HESI Comprehensive Exit Exam Practice
Test Questions And Answers Plus
Rationales 2026/27 | Instant Download
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1. A client with heart failure is prescribed furosemide
(Lasix) 40 mg IV push. Which assessment finding requires
immediate intervention?
A. Serum potassium level of 3.2 mEq/L
B. Blood pressure of 110/70 mmHg
C. Urine output of 200 mL in the last 4 hours
D. Mild crackles in bilateral lung bases
Answer: A. Serum potassium level of 3.2 mEq/L
Rationale: Furosemide is a loop diuretic that causes potassium
wasting. A potassium level of 3.2 is critically low (normal 3.5-
5.0) and increases the risk for fatal dysrhythmias. The other
findings are expected in heart failure.
2. A nurse is caring for a client 2 hours post-cardiac
catheterization via the right femoral artery. The client
,reports severe pain, numbness, and pallor in the right foot.
What is the nurse's priority action?
A. Administer prescribed morphine sulfate.
B. Elevate the right leg on two pillows.
C. Reassure the client this is expected.
D. Notify the healthcare provider immediately.
Answer: D. Notify the healthcare provider immediately.
Rationale: Pain, pallor, and paresthesia (numbness) distal to a
catheter insertion site are signs of acute arterial occlusion or
thromboembolism. This is a medical emergency requiring
immediate intervention.
3. A client with chronic obstructive pulmonary disease
(COPD) has a prescription for oxygen at 2 L/min via nasal
cannula. The client's spouse asks why the flow rate is low.
Which response by the nurse is best?
A. "Higher oxygen levels can decrease her drive to breathe."
B. "She will get used to the oxygen over the next few days."
C. "Her lung disease requires a specific mixture of gases."
D. "Too much oxygen can cause her lungs to stiffen."
Answer: A. "Higher oxygen levels can decrease her drive to
breathe."
,Rationale: Clients with chronic hypercapnia (COPD) rely on a
hypoxic drive to stimulate breathing. High oxygen
concentrations can remove this drive, leading to respiratory
depression and apnea.
4. A client with diabetic ketoacidosis (DKA) has a blood
glucose of 480 mg/dL and is receiving an insulin drip.
Which finding indicates that treatment is effective?
A. Blood glucose decreases to 200 mg/dL
B. Serum potassium level increases to 5.5 mEq/L
C. Client reports feeling hungry
D. Arterial blood gas shows pH 7.28
Answer: A. Blood glucose decreases to 200 mg/dL
Rationale: The primary goal in DKA is to lower blood glucose
and correct the metabolic acidosis. While the target is often to
lower glucose by 50-70 mg/dL per hour, a decrease toward
normal indicates effectiveness. A pH of 7.28 (normal 7.35-7.45)
still shows acidosis. Hyperkalemia (5.5) is a risk if treatment is
not carefully managed.
5. A nurse is teaching a client with rheumatoid arthritis
about methotrexate. Which statement by the client
indicates a need for further teaching?
, A. "I will need to have regular blood tests while on this drug."
B. "I should avoid drinking alcohol while taking this
medication."
C. "I can take an extra dose if my joints hurt more than usual."
D. "It may take several weeks to feel the full effects."
Answer: C. "I can take an extra dose if my joints hurt more than
usual."
Rationale: Methotrexate is a disease-modifying antirheumatic
drug (DMARD) taken weekly, not as needed for pain. Taking
extra doses can lead to severe toxicity, including bone marrow
suppression and liver damage.
6. A client with end-stage renal disease (ESRD) is scheduled
for hemodialysis. Which medication should the nurse
withhold on the morning of dialysis?
A. Calcium acetate (PhosLo)
B. Epoetin alfa (Epogen)
C. Lisinopril
D. Multivitamin
Answer: B. Epoetin alfa (Epogen)
Rationale: Epoetin alfa stimulates red blood cell production. It
is typically given after dialysis to prevent the dialyzer from
Test Questions And Answers Plus
Rationales 2026/27 | Instant Download
1. A client with heart failure is prescribed furosemide
(Lasix) 40 mg IV push. Which assessment finding requires
immediate intervention?
A. Serum potassium level of 3.2 mEq/L
B. Blood pressure of 110/70 mmHg
C. Urine output of 200 mL in the last 4 hours
D. Mild crackles in bilateral lung bases
Answer: A. Serum potassium level of 3.2 mEq/L
Rationale: Furosemide is a loop diuretic that causes potassium
wasting. A potassium level of 3.2 is critically low (normal 3.5-
5.0) and increases the risk for fatal dysrhythmias. The other
findings are expected in heart failure.
2. A nurse is caring for a client 2 hours post-cardiac
catheterization via the right femoral artery. The client
,reports severe pain, numbness, and pallor in the right foot.
What is the nurse's priority action?
A. Administer prescribed morphine sulfate.
B. Elevate the right leg on two pillows.
C. Reassure the client this is expected.
D. Notify the healthcare provider immediately.
Answer: D. Notify the healthcare provider immediately.
Rationale: Pain, pallor, and paresthesia (numbness) distal to a
catheter insertion site are signs of acute arterial occlusion or
thromboembolism. This is a medical emergency requiring
immediate intervention.
3. A client with chronic obstructive pulmonary disease
(COPD) has a prescription for oxygen at 2 L/min via nasal
cannula. The client's spouse asks why the flow rate is low.
Which response by the nurse is best?
A. "Higher oxygen levels can decrease her drive to breathe."
B. "She will get used to the oxygen over the next few days."
C. "Her lung disease requires a specific mixture of gases."
D. "Too much oxygen can cause her lungs to stiffen."
Answer: A. "Higher oxygen levels can decrease her drive to
breathe."
,Rationale: Clients with chronic hypercapnia (COPD) rely on a
hypoxic drive to stimulate breathing. High oxygen
concentrations can remove this drive, leading to respiratory
depression and apnea.
4. A client with diabetic ketoacidosis (DKA) has a blood
glucose of 480 mg/dL and is receiving an insulin drip.
Which finding indicates that treatment is effective?
A. Blood glucose decreases to 200 mg/dL
B. Serum potassium level increases to 5.5 mEq/L
C. Client reports feeling hungry
D. Arterial blood gas shows pH 7.28
Answer: A. Blood glucose decreases to 200 mg/dL
Rationale: The primary goal in DKA is to lower blood glucose
and correct the metabolic acidosis. While the target is often to
lower glucose by 50-70 mg/dL per hour, a decrease toward
normal indicates effectiveness. A pH of 7.28 (normal 7.35-7.45)
still shows acidosis. Hyperkalemia (5.5) is a risk if treatment is
not carefully managed.
5. A nurse is teaching a client with rheumatoid arthritis
about methotrexate. Which statement by the client
indicates a need for further teaching?
, A. "I will need to have regular blood tests while on this drug."
B. "I should avoid drinking alcohol while taking this
medication."
C. "I can take an extra dose if my joints hurt more than usual."
D. "It may take several weeks to feel the full effects."
Answer: C. "I can take an extra dose if my joints hurt more than
usual."
Rationale: Methotrexate is a disease-modifying antirheumatic
drug (DMARD) taken weekly, not as needed for pain. Taking
extra doses can lead to severe toxicity, including bone marrow
suppression and liver damage.
6. A client with end-stage renal disease (ESRD) is scheduled
for hemodialysis. Which medication should the nurse
withhold on the morning of dialysis?
A. Calcium acetate (PhosLo)
B. Epoetin alfa (Epogen)
C. Lisinopril
D. Multivitamin
Answer: B. Epoetin alfa (Epogen)
Rationale: Epoetin alfa stimulates red blood cell production. It
is typically given after dialysis to prevent the dialyzer from
