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2 025 HESI RN Exit Exam V1 (NGN-Ready) –
All Real Clinical Topics Questions & Answers
in Full with Rationales | 100% Verified |
Graded A+
Student Name:_________________________Date:_______________
Time Limit: 90 minutesTotal Questions: 75
Fluid & Electrolytes
1. A client with dehydration has a serum sodium level of 150 mEq/L. Which intervention should the
nurse prioritize?
A. Administer oral potassium supplements.
B. Initiate IV 0.9% sodium chloride at 100 mL/hr.
C. Encourage free water intake.
D. Restrict fluid intake to prevent overload.
Correct Answer:C. Encourage free water intake.
Rationale: A sodium level of 150 mEq/L indicateshypernatremia due to dehydration.
Encouraging free water intake corrects the imbalance by diluting serum sodium. Potassium
is unrelated, 0.9% sodium chloride worsens hypernatremia, and fluid restriction is
contraindicated.
2. A client with heart failure develops a potassium level of 5.8 mEq/L. What should the nurse do
first?
A. Administer a loop diuretic as prescribed.
B. Notify the healthcare provider.
C. Encourage potassium-rich foods.
D. Prepare to administer IV insulin and glucose.
Correct Answer:B. Notify the healthcare provider.
Rationale: A potassium level of 5.8 mEq/L indicateshyperkalemia, which can cause
life-threatening arrhythmias. Notifying the provider ensures prompt treatment, such as
insulin/glucose or diuretics. Encouraging potassium-rich foods worsens the condition.
3. SATA: A nurse is caring for a client with hypokalemia. Which findings should the nurse expect?
(Select All That Apply)
, . Muscle weakness
A
B. Hypertension
C. Cardiac arrhythmias
D. Hyperactive reflexes
E. Flat T waves on ECG
Correct Answers:A, C, E
Rationale: Hypokalemia causes muscle weakness, cardiacarrhythmias, and flat T waves
due to impaired muscle and cardiac function. Hypertension and hyperactive reflexes are not
typical.
4. Clinical Scenario: A client with diabetic ketoacidosis (DKA) has a serum potassium of 3.2
mEq/L. Which action should the nurse take?
A. Administer potassium chloride IV as prescribed.
B. Hold potassium replacement until acidosis resolves.
C. Increase insulin infusion to correct potassium.
D. Encourage oral potassium-rich foods.
Correct Answer:A. Administer potassium chlorideIV as prescribed.
Rationale: DKA causes hypokalemia due to potassiumshifts. IV potassium chloride
corrects the deficit safely under monitoring. Holding replacement risks arrhythmias, insulin
alone doesn’t correct potassium, and oral intake is unsafe in acute DKA.
5. A client receiving IV fluids develops shortness of breath and crackles. What should the nurse
suspect?
A. Hypovolemia
B. Fluid overload
C. Hypokalemia
D. Hypernatremia
Correct Answer:B. Fluid overload
Rationale: Shortness of breath and crackles indicatefluid overload from excessive IV
fluids, requiring immediate intervention to prevent pulmonary edema.
6. A client with chronic kidney disease has a magnesium level of 2.8 mg/dL. What should the nurse
monitor?
A. Hypertension
B. Muscle cramps
C. Bradycardia
D. Hyperactive reflexes
Correct Answer:C. Bradycardia
Rationale: A magnesium level of 2.8 mg/dL indicateshypermagnesemia, which can cause
bradycardia due to slowed cardiac conduction. Muscle cramps and hyperactive reflexes are
associated with hypomagnesemia.
7. A client with severe vomiting has a serum pH of 7.48. What should the nurse prioritize?
A. Administer IV sodium bicarbonate.
B. Monitor for respiratory alkalosis.
C. Replace fluid and electrolytes.
D. Restrict oral fluid intake.
Correct Answer:C. Replace fluid and electrolytes.
, ationale: A pH of 7.48 indicates metabolic alkalosis from vomiting-related loss of gastric
R
acid. Replacing fluids and electrolytes (e.g., chloride) corrects the imbalance. Bicarbonate
worsens alkalosis, and respiratory alkalosis is unrelated.
8. A client with hyponatremia is prescribed 3% saline IV. Which precaution should the nurse take?
A. Administer rapidly to correct sodium levels.
B. Monitor for signs of fluid overload.
C. Restrict potassium intake during infusion.
D. Administer without cardiac monitoring.
Correct Answer:B. Monitor for signs of fluid overload.
Rationale: 3% saline, a hypertonic solution, cancause fluid overload, requiring careful
monitoring. Rapid administration risks cerebral edema, potassium is unrelated, and cardiac
monitoring is necessary.
Page 1 of 9
Cardiac & Respiratory Priorities
9. A client with chest pain has an ECG showing ST elevation. What should the nurse prepare for?
A. Administer oxygen via nasal cannula.
B. Initiate IV heparin immediately.
C. Prepare for percutaneous coronary intervention (PCI).
D. Administer sublingual nitroglycerin.
Correct Answer:C. Prepare for percutaneous coronaryintervention (PCI).
Rationale: ST elevation indicates an acute myocardialinfarction, requiring urgent PCI to
restore coronary blood flow. Oxygen, heparin, and nitroglycerin are supportive but not the
priority.
10.A client with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of 88%.
What should the nurse do first?
A. Increase oxygen to 6 L/min via nasal cannula.
B. Place the client in a supine position.
C. Assess respiratory status and notify the provider.
D. Administer a bronchodilator nebulizer.
Correct Answer:C. Assess respiratory status andnotify the provider.
Rationale: An SpO2 of 88% is low for COPD, indicatingrespiratory distress. Assessing
status and notifying the provider guide treatment. High oxygen risks CO2 retention, supine
positioning worsens breathing, and bronchodilators require assessment first.
11.SATA: A nurse is caring for a client with heart failure.Which findings indicate worsening
condition? (Select All That Apply)
A. Weight gain of 3 lb in 2 days
B. Clear lung sounds
C. Shortness of breath at rest
D. Peripheral edema
2 025 HESI RN Exit Exam V1 (NGN-Ready) –
All Real Clinical Topics Questions & Answers
in Full with Rationales | 100% Verified |
Graded A+
Student Name:_________________________Date:_______________
Time Limit: 90 minutesTotal Questions: 75
Fluid & Electrolytes
1. A client with dehydration has a serum sodium level of 150 mEq/L. Which intervention should the
nurse prioritize?
A. Administer oral potassium supplements.
B. Initiate IV 0.9% sodium chloride at 100 mL/hr.
C. Encourage free water intake.
D. Restrict fluid intake to prevent overload.
Correct Answer:C. Encourage free water intake.
Rationale: A sodium level of 150 mEq/L indicateshypernatremia due to dehydration.
Encouraging free water intake corrects the imbalance by diluting serum sodium. Potassium
is unrelated, 0.9% sodium chloride worsens hypernatremia, and fluid restriction is
contraindicated.
2. A client with heart failure develops a potassium level of 5.8 mEq/L. What should the nurse do
first?
A. Administer a loop diuretic as prescribed.
B. Notify the healthcare provider.
C. Encourage potassium-rich foods.
D. Prepare to administer IV insulin and glucose.
Correct Answer:B. Notify the healthcare provider.
Rationale: A potassium level of 5.8 mEq/L indicateshyperkalemia, which can cause
life-threatening arrhythmias. Notifying the provider ensures prompt treatment, such as
insulin/glucose or diuretics. Encouraging potassium-rich foods worsens the condition.
3. SATA: A nurse is caring for a client with hypokalemia. Which findings should the nurse expect?
(Select All That Apply)
, . Muscle weakness
A
B. Hypertension
C. Cardiac arrhythmias
D. Hyperactive reflexes
E. Flat T waves on ECG
Correct Answers:A, C, E
Rationale: Hypokalemia causes muscle weakness, cardiacarrhythmias, and flat T waves
due to impaired muscle and cardiac function. Hypertension and hyperactive reflexes are not
typical.
4. Clinical Scenario: A client with diabetic ketoacidosis (DKA) has a serum potassium of 3.2
mEq/L. Which action should the nurse take?
A. Administer potassium chloride IV as prescribed.
B. Hold potassium replacement until acidosis resolves.
C. Increase insulin infusion to correct potassium.
D. Encourage oral potassium-rich foods.
Correct Answer:A. Administer potassium chlorideIV as prescribed.
Rationale: DKA causes hypokalemia due to potassiumshifts. IV potassium chloride
corrects the deficit safely under monitoring. Holding replacement risks arrhythmias, insulin
alone doesn’t correct potassium, and oral intake is unsafe in acute DKA.
5. A client receiving IV fluids develops shortness of breath and crackles. What should the nurse
suspect?
A. Hypovolemia
B. Fluid overload
C. Hypokalemia
D. Hypernatremia
Correct Answer:B. Fluid overload
Rationale: Shortness of breath and crackles indicatefluid overload from excessive IV
fluids, requiring immediate intervention to prevent pulmonary edema.
6. A client with chronic kidney disease has a magnesium level of 2.8 mg/dL. What should the nurse
monitor?
A. Hypertension
B. Muscle cramps
C. Bradycardia
D. Hyperactive reflexes
Correct Answer:C. Bradycardia
Rationale: A magnesium level of 2.8 mg/dL indicateshypermagnesemia, which can cause
bradycardia due to slowed cardiac conduction. Muscle cramps and hyperactive reflexes are
associated with hypomagnesemia.
7. A client with severe vomiting has a serum pH of 7.48. What should the nurse prioritize?
A. Administer IV sodium bicarbonate.
B. Monitor for respiratory alkalosis.
C. Replace fluid and electrolytes.
D. Restrict oral fluid intake.
Correct Answer:C. Replace fluid and electrolytes.
, ationale: A pH of 7.48 indicates metabolic alkalosis from vomiting-related loss of gastric
R
acid. Replacing fluids and electrolytes (e.g., chloride) corrects the imbalance. Bicarbonate
worsens alkalosis, and respiratory alkalosis is unrelated.
8. A client with hyponatremia is prescribed 3% saline IV. Which precaution should the nurse take?
A. Administer rapidly to correct sodium levels.
B. Monitor for signs of fluid overload.
C. Restrict potassium intake during infusion.
D. Administer without cardiac monitoring.
Correct Answer:B. Monitor for signs of fluid overload.
Rationale: 3% saline, a hypertonic solution, cancause fluid overload, requiring careful
monitoring. Rapid administration risks cerebral edema, potassium is unrelated, and cardiac
monitoring is necessary.
Page 1 of 9
Cardiac & Respiratory Priorities
9. A client with chest pain has an ECG showing ST elevation. What should the nurse prepare for?
A. Administer oxygen via nasal cannula.
B. Initiate IV heparin immediately.
C. Prepare for percutaneous coronary intervention (PCI).
D. Administer sublingual nitroglycerin.
Correct Answer:C. Prepare for percutaneous coronaryintervention (PCI).
Rationale: ST elevation indicates an acute myocardialinfarction, requiring urgent PCI to
restore coronary blood flow. Oxygen, heparin, and nitroglycerin are supportive but not the
priority.
10.A client with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of 88%.
What should the nurse do first?
A. Increase oxygen to 6 L/min via nasal cannula.
B. Place the client in a supine position.
C. Assess respiratory status and notify the provider.
D. Administer a bronchodilator nebulizer.
Correct Answer:C. Assess respiratory status andnotify the provider.
Rationale: An SpO2 of 88% is low for COPD, indicatingrespiratory distress. Assessing
status and notifying the provider guide treatment. High oxygen risks CO2 retention, supine
positioning worsens breathing, and bronchodilators require assessment first.
11.SATA: A nurse is caring for a client with heart failure.Which findings indicate worsening
condition? (Select All That Apply)
A. Weight gain of 3 lb in 2 days
B. Clear lung sounds
C. Shortness of breath at rest
D. Peripheral edema
