1
HESI RN EXIT EXAM V3 (2025/2026) - VERIFIED REAL
QUESTIONS Format: NGN (Next Generation NCLEX), OB, Med-
Surg, Pharmacology, SATA Graded A+, 100% Correct, Exam
Verified…HEALTHSTUDYPRO
Question 1 (Pharmacology – NGN)
A client prescribed warfarin has an INR of 5.2. Which action should the nurse take first?
A. Administer the next dose as prescribed
B. Prepare to give protamine sulfate
C. Hold the dose and notify the provider
D. Encourage intake of green leafy vegetables
Correct Answer: C. Hold the dose and notify the provider
Rationale: INR >3 indicates risk for bleeding. INR 5.2 is dangerously high. Hold warfarin and
alert the provider. Vitamin K, not protamine, is the antidote for warfarin.
Question 2 (SATA – Pharmacology)
Which of the following medications can cause hypokalemia? (Select all that apply.)
A. Furosemide
B. Spironolactone
C. Hydrochlorothiazide
D. Insulin
E. Lisinopril
Correct Answers: A, C, D
Rationale: Loop (furosemide) and thiazide diuretics (HCTZ) waste potassium. Insulin shifts
K+ into cells. Spironolactone is potassium-sparing, and Lisinopril can cause hyperkalemia.
Question 3 (NGN Case – OB + Pharm)
A pregnant client at 34 weeks with preeclampsia is started on magnesium sulfate IV. Which
finding requires immediate action?
, 2
A. Urine output of 45 mL/hr
B. Absent deep tendon reflexes
C. BP of 140/90
D. Mild nausea
Correct Answer: B. Absent deep tendon reflexes
Rationale: Sign of magnesium toxicity. Must stop the infusion and administer calcium
gluconate.
Question 4 (SATA – Pharmacology)
Which instructions should be included for a client taking lithium carbonate? (Select all that
apply.)
A. Maintain consistent salt intake
B. Limit fluids to reduce urination
C. Report signs of tremor or diarrhea
D. Avoid NSAIDs
E. Take on an empty stomach
Correct Answers: A, C, D
Rationale: Lithium toxicity is affected by sodium and hydration. NSAIDs increase levels.
Take with food to reduce GI upset.
Question 5 (NGN – Med-Surg + Pharm)
A client with heart failure is prescribed digoxin. Which lab value must the nurse report?
A. Potassium 3.2 mEq/L
B. Digoxin 1.5 ng/mL
C. Sodium 138 mEq/L
D. BUN 20 mg/dL
Correct Answer: A. Potassium 3.2 mEq/L
Rationale: Low potassium increases risk of digoxin toxicity. Normal K+ is 3.5–5.0.
Question 6 (NGN – OB Pharm)
A client in labor receives IV nalbuphine. Which is a priority to monitor?
, 3
A. Maternal blood pressure
B. Fetal heart rate variability
C. Cervical dilation
D. Frequency of contractions
Correct Answer: B. Fetal heart rate variability
Rationale: Nalbuphine is an opioid that may cause CNS depression in the fetus, reducing
variability.
Question 7 (SATA – Mental Health + Pharm)
Which are expected side effects of SSRIs like sertraline? (Select all that apply.)
A. Weight gain
B. Sexual dysfunction
C. Serotonin syndrome
D. Orthostatic hypotension
E. Increased suicidal thoughts in teens
Correct Answers: A, B, C, E
Rationale: SSRIs may cause sexual side effects, serotonin syndrome, and suicidal ideation,
especially early in treatment.
Question 8 (NGN – Pharm)
A client on gentamicin reports tinnitus. What should the nurse do?
A. Continue the drug
B. Monitor renal function
C. Stop the drug and notify the provider
D. Give diphenhydramine for side effects
Correct Answer: C. Stop the drug and notify the provider
Rationale: Tinnitus is a sign of ototoxicity. Stop med to prevent permanent damage.
Question 9 (NGN – OB Case)
A postpartum client is prescribed methylergonovine. Which condition contraindicates this
medication?
, 4
A. Hypertension
B. Uterine atony
C. Vaginal laceration
D. Anemia
Correct Answer: A. Hypertension
Rationale: Methylergonovine can cause vasoconstriction and dangerously raise BP.
Question 10 (SATA – Pharm + Med-Surg)
Which drugs increase risk for bleeding? (Select all that apply.)
A. Warfarin
B. Clopidogrel
C. Acetaminophen
D. Heparin
E. Naproxen
Correct Answers: A, B, D, E
Rationale: All except acetaminophen have antiplatelet/anticoagulant effects.
Question 11 (NGN – Pharm + Respiratory)
A client with asthma is prescribed theophylline. Which finding is most concerning?
A. HR 78 bpm
B. Nausea and restlessness
C. Productive cough
D. RR 20/min
Correct Answer: B. Nausea and restlessness
Rationale: Signs of theophylline toxicity. Therapeutic level: 10–20 mcg/mL.
Question 12 (SATA – Pharm + Cardio)
Which of the following are beta-blockers? (Select all that apply.)
A. Atenolol
B. Metoprolol
C. Lisinopril
HESI RN EXIT EXAM V3 (2025/2026) - VERIFIED REAL
QUESTIONS Format: NGN (Next Generation NCLEX), OB, Med-
Surg, Pharmacology, SATA Graded A+, 100% Correct, Exam
Verified…HEALTHSTUDYPRO
Question 1 (Pharmacology – NGN)
A client prescribed warfarin has an INR of 5.2. Which action should the nurse take first?
A. Administer the next dose as prescribed
B. Prepare to give protamine sulfate
C. Hold the dose and notify the provider
D. Encourage intake of green leafy vegetables
Correct Answer: C. Hold the dose and notify the provider
Rationale: INR >3 indicates risk for bleeding. INR 5.2 is dangerously high. Hold warfarin and
alert the provider. Vitamin K, not protamine, is the antidote for warfarin.
Question 2 (SATA – Pharmacology)
Which of the following medications can cause hypokalemia? (Select all that apply.)
A. Furosemide
B. Spironolactone
C. Hydrochlorothiazide
D. Insulin
E. Lisinopril
Correct Answers: A, C, D
Rationale: Loop (furosemide) and thiazide diuretics (HCTZ) waste potassium. Insulin shifts
K+ into cells. Spironolactone is potassium-sparing, and Lisinopril can cause hyperkalemia.
Question 3 (NGN Case – OB + Pharm)
A pregnant client at 34 weeks with preeclampsia is started on magnesium sulfate IV. Which
finding requires immediate action?
, 2
A. Urine output of 45 mL/hr
B. Absent deep tendon reflexes
C. BP of 140/90
D. Mild nausea
Correct Answer: B. Absent deep tendon reflexes
Rationale: Sign of magnesium toxicity. Must stop the infusion and administer calcium
gluconate.
Question 4 (SATA – Pharmacology)
Which instructions should be included for a client taking lithium carbonate? (Select all that
apply.)
A. Maintain consistent salt intake
B. Limit fluids to reduce urination
C. Report signs of tremor or diarrhea
D. Avoid NSAIDs
E. Take on an empty stomach
Correct Answers: A, C, D
Rationale: Lithium toxicity is affected by sodium and hydration. NSAIDs increase levels.
Take with food to reduce GI upset.
Question 5 (NGN – Med-Surg + Pharm)
A client with heart failure is prescribed digoxin. Which lab value must the nurse report?
A. Potassium 3.2 mEq/L
B. Digoxin 1.5 ng/mL
C. Sodium 138 mEq/L
D. BUN 20 mg/dL
Correct Answer: A. Potassium 3.2 mEq/L
Rationale: Low potassium increases risk of digoxin toxicity. Normal K+ is 3.5–5.0.
Question 6 (NGN – OB Pharm)
A client in labor receives IV nalbuphine. Which is a priority to monitor?
, 3
A. Maternal blood pressure
B. Fetal heart rate variability
C. Cervical dilation
D. Frequency of contractions
Correct Answer: B. Fetal heart rate variability
Rationale: Nalbuphine is an opioid that may cause CNS depression in the fetus, reducing
variability.
Question 7 (SATA – Mental Health + Pharm)
Which are expected side effects of SSRIs like sertraline? (Select all that apply.)
A. Weight gain
B. Sexual dysfunction
C. Serotonin syndrome
D. Orthostatic hypotension
E. Increased suicidal thoughts in teens
Correct Answers: A, B, C, E
Rationale: SSRIs may cause sexual side effects, serotonin syndrome, and suicidal ideation,
especially early in treatment.
Question 8 (NGN – Pharm)
A client on gentamicin reports tinnitus. What should the nurse do?
A. Continue the drug
B. Monitor renal function
C. Stop the drug and notify the provider
D. Give diphenhydramine for side effects
Correct Answer: C. Stop the drug and notify the provider
Rationale: Tinnitus is a sign of ototoxicity. Stop med to prevent permanent damage.
Question 9 (NGN – OB Case)
A postpartum client is prescribed methylergonovine. Which condition contraindicates this
medication?
, 4
A. Hypertension
B. Uterine atony
C. Vaginal laceration
D. Anemia
Correct Answer: A. Hypertension
Rationale: Methylergonovine can cause vasoconstriction and dangerously raise BP.
Question 10 (SATA – Pharm + Med-Surg)
Which drugs increase risk for bleeding? (Select all that apply.)
A. Warfarin
B. Clopidogrel
C. Acetaminophen
D. Heparin
E. Naproxen
Correct Answers: A, B, D, E
Rationale: All except acetaminophen have antiplatelet/anticoagulant effects.
Question 11 (NGN – Pharm + Respiratory)
A client with asthma is prescribed theophylline. Which finding is most concerning?
A. HR 78 bpm
B. Nausea and restlessness
C. Productive cough
D. RR 20/min
Correct Answer: B. Nausea and restlessness
Rationale: Signs of theophylline toxicity. Therapeutic level: 10–20 mcg/mL.
Question 12 (SATA – Pharm + Cardio)
Which of the following are beta-blockers? (Select all that apply.)
A. Atenolol
B. Metoprolol
C. Lisinopril
