1
2025 HESI RN Exit Exam (V1–V3
Updated) – Verified Questions with
100% Correct Answers and Expert-
Level Rationales
Question 1
A client with heart failure is prescribed furosemide 40 mg IV. The nurse notes the client’s
potassium level is 3.2 mEq/L. What is the nurse’s priority action?
A. Administer the furosemide as prescribed
B. Notify the healthcare provider about the potassium level
C. Encourage the client to eat potassium-rich foods
D. Monitor the client’s urine output
Correct Answer: B. Notify the healthcare provider about the potassium level
Rationale: A potassium level of 3.2 mEq/L indicates hypokalemia, which can be
exacerbated by furosemide, a loop diuretic that increases potassium excretion. Hypokalemia
increases the risk of cardiac arrhythmias, especially in clients with heart failure. Notifying t he
healthcare provider is the priority to obtain orders for potassium supplementation or further
evaluation before administering furosemide. Administering the diuretic (A) could worsen
hypokalemia, encouraging potassium-rich foods (C) is not immediate enough, and monitoring
urine output (D) does not address the critical electrolyte imbalance.
Question 2
A client with type 1 diabetes mellitus presents with a blood glucose level of 450 mg/dL and
reports nausea and confusion. Which assessment finding should the nurse prioritize?
A. Blood pressure
B. Respiratory rate
C. Ketone levels
D. Skin turgor
Correct Answer: C. Ketone levels
, 2
Rationale: A blood glucose level of 450 mg/dL with nausea and confusion suggests diabetic
ketoacidosis (DKA), a life-threatening complication of type 1 diabetes. Checking ketone levels is
the priority to confirm DKA, as it guides immediate treatment with insulin and fluids. While
blood pressure (A), respiratory rate (B), and skin turgor (D) are important, they are secondary to
confirming the presence of ketones, which directly indicates the severity of the condition.
Question 3
The nurse is caring for a client with a suspected pulmonary embolism. Which diagnostic test
should the nurse anticipate?
A. Chest X-ray
B. Arterial blood gas (ABG)
C. CT pulmonary angiography
D. Electrocardiogram (ECG)
Correct Answer: C. CT pulmonary angiography
Rationale: CT pulmonary angiography is the gold standard for diagnosing pulmonary
embolism, as it directly visualizes the pulmonary arteries for blockages. A chest X-ray (A) may
rule out other conditions but is not specific for pulmonary embolism. ABG (B) may show
hypoxemia but is not diagnostic, and an ECG (D) may reveal right heart strain but is not
confirmatory. The nurse should anticipate the most definitive test to guide treatment.
Question 4
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min via
nasal cannula. The client’s SpO2 is 88%. What is the nurse’s best action?
A. Increase oxygen to 4 L/min
B. Encourage deep breathing exercises
C. Notify the healthcare provider
D. Position the client in high Fowler’s position
Correct Answer: C. Notify the healthcare provider
Rationale: An SpO2 of 88% in a client with COPD indicates hypoxemia, which may require
adjustment of oxygen therapy or further evaluation. Increasing oxygen (A) without an order risks
suppressing the respiratory drive in COPD clients. Deep breathing (B) and positioning (D) are
helpful but not the priority when SpO2 is critically low. Notifying the provider ensures safe and
appropriate management.
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Question 5
A client with schizophrenia is pacing and shouting, “They’re coming for me!” What is the
nurse’s priority action?
A. Administer an antipsychotic medication as prescribed
B. Place the client in seclusion immediately
C. Assess the client’s level of agitation and safety risk
D. Instruct the client to sit down and be quiet
Correct Answer: C. Assess the client’s level of agitation and safety risk
Rationale: Assessing the client’s agitation and potential for harm to self or others is the
priority to guide interventions. Administering medication (A) or using seclusion (B) may be
appropriate after assessment, but premature action could escalate the situation. Instructing the
client to sit (D) may increase agitation and is not therapeutic. A thorough assessment ensures
safe and effective care.
Question 6
A client with a history of atrial fibrillation is prescribed warfarin. The nurse notes the client’s
INR is 4.8. What is the nurse’s best action?
A. Administer the next dose of warfarin as scheduled
B. Hold the warfarin and notify the healthcare provider
C. Encourage the client to consume more green leafy vegetables
D. Monitor for signs of bleeding
Correct Answer: B. Hold the warfarin and notify the healthcare provider
Rationale: An INR of 4.8 is above the therapeutic range (2.0–3.0 for atrial fibrillation),
indicating an increased risk of bleeding. Holding the warfarin and notifying the provider is the
priority to prevent complications. Administering the next dose (A) could worsen the risk,
encouraging green leafy vegetables (C) may further alter INR, and monitoring for bleeding (D) is
important but not the immediate priority.
Question 7
A client with a new colostomy reports feeling embarrassed about the appliance. Which response
by the nurse is most therapeutic?
A. “You’ll get used to it over time.”
B. “Let’s discuss how you’re feeling about the colostomy.”
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C. “Many people live normal lives with a colostomy.”
D. “It’s better than the alternative of not having surgery.”
Correct Answer: B. Let’s discuss how you’re feeling about the colostomy.”
Rationale: Encouraging the client to express feelings promotes therapeutic communication
and addresses emotional needs. Option A dismisses the client’s concerns, option C provides
reassurance but does not explore feelings, and option D minimizes the client’s emotions. Open-
ended discussion fosters trust and supports psychosocial adjustment.
Question 8
A client with acute pancreatitis reports severe epigastric pain radiating to the back. Which
intervention should the nurse prioritize?
A. Administer morphine as prescribed
B. Place the client in a supine position
C. Encourage oral fluid intake
D. Assess for Cullen’s sign
Correct Answer: A. Administer morphine as prescribed
Rationale: Severe pain is a hallmark of acute pancreatitis, and administering prescribed
morphine is the priority to provide relief and reduce stress on the pancreas. A supine position (B)
may worsen pain, oral fluids (C) are contraindicated due to risk of stimulating pancreatic
secretions, and assessing for Cullen’s sign (D) is not the priority over pain management.
Question 9
A newborn is diagnosed with respiratory distress syndrome. Which medication should the nurse
anticipate administering?
A. Digoxin
B. Surfactant
C. Albuterol
D. Furosemide
Correct Answer: B. Surfactant
Rationale: Respiratory distress syndrome in newborns is caused by surfactant deficiency,
leading to alveolar collapse. Surfactant replacement therapy is the standard treatment to improve
2025 HESI RN Exit Exam (V1–V3
Updated) – Verified Questions with
100% Correct Answers and Expert-
Level Rationales
Question 1
A client with heart failure is prescribed furosemide 40 mg IV. The nurse notes the client’s
potassium level is 3.2 mEq/L. What is the nurse’s priority action?
A. Administer the furosemide as prescribed
B. Notify the healthcare provider about the potassium level
C. Encourage the client to eat potassium-rich foods
D. Monitor the client’s urine output
Correct Answer: B. Notify the healthcare provider about the potassium level
Rationale: A potassium level of 3.2 mEq/L indicates hypokalemia, which can be
exacerbated by furosemide, a loop diuretic that increases potassium excretion. Hypokalemia
increases the risk of cardiac arrhythmias, especially in clients with heart failure. Notifying t he
healthcare provider is the priority to obtain orders for potassium supplementation or further
evaluation before administering furosemide. Administering the diuretic (A) could worsen
hypokalemia, encouraging potassium-rich foods (C) is not immediate enough, and monitoring
urine output (D) does not address the critical electrolyte imbalance.
Question 2
A client with type 1 diabetes mellitus presents with a blood glucose level of 450 mg/dL and
reports nausea and confusion. Which assessment finding should the nurse prioritize?
A. Blood pressure
B. Respiratory rate
C. Ketone levels
D. Skin turgor
Correct Answer: C. Ketone levels
, 2
Rationale: A blood glucose level of 450 mg/dL with nausea and confusion suggests diabetic
ketoacidosis (DKA), a life-threatening complication of type 1 diabetes. Checking ketone levels is
the priority to confirm DKA, as it guides immediate treatment with insulin and fluids. While
blood pressure (A), respiratory rate (B), and skin turgor (D) are important, they are secondary to
confirming the presence of ketones, which directly indicates the severity of the condition.
Question 3
The nurse is caring for a client with a suspected pulmonary embolism. Which diagnostic test
should the nurse anticipate?
A. Chest X-ray
B. Arterial blood gas (ABG)
C. CT pulmonary angiography
D. Electrocardiogram (ECG)
Correct Answer: C. CT pulmonary angiography
Rationale: CT pulmonary angiography is the gold standard for diagnosing pulmonary
embolism, as it directly visualizes the pulmonary arteries for blockages. A chest X-ray (A) may
rule out other conditions but is not specific for pulmonary embolism. ABG (B) may show
hypoxemia but is not diagnostic, and an ECG (D) may reveal right heart strain but is not
confirmatory. The nurse should anticipate the most definitive test to guide treatment.
Question 4
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min via
nasal cannula. The client’s SpO2 is 88%. What is the nurse’s best action?
A. Increase oxygen to 4 L/min
B. Encourage deep breathing exercises
C. Notify the healthcare provider
D. Position the client in high Fowler’s position
Correct Answer: C. Notify the healthcare provider
Rationale: An SpO2 of 88% in a client with COPD indicates hypoxemia, which may require
adjustment of oxygen therapy or further evaluation. Increasing oxygen (A) without an order risks
suppressing the respiratory drive in COPD clients. Deep breathing (B) and positioning (D) are
helpful but not the priority when SpO2 is critically low. Notifying the provider ensures safe and
appropriate management.
, 3
Question 5
A client with schizophrenia is pacing and shouting, “They’re coming for me!” What is the
nurse’s priority action?
A. Administer an antipsychotic medication as prescribed
B. Place the client in seclusion immediately
C. Assess the client’s level of agitation and safety risk
D. Instruct the client to sit down and be quiet
Correct Answer: C. Assess the client’s level of agitation and safety risk
Rationale: Assessing the client’s agitation and potential for harm to self or others is the
priority to guide interventions. Administering medication (A) or using seclusion (B) may be
appropriate after assessment, but premature action could escalate the situation. Instructing the
client to sit (D) may increase agitation and is not therapeutic. A thorough assessment ensures
safe and effective care.
Question 6
A client with a history of atrial fibrillation is prescribed warfarin. The nurse notes the client’s
INR is 4.8. What is the nurse’s best action?
A. Administer the next dose of warfarin as scheduled
B. Hold the warfarin and notify the healthcare provider
C. Encourage the client to consume more green leafy vegetables
D. Monitor for signs of bleeding
Correct Answer: B. Hold the warfarin and notify the healthcare provider
Rationale: An INR of 4.8 is above the therapeutic range (2.0–3.0 for atrial fibrillation),
indicating an increased risk of bleeding. Holding the warfarin and notifying the provider is the
priority to prevent complications. Administering the next dose (A) could worsen the risk,
encouraging green leafy vegetables (C) may further alter INR, and monitoring for bleeding (D) is
important but not the immediate priority.
Question 7
A client with a new colostomy reports feeling embarrassed about the appliance. Which response
by the nurse is most therapeutic?
A. “You’ll get used to it over time.”
B. “Let’s discuss how you’re feeling about the colostomy.”
, 4
C. “Many people live normal lives with a colostomy.”
D. “It’s better than the alternative of not having surgery.”
Correct Answer: B. Let’s discuss how you’re feeling about the colostomy.”
Rationale: Encouraging the client to express feelings promotes therapeutic communication
and addresses emotional needs. Option A dismisses the client’s concerns, option C provides
reassurance but does not explore feelings, and option D minimizes the client’s emotions. Open-
ended discussion fosters trust and supports psychosocial adjustment.
Question 8
A client with acute pancreatitis reports severe epigastric pain radiating to the back. Which
intervention should the nurse prioritize?
A. Administer morphine as prescribed
B. Place the client in a supine position
C. Encourage oral fluid intake
D. Assess for Cullen’s sign
Correct Answer: A. Administer morphine as prescribed
Rationale: Severe pain is a hallmark of acute pancreatitis, and administering prescribed
morphine is the priority to provide relief and reduce stress on the pancreas. A supine position (B)
may worsen pain, oral fluids (C) are contraindicated due to risk of stimulating pancreatic
secretions, and assessing for Cullen’s sign (D) is not the priority over pain management.
Question 9
A newborn is diagnosed with respiratory distress syndrome. Which medication should the nurse
anticipate administering?
A. Digoxin
B. Surfactant
C. Albuterol
D. Furosemide
Correct Answer: B. Surfactant
Rationale: Respiratory distress syndrome in newborns is caused by surfactant deficiency,
leading to alveolar collapse. Surfactant replacement therapy is the standard treatment to improve
