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2025 HESI RN Exit Exam – 110
Authentic NGN Practice Questions
with 100% Verified Answers &
Clinical Decision-Making
Rationales | A+ Graded
Student Name: _________________________
Date: _______________
Time Limit: 120 minutes
Total Questions: 110
Question 1
A nurse is caring for a client with a new diagnosis of heart failure. Which assessment finding
indicates worsening condition?
A. Blood pressure of 130/80 mmHg
B. Crackles in bilateral lung bases
C. Heart rate of 80 bpm
D. Oxygen saturation of 95%
Correct Answer: B. Crackles in bilateral lung bases
Rationale: Crackles in the lung bases indicate pulmonary edema, a sign of worsening heart
failure due to fluid overload. This requires immediate intervention to prevent respiratory
compromise. The other findings are within normal limits for a client with heart failure.
Question 2
A client with type 1 diabetes reports nausea and shakiness. The nurse checks the blood glucose,
which is 50 mg/dL. What should the nurse do first?
A. Administer insulin glargine
B. Provide 15 grams of a fast-acting carbohydrate
C. Encourage the client to rest
D. Check the client’s blood pressure
Correct Answer: B. Provide 15 grams of a fast-acting carbohydrate
, 2
Rationale: A blood glucose of 50 mg/dL indicates hypoglycemia, requiring immediate
administration of 15 grams of a fast-acting carbohydrate (e.g., juice or glucose tablets) to raise
blood glucose levels. Insulin would worsen hypoglycemia, rest does not address the issue, and
blood pressure is not the priority.
Question 3
A nurse is caring for a client post-appendectomy. Which finding requires immediate action?
A. Temperature of 99.2°F
B. Heart rate of 110 bpm
C. Pain level of 4/10 at the incision site
D. Clear urine output
Correct Answer: B. Heart rate of 110 bpm
Rationale: A heart rate of 110 bpm (tachycardia) may indicate postoperative complications such
as infection, bleeding, or dehydration, requiring immediate assessment. A slight fever, mild pain,
and clear urine are expected or less urgent findings.
Question 4
A nurse is teaching a client with chronic obstructive pulmonary disease (COPD) about pursed -lip
breathing. What is the primary purpose of this technique?
A. Increase carbon dioxide retention
B. Decrease oxygen saturation
C. Prolong exhalation to reduce air trapping
D. Reduce respiratory rate
Correct Answer: C. Prolong exhalation to reduce air trapping
Rationale: Pursed-lip breathing prolongs exhalation, preventing air trapping in COPD by
maintaining positive pressure in the airways. It does not increase carbon dioxide retention,
decrease oxygen saturation, or primarily reduce respiratory rate.
Question 5
A nurse is preparing to administer digoxin 0.125 mg to a client with heart failure. The client’s
heart rate is 56 bpm. What should the nurse do?
A. Administer the dose as prescribed
B. Hold the dose and notify the provider
C. Administer half the dose
D. Recheck the heart rate in 1 hour
Correct Answer: B. Hold the dose and notify the provider
Rationale: Digoxin, a cardiac glycoside, is contraindicated if the heart rate is below 60 bpm due
, 3
to the risk of worsening bradycardia or toxicity. The nurse should hold the dose and notify the
provider. Administering any dose or delaying reassessment is unsafe.
Question 6
A client with a history of seizures is prescribed phenytoin. Which laboratory value should the
nurse monitor?
A. Serum potassium
B. Serum phenytoin level
C. Blood urea nitrogen (BUN)
D. Hemoglobin A1c
Correct Answer: B. Serum phenytoin level
Rationale: Phenytoin, an anticonvulsant, has a narrow therapeutic range (10–20 mcg/mL).
Monitoring serum levels ensures efficacy and prevents toxicity, which can cause ataxia or
nystagmus. The other values are not directly related to phenytoin therapy.
Question 7
A nurse is assessing a newborn 12 hours after birth. Which finding requires immediate
intervention?
A. Heart rate of 140 bpm
B. Respiratory rate of 60 breaths/min
C. Acrocyanosis
D. Grunting respirations
Correct Answer: D. Grunting respirations
Rationale: Grunting respirations in a newborn indicate respiratory distress, potentially due to
conditions like respiratory distress syndrome, requiring immediate intervention. The other
findings are within normal limits for a newborn.
Question 8
A client with schizophrenia reports hearing voices. Which nursing intervention is the priority?
A. Administer an antianxiety medication
B. Encourage group therapy participation
C. Assess the content of the hallucinations
D. Distract the client with music
Correct Answer: C. Assess the content of the hallucinations
Rationale: Assessing the content of hallucinations determines if they are command
hallucinations that could pose a safety risk (e.g., self-harm). This is the priority before
administering medications, encouraging therapy, or using distraction.
, 4
Question 9
A nurse is caring for a client receiving total parenteral nutrition (TPN). Which complication
should the nurse monitor for?
A. Hypoglycemia
B. Hyperglycemia
C. Hypokalemia
D. Hypernatremia
Correct Answer: B. Hyperglycemia
Rationale: TPN contains high dextrose concentrations, increasing the risk of hyperglycemia.
Regular blood glucose monitoring is essential. Hypoglycemia, hypokalemia, and hypernatremia
are less common if TPN is properly managed.
Question 10
A nurse is teaching a client with hypertension about lisinopril. Which side effect should the nurse
include?
A. Dry cough
B. Weight loss
C. Hypokalemia
D. Tachycardia
Correct Answer: A. Dry cough
Rationale: Lisinopril, an ACE inhibitor, commonly causes a dry cough due to bradykinin
accumulation. Weight loss, hypokalemia, and tachycardia are not typical side effects of this
medication.
Question 11
A client with a pulmonary embolism is receiving heparin. Which laboratory value should the
nurse monitor?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International normalized ratio (INR)
D. Platelet count
Correct Answer: B. Activated partial thromboplastin time (aPTT)
Rationale: Heparin, an anticoagulant, is monitored using aPTT to ensure therapeutic
anticoagulation (1.5–2.5 times the control value). PT/INR is used for warfarin, and while platelet
count is relevant for heparin-induced thrombocytopenia, aPTT is the primary monitoring
parameter.
2025 HESI RN Exit Exam – 110
Authentic NGN Practice Questions
with 100% Verified Answers &
Clinical Decision-Making
Rationales | A+ Graded
Student Name: _________________________
Date: _______________
Time Limit: 120 minutes
Total Questions: 110
Question 1
A nurse is caring for a client with a new diagnosis of heart failure. Which assessment finding
indicates worsening condition?
A. Blood pressure of 130/80 mmHg
B. Crackles in bilateral lung bases
C. Heart rate of 80 bpm
D. Oxygen saturation of 95%
Correct Answer: B. Crackles in bilateral lung bases
Rationale: Crackles in the lung bases indicate pulmonary edema, a sign of worsening heart
failure due to fluid overload. This requires immediate intervention to prevent respiratory
compromise. The other findings are within normal limits for a client with heart failure.
Question 2
A client with type 1 diabetes reports nausea and shakiness. The nurse checks the blood glucose,
which is 50 mg/dL. What should the nurse do first?
A. Administer insulin glargine
B. Provide 15 grams of a fast-acting carbohydrate
C. Encourage the client to rest
D. Check the client’s blood pressure
Correct Answer: B. Provide 15 grams of a fast-acting carbohydrate
, 2
Rationale: A blood glucose of 50 mg/dL indicates hypoglycemia, requiring immediate
administration of 15 grams of a fast-acting carbohydrate (e.g., juice or glucose tablets) to raise
blood glucose levels. Insulin would worsen hypoglycemia, rest does not address the issue, and
blood pressure is not the priority.
Question 3
A nurse is caring for a client post-appendectomy. Which finding requires immediate action?
A. Temperature of 99.2°F
B. Heart rate of 110 bpm
C. Pain level of 4/10 at the incision site
D. Clear urine output
Correct Answer: B. Heart rate of 110 bpm
Rationale: A heart rate of 110 bpm (tachycardia) may indicate postoperative complications such
as infection, bleeding, or dehydration, requiring immediate assessment. A slight fever, mild pain,
and clear urine are expected or less urgent findings.
Question 4
A nurse is teaching a client with chronic obstructive pulmonary disease (COPD) about pursed -lip
breathing. What is the primary purpose of this technique?
A. Increase carbon dioxide retention
B. Decrease oxygen saturation
C. Prolong exhalation to reduce air trapping
D. Reduce respiratory rate
Correct Answer: C. Prolong exhalation to reduce air trapping
Rationale: Pursed-lip breathing prolongs exhalation, preventing air trapping in COPD by
maintaining positive pressure in the airways. It does not increase carbon dioxide retention,
decrease oxygen saturation, or primarily reduce respiratory rate.
Question 5
A nurse is preparing to administer digoxin 0.125 mg to a client with heart failure. The client’s
heart rate is 56 bpm. What should the nurse do?
A. Administer the dose as prescribed
B. Hold the dose and notify the provider
C. Administer half the dose
D. Recheck the heart rate in 1 hour
Correct Answer: B. Hold the dose and notify the provider
Rationale: Digoxin, a cardiac glycoside, is contraindicated if the heart rate is below 60 bpm due
, 3
to the risk of worsening bradycardia or toxicity. The nurse should hold the dose and notify the
provider. Administering any dose or delaying reassessment is unsafe.
Question 6
A client with a history of seizures is prescribed phenytoin. Which laboratory value should the
nurse monitor?
A. Serum potassium
B. Serum phenytoin level
C. Blood urea nitrogen (BUN)
D. Hemoglobin A1c
Correct Answer: B. Serum phenytoin level
Rationale: Phenytoin, an anticonvulsant, has a narrow therapeutic range (10–20 mcg/mL).
Monitoring serum levels ensures efficacy and prevents toxicity, which can cause ataxia or
nystagmus. The other values are not directly related to phenytoin therapy.
Question 7
A nurse is assessing a newborn 12 hours after birth. Which finding requires immediate
intervention?
A. Heart rate of 140 bpm
B. Respiratory rate of 60 breaths/min
C. Acrocyanosis
D. Grunting respirations
Correct Answer: D. Grunting respirations
Rationale: Grunting respirations in a newborn indicate respiratory distress, potentially due to
conditions like respiratory distress syndrome, requiring immediate intervention. The other
findings are within normal limits for a newborn.
Question 8
A client with schizophrenia reports hearing voices. Which nursing intervention is the priority?
A. Administer an antianxiety medication
B. Encourage group therapy participation
C. Assess the content of the hallucinations
D. Distract the client with music
Correct Answer: C. Assess the content of the hallucinations
Rationale: Assessing the content of hallucinations determines if they are command
hallucinations that could pose a safety risk (e.g., self-harm). This is the priority before
administering medications, encouraging therapy, or using distraction.
, 4
Question 9
A nurse is caring for a client receiving total parenteral nutrition (TPN). Which complication
should the nurse monitor for?
A. Hypoglycemia
B. Hyperglycemia
C. Hypokalemia
D. Hypernatremia
Correct Answer: B. Hyperglycemia
Rationale: TPN contains high dextrose concentrations, increasing the risk of hyperglycemia.
Regular blood glucose monitoring is essential. Hypoglycemia, hypokalemia, and hypernatremia
are less common if TPN is properly managed.
Question 10
A nurse is teaching a client with hypertension about lisinopril. Which side effect should the nurse
include?
A. Dry cough
B. Weight loss
C. Hypokalemia
D. Tachycardia
Correct Answer: A. Dry cough
Rationale: Lisinopril, an ACE inhibitor, commonly causes a dry cough due to bradykinin
accumulation. Weight loss, hypokalemia, and tachycardia are not typical side effects of this
medication.
Question 11
A client with a pulmonary embolism is receiving heparin. Which laboratory value should the
nurse monitor?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International normalized ratio (INR)
D. Platelet count
Correct Answer: B. Activated partial thromboplastin time (aPTT)
Rationale: Heparin, an anticoagulant, is monitored using aPTT to ensure therapeutic
anticoagulation (1.5–2.5 times the control value). PT/INR is used for warfarin, and while platelet
count is relevant for heparin-induced thrombocytopenia, aPTT is the primary monitoring
parameter.
