HESI RN Exit Exam 2025 – Verified Questions with Updated Answer Key & Case Rationales | 100% Graded A+

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HESI RN Exit Exam 2025 –
Verified Questions with
Updated Answer Key & Case
Rationales | 100% Graded A+
Nursing Process (Questions 1–30)
Question 1
Case Study: A client with pneumonia reports shortness of breath and a productive cough.
Question: What is the nurse’s first step in the nursing process?
A. Administer oxygen
B. Assess respiratory status
C. Document findings
D. Notify the provider

Correct Answer:
B. Assess respiratory status

Rationale: Assessment is the first step in the nursing process, gathering data on respiratory status
(e.g., oxygen saturation, lung sounds) to guide interventions. Administering oxygen,
documenting, or notifying are subsequent steps.

Question 2
Case Study: A client with diabetes has a blood glucose of 300 mg/dL.
Question: Which nursing diagnosis is most appropriate?
A. Risk for infection
B. Hyperglycemia
C. Impaired mobility
D. Deficient knowledge

Correct Answer:
B. Hyperglycemia

Rationale: Hyperglycemia directly addresses the client’s elevated blood glucose, a priority
diagnosis. Infection and knowledge may be secondary, and mobility is unrelated.

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Question 3 (NGN - Select All That Apply)
Case Study: A client post-myocardial infarction reports chest pain.
Question: Which interventions should the nurse include in the plan of care? Select all that apply.
A. Administer nitroglycerin as prescribed
B. Assess vital signs
C. Encourage ambulation
D. Monitor electrocardiogram (ECG)
E. Provide a high-fat meal

Correct Answers:

A. Administer nitroglycerin as prescribed
B. Assess vital signs
D. Monitor electrocardiogram (ECG)

Rationale: Nitroglycerin relieves chest pain, vital signs assess stability, and ECG monitoring
detects cardiac changes. Ambulation risks worsening ischemia, and high-fat meals are
contraindicated.

Question 4
Case Study: A client with heart failure has crackles in the lungs.
Question: What is the nurse’s priority intervention?
A. Administer a bronchodilator
B. Position in high Fowler’s
C. Restrict all fluids
D. Encourage deep breathing

Correct Answer:
B. Position in high Fowler’s

Rationale: High Fowler’s position promotes lung expansion and eases breathing in pulmonary
edema. Bronchodilators are for asthma/COPD, fluid restriction requires orders, and deep
breathing is secondary.

Question 5
Case Study: A client with a new colostomy needs discharge planning.
Question: What should the nurse evaluate first?
A. Client’s ability to change the ostomy bag
B. Family support system
C. Dietary preferences
D. Home environment safety

Correct Answer:
A. Client’s ability to change the ostomy bag

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Rationale: Evaluating self-care ability ensures the client can manage the colostomy
independently, a priority for discharge. Family, diet, and environment are secondary.

Question 6
Case Study: A client with chronic kidney disease reports fatigue.
Question: Which laboratory value should the nurse assess first?
A. Serum potassium
B. Hemoglobin
C. Blood urea nitrogen
D. Serum calcium

Correct Answer:
B. Hemoglobin

Rationale: Fatigue in CKD is often due to anemia (low hemoglobin) from reduced
erythropoietin. Potassium, BUN, and calcium are relevant but less directly linked to fatigue.

Question 7 (NGN - Drag and Drop)
Case Study: A client with sepsis requires interventions.
Question: Place the following nursing actions in the correct order.

1. Administer IV antibiotics
2. Obtain blood cultures
3. Monitor vital signs
4. Notify the provider

Correct Answer:
2, 4, 1, 3

Rationale: Blood cultures are obtained first to identify the pathogen, followed by notifying the
provider, administering antibiotics, and monitoring vital signs to evaluate response.

Question 8
Case Study: A client with a pressure ulcer needs wound care.
Question: Which intervention should the nurse implement?
A. Cleanse with hydrogen peroxide
B. Apply a moist saline dressing
C. Leave the wound open to air
D. Use adhesive tape on the wound

Correct Answer:
B. Apply a moist saline dressing

Rationale: Moist saline dressings promote healing in pressure ulcers. Hydrogen peroxide
damages tissue, open air delays healing, and adhesive tape risks skin injury.

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Question 9
Case Study: A client with COPD reports dyspnea.
Question: What should the nurse assess first?
A. Oxygen saturation
B. Blood pressure
C. Temperature
D. Pain level

Correct Answer:
A. Oxygen saturation

Rationale: Dyspnea in COPD indicates potential hypoxemia, making oxygen saturation the
priority assessment. Other parameters are secondary.

Question 10
Case Study: A client post-appendectomy reports nausea.
Question: What is the nurse’s first action?
A. Administer an antiemetic
B. Assess for bowel sounds
C. Encourage oral fluids
D. Notify the provider

Correct Answer:
B. Assess for bowel sounds

Rationale: Nausea post-appendectomy may indicate ileus, requiring bowel sound assessment.
Antiemetics, fluids, or notification are secondary.

Question 11
Case Study: A client with type 1 diabetes reports shakiness.
Question: What is the nurse’s priority intervention?
A. Administer insulin
B. Provide a carbohydrate snack
C. Restrict all food
D. Monitor blood glucose later

Correct Answer:
B. Provide a carbohydrate snack

Rationale: Shakiness suggests hypoglycemia, requiring a fast-acting carbohydrate (e.g., juice).
Insulin worsens hypoglycemia, restriction is harmful, and delayed monitoring risks deterioration.

Question 12 (NGN - Matrix)
Case Study: A client with heart failure is admitted.
Question: Match the assessment finding to the appropriate nursing action.
Findings: