HESI RN EXIT EXAM PACK 2025/2026 VERIFIED
QUESTIONS AND ANSWERS WITH RATIONALE
GRADED A+
If the nurse is initiating IV fluid replacement for a child who has dry, sticky
mucous membranes, flushed skin, and fever of 103.6 F. Laboratory finding
indicate that the child has a sodium concentration of 156 mEq/L. What physiologic
mechanism contributes to this finding?
a. The intravenous fluid replacement contains a hypertonic solution of sodium
chloride
b. Urinary and Gastrointestinal fluid loss reduce blood viscosity and stimulate
thirst
c. Insensible loss of body fluids contributes to the hemoconcentration of serum
solutes
d. Hypothalamic resetting of core body temperature causes vasodilation to reduce
body heat
Insensible loss of body fluids contributes to the hemoconcentration of serum
solutes
Rationale: Fever causes insensible fluid loss, which contribute to fluid volume and
results in hemoconcentration of sodium (serum sodium greater than 150 mEq/L).
Dehydration, which is manifested by dry, sticky mucous membranes, and flushed
skin, is often managed by replacing lost fluids and electrolytes with IV fluids that
contain varying concentration of sodium chloride. Although other options are
consistent with fluid volume deficit, the physiologic response of hypernatremia is
explained by hem concentration.
,The nurse is preparing a discharge teaching plan for a client who had a liver
transplant. Which instruction is most important to include in this plan?
a. Limit intake fatty foods for one month after surgery.
b. Notify the healthcare provider if edema occurs.
c. Increase activity and exercise gradually, as tolerated.
d. Avoid crowds for first two months after surgery.
Avoid crowds for first two months after surgery.
During a Woman's Health fair, which assignment is the best for the Practical Nurse
(PN) who is working with a register nurse (RN)
a. Encourage the woman at risk for cancer to obtain colonoscopy.
b. Present a class of breast-self examination
c. Prepare a woman for a bone density screening
d. Explain the follow-up need it for a client with prehypertension.
Prepare a woman for a bone density screening
Rationale: A bone density screening is a fast, noninvasive screening test for
osteoporosis that can be explained by the PN. There is no additional preparation
needed (A) required a high level of communication skill to provide teaching and
,address the client's fear. (B) Requires a higher level of client teaching skill than
responding to one client. (D) Requires higher level of knowledge and expertise to
provide needed teaching regarding this complex topic.
An adult client present to the clinic with large draining ulcers on both lower legs
that are characteristics of Kaposi's sarcoma lesions. The client is accompanied by
two family member. Which action should the nurse take?
a. Ask family member to wear gloves when touching the patient
b. Send family to the waiting area while the client's history is taking
c. Obtain a blood sample to determine is the client is HIV positive
d. Complete the head to toes assessment to identify other sign of HIV
Send family to the waiting area while the client's history is taking
Rationale: To protect the client privacy, the family member should be asked to
wait outside while the client's history is take. Gloves should be worn when
touching the client's body fluids if the client is HIV positive and these lesion are
actually Kaposi sarcoma lesion. HIV testing cannot legally be done without the
client explicit permission. A further assessment can be implemented after the
family left the room.
An adult client is exhibit the manic stage of bipolar disorder is admitted to the
psychiatric unit. The client has lost 10 pounds in the last two weeks and has no
bathed in a week "I'm trying to start a new business and "I'm too busy to eat". The
, client is oriented to time, place, person but not situation. Which nursing problem
has the greatest priority?
a. Hygiene-self-care deficit
b. Imbalance nutrition
c. Disturbed sleep pattern
d. Self-neglect
Imbalance nutrition
Rationale: The client's nutritional status has the highest priority at this time, and
finger foods are often provided, so the client who is on the maniac phase of bipolar
disease can receive adequate nutrition. Other options are nursing problems that
should also be addresses with the client's plan of care, but at this stage in the
client's treatment, adequate nutrition is a priority
Following discharge teaching, a male client with duodenal ulcer tells the nurse the
he will drink plenty of dairy products, such as milk, to help coat and protect his
ulcer. What is the best follow-up action by the nurse?
a. Remind the client that it is also important to switch to decaffeinated coffee and
tea.
b. Suggest that the client also plan to eat frequent small meals to reduce discomfort
QUESTIONS AND ANSWERS WITH RATIONALE
GRADED A+
If the nurse is initiating IV fluid replacement for a child who has dry, sticky
mucous membranes, flushed skin, and fever of 103.6 F. Laboratory finding
indicate that the child has a sodium concentration of 156 mEq/L. What physiologic
mechanism contributes to this finding?
a. The intravenous fluid replacement contains a hypertonic solution of sodium
chloride
b. Urinary and Gastrointestinal fluid loss reduce blood viscosity and stimulate
thirst
c. Insensible loss of body fluids contributes to the hemoconcentration of serum
solutes
d. Hypothalamic resetting of core body temperature causes vasodilation to reduce
body heat
Insensible loss of body fluids contributes to the hemoconcentration of serum
solutes
Rationale: Fever causes insensible fluid loss, which contribute to fluid volume and
results in hemoconcentration of sodium (serum sodium greater than 150 mEq/L).
Dehydration, which is manifested by dry, sticky mucous membranes, and flushed
skin, is often managed by replacing lost fluids and electrolytes with IV fluids that
contain varying concentration of sodium chloride. Although other options are
consistent with fluid volume deficit, the physiologic response of hypernatremia is
explained by hem concentration.
,The nurse is preparing a discharge teaching plan for a client who had a liver
transplant. Which instruction is most important to include in this plan?
a. Limit intake fatty foods for one month after surgery.
b. Notify the healthcare provider if edema occurs.
c. Increase activity and exercise gradually, as tolerated.
d. Avoid crowds for first two months after surgery.
Avoid crowds for first two months after surgery.
During a Woman's Health fair, which assignment is the best for the Practical Nurse
(PN) who is working with a register nurse (RN)
a. Encourage the woman at risk for cancer to obtain colonoscopy.
b. Present a class of breast-self examination
c. Prepare a woman for a bone density screening
d. Explain the follow-up need it for a client with prehypertension.
Prepare a woman for a bone density screening
Rationale: A bone density screening is a fast, noninvasive screening test for
osteoporosis that can be explained by the PN. There is no additional preparation
needed (A) required a high level of communication skill to provide teaching and
,address the client's fear. (B) Requires a higher level of client teaching skill than
responding to one client. (D) Requires higher level of knowledge and expertise to
provide needed teaching regarding this complex topic.
An adult client present to the clinic with large draining ulcers on both lower legs
that are characteristics of Kaposi's sarcoma lesions. The client is accompanied by
two family member. Which action should the nurse take?
a. Ask family member to wear gloves when touching the patient
b. Send family to the waiting area while the client's history is taking
c. Obtain a blood sample to determine is the client is HIV positive
d. Complete the head to toes assessment to identify other sign of HIV
Send family to the waiting area while the client's history is taking
Rationale: To protect the client privacy, the family member should be asked to
wait outside while the client's history is take. Gloves should be worn when
touching the client's body fluids if the client is HIV positive and these lesion are
actually Kaposi sarcoma lesion. HIV testing cannot legally be done without the
client explicit permission. A further assessment can be implemented after the
family left the room.
An adult client is exhibit the manic stage of bipolar disorder is admitted to the
psychiatric unit. The client has lost 10 pounds in the last two weeks and has no
bathed in a week "I'm trying to start a new business and "I'm too busy to eat". The
, client is oriented to time, place, person but not situation. Which nursing problem
has the greatest priority?
a. Hygiene-self-care deficit
b. Imbalance nutrition
c. Disturbed sleep pattern
d. Self-neglect
Imbalance nutrition
Rationale: The client's nutritional status has the highest priority at this time, and
finger foods are often provided, so the client who is on the maniac phase of bipolar
disease can receive adequate nutrition. Other options are nursing problems that
should also be addresses with the client's plan of care, but at this stage in the
client's treatment, adequate nutrition is a priority
Following discharge teaching, a male client with duodenal ulcer tells the nurse the
he will drink plenty of dairy products, such as milk, to help coat and protect his
ulcer. What is the best follow-up action by the nurse?
a. Remind the client that it is also important to switch to decaffeinated coffee and
tea.
b. Suggest that the client also plan to eat frequent small meals to reduce discomfort
