HESI RN Exit Exam
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Free HESI RN Exit Exam Questions
Currently prescribed medications.
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Currently prescribed medications.
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Client's healthcare power of attorney
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Increasing confusion of the client
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Fall at home as reason for admission
Explanation
Correct Answer:
C. Increasing confusion of the client.
Explanation of Correct Answer
C. Increasing confusion of the client
In SBAR, the Situation is presented first. The most urgent and immediate concern is the client’s sudden confusion and agitation, which could indicate complications such as fat embolism syndrome, hypoxia, or delirium. Reporting this change in mental status first ensures the provider is alerted to the acute issue before reviewing background details and recommendations.
After being treated in the emergency department for an opioid overdose two weeks ago, a client arrives to an outpatient treatment clinic. During the admission interview with the nurse, the client denies having a problem with opioid addiction, but admits to gradually increasing the dosage. Which approach is best for the nurse to make?
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Recommend substituting opioids with other pain medication
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Explore other coping stategies aside from using medications
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Provide a list of local Narcotics Anonymous meetings
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Explain that opioid abuse poses a great risk to life
Explanation
Correct Answer:
B. Explore other coping strategies aside from using medications.
Explanation
The client is in denial about having an opioid problem, which makes direct confrontation or providing solutions like referrals less effective. The best approach is to use therapeutic communication and motivational interviewing techniques by exploring coping strategies beyond medication. This opens discussion without judgment, encourages self-reflection, and helps the client recognize problematic patterns at their own pace, fostering trust and engagement in treatment.
Why Other Options Are Wrong
A. Recommend substituting opioids with other pain medication
This is premature because the client does not yet acknowledge addiction. Simply substituting medications does not address denial or underlying issues.
C. Provide a list of local Narcotics Anonymous meetings
Referrals are useful once the client accepts the problem, but denial must first be addressed. Giving resources now may be dismissed or ignored.
D. Explain that opioid abuse poses a great risk to life
While factual, this confrontational approach may increase resistance and defensiveness. Clients in denial often respond poorly to direct warnings.
While a child is hospitalized with acute glomerulonephritis, the parents ask why blood pressure readings are taken so often. Which response by the nurse is most accurate?
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Sodium intake with meals and snacks affects the blood pressure.
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Hypotension leading to sudden shock can develop at any time.
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Elevated blood pressure must be anticipated and identified quickly
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Blood pressure fluctuations means that the condition has become chronic
Explanation
Correct Answer:
C. Elevated blood pressure must be anticipated and identified quickly.
Explanation of Correct Answer
C. Elevated blood pressure must be anticipated and identified quickly
Acute glomerulonephritis often leads to fluid retention and decreased kidney function, which can cause hypertension. Frequent blood pressure monitoring ensures early detection and treatment of hypertension, helping to prevent complications such as seizures, heart failure, or encephalopathy. This is the most accurate explanation for the need to check blood pressure often.
A patient who has a history of unstable angina arrives at the emergency room with persistent chest pain that does not go away when they rest. The customer is diaphoretic, pallid, and worried. What should the nurse do next after taking the client's vital signs?
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Place an indwelling urinary catheter and institute strict intake and output measurements
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Evaluate upper and lower extremities for perfusion, pulse volume, and pitting edema.
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Administer four 81 mg aspirin tablets providing instructions to chew before swallowing
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Secure client consent for coronary angiography and percutaneous coronary intervention.
Explanation
Correct Answer:
C. Administer four 81 mg aspirin tablets providing instructions to chew before swallowing
Explanation
In a client with suspected myocardial infarction (constant chest pain, pale, diaphoretic, and anxious), the priority after vital signs is to administer aspirin immediately. Chewing 325 mg of aspirin inhibits platelet aggregation and reduces clot progression, significantly lowering mortality risk. It is a time-sensitive, evidence-based intervention that must be performed before diagnostic or invasive procedures.
A newly admitted adult client has a diagnosis of hepatitis A. The charge nurse should reinforce to the staff members that the most significant routine infection control strategy, in addition to hand washing, to be implemented is which of these
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Apply appropriate signs outside and inside the room
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Apply a mask with a shield if there is a risk of fluid splash
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Wear a gown to change soiled linens from incontinence
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Have gloves on while handling bedpans with feces
Explanation
Correct Answer D: Have gloves on while handling bedpans with feces
Explanation:
Hepatitis A is transmitted primarily via the fecal-oral route. The most significant infection control measure, aside from diligent hand hygiene, is to wear gloves when handling items contaminated with feces. This prevents direct contact and reduces the risk of transmission to staff or other clients. Since the virus is shed in stool, barrier protection during toileting and waste disposal is crucial.
Why Other Options Are Wrong:
A) Apply appropriate signs outside and inside the room
While helpful for general awareness, signs alone do not prevent transmission. The key precaution is preventing contact with fecal matter.
B) Apply a mask with a shield if there is a risk of fluid splash
Hepatitis A is not spread through respiratory droplets or blood splashes. Masks are not routinely required unless other risks exist.
C) Wear a gown to change soiled linens from incontinence
A gown may help reduce contamination of clothing, but gloves are more critical for direct protection when handling fecal matter.
Which of these findings would the nurse more closely associate with anemia in a 10 month-old infant
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Hemoglobin level of 12 g/dl
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Pale mucosa of the eyelids and lips
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Hypoactivity
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A heart rate between 140 to 160
Explanation
Correct Answer B. Pale mucosa of the eyelids and lips
Explanation:
B. Pale mucosa of the eyelids and lips
Pallor of the conjunctiva, lips, and oral mucosa is a classic and reliable clinical indicator of anemia in infants. It reflects reduced hemoglobin and oxygen-carrying capacity in the blood. In infants, pallor is one of the earliest observable signs of anemia and often prompts further testing to confirm the diagnosis. This finding is more specific to anemia than other general or age-appropriate observations.
Why Other Options Are Incorrect:
A. Hemoglobin level of 12 g/dl
A hemoglobin of 12 g/dl is within the normal range for a 10-month-old infant (typically 10.5–12 g/dl). This does not indicate anemia.
C. Hypoactivity
While some anemic infants may appear fatigued or less active, hypoactivity is a nonspecific symptom. It could result from many causes, including infection, poor nutrition, or developmental variation, making it less directly associated with anemia than pallor.
D. A heart rate between 140 to 160
This heart rate is within the normal range for infants at 10 months old (100–160 beats per minute). Tachycardia can be a compensatory response to anemia, but these values are not abnormal for age and therefore do not specifically indicate anemia.
A client who had a below-the-knee amputation is experiencing severe phantom limb pain (PLP) and asks the nurse if mirror therapy will make the pain stop. Which response by the nurse is likely to be most helpful
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Research indicates that mirror therapy is effective in reducing phantom limb pain
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You can try mirror therapy, but do not expect complete elimination of the pain
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Transcutaneous electrical nerve stimulators (TENS) have been found to be more effective
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Where did you learn about the use of mirror therapy in treating phantom limb pain?
Explanation
Correct Answer A: Research indicates that mirror therapy is effective in reducing phantom limb pain
Explanation:
A) Research indicates that mirror therapy is effective in reducing phantom limb pain.
This is the best response because it provides the client with evidence-based information. Mirror therapy works by using the reflection of the intact limb in a mirror to “trick” the brain into perceiving movement in the amputated limb, which can reduce painful signals. Clinical studies have demonstrated its effectiveness in decreasing both the intensity and frequency of phantom limb pain for many clients. Giving this factual, supportive response validates the client’s concern and encourages the use of a non-invasive, low-risk intervention that may bring meaningful relief.
Why Other Options Are Wrong:
B) You can try mirror therapy, but do not expect complete elimination of the pain.
This sets a discouraging tone. While mirror therapy may not completely remove pain, dismissing its potential reduces hope and minimizes the client’s interest in trying a proven technique.
C) Transcutaneous electrical nerve stimulators (TENS) have been found to be more effective.
This is not accurate. Evidence suggests mirror therapy has stronger benefits for phantom limb pain than TENS. TENS may help some neuropathic pain but is not considered superior for PLP.
D) Where did you learn about the use of mirror therapy in treating phantom limb pain?
This response is not helpful and could feel dismissive. The client is seeking confirmation and guidance, not a challenge about their knowledge source.
A client is receiving external beam radiation to the mediastinum for treatment of bronchial cancer. Which of the following should take priority in planning care
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Esophagitis
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Leukopenia
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Fatigue
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Skin irritation
Explanation
Correct Answer B: Leukopenia
Explanation:
Radiation to the mediastinum exposes the sternum and ribs, which contain active bone marrow, to high doses of radiation. This can suppress bone marrow and lead to leukopenia, placing the client at high risk for life-threatening infections. While all the other effects are expected side effects of mediastinal radiation, infection risk from leukopenia is the highest priority due to its potential severity.
Why Other Options Are Wrong:
A) Esophagitis
Radiation can inflame the esophagus, causing pain and difficulty swallowing, but this is not life-threatening compared to infection risk from leukopenia.
C) Fatigue
Fatigue is a common side effect of both radiation and cancer but is not as urgent or dangerous as leukopenia.
D) Skin irritation
Skin reactions such as redness or dryness are expected and can be managed with supportive care, but they do not pose the same critical risk as leukopenia.
Which of these clients who call the community health clinic would the nurse ask to come in that day to be seen by the health care provider
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I started my period and now my urine has turned bright red.
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I am a diabetic and today I have been going to the bathroom every hour.
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I was started on medicine yesterday for a urine infection. Now my lower belly hurts when I go to the bathroom.
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I went to the bathroom and my urine looked very red and it didn't hurt when I went.
Explanation
Correct Answer B. I am a diabetic and today I have been going to the bathroom every hour.
Explanation:
B. I am a diabetic and today I have been going to the bathroom every hour.
A diabetic reporting frequent urination could be experiencing hyperglycemia, glycosuria, or even the onset of diabetic ketoacidosis (DKA), all of which can escalate rapidly and require immediate assessment and intervention. Polyuria in a diabetic is always concerning because it may indicate poor glucose control and potential metabolic decompensation. This situation warrants same-day evaluation to prevent complications.
Why Other Options Are Incorrect:
A. I started my period and now my urine has turned bright red.
The red urine may actually be menstrual blood rather than hematuria. This is a common occurrence and does not require urgent evaluation unless accompanied by other concerning symptoms.
C. I was started on medicine yesterday for a urine infection. Now my lower belly hurts when I go to the bathroom.
This client may still have dysuria from the UTI, and antibiotics often take 24–48 hours to relieve symptoms. Persistent discomfort is expected early in treatment and does not require immediate same-day assessment unless fever, flank pain, or worsening symptoms occur.
D. I went to the bathroom and my urine looked very red and it didn't hurt when I went.
Painless hematuria is concerning for possible urinary tract pathology, such as stones or malignancy, but it is not an emergency that requires same-day evaluation. This client should be scheduled for an appointment soon but not urgently.
The client who has emphysema and recently experienced a stroke receives a prescription for a metered-dose inhaler with a spacer device. The client asks the nurse if using the spacer is necessary. Which information should the nurse provide?
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It prevents mouth infections when an inhaler is used.
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It allows the medication to slowly enter the lungs.
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It increases the effectiveness of the medication.
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It allows time to inhale the entire dispensed dose.
Explanation
Correct Answer:
C. It increases the effectiveness of the medication.
Explanation of Correct Answer
C. It increases the effectiveness of the medication
A spacer helps deliver more medication directly into the lungs instead of being deposited in the mouth or throat. This is especially helpful for clients who may have difficulty coordinating inhalation due to conditions such as stroke. By improving delivery to the lungs, the spacer increases the overall effectiveness of the prescribed inhaler therapy.
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Frequently Asked Question
The HESI RN Exit Exam is a comprehensive assessment designed to evaluate the readiness of nursing students for licensure and practice. It covers a wide range of topics, including clinical reasoning, pharmacology, medical-surgical nursing, and more, to assess your understanding and application of nursing knowledge.
Preparation for the HESI RN Exit Exam involves reviewing nursing fundamentals, practicing with exam-aligned questions, studying detailed rationales, and using case studies to enhance critical thinking. Updated materials for 2025 standards will also ensure you’re well-prepared for the exam content.
The detailed answer rationales explain why each answer is correct or incorrect, helping you to understand the underlying nursing principles. This is crucial for developing a deeper understanding of nursing concepts, improving clinical decision-making, and preventing errors in practice.
Yes, the practice questions in our guide are designed to closely mirror the format and difficulty level of the HESI RN Exit Exam. They include multiple-choice questions, case studies, and scenarios that require critical thinking and clinical judgment.
The study materials are updated to reflect the latest evidence-based practices, clinical guidelines, and nursing standards for 2025. This ensures you’re studying current, relevant content that matches the exam’s expectations.