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ESI RN Exit Exam 2025/2026 – Verified
H
Questions with Correct Answers & Clinical
Rationales | Graded A+
Student Name: _________________________
Date:_______________
Time Limit:90 minutes
Total Questions:70
Medical-Surgical Nursing (20 Questions)
Question 1 (MCQ)
client with chronic heart failure is prescribed furosemide. Which electrolyte imbalance should the nurse
A
monitor?
a. Hyperkalemia
b.Hypokalemia
c. Hypernatremia
d. Hypocalcemia
Rationale: Furosemide, a loop diuretic, promotespotassium excretion, increasing the risk of
hypokalemia.
Question 2 (SATA)
client with myocardial infarction presents to the emergency department. Which interventions should the
A
nurse anticipate? (Select all that apply)
a.Administer oxygen
b. Administer insulin
c.Obtain an ECG
d.Administer nitroglycerin
e. Encourage ambulation
Rationale: Myocardial infarction requires oxygento improve myocardial oxygenation, an ECG to
,c onfirm diagnosis, and nitroglycerin to relieve chest pain. Insulin is not indicated unless hyperglycemia is
present, and ambulation is contraindicated during acute MI.
Question 3 (Critical Thinking)
cenario: A client with pneumonia has a respiratoryrate of 32 breaths/min and oxygen saturation of
S
88%. What is the priority nursing action?
a. Administer antibiotics
b.Administer oxygen
c. Encourage coughing
d. Monitor temperature
Rationale: Low oxygen saturation indicates hypoxia,making oxygen administration the priority to
ensure adequate tissue perfusion.
Question 4 (MCQ)
client with type 2 diabetes has a blood glucose of 350 mg/dL. What should the nurse do first?
A
a. Administer oral glucose
b.Administer insulin
c. Encourage fluid intake
d. Restrict carbohydrates
Rationale: A blood glucose of 350 mg/dL indicateshyperglycemia, requiring insulin to lower glucose
levels.
Question 5 (SATA)
client with chronic obstructive pulmonary disease (COPD) is experiencing an exacerbation. Which
A
findings should the nurse expect? (Select all that apply)
a.Wheezing
b.Dyspnea
c. Hypotension
d.Use of accessory muscles
e. Bradycardia
Rationale: COPD exacerbations cause wheezing, dyspnea,and use of accessory muscles due to airway
obstruction and respiratory distress. Hypotension and bradycardia are not typical findings.
Question 6 (MCQ)
client with a peptic ulcer reports sudden, severe abdominal pain. What should the nurse suspect?
A
a. Gastritis
b.Perforation
c. Reflux
d. Obstruction
Rationale: Sudden, severe abdominal pain in a clientwith a peptic ulcer suggests perforation, a surgical
emergency.
, Question 7 (Critical Thinking)
ow-Tie Question: A client with acute pancreatitispresents with severe epigastric pain. Drag and drop
B
assessments and interventions.
Left Side (Assessments): Monitor amylase levels,Assess pain level
Right Side (Interventions): Administer analgesics,Maintain NPO status
Center (Condition): Acute pancreatitis
Rationale: Acute pancreatitis requires amylase monitoringand pain assessment, with analgesics for pain
relief and NPO status to rest the pancreas.
Question 8 (MCQ)
client with a new colostomy reports leakage around the stoma. What should the nurse do?
A
a. Change the appliance daily
b.Assess the stoma and skin
c. Apply adhesive tape
d. Ignore the leakage
Rationale: Leakage around a colostomy stoma requiresassessment of the stoma and skin to ensure
proper appliance fit and prevent skin breakdown.
Question 9 (SATA)
client with septic shock is admitted to the ICU. Which interventions should the nurse prioritize? (Select
A
all that apply)
a.Administer IV fluids
b.Monitor vital signs
c. Encourage oral intake
d.Administer antibiotics
e. Restrict fluids
Rationale: Septic shock requires IV fluids for hypotension,vital sign monitoring, and antibiotics to treat
infection. Oral intake and fluid restriction are contraindicated.
Question 10 (MCQ)
client with a history of stroke has dysphagia. What is the priority nursing intervention?
A
a. Offer soft foods
b.Perform a swallow evaluation
c. Encourage liquids
d. Position supine for meals
Rationale: Dysphagia increases aspiration risk, requiringa swallow evaluation to determine safe feeding
methods.
Question 11 (Critical Thinking)
ESI RN Exit Exam 2025/2026 – Verified
H
Questions with Correct Answers & Clinical
Rationales | Graded A+
Student Name: _________________________
Date:_______________
Time Limit:90 minutes
Total Questions:70
Medical-Surgical Nursing (20 Questions)
Question 1 (MCQ)
client with chronic heart failure is prescribed furosemide. Which electrolyte imbalance should the nurse
A
monitor?
a. Hyperkalemia
b.Hypokalemia
c. Hypernatremia
d. Hypocalcemia
Rationale: Furosemide, a loop diuretic, promotespotassium excretion, increasing the risk of
hypokalemia.
Question 2 (SATA)
client with myocardial infarction presents to the emergency department. Which interventions should the
A
nurse anticipate? (Select all that apply)
a.Administer oxygen
b. Administer insulin
c.Obtain an ECG
d.Administer nitroglycerin
e. Encourage ambulation
Rationale: Myocardial infarction requires oxygento improve myocardial oxygenation, an ECG to
,c onfirm diagnosis, and nitroglycerin to relieve chest pain. Insulin is not indicated unless hyperglycemia is
present, and ambulation is contraindicated during acute MI.
Question 3 (Critical Thinking)
cenario: A client with pneumonia has a respiratoryrate of 32 breaths/min and oxygen saturation of
S
88%. What is the priority nursing action?
a. Administer antibiotics
b.Administer oxygen
c. Encourage coughing
d. Monitor temperature
Rationale: Low oxygen saturation indicates hypoxia,making oxygen administration the priority to
ensure adequate tissue perfusion.
Question 4 (MCQ)
client with type 2 diabetes has a blood glucose of 350 mg/dL. What should the nurse do first?
A
a. Administer oral glucose
b.Administer insulin
c. Encourage fluid intake
d. Restrict carbohydrates
Rationale: A blood glucose of 350 mg/dL indicateshyperglycemia, requiring insulin to lower glucose
levels.
Question 5 (SATA)
client with chronic obstructive pulmonary disease (COPD) is experiencing an exacerbation. Which
A
findings should the nurse expect? (Select all that apply)
a.Wheezing
b.Dyspnea
c. Hypotension
d.Use of accessory muscles
e. Bradycardia
Rationale: COPD exacerbations cause wheezing, dyspnea,and use of accessory muscles due to airway
obstruction and respiratory distress. Hypotension and bradycardia are not typical findings.
Question 6 (MCQ)
client with a peptic ulcer reports sudden, severe abdominal pain. What should the nurse suspect?
A
a. Gastritis
b.Perforation
c. Reflux
d. Obstruction
Rationale: Sudden, severe abdominal pain in a clientwith a peptic ulcer suggests perforation, a surgical
emergency.
, Question 7 (Critical Thinking)
ow-Tie Question: A client with acute pancreatitispresents with severe epigastric pain. Drag and drop
B
assessments and interventions.
Left Side (Assessments): Monitor amylase levels,Assess pain level
Right Side (Interventions): Administer analgesics,Maintain NPO status
Center (Condition): Acute pancreatitis
Rationale: Acute pancreatitis requires amylase monitoringand pain assessment, with analgesics for pain
relief and NPO status to rest the pancreas.
Question 8 (MCQ)
client with a new colostomy reports leakage around the stoma. What should the nurse do?
A
a. Change the appliance daily
b.Assess the stoma and skin
c. Apply adhesive tape
d. Ignore the leakage
Rationale: Leakage around a colostomy stoma requiresassessment of the stoma and skin to ensure
proper appliance fit and prevent skin breakdown.
Question 9 (SATA)
client with septic shock is admitted to the ICU. Which interventions should the nurse prioritize? (Select
A
all that apply)
a.Administer IV fluids
b.Monitor vital signs
c. Encourage oral intake
d.Administer antibiotics
e. Restrict fluids
Rationale: Septic shock requires IV fluids for hypotension,vital sign monitoring, and antibiotics to treat
infection. Oral intake and fluid restriction are contraindicated.
Question 10 (MCQ)
client with a history of stroke has dysphagia. What is the priority nursing intervention?
A
a. Offer soft foods
b.Perform a swallow evaluation
c. Encourage liquids
d. Position supine for meals
Rationale: Dysphagia increases aspiration risk, requiringa swallow evaluation to determine safe feeding
methods.
Question 11 (Critical Thinking)
