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2025 HESI RN Exit Exam – 70
Authentic NGN Questions with
100% Verified Answers & NCLEX-
Level Explanations | A+ Graded
Student Name: _________________________
Date: _______________
Time Limit: 120 minutes
Total Questions: 75
Instructions
• This exam contains 75 questions, including multiple-choice (MCQs) and select-all-that-
apply (SATA), aligned with the 2025 HESI RN Exit Exam and NCLEX-RN test plan.
• Read each question carefully and select the best answer(s). For SATA questions, choose
all options that apply.
• Complete the exam within the 120-minute time limit to simulate the actual test.
• Questions cover medical-surgical nursing, psychiatric nursing, maternity nursing,
pediatric nursing, and prioritization/delegation.
• A non-programmable calculator, pencil/pen, and scratch paper (provided by the proctor)
are permitted. No other materials are allowed..
Medical-Surgical Nursing (Questions 1–20)
1. A client with heart failure reports increased dyspnea and a 3-kg weight gain over 2
days. What is the nurse’s priority action?
A. Administer oxygen at 2 L/min via nasal cannula
B. Notify the healthcare provider
C. Encourage fluid intake
D. Elevate the legs
Answer: B. Notify the healthcare provider
Rationale: A 3-kg weight gain over 2 days and increased dyspnea indicate fluid overload
in heart failure, requiring immediate medical intervention. Notifying the provider
facilitates diuretic or other therapy. Oxygen (A) may be needed but requires a
prescription, fluid intake (C) worsens overload, and leg elevation (D) is irrelevant.
, 2
2. A client post-myocardial infarction is prescribed lisinopril. What should the nurse
monitor?
A. Blood glucose
B. Blood pressure
C. INR
D. Oxygen saturation
Answer: B. Blood pressure
Rationale: Lisinopril, an ACE inhibitor, lowers blood pressure, requiring monitoring for
hypotension. Glucose (A), INR (C), and oxygen saturation (D) are not primary concerns
for lisinopril.
3. Select All That Apply: Which findings indicate a client with pneumonia is
deteriorating?
A. Increased respiratory rate
B. Improved oxygen saturation
C. Confusion
D. Decreased temperature
E. Worsening cough
Answer: A, C, E
Rationale: Increased respiratory rate (A), confusion (C, indicating hypoxia), and
worsening cough (E) suggest worsening pneumonia. Improved oxygen saturation (B)
indicates improvement, and decreased temperature (D) is not specific to deterioration.
4. A client with diabetes mellitus reports nausea and fruity breath odor. What is the
nurse’s priority action?
A. Administer insulin per sliding scale
B. Check blood glucose level
C. Provide oral fluids
D. Encourage a high-carbohydrate diet
Answer: B. Check blood glucose level
Rationale: Fruity breath and nausea suggest diabetic ketoacidosis (DKA), requiring
immediate blood glucose assessment to confirm hyperglycemia. Insulin (A) requires
glucose confirmation, fluids (C) may be needed IV, and carbohydrates (D) worsen DKA.
5. A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 88%. What is the nurse’s best action?
A. Increase oxygen to 4 L/min
B. Encourage deep breathing exercises
C. Administer a bronchodilator
D. Notify the healthcare provider
Answer: B. Encourage deep breathing exercises
Rationale: An oxygen saturation of 88% is typical for COPD clients due to chronic
hypoxia; deep breathing optimizes lung function. Increasing oxygen (A) risks CO2
retention, bronchodilators (C) require a prescription, and notification (D) is unnecessary
unless acute changes occur.
6. A client post-appendectomy reports severe right lower quadrant pain. What is the
nurse’s priority action?
A. Administer pain medication
B. Assess the surgical site
, 3
C. Encourage ambulation
D. Apply a warm compress
Answer: B. Assess the surgical site
Rationale: Severe pain post-appendectomy suggests complications like infection or
dehiscence, requiring site assessment. Pain medication (A) may mask symptoms,
ambulation (C) is inappropriate, and heat (D) may worsen infection.
7. A client with hypertension is prescribed hydrochlorothiazide. What should the
nurse teach the client?
A. Monitor for hyperglycemia
B. Check daily weight
C. Expect weight gain
D. Increase sodium intake
Answer: B. Check daily weight
Rationale: Hydrochlorothiazide, a diuretic, requires monitoring daily weight to assess
fluid loss. Hyperglycemia (A) is not a primary concern, weight gain (C) is unexpected,
and sodium intake (D) should be limited.
8. A client with a peptic ulcer reports sudden, severe epigastric pain. What is the
nurse’s priority action?
A. Administer an antacid
B. Notify the healthcare provider
C. Provide a high-fiber diet
D. Encourage rest
Answer: B. Notify the healthcare provider
Rationale: Sudden, severe epigastric pain suggests ulcer perforation, a medical
emergency requiring immediate provider notification. Antacids (A) are ineffective, high-
fiber diets (C) are irrelevant, and rest (D) delays intervention.
9. A client with atrial fibrillation is prescribed warfarin. What should the nurse
monitor?
A. INR
B. Blood glucose
C. Creatinine
D. Oxygen saturation
Answer: A. INR
Rationale: Warfarin requires INR monitoring (therapeutic range: 2–3) to assess
anticoagulation efficacy and bleeding risk. Glucose (B), creatinine (C), and oxygen
saturation (D) are not primary concerns.
10. A client post-total knee replacement reports calf pain and swelling. What is the
nurse’s priority action?
A. Apply a warm compress
B. Notify the healthcare provider
C. Encourage ambulation
D. Administer pain medication
Answer: B. Notify the healthcare provider
Rationale: Calf pain and swelling post-surgery suggest deep vein thrombosis (DVT),
requiring immediate provider notification for imaging and anticoagulation. Heat (A)
2025 HESI RN Exit Exam – 70
Authentic NGN Questions with
100% Verified Answers & NCLEX-
Level Explanations | A+ Graded
Student Name: _________________________
Date: _______________
Time Limit: 120 minutes
Total Questions: 75
Instructions
• This exam contains 75 questions, including multiple-choice (MCQs) and select-all-that-
apply (SATA), aligned with the 2025 HESI RN Exit Exam and NCLEX-RN test plan.
• Read each question carefully and select the best answer(s). For SATA questions, choose
all options that apply.
• Complete the exam within the 120-minute time limit to simulate the actual test.
• Questions cover medical-surgical nursing, psychiatric nursing, maternity nursing,
pediatric nursing, and prioritization/delegation.
• A non-programmable calculator, pencil/pen, and scratch paper (provided by the proctor)
are permitted. No other materials are allowed..
Medical-Surgical Nursing (Questions 1–20)
1. A client with heart failure reports increased dyspnea and a 3-kg weight gain over 2
days. What is the nurse’s priority action?
A. Administer oxygen at 2 L/min via nasal cannula
B. Notify the healthcare provider
C. Encourage fluid intake
D. Elevate the legs
Answer: B. Notify the healthcare provider
Rationale: A 3-kg weight gain over 2 days and increased dyspnea indicate fluid overload
in heart failure, requiring immediate medical intervention. Notifying the provider
facilitates diuretic or other therapy. Oxygen (A) may be needed but requires a
prescription, fluid intake (C) worsens overload, and leg elevation (D) is irrelevant.
, 2
2. A client post-myocardial infarction is prescribed lisinopril. What should the nurse
monitor?
A. Blood glucose
B. Blood pressure
C. INR
D. Oxygen saturation
Answer: B. Blood pressure
Rationale: Lisinopril, an ACE inhibitor, lowers blood pressure, requiring monitoring for
hypotension. Glucose (A), INR (C), and oxygen saturation (D) are not primary concerns
for lisinopril.
3. Select All That Apply: Which findings indicate a client with pneumonia is
deteriorating?
A. Increased respiratory rate
B. Improved oxygen saturation
C. Confusion
D. Decreased temperature
E. Worsening cough
Answer: A, C, E
Rationale: Increased respiratory rate (A), confusion (C, indicating hypoxia), and
worsening cough (E) suggest worsening pneumonia. Improved oxygen saturation (B)
indicates improvement, and decreased temperature (D) is not specific to deterioration.
4. A client with diabetes mellitus reports nausea and fruity breath odor. What is the
nurse’s priority action?
A. Administer insulin per sliding scale
B. Check blood glucose level
C. Provide oral fluids
D. Encourage a high-carbohydrate diet
Answer: B. Check blood glucose level
Rationale: Fruity breath and nausea suggest diabetic ketoacidosis (DKA), requiring
immediate blood glucose assessment to confirm hyperglycemia. Insulin (A) requires
glucose confirmation, fluids (C) may be needed IV, and carbohydrates (D) worsen DKA.
5. A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 88%. What is the nurse’s best action?
A. Increase oxygen to 4 L/min
B. Encourage deep breathing exercises
C. Administer a bronchodilator
D. Notify the healthcare provider
Answer: B. Encourage deep breathing exercises
Rationale: An oxygen saturation of 88% is typical for COPD clients due to chronic
hypoxia; deep breathing optimizes lung function. Increasing oxygen (A) risks CO2
retention, bronchodilators (C) require a prescription, and notification (D) is unnecessary
unless acute changes occur.
6. A client post-appendectomy reports severe right lower quadrant pain. What is the
nurse’s priority action?
A. Administer pain medication
B. Assess the surgical site
, 3
C. Encourage ambulation
D. Apply a warm compress
Answer: B. Assess the surgical site
Rationale: Severe pain post-appendectomy suggests complications like infection or
dehiscence, requiring site assessment. Pain medication (A) may mask symptoms,
ambulation (C) is inappropriate, and heat (D) may worsen infection.
7. A client with hypertension is prescribed hydrochlorothiazide. What should the
nurse teach the client?
A. Monitor for hyperglycemia
B. Check daily weight
C. Expect weight gain
D. Increase sodium intake
Answer: B. Check daily weight
Rationale: Hydrochlorothiazide, a diuretic, requires monitoring daily weight to assess
fluid loss. Hyperglycemia (A) is not a primary concern, weight gain (C) is unexpected,
and sodium intake (D) should be limited.
8. A client with a peptic ulcer reports sudden, severe epigastric pain. What is the
nurse’s priority action?
A. Administer an antacid
B. Notify the healthcare provider
C. Provide a high-fiber diet
D. Encourage rest
Answer: B. Notify the healthcare provider
Rationale: Sudden, severe epigastric pain suggests ulcer perforation, a medical
emergency requiring immediate provider notification. Antacids (A) are ineffective, high-
fiber diets (C) are irrelevant, and rest (D) delays intervention.
9. A client with atrial fibrillation is prescribed warfarin. What should the nurse
monitor?
A. INR
B. Blood glucose
C. Creatinine
D. Oxygen saturation
Answer: A. INR
Rationale: Warfarin requires INR monitoring (therapeutic range: 2–3) to assess
anticoagulation efficacy and bleeding risk. Glucose (B), creatinine (C), and oxygen
saturation (D) are not primary concerns.
10. A client post-total knee replacement reports calf pain and swelling. What is the
nurse’s priority action?
A. Apply a warm compress
B. Notify the healthcare provider
C. Encourage ambulation
D. Administer pain medication
Answer: B. Notify the healthcare provider
Rationale: Calf pain and swelling post-surgery suggest deep vein thrombosis (DVT),
requiring immediate provider notification for imaging and anticoagulation. Heat (A)
