HESI RN Exit Exam Practice Questions
Question 1:
A 65-year-old female patient with a history of chronic obstructive pulmonary disease (COPD) is
admitted to the hospital with shortness of breath and increased sputum production. What is the
primary goal of nursing care for this patient?
A. Encourage a high-protein diet B. Minimize the patient’s oxygen requirements C. Prevent
secondary infections D. Promote hydration
Answer: B. Minimize the patient’s oxygen requirements
Rationale: The primary goal in managing a patient with COPD is to minimize their oxygen
requirements to reduce the workload on the respiratory system. This can be achieved through
interventions such as administering bronchodilators, providing supplemental oxygen as needed,
and encouraging rest.
Question 2:
A patient with type 1 diabetes mellitus is learning how to self-administer insulin. Which
injection site should the nurse recommend for the fastest absorption?
A. Thigh B. Buttock C. Abdomen D. Upper arm
Answer: C. Abdomen
Rationale: The abdomen is the preferred site for insulin injections because it has the fastest
absorption rate compared to other sites such as the thigh, buttock, or upper arm. This is
particularly important for rapid-acting insulin.
Question 3:
The nurse is caring for a patient with a new colostomy. Which of the following is the most
appropriate initial action to help the patient adapt to the colostomy?
,A. Encourage the patient to look at the stoma B. Teach the patient how to change the colostomy
bag C. Provide written materials about colostomy care D. Refer the patient to a colostomy
support group
Answer: A. Encourage the patient to look at the stoma
Rationale: Encouraging the patient to look at the stoma is an important initial step in helping
them adapt to the colostomy. It helps the patient begin to accept the change in their body and is a
precursor to further education and self-care practices.
Question 4:
A patient is receiving intravenous (IV) morphine for postoperative pain. Which assessment
finding requires immediate intervention by the nurse?
A. Respiratory rate of 8 breaths per minute B. Heart rate of 90 beats per minute C. Blood
pressure of 140/90 mmHg D. Temperature of 37.5°C (99.5°F)
Answer: A. Respiratory rate of 8 breaths per minute
Rationale: A respiratory rate of 8 breaths per minute indicates respiratory depression, which is a
serious side effect of morphine and requires immediate intervention. The nurse should consider
administering naloxone and providing supportive care.
Question 5:
A patient with heart failure is prescribed furosemide (Lasix). Which laboratory value should the
nurse monitor closely?
A. Hemoglobin B. Potassium C. Sodium D. Calcium
Answer: B. Potassium
,Rationale: Furosemide is a loop diuretic that can cause significant potassium loss. Monitoring
potassium levels is essential to prevent hypokalemia, which can lead to serious cardiac
arrhythmias.
Question 6:
A nurse is caring for a patient with a suspected myocardial infarction (MI). Which diagnostic test
is most specific for confirming an MI?
A. Troponin I B. Creatine kinase (CK) C. Myoglobin D. Electrocardiogram (ECG)
Answer: A. Troponin I
Rationale: Troponin I is the most specific and sensitive biomarker for myocardial infarction. It
remains elevated for a longer period compared to other markers and is specific to cardiac muscle
injury.
Question 7:
A patient with chronic kidney disease (CKD) is receiving hemodialysis. Which dietary
modification should the nurse recommend?
A. High protein, low potassium B. Low protein, high potassium C. Low sodium, high
phosphorus D. High calcium, low sodium
Answer: A. High protein, low potassium
Rationale: Patients with CKD often require a diet that is high in protein to compensate for
protein loss during dialysis but low in potassium to prevent hyperkalemia, which can be life-
threatening.
Question 8:
A nurse is assessing a patient who has been diagnosed with hyperthyroidism. Which symptom is
most indicative of this condition?
,A. Bradycardia B. Weight gain C. Heat intolerance D. Constipation
Answer: C. Heat intolerance
Rationale: Heat intolerance is a common symptom of hyperthyroidism due to the increased
metabolic rate. Other symptoms include weight loss, tachycardia, and increased bowel
movements.
Question 9:
A patient is admitted with acute pancreatitis. Which laboratory value is most indicative of this
condition?
A. Elevated serum amylase B. Elevated serum bilirubin C. Elevated serum creatinine D.
Elevated serum calcium
Answer: A. Elevated serum amylase
Rationale: Elevated serum amylase is a key indicator of acute pancreatitis. It is often
accompanied by elevated serum lipase levels, which are more specific to pancreatic injury.
Question 10:
A nurse is caring for a patient with severe anemia. Which of the following symptoms is least
likely to be associated with anemia?
A. Fatigue B. Pallor C. Jaundice D. Tachycardia
Answer: C. Jaundice
,Rationale: Jaundice is not commonly associated with anemia unless it is hemolytic anemia,
where there is excessive breakdown of red blood cells. Common symptoms of anemia include
fatigue, pallor, and tachycardia.
Question 11
A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy.
Which of the following oxygen delivery systems is most appropriate for this patient? a. Nasal
cannula
b. Simple face mask
c. Non-rebreather mask
d. Venturi mask
Answer: d. Venturi mask
Rationale: The Venturi mask is the most appropriate oxygen delivery system for patients with
COPD because it delivers a precise concentration of oxygen, which is crucial for these patients to
avoid oxygen-induced hypoventilation.
Question 12
A nurse is caring for a patient who has just undergone a thyroidectomy. Which of the following
is the most important postoperative assessment? a. Monitoring for signs of hypocalcemia
b. Checking for signs of infection
c. Assessing for pain
d. Observing for signs of hemorrhage
Answer: a. Monitoring for signs of hypocalcemia
Rationale: After a thyroidectomy, it is crucial to monitor for signs of hypocalcemia because the
parathyroid glands, which regulate calcium levels, may have been inadvertently damaged or
removed during surgery.
Question 11
A patient with a history of chronic kidney disease is admitted with hyperkalemia. Which of the
following medications should the nurse anticipate administering to help lower the patient’s
potassium level? a. Sodium bicarbonate
b. Calcium gluconate
c. Insulin and glucose
d. Furosemide
Answer: c. Insulin and glucose
Rationale: Insulin, when given with glucose, helps to shift potassium from the extracellular
space into the cells, thereby lowering the serum potassium level.
Question 12
A nurse is caring for a patient who has been diagnosed with deep vein thrombosis (DVT). Which
of the following interventions is most appropriate? a. Massaging the affected leg
b. Applying warm compresses to the affected leg
,c. Encouraging ambulation
d. Administering anticoagulant therapy
Answer: d. Administering anticoagulant therapy
Rationale: Anticoagulant therapy is essential in the treatment of DVT to prevent further clot
formation and reduce the risk of complications such as pulmonary embolism.
Question 13
A patient with type 1 diabetes is experiencing symptoms of hypoglycemia. Which of the
following is the nurse’s priority action? a. Administering glucagon
b. Giving the patient a glass of orange juice
c. Checking the patient’s blood glucose level
d. Notifying the healthcare provider
Answer: c. Checking the patient’s blood glucose level
Rationale: The nurse should first check the patient’s blood glucose level to confirm
hypoglycemia before administering any treatment.
Question 14
A nurse is providing discharge teaching to a patient who has been prescribed warfarin. Which of
the following statements indicates that the patient understands the teaching? a. “I will take
aspirin for headaches.”
b. “I will eat more green leafy vegetables.”
c. “I will use an electric razor for shaving.”
d. “I will stop taking the medication if I have bruising.”
Answer: c. “I will use an electric razor for shaving.”
Rationale: Using an electric razor helps to reduce the risk of cuts and bleeding, which is
important for patients on anticoagulant therapy like warfarin.
Question 15
A patient with pneumonia is receiving intravenous antibiotics. Which of the following laboratory
tests should the nurse monitor to assess the effectiveness of the treatment? a. White blood cell
count
b. Hemoglobin level
c. Platelet count
d. Blood urea nitrogen (BUN)
Answer: a. White blood cell count
Rationale: Monitoring the white blood cell count helps to assess the body’s response to infection
and the effectiveness of antibiotic therapy.
Question 16
A nurse is assessing a patient with suspected meningitis. Which of the following findings would
be most indicative of meningitis? a. Positive Babinski sign
b. Positive Brudzinski’s sign
,c. Negative Romberg test
d. Negative Kernig’s sign
Answer: b. Positive Brudzinski’s sign
Rationale: A positive Brudzinski’s sign, which involves involuntary lifting of the legs when
lifting a patient’s head, is indicative of meningeal irritation and is a common sign of meningitis.
Question 17
A patient with a history of hypertension is prescribed a new antihypertensive medication. Which
of the following instructions should the nurse include in the patient’s teaching? a. “Increase your
intake of potassium-rich foods.”
b. “Monitor your blood pressure regularly.”
c. “Take the medication on an empty stomach.”
d. “Avoid drinking grapefruit juice.”
Answer: b. “Monitor your blood pressure regularly.”
Rationale: It is important for patients on antihypertensive medications to monitor their blood
pressure regularly to ensure the medication is effective and to detect any significant changes.
Question 18
A nurse is caring for a patient with cirrhosis of the liver. Which of the following laboratory
results would the nurse expect to be elevated? a. Albumin
b. Bilirubin
c. Hemoglobin
d. Platelets
Answer: b. Bilirubin
Rationale: In patients with cirrhosis, liver function is impaired, leading to an accumulation of
bilirubin in the blood, which results in elevated bilirubin levels.
Question 19
A patient is admitted with acute pancreatitis. Which of the following interventions should the
nurse implement first? a. Administering pain medication
b. Initiating enteral nutrition
c. Encouraging oral fluids
d. Placing the patient in a supine position
Answer: a. Administering pain medication
Rationale: Pain management is a priority in patients with acute pancreatitis due to the severe
abdominal pain associated with the condition.
Question 20
A nurse is providing care for a patient with a chest tube. Which of the following observations
would require immediate intervention? a. Continuous bubbling in the water seal chamber
b. Tidaling in the water seal chamber
c. Drainage of 50 mL per hour
d. The chest tube is secured with tape
, Answer: a. Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling in the water seal chamber indicates an air leak, which requires
immediate intervention to prevent complications.
Question 21
A nurse is caring for a patient with a new colostomy. Which of the following statements
indicates that the patient needs further teaching about colostomy care? a. “I will change the
colostomy bag every day.”
b. “I will clean around the stoma with mild soap and water.”
c. “I will avoid foods that cause gas and odor.”
d. “I will check the stoma for color and swelling.”
Answer: a. “I will change the colostomy bag every day.”
Rationale: Colostomy bags do not need to be changed daily unless there is a specific reason
such as leakage or skin irritation. Typically, they are changed every 3-7 days.
Question 22
A patient with a history of atrial fibrillation is prescribed warfarin. Which of the following
laboratory tests should the nurse monitor to evaluate the effectiveness of the medication? a.
Complete blood count (CBC)
b. Prothrombin time (PT) and International Normalized Ratio (INR)
c. Activated partial thromboplastin time (aPTT)
d. Serum potassium level
Answer: b. Prothrombin time (PT) and International Normalized Ratio (INR)
Rationale: PT and INR are used to monitor the effectiveness of warfarin therapy and to ensure
that the patient is within the therapeutic range to prevent clot formation.
Question 23
A nurse is providing care for a patient with a nasogastric (NG) tube. Which of the following
actions should the nurse take to ensure proper NG tube function? a. Flush the tube with 30 mL of
air every 4 hours
b. Keep the head of the bed flat
c. Check the tube placement before each feeding
d. Administer medications through the tube without flushing
Answer: c. Check the tube placement before each feeding
Rationale: It is essential to check the placement of the NG tube before each feeding to ensure it
is in the correct position and to prevent complications such as aspiration.
Question 24
A patient with a history of myocardial infarction is prescribed a beta-blocker. Which of the
following side effects should the nurse monitor for? a. Tachycardia
b. Hypotension
c. Hyperglycemia
d. Hyperkalemia
Question 1:
A 65-year-old female patient with a history of chronic obstructive pulmonary disease (COPD) is
admitted to the hospital with shortness of breath and increased sputum production. What is the
primary goal of nursing care for this patient?
A. Encourage a high-protein diet B. Minimize the patient’s oxygen requirements C. Prevent
secondary infections D. Promote hydration
Answer: B. Minimize the patient’s oxygen requirements
Rationale: The primary goal in managing a patient with COPD is to minimize their oxygen
requirements to reduce the workload on the respiratory system. This can be achieved through
interventions such as administering bronchodilators, providing supplemental oxygen as needed,
and encouraging rest.
Question 2:
A patient with type 1 diabetes mellitus is learning how to self-administer insulin. Which
injection site should the nurse recommend for the fastest absorption?
A. Thigh B. Buttock C. Abdomen D. Upper arm
Answer: C. Abdomen
Rationale: The abdomen is the preferred site for insulin injections because it has the fastest
absorption rate compared to other sites such as the thigh, buttock, or upper arm. This is
particularly important for rapid-acting insulin.
Question 3:
The nurse is caring for a patient with a new colostomy. Which of the following is the most
appropriate initial action to help the patient adapt to the colostomy?
,A. Encourage the patient to look at the stoma B. Teach the patient how to change the colostomy
bag C. Provide written materials about colostomy care D. Refer the patient to a colostomy
support group
Answer: A. Encourage the patient to look at the stoma
Rationale: Encouraging the patient to look at the stoma is an important initial step in helping
them adapt to the colostomy. It helps the patient begin to accept the change in their body and is a
precursor to further education and self-care practices.
Question 4:
A patient is receiving intravenous (IV) morphine for postoperative pain. Which assessment
finding requires immediate intervention by the nurse?
A. Respiratory rate of 8 breaths per minute B. Heart rate of 90 beats per minute C. Blood
pressure of 140/90 mmHg D. Temperature of 37.5°C (99.5°F)
Answer: A. Respiratory rate of 8 breaths per minute
Rationale: A respiratory rate of 8 breaths per minute indicates respiratory depression, which is a
serious side effect of morphine and requires immediate intervention. The nurse should consider
administering naloxone and providing supportive care.
Question 5:
A patient with heart failure is prescribed furosemide (Lasix). Which laboratory value should the
nurse monitor closely?
A. Hemoglobin B. Potassium C. Sodium D. Calcium
Answer: B. Potassium
,Rationale: Furosemide is a loop diuretic that can cause significant potassium loss. Monitoring
potassium levels is essential to prevent hypokalemia, which can lead to serious cardiac
arrhythmias.
Question 6:
A nurse is caring for a patient with a suspected myocardial infarction (MI). Which diagnostic test
is most specific for confirming an MI?
A. Troponin I B. Creatine kinase (CK) C. Myoglobin D. Electrocardiogram (ECG)
Answer: A. Troponin I
Rationale: Troponin I is the most specific and sensitive biomarker for myocardial infarction. It
remains elevated for a longer period compared to other markers and is specific to cardiac muscle
injury.
Question 7:
A patient with chronic kidney disease (CKD) is receiving hemodialysis. Which dietary
modification should the nurse recommend?
A. High protein, low potassium B. Low protein, high potassium C. Low sodium, high
phosphorus D. High calcium, low sodium
Answer: A. High protein, low potassium
Rationale: Patients with CKD often require a diet that is high in protein to compensate for
protein loss during dialysis but low in potassium to prevent hyperkalemia, which can be life-
threatening.
Question 8:
A nurse is assessing a patient who has been diagnosed with hyperthyroidism. Which symptom is
most indicative of this condition?
,A. Bradycardia B. Weight gain C. Heat intolerance D. Constipation
Answer: C. Heat intolerance
Rationale: Heat intolerance is a common symptom of hyperthyroidism due to the increased
metabolic rate. Other symptoms include weight loss, tachycardia, and increased bowel
movements.
Question 9:
A patient is admitted with acute pancreatitis. Which laboratory value is most indicative of this
condition?
A. Elevated serum amylase B. Elevated serum bilirubin C. Elevated serum creatinine D.
Elevated serum calcium
Answer: A. Elevated serum amylase
Rationale: Elevated serum amylase is a key indicator of acute pancreatitis. It is often
accompanied by elevated serum lipase levels, which are more specific to pancreatic injury.
Question 10:
A nurse is caring for a patient with severe anemia. Which of the following symptoms is least
likely to be associated with anemia?
A. Fatigue B. Pallor C. Jaundice D. Tachycardia
Answer: C. Jaundice
,Rationale: Jaundice is not commonly associated with anemia unless it is hemolytic anemia,
where there is excessive breakdown of red blood cells. Common symptoms of anemia include
fatigue, pallor, and tachycardia.
Question 11
A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy.
Which of the following oxygen delivery systems is most appropriate for this patient? a. Nasal
cannula
b. Simple face mask
c. Non-rebreather mask
d. Venturi mask
Answer: d. Venturi mask
Rationale: The Venturi mask is the most appropriate oxygen delivery system for patients with
COPD because it delivers a precise concentration of oxygen, which is crucial for these patients to
avoid oxygen-induced hypoventilation.
Question 12
A nurse is caring for a patient who has just undergone a thyroidectomy. Which of the following
is the most important postoperative assessment? a. Monitoring for signs of hypocalcemia
b. Checking for signs of infection
c. Assessing for pain
d. Observing for signs of hemorrhage
Answer: a. Monitoring for signs of hypocalcemia
Rationale: After a thyroidectomy, it is crucial to monitor for signs of hypocalcemia because the
parathyroid glands, which regulate calcium levels, may have been inadvertently damaged or
removed during surgery.
Question 11
A patient with a history of chronic kidney disease is admitted with hyperkalemia. Which of the
following medications should the nurse anticipate administering to help lower the patient’s
potassium level? a. Sodium bicarbonate
b. Calcium gluconate
c. Insulin and glucose
d. Furosemide
Answer: c. Insulin and glucose
Rationale: Insulin, when given with glucose, helps to shift potassium from the extracellular
space into the cells, thereby lowering the serum potassium level.
Question 12
A nurse is caring for a patient who has been diagnosed with deep vein thrombosis (DVT). Which
of the following interventions is most appropriate? a. Massaging the affected leg
b. Applying warm compresses to the affected leg
,c. Encouraging ambulation
d. Administering anticoagulant therapy
Answer: d. Administering anticoagulant therapy
Rationale: Anticoagulant therapy is essential in the treatment of DVT to prevent further clot
formation and reduce the risk of complications such as pulmonary embolism.
Question 13
A patient with type 1 diabetes is experiencing symptoms of hypoglycemia. Which of the
following is the nurse’s priority action? a. Administering glucagon
b. Giving the patient a glass of orange juice
c. Checking the patient’s blood glucose level
d. Notifying the healthcare provider
Answer: c. Checking the patient’s blood glucose level
Rationale: The nurse should first check the patient’s blood glucose level to confirm
hypoglycemia before administering any treatment.
Question 14
A nurse is providing discharge teaching to a patient who has been prescribed warfarin. Which of
the following statements indicates that the patient understands the teaching? a. “I will take
aspirin for headaches.”
b. “I will eat more green leafy vegetables.”
c. “I will use an electric razor for shaving.”
d. “I will stop taking the medication if I have bruising.”
Answer: c. “I will use an electric razor for shaving.”
Rationale: Using an electric razor helps to reduce the risk of cuts and bleeding, which is
important for patients on anticoagulant therapy like warfarin.
Question 15
A patient with pneumonia is receiving intravenous antibiotics. Which of the following laboratory
tests should the nurse monitor to assess the effectiveness of the treatment? a. White blood cell
count
b. Hemoglobin level
c. Platelet count
d. Blood urea nitrogen (BUN)
Answer: a. White blood cell count
Rationale: Monitoring the white blood cell count helps to assess the body’s response to infection
and the effectiveness of antibiotic therapy.
Question 16
A nurse is assessing a patient with suspected meningitis. Which of the following findings would
be most indicative of meningitis? a. Positive Babinski sign
b. Positive Brudzinski’s sign
,c. Negative Romberg test
d. Negative Kernig’s sign
Answer: b. Positive Brudzinski’s sign
Rationale: A positive Brudzinski’s sign, which involves involuntary lifting of the legs when
lifting a patient’s head, is indicative of meningeal irritation and is a common sign of meningitis.
Question 17
A patient with a history of hypertension is prescribed a new antihypertensive medication. Which
of the following instructions should the nurse include in the patient’s teaching? a. “Increase your
intake of potassium-rich foods.”
b. “Monitor your blood pressure regularly.”
c. “Take the medication on an empty stomach.”
d. “Avoid drinking grapefruit juice.”
Answer: b. “Monitor your blood pressure regularly.”
Rationale: It is important for patients on antihypertensive medications to monitor their blood
pressure regularly to ensure the medication is effective and to detect any significant changes.
Question 18
A nurse is caring for a patient with cirrhosis of the liver. Which of the following laboratory
results would the nurse expect to be elevated? a. Albumin
b. Bilirubin
c. Hemoglobin
d. Platelets
Answer: b. Bilirubin
Rationale: In patients with cirrhosis, liver function is impaired, leading to an accumulation of
bilirubin in the blood, which results in elevated bilirubin levels.
Question 19
A patient is admitted with acute pancreatitis. Which of the following interventions should the
nurse implement first? a. Administering pain medication
b. Initiating enteral nutrition
c. Encouraging oral fluids
d. Placing the patient in a supine position
Answer: a. Administering pain medication
Rationale: Pain management is a priority in patients with acute pancreatitis due to the severe
abdominal pain associated with the condition.
Question 20
A nurse is providing care for a patient with a chest tube. Which of the following observations
would require immediate intervention? a. Continuous bubbling in the water seal chamber
b. Tidaling in the water seal chamber
c. Drainage of 50 mL per hour
d. The chest tube is secured with tape
, Answer: a. Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling in the water seal chamber indicates an air leak, which requires
immediate intervention to prevent complications.
Question 21
A nurse is caring for a patient with a new colostomy. Which of the following statements
indicates that the patient needs further teaching about colostomy care? a. “I will change the
colostomy bag every day.”
b. “I will clean around the stoma with mild soap and water.”
c. “I will avoid foods that cause gas and odor.”
d. “I will check the stoma for color and swelling.”
Answer: a. “I will change the colostomy bag every day.”
Rationale: Colostomy bags do not need to be changed daily unless there is a specific reason
such as leakage or skin irritation. Typically, they are changed every 3-7 days.
Question 22
A patient with a history of atrial fibrillation is prescribed warfarin. Which of the following
laboratory tests should the nurse monitor to evaluate the effectiveness of the medication? a.
Complete blood count (CBC)
b. Prothrombin time (PT) and International Normalized Ratio (INR)
c. Activated partial thromboplastin time (aPTT)
d. Serum potassium level
Answer: b. Prothrombin time (PT) and International Normalized Ratio (INR)
Rationale: PT and INR are used to monitor the effectiveness of warfarin therapy and to ensure
that the patient is within the therapeutic range to prevent clot formation.
Question 23
A nurse is providing care for a patient with a nasogastric (NG) tube. Which of the following
actions should the nurse take to ensure proper NG tube function? a. Flush the tube with 30 mL of
air every 4 hours
b. Keep the head of the bed flat
c. Check the tube placement before each feeding
d. Administer medications through the tube without flushing
Answer: c. Check the tube placement before each feeding
Rationale: It is essential to check the placement of the NG tube before each feeding to ensure it
is in the correct position and to prevent complications such as aspiration.
Question 24
A patient with a history of myocardial infarction is prescribed a beta-blocker. Which of the
following side effects should the nurse monitor for? a. Tachycardia
b. Hypotension
c. Hyperglycemia
d. Hyperkalemia
