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HESI RN Exit Exam 2025-2026 | 200 Actual Questions with
Verified Correct Answers & Detailed Rationales (Newest A+
Graded Version)
Q1. A nurse is caring for a patient receiving IV potassium chloride. Which intervention is
most important to ensure patient safety?
A. Administer potassium chloride as a rapid IV push.
B. Dilute potassium chloride in IV fluid and infuse slowly.
C. Keep the IV line patent with normal saline only.
D. Monitor intake and output every 12 hours.
Correct Answer: B. Dilute potassium chloride in IV fluid and infuse slowly.
Rationale: Potassium chloride must never be given as a rapid IV push because it can cause
cardiac arrest. It should always be diluted and infused slowly with continuous cardiac
monitoring. Monitoring intake/output is important but not as critical as safe infusion practice.
Q2. A patient with COPD is receiving oxygen therapy at 4 L/min via nasal cannula. The
nurse notices drowsiness and decreased respiratory rate. What is the priority action?
A. Increase oxygen to 6 L/min.
B. Place patient in high Fowler’s position.
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C. Lower oxygen flow rate.
D. Encourage coughing and deep breathing.
Correct Answer: C. Lower oxygen flow rate.
Rationale: COPD patients rely on hypoxic drive to stimulate breathing. High oxygen
concentrations can suppress respirations, leading to CO₂ retention. Reducing oxygen flow
prevents further hypoventilation.
Q3. A nurse is assessing a patient with heart failure who reports sudden weight gain of 3 lbs
in 24 hours. What does this finding indicate?
A. Fluid retention.
B. Malnutrition.
C. Medication non-adherence.
D. Normal weight fluctuation.
Correct Answer: A. Fluid retention.
Rationale: A weight gain of 2–3 lbs in 24 hours or 5 lbs in a week in a heart failure patient
indicates fluid retention and worsening heart failure.
Q4. Which nursing action is appropriate when administering blood transfusion?
A. Start infusion with D5W.
B. Use normal saline as the IV solution.
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C. Prime tubing with heparin solution.
D. Warm blood using a microwave before infusion.
Correct Answer: B. Use normal saline as the IV solution.
Rationale: Blood transfusions should only be infused with 0.9% normal saline to prevent
hemolysis. D5W or other solutions can cause RBC damage.
Q5. A patient on digoxin therapy reports nausea, vomiting, and blurred vision. What
should the nurse do first?
A. Hold the next dose and notify the provider.
B. Give antiemetic as prescribed.
C. Increase fluid intake.
D. Monitor blood pressure every hour.
Correct Answer: A. Hold the next dose and notify the provider.
Rationale: Symptoms indicate digoxin toxicity. The nurse should hold the dose and notify the
healthcare provider immediately for serum digoxin level evaluation.
Q6. A client with type 1 diabetes is found unconscious. The nurse finds the client’s blood
glucose is 38 mg/dL. What is the priority action?
A. Administer IV dextrose.
B. Encourage oral carbohydrate intake.
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C. Give insulin as prescribed.
D. Document the findings.
Correct Answer: A. Administer IV dextrose.
Rationale: In severe hypoglycemia with loss of consciousness, IV dextrose (or IM glucagon if
no IV access) is the priority intervention. Oral intake is unsafe due to aspiration risk.
Q7. A nurse is caring for a client post-thyroidectomy. Which complication should the nurse
monitor for first?
A. Constipation.
B. Hemorrhage.
C. Hypoglycemia.
D. Urinary retention.
Correct Answer: B. Hemorrhage.
Rationale: Post-thyroidectomy, hemorrhage and airway obstruction are the most life-threatening
complications. The nurse should monitor for neck swelling, bleeding, and respiratory distress.
Q8. The nurse is assessing a patient receiving morphine for severe pain. Which finding
requires immediate intervention?
A. Respiratory rate of 8 breaths/min.
B. Nausea and vomiting.
HESI RN Exit Exam 2025-2026 | 200 Actual Questions with
Verified Correct Answers & Detailed Rationales (Newest A+
Graded Version)
Q1. A nurse is caring for a patient receiving IV potassium chloride. Which intervention is
most important to ensure patient safety?
A. Administer potassium chloride as a rapid IV push.
B. Dilute potassium chloride in IV fluid and infuse slowly.
C. Keep the IV line patent with normal saline only.
D. Monitor intake and output every 12 hours.
Correct Answer: B. Dilute potassium chloride in IV fluid and infuse slowly.
Rationale: Potassium chloride must never be given as a rapid IV push because it can cause
cardiac arrest. It should always be diluted and infused slowly with continuous cardiac
monitoring. Monitoring intake/output is important but not as critical as safe infusion practice.
Q2. A patient with COPD is receiving oxygen therapy at 4 L/min via nasal cannula. The
nurse notices drowsiness and decreased respiratory rate. What is the priority action?
A. Increase oxygen to 6 L/min.
B. Place patient in high Fowler’s position.
,2
C. Lower oxygen flow rate.
D. Encourage coughing and deep breathing.
Correct Answer: C. Lower oxygen flow rate.
Rationale: COPD patients rely on hypoxic drive to stimulate breathing. High oxygen
concentrations can suppress respirations, leading to CO₂ retention. Reducing oxygen flow
prevents further hypoventilation.
Q3. A nurse is assessing a patient with heart failure who reports sudden weight gain of 3 lbs
in 24 hours. What does this finding indicate?
A. Fluid retention.
B. Malnutrition.
C. Medication non-adherence.
D. Normal weight fluctuation.
Correct Answer: A. Fluid retention.
Rationale: A weight gain of 2–3 lbs in 24 hours or 5 lbs in a week in a heart failure patient
indicates fluid retention and worsening heart failure.
Q4. Which nursing action is appropriate when administering blood transfusion?
A. Start infusion with D5W.
B. Use normal saline as the IV solution.
,3
C. Prime tubing with heparin solution.
D. Warm blood using a microwave before infusion.
Correct Answer: B. Use normal saline as the IV solution.
Rationale: Blood transfusions should only be infused with 0.9% normal saline to prevent
hemolysis. D5W or other solutions can cause RBC damage.
Q5. A patient on digoxin therapy reports nausea, vomiting, and blurred vision. What
should the nurse do first?
A. Hold the next dose and notify the provider.
B. Give antiemetic as prescribed.
C. Increase fluid intake.
D. Monitor blood pressure every hour.
Correct Answer: A. Hold the next dose and notify the provider.
Rationale: Symptoms indicate digoxin toxicity. The nurse should hold the dose and notify the
healthcare provider immediately for serum digoxin level evaluation.
Q6. A client with type 1 diabetes is found unconscious. The nurse finds the client’s blood
glucose is 38 mg/dL. What is the priority action?
A. Administer IV dextrose.
B. Encourage oral carbohydrate intake.
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C. Give insulin as prescribed.
D. Document the findings.
Correct Answer: A. Administer IV dextrose.
Rationale: In severe hypoglycemia with loss of consciousness, IV dextrose (or IM glucagon if
no IV access) is the priority intervention. Oral intake is unsafe due to aspiration risk.
Q7. A nurse is caring for a client post-thyroidectomy. Which complication should the nurse
monitor for first?
A. Constipation.
B. Hemorrhage.
C. Hypoglycemia.
D. Urinary retention.
Correct Answer: B. Hemorrhage.
Rationale: Post-thyroidectomy, hemorrhage and airway obstruction are the most life-threatening
complications. The nurse should monitor for neck swelling, bleeding, and respiratory distress.
Q8. The nurse is assessing a patient receiving morphine for severe pain. Which finding
requires immediate intervention?
A. Respiratory rate of 8 breaths/min.
B. Nausea and vomiting.
