HESI RN EXIT ACTUAL EXAM 2025:
COMPREHENSIVE REVIEW WITH
ANSWERS & RATIONALE
Question 1 (Fundamentals)
A client reports being sexually assaulted 6 hours ago. What is the nurse’s priority question?
A: Did you report the assault to the police?
B: Have you bathed or showered since the assault?
C: Do you know the assailant?
D: Are you feeling safe now?
Correct Answer: B
Rationale: Asking about bathing or showering is critical to preserve forensic evidence for a
sexual assault examination, which is time-sensitive and takes priority.
Question 2 (Fundamentals)
A client with a new colostomy refuses to look at the stoma. What should the nurse do?
A: Insist the client inspect the stoma
B: Provide education and emotional support
C: Change the appliance without discussion
D: Refer the client to a psychiatrist
Correct Answer: B
Rationale: Education and emotional support address the client’s emotional barriers, promoting
acceptance and self-care.
Question 3 (Pharmacology, Fill-in-the-Blank)
A client is prescribed cefazolin 500 mg IV every 8 hours. The vial is labeled “Cefazolin 1 g, add
3 mL sterile water for a total volume of 3.5 mL.” How many mL should the nurse administer per
dose? (Enter numeric value only)
Correct Answer: 1.75
Rationale: 1 g (1000 mg) in 3.5 mL = 1000 ÷ 3.5 = 285.71 mg/mL. For 500 mg: 500 ÷ 285.71 =
1.75 mL.
Question 4 (Medical-Surgical)
, A client with heart failure reports dyspnea and coughs up pink, frothy sputum. What is the
priority action?
A: Draw arterial blood gases
B: Position in high Fowler’s with legs down
C: Obtain a chest X-ray
D: Administer a diuretic immediately
Correct Answer: B
Rationale: High Fowler’s position with legs down reduces venous return, alleviating pulmonary
edema symptoms.
Question 5 (Pediatrics)
A 3-year-old with bacterial meningitis has a bulging fontanel. What should the nurse suspect?
A: Normal development
B: Increased intracranial pressure
C: Dehydration
D: Vitamin D deficiency
Correct Answer: B
Rationale: A bulging fontanel in a young child indicates increased intracranial pressure, a
critical finding in meningitis.
Question 6 (Maternal Health)
A client at 8 weeks gestation reports nausea and vomiting. What should the nurse recommend?
A: Avoid all food intake
B: Eat small, frequent meals
C: Restrict fluids
D: Take antacids before meals
Correct Answer: B
Rationale: Small, frequent meals stabilize stomach acid and blood sugar, reducing nausea.
Question 7 (Mental Health)
A client with schizophrenia reports hearing voices commanding harm. What should the nurse
do?
A: Argue the voices are not real
B: Notify the healthcare provider
C: Ignore the report
D: Restrain the client
Correct Answer: B
Rationale: Command hallucinations pose a safety risk, requiring immediate provider
notification.
Question 8 (Fundamentals, Select-All-That-Apply)
COMPREHENSIVE REVIEW WITH
ANSWERS & RATIONALE
Question 1 (Fundamentals)
A client reports being sexually assaulted 6 hours ago. What is the nurse’s priority question?
A: Did you report the assault to the police?
B: Have you bathed or showered since the assault?
C: Do you know the assailant?
D: Are you feeling safe now?
Correct Answer: B
Rationale: Asking about bathing or showering is critical to preserve forensic evidence for a
sexual assault examination, which is time-sensitive and takes priority.
Question 2 (Fundamentals)
A client with a new colostomy refuses to look at the stoma. What should the nurse do?
A: Insist the client inspect the stoma
B: Provide education and emotional support
C: Change the appliance without discussion
D: Refer the client to a psychiatrist
Correct Answer: B
Rationale: Education and emotional support address the client’s emotional barriers, promoting
acceptance and self-care.
Question 3 (Pharmacology, Fill-in-the-Blank)
A client is prescribed cefazolin 500 mg IV every 8 hours. The vial is labeled “Cefazolin 1 g, add
3 mL sterile water for a total volume of 3.5 mL.” How many mL should the nurse administer per
dose? (Enter numeric value only)
Correct Answer: 1.75
Rationale: 1 g (1000 mg) in 3.5 mL = 1000 ÷ 3.5 = 285.71 mg/mL. For 500 mg: 500 ÷ 285.71 =
1.75 mL.
Question 4 (Medical-Surgical)
, A client with heart failure reports dyspnea and coughs up pink, frothy sputum. What is the
priority action?
A: Draw arterial blood gases
B: Position in high Fowler’s with legs down
C: Obtain a chest X-ray
D: Administer a diuretic immediately
Correct Answer: B
Rationale: High Fowler’s position with legs down reduces venous return, alleviating pulmonary
edema symptoms.
Question 5 (Pediatrics)
A 3-year-old with bacterial meningitis has a bulging fontanel. What should the nurse suspect?
A: Normal development
B: Increased intracranial pressure
C: Dehydration
D: Vitamin D deficiency
Correct Answer: B
Rationale: A bulging fontanel in a young child indicates increased intracranial pressure, a
critical finding in meningitis.
Question 6 (Maternal Health)
A client at 8 weeks gestation reports nausea and vomiting. What should the nurse recommend?
A: Avoid all food intake
B: Eat small, frequent meals
C: Restrict fluids
D: Take antacids before meals
Correct Answer: B
Rationale: Small, frequent meals stabilize stomach acid and blood sugar, reducing nausea.
Question 7 (Mental Health)
A client with schizophrenia reports hearing voices commanding harm. What should the nurse
do?
A: Argue the voices are not real
B: Notify the healthcare provider
C: Ignore the report
D: Restrain the client
Correct Answer: B
Rationale: Command hallucinations pose a safety risk, requiring immediate provider
notification.
Question 8 (Fundamentals, Select-All-That-Apply)
