and fluid restriction is contraindicated
due to dehydration.
3. Which finding in a patient with a head injury is most concerning?
A. Headache
B. Nausea
C. Unequal pupils
D. Dizziness
Correct Answer: C. Unequal pupils
Rationale: Unequal pupils suggest increased intracranial pressure or neurological
, 2
deterioration, requiring immediate intervention. Headache, nausea, and dizziness are
common but less urgent.
4. A patient with chronic kidney disease reports fatigue. What is the likely cause?
A. Hyperglycemia
B. Anemia
C. Hypothyroidism
D. Dehydration
Correct Answer: B. Anemia
Rationale: Chronic kidney disease reduces erythropoietin production, causing anemia
and fatigue. Hyperglycemia, hypothyroidism, or dehydration are less likely causes.
5. A patient with a potassium level of 6.2 mEq/L is at risk for which complication?
A. Seizures
B. Cardiac arrhythmias
C. Hypoventilation
D. Muscle cramps
Correct Answer: B. Cardiac arrhythmias
Rationale: Hyperkalemia (potassium >5.0 mEq/L) disrupts cardiac conduction, risking
arrhythmias. Seizures, hypoventilation, and cramps are not directly related.
6. What is the priority nursing action for a patient with suspected myocardial
infarction?
A. Administer morphine
B. Obtain a 12-lead ECG
C. Encourage ambulation
D. Restrict all fluids
Correct Answer: B. Obtain a 12-lead ECG
Rationale: A 12-lead ECG confirms myocardial infarction, guiding treatment. Morphine
is provider-ordered, ambulation is contraindicated, and fluid restriction is irrelevant.
7. A patient with hyponatremia exhibits which symptom?
A. Dry mucous membranes
B. Confusion
C. Increased urine output
D. Bradycardia
Correct Answer: B. Confusion
Rationale: Hyponatremia causes neurological symptoms like confusion due to cerebral
edema. Dry mucous membranes and increased urine output suggest hypernatremia, and
bradycardia is unrelated.
8. Which precaution is required for a patient with MRSA?
A. Airborne precautions
B. Contact precautions
C. Droplet precautions
D. Standard precautions only
Correct Answer: B. Contact precautions
Rationale: MRSA is transmitted via contact, requiring gloves, gowns, and dedicated
equipment. Airborne and droplet precautions are for respiratory pathogens, and standard
precautions are insufficient.
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9. A patient with a new tracheostomy requires which priority nursing action?
A. Suction every 4 hours
B. Ensure airway patency
C. Change the dressing daily
D. Restrict oral intake
Correct Answer: B. Ensure airway patency
Rationale: Airway patency is critical for tracheostomy patients to prevent obstruction.
Suctioning, dressing changes, and oral intake are secondary.
10. What is the therapeutic range for INR in a patient on warfarin?
A. 0.5–1.0
B. 2.0–3.0
C. 3.5–4.5
D. 5.0–6.0
Correct Answer: B. 2.0–3.0
Rationale: An INR of 2.0–3.0 is therapeutic for conditions like atrial fibrillation or DVT,
balancing anticoagulation and bleeding risk. Higher or lower ranges increase
complications.
11. A patient with a history of seizures stops phenytoin abruptly. What is the risk?
A. Hypoglycemia
B. Rebound seizures
C. Hypertension
D. Bradycardia
Correct Answer: B. Rebound seizures
Rationale: Abrupt phenytoin cessation increases seizure risk due to loss of
anticonvulsant control. Hypoglycemia, hypertension, or bradycardia are unrelated.
12. Which symptom indicates hypoglycemia in a patient with diabetes?
A. Polyuria
B. Sweating
C. Flushed skin
D. Thirst
Correct Answer: B. Sweating
Rationale: Hypoglycemia causes sympathetic activation, leading to sweating, shakiness,
and anxiety. Polyuria, flushed skin, and thirst are associated with hyperglycemia.
13. A patient with a chest tube reports sudden shortness of breath. What should the
nurse do first?
A. Increase oxygen flow
B. Check tube connections
C. Administer analgesics
D. Notify the provider
Correct Answer: B. Check tube connections
Rationale: Sudden shortness of breath may indicate a disconnected or occluded chest
tube, requiring immediate inspection. Oxygen, analgesics, and notification are secondary.
14. What is the normal range for arterial blood gas pH?
A. 7.25–7.35
B. 7.35–7.45
C. 7.45–7.55
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D. 7.15–7.25
Correct Answer: B. 7.35–7.45
Rationale: The normal pH range for arterial blood gases is 7.35–7.45, indicating acid-
base balance. Values outside this range suggest acidosis or alkalosis.
15. A patient with COPD is prescribed albuterol. Which side effect should the nurse
monitor?
A. Bradycardia
B. Tremors
C. Hypotension
D. Sedation
Correct Answer: B. Tremors
Rationale: Albuterol, a beta-agonist, causes tremors due to sympathetic stimulation.
Bradycardia, hypotension, and sedation are not typical side effects.
16. Which nursing action is contraindicated for a patient with an arteriovenous fistula?
A. Palpate for a thrill
B. Take blood pressure on the fistula arm
C. Assess for bruit
D. Monitor for infection
Correct Answer: B. Take blood pressure on the fistula arm
Rationale: Blood pressure measurement on the fistula arm risks occlusion. Palpating for
a thrill, assessing for a bruit, and monitoring for infection are essential.
17. A patient with Parkinson’s disease takes carbidopa-levodopa. When should it be
administered?
A. With high-protein meals
B. 30 minutes before or after meals
C. At bedtime only
D. Every 12 hours
Correct Answer: B. 30 minutes before or after meals
Rationale: Carbidopa-levodopa is absorbed best on an empty stomach. Protein interferes
with absorption, and timing is not restricted to bedtime or 12-hour intervals.
18. What is the priority nursing diagnosis for a patient post-leg amputation?
A. Risk for infection
B. Disturbed body image
C. Impaired mobility
D. Acute pain
Correct Answer: B. Disturbed body image
Rationale: Post-amputation, disturbed body image is the priority due to psychological
impact. Pain, mobility, and infection are important but secondary to emotional
adjustment.
19. A patient with a blood transfusion develops fever and chills. What should the nurse
do first?
A. Continue the transfusion
B. Stop the transfusion
C. Administer acetaminophen
D. Increase the infusion rate
Correct Answer: B. Stop the transfusion
RN HESI Exit Exam 2025 –
Versions 1, 2 & 3 | 200
Updated Questions, 100%
Verified Answers &
Rationales
1. A patient with heart failure is prescribed furosemide. Which laboratory value
should the nurse monitor closely?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Correct Answer: B. Potassium
Rationale: Furosemide, a loop diuretic, increases potassium excretion, risking
hypokalemia. Monitoring potassium levels is critical to prevent arrhythmias. Sodium,
calcium, and magnesium are less directly affected.
2. A patient with diabetic ketoacidosis (DKA) has a blood glucose of 450 mg/dL. What
is the priority nursing action?
A. Administer oral glucose
B. Initiate IV insulin
C. Restrict all fluids
D. Give glucagon
Correct Answer: B. Initiate IV insulin
Rationale: DKA requires IV insulin to lower blood glucose and halt ketone production.
Oral glucose and glucagon worsen hyperglycemia, and fluid restriction is contraindicated
due to dehydration.
3. Which finding in a patient with a head injury is most concerning?
A. Headache
B. Nausea
C. Unequal pupils
D. Dizziness
Correct Answer: C. Unequal pupils
Rationale: Unequal pupils suggest increased intracranial pressure or neurological
, 2
deterioration, requiring immediate intervention. Headache, nausea, and dizziness are
common but less urgent.
4. A patient with chronic kidney disease reports fatigue. What is the likely cause?
A. Hyperglycemia
B. Anemia
C. Hypothyroidism
D. Dehydration
Correct Answer: B. Anemia
Rationale: Chronic kidney disease reduces erythropoietin production, causing anemia
and fatigue. Hyperglycemia, hypothyroidism, or dehydration are less likely causes.
5. A patient with a potassium level of 6.2 mEq/L is at risk for which complication?
A. Seizures
B. Cardiac arrhythmias
C. Hypoventilation
D. Muscle cramps
Correct Answer: B. Cardiac arrhythmias
Rationale: Hyperkalemia (potassium >5.0 mEq/L) disrupts cardiac conduction, risking
arrhythmias. Seizures, hypoventilation, and cramps are not directly related.
6. What is the priority nursing action for a patient with suspected myocardial
infarction?
A. Administer morphine
B. Obtain a 12-lead ECG
C. Encourage ambulation
D. Restrict all fluids
Correct Answer: B. Obtain a 12-lead ECG
Rationale: A 12-lead ECG confirms myocardial infarction, guiding treatment. Morphine
is provider-ordered, ambulation is contraindicated, and fluid restriction is irrelevant.
7. A patient with hyponatremia exhibits which symptom?
A. Dry mucous membranes
B. Confusion
C. Increased urine output
D. Bradycardia
Correct Answer: B. Confusion
Rationale: Hyponatremia causes neurological symptoms like confusion due to cerebral
edema. Dry mucous membranes and increased urine output suggest hypernatremia, and
bradycardia is unrelated.
8. Which precaution is required for a patient with MRSA?
A. Airborne precautions
B. Contact precautions
C. Droplet precautions
D. Standard precautions only
Correct Answer: B. Contact precautions
Rationale: MRSA is transmitted via contact, requiring gloves, gowns, and dedicated
equipment. Airborne and droplet precautions are for respiratory pathogens, and standard
precautions are insufficient.
, 3
9. A patient with a new tracheostomy requires which priority nursing action?
A. Suction every 4 hours
B. Ensure airway patency
C. Change the dressing daily
D. Restrict oral intake
Correct Answer: B. Ensure airway patency
Rationale: Airway patency is critical for tracheostomy patients to prevent obstruction.
Suctioning, dressing changes, and oral intake are secondary.
10. What is the therapeutic range for INR in a patient on warfarin?
A. 0.5–1.0
B. 2.0–3.0
C. 3.5–4.5
D. 5.0–6.0
Correct Answer: B. 2.0–3.0
Rationale: An INR of 2.0–3.0 is therapeutic for conditions like atrial fibrillation or DVT,
balancing anticoagulation and bleeding risk. Higher or lower ranges increase
complications.
11. A patient with a history of seizures stops phenytoin abruptly. What is the risk?
A. Hypoglycemia
B. Rebound seizures
C. Hypertension
D. Bradycardia
Correct Answer: B. Rebound seizures
Rationale: Abrupt phenytoin cessation increases seizure risk due to loss of
anticonvulsant control. Hypoglycemia, hypertension, or bradycardia are unrelated.
12. Which symptom indicates hypoglycemia in a patient with diabetes?
A. Polyuria
B. Sweating
C. Flushed skin
D. Thirst
Correct Answer: B. Sweating
Rationale: Hypoglycemia causes sympathetic activation, leading to sweating, shakiness,
and anxiety. Polyuria, flushed skin, and thirst are associated with hyperglycemia.
13. A patient with a chest tube reports sudden shortness of breath. What should the
nurse do first?
A. Increase oxygen flow
B. Check tube connections
C. Administer analgesics
D. Notify the provider
Correct Answer: B. Check tube connections
Rationale: Sudden shortness of breath may indicate a disconnected or occluded chest
tube, requiring immediate inspection. Oxygen, analgesics, and notification are secondary.
14. What is the normal range for arterial blood gas pH?
A. 7.25–7.35
B. 7.35–7.45
C. 7.45–7.55
, 4
D. 7.15–7.25
Correct Answer: B. 7.35–7.45
Rationale: The normal pH range for arterial blood gases is 7.35–7.45, indicating acid-
base balance. Values outside this range suggest acidosis or alkalosis.
15. A patient with COPD is prescribed albuterol. Which side effect should the nurse
monitor?
A. Bradycardia
B. Tremors
C. Hypotension
D. Sedation
Correct Answer: B. Tremors
Rationale: Albuterol, a beta-agonist, causes tremors due to sympathetic stimulation.
Bradycardia, hypotension, and sedation are not typical side effects.
16. Which nursing action is contraindicated for a patient with an arteriovenous fistula?
A. Palpate for a thrill
B. Take blood pressure on the fistula arm
C. Assess for bruit
D. Monitor for infection
Correct Answer: B. Take blood pressure on the fistula arm
Rationale: Blood pressure measurement on the fistula arm risks occlusion. Palpating for
a thrill, assessing for a bruit, and monitoring for infection are essential.
17. A patient with Parkinson’s disease takes carbidopa-levodopa. When should it be
administered?
A. With high-protein meals
B. 30 minutes before or after meals
C. At bedtime only
D. Every 12 hours
Correct Answer: B. 30 minutes before or after meals
Rationale: Carbidopa-levodopa is absorbed best on an empty stomach. Protein interferes
with absorption, and timing is not restricted to bedtime or 12-hour intervals.
18. What is the priority nursing diagnosis for a patient post-leg amputation?
A. Risk for infection
B. Disturbed body image
C. Impaired mobility
D. Acute pain
Correct Answer: B. Disturbed body image
Rationale: Post-amputation, disturbed body image is the priority due to psychological
impact. Pain, mobility, and infection are important but secondary to emotional
adjustment.
19. A patient with a blood transfusion develops fever and chills. What should the nurse
do first?
A. Continue the transfusion
B. Stop the transfusion
C. Administer acetaminophen
D. Increase the infusion rate
Correct Answer: B. Stop the transfusion
