Complete Nursing HESI Exam Preparation Bundle 2026 | HESI
Nursing Exit Exam Study Guide, Practice Questions, Detailed
Rationales, and Proven Strategies to Pass the Nursing HESI
Exam with Confidence
Question 1: A nurse is assessing a client with a suspected deep vein thrombosis (DVT). Which
finding should the nurse prioritize reporting to the provider?
A. Warmth and redness in the affected limb
B. Unilateral leg swelling
C. Sudden onset of shortness of breath
D. Pain upon dorsiflexion of the foot
CORRECT ANSWER: C. Sudden onset of shortness of breath
Rationale: Sudden shortness of breath indicates a potential pulmonary embolism, a life-
threatening complication of DVT requiring immediate intervention. While warmth, swelling,
and pain are signs of DVT, respiratory distress signals embolization.
Question 2: A client with heart failure is prescribed furosemide. Which laboratory value
requires monitoring due to this medication?
A. Serum calcium
B. Serum potassium
C. Serum glucose
D. Serum magnesium
CORRECT ANSWER: B. Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium excretion. Hypokalemia is a
common and dangerous side effect that can lead to cardiac dysrhythmias.
Question 3: A nurse is preparing to administer insulin lispro. When should this medication be
given?
A. 30 minutes before a meal
B. 15 minutes before a meal
C. Immediately after a meal
D. At bedtime
CORRECT ANSWER: B. 15 minutes before a meal
Rationale: Insulin lispro is a rapid-acting insulin. It should be administered 15 minutes before a
meal to align its peak action with postprandial glucose elevation.
Question 4: Which assessment finding indicates effective chest compressions during CPR?
A. Pupils constricting
B. Palpable carotid pulse with each compression
C. Skin turning pale
D. Breath sounds becoming clear
CORRECT ANSWER: B. Palpable carotid pulse with each compression
Rationale: A palpable carotid pulse during compressions indicates that blood is being circulated
effectively to the brain and vital organs.
Question 5: A client is admitted with diabetic ketoacidosis (DKA). What breathing pattern
should the nurse expect?
,A. Cheyne-Stokes
B. Kussmaul respirations
C. Biot's respirations
D. Bradypnea
CORRECT ANSWER: B. Kussmaul respirations
Rationale: Kussmaul respirations are deep, rapid breaths associated with DKA as the body
attempts to compensate for metabolic acidosis by exhaling carbon dioxide.
Question 6: A nurse is caring for a client with a nasogastric (NG) tube on suction. Which
finding suggests the tube is functioning properly?
A. Greenish-yellow drainage
B. Absence of bowel sounds
C. Client reporting nausea
D. Abdominal distension
CORRECT ANSWER: A. Greenish-yellow drainage
Rationale: Greenish-yellow drainage indicates gastric contents are being successfully removed.
Nausea, distension, or absent bowel sounds suggest obstruction or malfunction.
Question 7: Which intervention is priority for a client experiencing anaphylaxis?
A. Administer diphenhydramine
B. Establish a patent airway
C. Apply a tourniquet
D. Document the allergen
CORRECT ANSWER: B. Establish a patent airway
Rationale: Airway compromise is the immediate life threat in anaphylaxis. Securing the airway
takes precedence over medications or documentation.
Question 8: A client with chronic kidney disease (CKD) should limit intake of which nutrient?
A. Protein
B. Potassium
C. Carbohydrates
D. Fiber
CORRECT ANSWER: B. Potassium
Rationale: Damaged kidneys cannot excrete potassium effectively, leading to hyperkalemia,
which can cause fatal dysrhythmias. Protein may also be restricted depending on the stage.
Question 9: A nurse notes a client's wound has bright red bleeding. What is the initial action?
A. Apply direct pressure
B. Elevate the extremity
C. Notify the provider
D. Apply a tourniquet
CORRECT ANSWER: A. Apply direct pressure
Rationale: Direct pressure is the first-line intervention to control external bleeding. Elevation is
secondary, and tourniquets are reserved for life-threatening hemorrhage uncontrolled by
pressure.
Question 10: Which sign indicates increased intracranial pressure (ICP)?
,A. Tachycardia
B. Hypotension
C. Widening pulse pressure
D. Hyperthermia
CORRECT ANSWER: C. Widening pulse pressure
Rationale: Cushing's triad includes widening pulse pressure, bradycardia, and irregular
respirations, indicating increased ICP. Tachycardia and hypotension are signs of shock.
Question 11: A client is prescribed warfarin. Which food should the client consume
consistently?
A. Leafy green vegetables
B. Grapefruit
C. Dairy products
D. Red meat
CORRECT ANSWER: A. Leafy green vegetables
Rationale: Leafy greens contain Vitamin K, which antagonizes warfarin. Consistency in intake is
key to maintaining stable INR levels, rather than avoidance.
Question 12: A nurse is assessing a client with pneumonia. Which finding is expected?
A. Decreased tactile fremitus
B. Crackles upon auscultation
C. Hyperresonance on percussion
D. Wheezing on expiration
CORRECT ANSWER: B. Crackles upon auscultation
Rationale: Crackles indicate fluid in the alveoli, common in pneumonia. Fremitus is usually
increased, percussion is dull, and wheezing is more associated with asthma/COPD.
Question 13: What is the priority nursing diagnosis for a client with a new tracheostomy?
A. Impaired verbal communication
B. Ineffective airway clearance
C. Risk for infection
D. Disturbed body image
CORRECT ANSWER: B. Ineffective airway clearance
Rationale: Airway patency is the highest priority (ABCs). Communication and infection are
important but secondary to maintaining an open airway.
Question 14: A client with a hip replacement should avoid which position?
A. Supine
B. Adduction of the affected leg
C. Abduction of the affected leg
D. Elevated head of bed
CORRECT ANSWER: B. Adduction of the affected leg
Rationale: Adduction (crossing legs) can cause dislocation of the new hip prosthesis. Abduction
is encouraged to maintain alignment.
Question 15: Which symptom is indicative of hypoglycemia in a diabetic client?
, A. Polyuria
B. Diaphoresis
C. Dry skin
D. Fruity breath odor
CORRECT ANSWER: B. Diaphoresis
Rationale: Diaphoresis (sweating), tremors, and confusion are adrenergic signs of
hypoglycemia. Polyuria and fruity breath are signs of hyperglycemia/DKA.
Question 16: A nurse is administering a blood transfusion. What is the first action if a reaction
is suspected?
A. Notify the provider
B. Stop the transfusion
C. Administer epinephrine
D. Check vital signs
CORRECT ANSWER: B. Stop the transfusion
Rationale: The immediate priority is to stop the infusion to prevent further administration of
the incompatible blood. Saline is then hung, and the provider is notified.
Question 17: Which assessment is crucial before administering digoxin?
A. Blood pressure
B. Apical pulse
C. Respiratory rate
D. Temperature
CORRECT ANSWER: B. Apical pulse
Rationale: Digoxin slows the heart rate. If the apical pulse is below 60 beats/min (adult), the
medication should be withheld to prevent severe bradycardia.
Question 18: A client with a spinal cord injury at T4 is at risk for which complication?
A. Autonomic dysreflexia
B. Neurogenic shock
C. Spinal shock
D. Phantom limb pain
CORRECT ANSWER: A. Autonomic dysreflexia
Rationale: Injuries at T6 or higher put clients at risk for autonomic dysreflexia, a life-threatening
hypertensive crisis triggered by noxious stimuli below the injury.
Question 19: What is the best method to verify nasogastric tube placement?
A. Auscultating over the stomach
B. Checking pH of aspirate
C. Chest X-ray
D. Observing for coughing
CORRECT ANSWER: C. Chest X-ray
Rationale: A chest X-ray is the gold standard for confirming NG tube placement before initial
use. pH testing is supportive but not definitive.
Question 20: A client is receiving total parenteral nutrition (TPN). Which monitoring is
essential?
Nursing Exit Exam Study Guide, Practice Questions, Detailed
Rationales, and Proven Strategies to Pass the Nursing HESI
Exam with Confidence
Question 1: A nurse is assessing a client with a suspected deep vein thrombosis (DVT). Which
finding should the nurse prioritize reporting to the provider?
A. Warmth and redness in the affected limb
B. Unilateral leg swelling
C. Sudden onset of shortness of breath
D. Pain upon dorsiflexion of the foot
CORRECT ANSWER: C. Sudden onset of shortness of breath
Rationale: Sudden shortness of breath indicates a potential pulmonary embolism, a life-
threatening complication of DVT requiring immediate intervention. While warmth, swelling,
and pain are signs of DVT, respiratory distress signals embolization.
Question 2: A client with heart failure is prescribed furosemide. Which laboratory value
requires monitoring due to this medication?
A. Serum calcium
B. Serum potassium
C. Serum glucose
D. Serum magnesium
CORRECT ANSWER: B. Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium excretion. Hypokalemia is a
common and dangerous side effect that can lead to cardiac dysrhythmias.
Question 3: A nurse is preparing to administer insulin lispro. When should this medication be
given?
A. 30 minutes before a meal
B. 15 minutes before a meal
C. Immediately after a meal
D. At bedtime
CORRECT ANSWER: B. 15 minutes before a meal
Rationale: Insulin lispro is a rapid-acting insulin. It should be administered 15 minutes before a
meal to align its peak action with postprandial glucose elevation.
Question 4: Which assessment finding indicates effective chest compressions during CPR?
A. Pupils constricting
B. Palpable carotid pulse with each compression
C. Skin turning pale
D. Breath sounds becoming clear
CORRECT ANSWER: B. Palpable carotid pulse with each compression
Rationale: A palpable carotid pulse during compressions indicates that blood is being circulated
effectively to the brain and vital organs.
Question 5: A client is admitted with diabetic ketoacidosis (DKA). What breathing pattern
should the nurse expect?
,A. Cheyne-Stokes
B. Kussmaul respirations
C. Biot's respirations
D. Bradypnea
CORRECT ANSWER: B. Kussmaul respirations
Rationale: Kussmaul respirations are deep, rapid breaths associated with DKA as the body
attempts to compensate for metabolic acidosis by exhaling carbon dioxide.
Question 6: A nurse is caring for a client with a nasogastric (NG) tube on suction. Which
finding suggests the tube is functioning properly?
A. Greenish-yellow drainage
B. Absence of bowel sounds
C. Client reporting nausea
D. Abdominal distension
CORRECT ANSWER: A. Greenish-yellow drainage
Rationale: Greenish-yellow drainage indicates gastric contents are being successfully removed.
Nausea, distension, or absent bowel sounds suggest obstruction or malfunction.
Question 7: Which intervention is priority for a client experiencing anaphylaxis?
A. Administer diphenhydramine
B. Establish a patent airway
C. Apply a tourniquet
D. Document the allergen
CORRECT ANSWER: B. Establish a patent airway
Rationale: Airway compromise is the immediate life threat in anaphylaxis. Securing the airway
takes precedence over medications or documentation.
Question 8: A client with chronic kidney disease (CKD) should limit intake of which nutrient?
A. Protein
B. Potassium
C. Carbohydrates
D. Fiber
CORRECT ANSWER: B. Potassium
Rationale: Damaged kidneys cannot excrete potassium effectively, leading to hyperkalemia,
which can cause fatal dysrhythmias. Protein may also be restricted depending on the stage.
Question 9: A nurse notes a client's wound has bright red bleeding. What is the initial action?
A. Apply direct pressure
B. Elevate the extremity
C. Notify the provider
D. Apply a tourniquet
CORRECT ANSWER: A. Apply direct pressure
Rationale: Direct pressure is the first-line intervention to control external bleeding. Elevation is
secondary, and tourniquets are reserved for life-threatening hemorrhage uncontrolled by
pressure.
Question 10: Which sign indicates increased intracranial pressure (ICP)?
,A. Tachycardia
B. Hypotension
C. Widening pulse pressure
D. Hyperthermia
CORRECT ANSWER: C. Widening pulse pressure
Rationale: Cushing's triad includes widening pulse pressure, bradycardia, and irregular
respirations, indicating increased ICP. Tachycardia and hypotension are signs of shock.
Question 11: A client is prescribed warfarin. Which food should the client consume
consistently?
A. Leafy green vegetables
B. Grapefruit
C. Dairy products
D. Red meat
CORRECT ANSWER: A. Leafy green vegetables
Rationale: Leafy greens contain Vitamin K, which antagonizes warfarin. Consistency in intake is
key to maintaining stable INR levels, rather than avoidance.
Question 12: A nurse is assessing a client with pneumonia. Which finding is expected?
A. Decreased tactile fremitus
B. Crackles upon auscultation
C. Hyperresonance on percussion
D. Wheezing on expiration
CORRECT ANSWER: B. Crackles upon auscultation
Rationale: Crackles indicate fluid in the alveoli, common in pneumonia. Fremitus is usually
increased, percussion is dull, and wheezing is more associated with asthma/COPD.
Question 13: What is the priority nursing diagnosis for a client with a new tracheostomy?
A. Impaired verbal communication
B. Ineffective airway clearance
C. Risk for infection
D. Disturbed body image
CORRECT ANSWER: B. Ineffective airway clearance
Rationale: Airway patency is the highest priority (ABCs). Communication and infection are
important but secondary to maintaining an open airway.
Question 14: A client with a hip replacement should avoid which position?
A. Supine
B. Adduction of the affected leg
C. Abduction of the affected leg
D. Elevated head of bed
CORRECT ANSWER: B. Adduction of the affected leg
Rationale: Adduction (crossing legs) can cause dislocation of the new hip prosthesis. Abduction
is encouraged to maintain alignment.
Question 15: Which symptom is indicative of hypoglycemia in a diabetic client?
, A. Polyuria
B. Diaphoresis
C. Dry skin
D. Fruity breath odor
CORRECT ANSWER: B. Diaphoresis
Rationale: Diaphoresis (sweating), tremors, and confusion are adrenergic signs of
hypoglycemia. Polyuria and fruity breath are signs of hyperglycemia/DKA.
Question 16: A nurse is administering a blood transfusion. What is the first action if a reaction
is suspected?
A. Notify the provider
B. Stop the transfusion
C. Administer epinephrine
D. Check vital signs
CORRECT ANSWER: B. Stop the transfusion
Rationale: The immediate priority is to stop the infusion to prevent further administration of
the incompatible blood. Saline is then hung, and the provider is notified.
Question 17: Which assessment is crucial before administering digoxin?
A. Blood pressure
B. Apical pulse
C. Respiratory rate
D. Temperature
CORRECT ANSWER: B. Apical pulse
Rationale: Digoxin slows the heart rate. If the apical pulse is below 60 beats/min (adult), the
medication should be withheld to prevent severe bradycardia.
Question 18: A client with a spinal cord injury at T4 is at risk for which complication?
A. Autonomic dysreflexia
B. Neurogenic shock
C. Spinal shock
D. Phantom limb pain
CORRECT ANSWER: A. Autonomic dysreflexia
Rationale: Injuries at T6 or higher put clients at risk for autonomic dysreflexia, a life-threatening
hypertensive crisis triggered by noxious stimuli below the injury.
Question 19: What is the best method to verify nasogastric tube placement?
A. Auscultating over the stomach
B. Checking pH of aspirate
C. Chest X-ray
D. Observing for coughing
CORRECT ANSWER: C. Chest X-ray
Rationale: A chest X-ray is the gold standard for confirming NG tube placement before initial
use. pH testing is supportive but not definitive.
Question 20: A client is receiving total parenteral nutrition (TPN). Which monitoring is
essential?
