1
HESI RN Exit Exam 2025 –
Authentic, A+ Rated Actual
Questions and Complete
Answer
Medical-Surgical Nursing
1. A 62-year-old patient with chest pain reports a pain level of 8/10 and diaphoresis. What is
the nurse’s priority action?
A. Administer acetaminophen
B. Administer nitroglycerin as prescribed
C. Encourage deep breathing
D. Document the pain
Rationale: Chest pain with diaphoresis suggests acute coronary syndrome; nitroglycerin
relieves angina, per ACS management protocols.
2. A patient with heart failure has a weight gain of 3 kg in 48 hours. What should the nurse
suspect?
A. Hypovolemia
B. Fluid overload
C. Normal weight fluctuation
D. Hyperkalemia
Rationale: A 3 kg weight gain in 48 hours indicates fluid overload in heart failure, per
fluid balance assessment.
3. (SATA) Which interventions are appropriate for a patient with pneumonia? (Select all
that apply)
A. Encourage deep breathing exercises
B. Administer prescribed antibiotics
C. Restrict all fluids
D. Monitor oxygen saturation
E. Avoid hand hygiene
Rationale: Deep breathing, antibiotics, and oxygen monitoring manage pneumonia. Fluid
restriction and avoiding hygiene are inappropriate, per respiratory care standards.
4. A patient with a blood pressure of 200/110 mmHg reports a headache. What is the
nurse’s priority?
A. Encourage ambulation
B. Notify the provider immediately
C. Administer acetaminophen
, 2
D. Document the findings
Rationale: Severe hypertension with symptoms requires urgent provider intervention to
prevent stroke, per hypertensive crisis management.
5. A patient with COPD reports increased dyspnea. What is the nurse’s first action?
A. Administer a diuretic
B. Administer prescribed albuterol
C. Restrict oxygen use
D. Document the symptom
Rationale: Albuterol relieves acute dyspnea in COPD, per bronchodilator therapy.
6. A patient with a new colostomy reports leakage around the appliance. What should the
nurse do?
A. Ignore the leakage
B. Assess the stoma and appliance fit
C. Remove the appliance immediately
D. Apply tape over the leakage
Rationale: Assessing the stoma and appliance ensures proper fit and prevents skin
breakdown, per ostomy care standards.
7. A patient with diabetes has a blood glucose of 50 mg/dL. What is the nurse’s priority?
A. Administer insulin
B. Give 15 g of fast-acting carbohydrate
C. Monitor for 30 minutes
D. Restrict fluids
Rationale: Hypoglycemia (<70 mg/dL) requires fast-acting carbohydrates to raise
glucose, per diabetes management.
8. A patient with a stage 3 pressure injury has redness and drainage. What should the nurse
do?
A. Apply a dry dressing
B. Use a moist dressing and notify the provider
C. Restrict repositioning
D. Document the findings only
Rationale: Moist dressings promote healing; drainage suggests infection, requiring
provider notification, per wound care protocols.
9. A patient with sepsis has a temperature of 103°F and heart rate of 115 bpm. What is the
priority?
A. Administer antipyretics first
B. Initiate prescribed IV antibiotics
C. Encourage oral fluids only
D. Monitor vital signs hourly
Rationale: Antibiotics treat the infection causing sepsis, a priority to prevent
deterioration, per sepsis protocols.
10. A patient with renal failure has a potassium level of 6.0 mEq/L. What should the nurse
do?
A. Administer potassium supplements
B. Notify the provider immediately
C. Encourage potassium-rich foods
D. Document the lab result
, 3
Rationale: Hyperkalemia (>5.5 mEq/L) risks arrhythmias, requiring urgent provider
intervention, per electrolyte management.
Pediatric Nursing
11. A 3-year-old with asthma has wheezing and a respiratory rate of 40 breaths/min. What is
the priority?
A. Administer oxygen at 6 L/min
B. Administer prescribed albuterol
C. Encourage fluid restriction
D. Place in a supine position
Rationale: Albuterol relieves acute bronchospasm in asthma, per pediatric respiratory
management.
12. A 6-month-old has a fever of 101°F. What should the nurse teach the parents?
A. Use aspirin for fever
B. Give acetaminophen as prescribed
C. Apply ice baths
D. Avoid monitoring temperature
Rationale: Acetaminophen is safe for fever in infants; aspirin risks Reye’s syndrome,
and ice baths are unsafe, per pediatric fever management.
13. (SATA) Which milestones are expected in a 12-month-old? (Select all that apply)
A. Says “mama” or “dada” specifically
B. Takes a few steps alone
C. Draws a straight line
D. Uses a pincer grasp
E. Rides a tricycle
Rationale: At 12 months, children say specific words, take steps, and use a pincer grasp.
Drawing lines and riding tricycles occur later, per developmental milestones.
14. A 4-year-old with type 1 diabetes reports shakiness. What is the nurse’s first action?
A. Administer insulin
B. Check blood glucose level
C. Restrict carbohydrates
D. Document the symptom
Rationale: Shakiness suggests hypoglycemia; checking blood glucose guides treatment,
per pediatric diabetes management.
15. A 2-year-old with a burn reports pain. What is the nurse’s priority?
A. Apply ice to the burn
B. Assess pain and administer analgesics
C. Restrict fluids
D. Document the pain only
Rationale: Pain assessment and analgesics improve comfort; ice worsens burns, per
pediatric burn care.
16. A 5-year-old with cystic fibrosis has thick sputum. What should the nurse do?
A. Restrict fluids
B. Perform chest physiotherapy
, 4
C. Administer a diuretic
D. Place in a supine position
Rationale: Chest physiotherapy mobilizes secretions in cystic fibrosis, per pulmonary
management.
17. A 1-year-old is prescribed amoxicillin 40 mg/kg/day in 3 doses. The child weighs 10 kg.
What is each dose?
A. 100 mg
B. 133.3 mg
C. 200 mg
D. 300 mg
Rationale: Amoxicillin 40 mg/kg/day × 10 kg = 400 mg/day; 400 mg ÷ 3 doses = 133.3
mg/dose, per pediatric dosing.
18. A 3-year-old with a fever has a seizure. What should the nurse do?
A. Restrain the child
B. Place the child on their side
C. Insert a tongue depressor
D. Administer sugar syrup
Rationale: Positioning on the side ensures airway safety during a seizure; restraints and
tongue depressors are unsafe, per seizure management.
19. A parent asks about safe sleep for a 6-month-old. What should the nurse teach?
A. Place on stomach with bedding
B. Place on back with no bedding
C. Use a soft mattress
D. Share the parent’s bed
Rationale: Back sleeping with no bedding reduces SIDS risk, per pediatric safety
guidelines.
20. A 7-year-old with leukemia reports bone pain. What should the nurse do?
A. Encourage vigorous exercise
B. Administer prescribed pain medication
C. Apply heat to the area
D. Document the pain only
Rationale: Bone pain in leukemia requires pain management, per oncologic care.
Maternity Nursing
21. A postpartum patient reports heavy vaginal bleeding. What is the nurse’s priority?
A. Encourage ambulation
B. Assess the uterus and notify the provider
C. Document the bleeding
D. Administer pain medication
Rationale: Heavy bleeding suggests postpartum hemorrhage; uterine assessment and
provider notification are critical, per maternity emergency protocols.
22. A pregnant patient at 36 weeks reports decreased fetal movement. What should the nurse
do?
A. Encourage rest
HESI RN Exit Exam 2025 –
Authentic, A+ Rated Actual
Questions and Complete
Answer
Medical-Surgical Nursing
1. A 62-year-old patient with chest pain reports a pain level of 8/10 and diaphoresis. What is
the nurse’s priority action?
A. Administer acetaminophen
B. Administer nitroglycerin as prescribed
C. Encourage deep breathing
D. Document the pain
Rationale: Chest pain with diaphoresis suggests acute coronary syndrome; nitroglycerin
relieves angina, per ACS management protocols.
2. A patient with heart failure has a weight gain of 3 kg in 48 hours. What should the nurse
suspect?
A. Hypovolemia
B. Fluid overload
C. Normal weight fluctuation
D. Hyperkalemia
Rationale: A 3 kg weight gain in 48 hours indicates fluid overload in heart failure, per
fluid balance assessment.
3. (SATA) Which interventions are appropriate for a patient with pneumonia? (Select all
that apply)
A. Encourage deep breathing exercises
B. Administer prescribed antibiotics
C. Restrict all fluids
D. Monitor oxygen saturation
E. Avoid hand hygiene
Rationale: Deep breathing, antibiotics, and oxygen monitoring manage pneumonia. Fluid
restriction and avoiding hygiene are inappropriate, per respiratory care standards.
4. A patient with a blood pressure of 200/110 mmHg reports a headache. What is the
nurse’s priority?
A. Encourage ambulation
B. Notify the provider immediately
C. Administer acetaminophen
, 2
D. Document the findings
Rationale: Severe hypertension with symptoms requires urgent provider intervention to
prevent stroke, per hypertensive crisis management.
5. A patient with COPD reports increased dyspnea. What is the nurse’s first action?
A. Administer a diuretic
B. Administer prescribed albuterol
C. Restrict oxygen use
D. Document the symptom
Rationale: Albuterol relieves acute dyspnea in COPD, per bronchodilator therapy.
6. A patient with a new colostomy reports leakage around the appliance. What should the
nurse do?
A. Ignore the leakage
B. Assess the stoma and appliance fit
C. Remove the appliance immediately
D. Apply tape over the leakage
Rationale: Assessing the stoma and appliance ensures proper fit and prevents skin
breakdown, per ostomy care standards.
7. A patient with diabetes has a blood glucose of 50 mg/dL. What is the nurse’s priority?
A. Administer insulin
B. Give 15 g of fast-acting carbohydrate
C. Monitor for 30 minutes
D. Restrict fluids
Rationale: Hypoglycemia (<70 mg/dL) requires fast-acting carbohydrates to raise
glucose, per diabetes management.
8. A patient with a stage 3 pressure injury has redness and drainage. What should the nurse
do?
A. Apply a dry dressing
B. Use a moist dressing and notify the provider
C. Restrict repositioning
D. Document the findings only
Rationale: Moist dressings promote healing; drainage suggests infection, requiring
provider notification, per wound care protocols.
9. A patient with sepsis has a temperature of 103°F and heart rate of 115 bpm. What is the
priority?
A. Administer antipyretics first
B. Initiate prescribed IV antibiotics
C. Encourage oral fluids only
D. Monitor vital signs hourly
Rationale: Antibiotics treat the infection causing sepsis, a priority to prevent
deterioration, per sepsis protocols.
10. A patient with renal failure has a potassium level of 6.0 mEq/L. What should the nurse
do?
A. Administer potassium supplements
B. Notify the provider immediately
C. Encourage potassium-rich foods
D. Document the lab result
, 3
Rationale: Hyperkalemia (>5.5 mEq/L) risks arrhythmias, requiring urgent provider
intervention, per electrolyte management.
Pediatric Nursing
11. A 3-year-old with asthma has wheezing and a respiratory rate of 40 breaths/min. What is
the priority?
A. Administer oxygen at 6 L/min
B. Administer prescribed albuterol
C. Encourage fluid restriction
D. Place in a supine position
Rationale: Albuterol relieves acute bronchospasm in asthma, per pediatric respiratory
management.
12. A 6-month-old has a fever of 101°F. What should the nurse teach the parents?
A. Use aspirin for fever
B. Give acetaminophen as prescribed
C. Apply ice baths
D. Avoid monitoring temperature
Rationale: Acetaminophen is safe for fever in infants; aspirin risks Reye’s syndrome,
and ice baths are unsafe, per pediatric fever management.
13. (SATA) Which milestones are expected in a 12-month-old? (Select all that apply)
A. Says “mama” or “dada” specifically
B. Takes a few steps alone
C. Draws a straight line
D. Uses a pincer grasp
E. Rides a tricycle
Rationale: At 12 months, children say specific words, take steps, and use a pincer grasp.
Drawing lines and riding tricycles occur later, per developmental milestones.
14. A 4-year-old with type 1 diabetes reports shakiness. What is the nurse’s first action?
A. Administer insulin
B. Check blood glucose level
C. Restrict carbohydrates
D. Document the symptom
Rationale: Shakiness suggests hypoglycemia; checking blood glucose guides treatment,
per pediatric diabetes management.
15. A 2-year-old with a burn reports pain. What is the nurse’s priority?
A. Apply ice to the burn
B. Assess pain and administer analgesics
C. Restrict fluids
D. Document the pain only
Rationale: Pain assessment and analgesics improve comfort; ice worsens burns, per
pediatric burn care.
16. A 5-year-old with cystic fibrosis has thick sputum. What should the nurse do?
A. Restrict fluids
B. Perform chest physiotherapy
, 4
C. Administer a diuretic
D. Place in a supine position
Rationale: Chest physiotherapy mobilizes secretions in cystic fibrosis, per pulmonary
management.
17. A 1-year-old is prescribed amoxicillin 40 mg/kg/day in 3 doses. The child weighs 10 kg.
What is each dose?
A. 100 mg
B. 133.3 mg
C. 200 mg
D. 300 mg
Rationale: Amoxicillin 40 mg/kg/day × 10 kg = 400 mg/day; 400 mg ÷ 3 doses = 133.3
mg/dose, per pediatric dosing.
18. A 3-year-old with a fever has a seizure. What should the nurse do?
A. Restrain the child
B. Place the child on their side
C. Insert a tongue depressor
D. Administer sugar syrup
Rationale: Positioning on the side ensures airway safety during a seizure; restraints and
tongue depressors are unsafe, per seizure management.
19. A parent asks about safe sleep for a 6-month-old. What should the nurse teach?
A. Place on stomach with bedding
B. Place on back with no bedding
C. Use a soft mattress
D. Share the parent’s bed
Rationale: Back sleeping with no bedding reduces SIDS risk, per pediatric safety
guidelines.
20. A 7-year-old with leukemia reports bone pain. What should the nurse do?
A. Encourage vigorous exercise
B. Administer prescribed pain medication
C. Apply heat to the area
D. Document the pain only
Rationale: Bone pain in leukemia requires pain management, per oncologic care.
Maternity Nursing
21. A postpartum patient reports heavy vaginal bleeding. What is the nurse’s priority?
A. Encourage ambulation
B. Assess the uterus and notify the provider
C. Document the bleeding
D. Administer pain medication
Rationale: Heavy bleeding suggests postpartum hemorrhage; uterine assessment and
provider notification are critical, per maternity emergency protocols.
22. A pregnant patient at 36 weeks reports decreased fetal movement. What should the nurse
do?
A. Encourage rest
