HESI RN Exit Exam
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Free HESI RN Exit Exam Questions
A client reports passing 2 to 3 small, hard stools per week since being placed on a low-residue diet three months ago. Which type of laxative should the nurse expect the healthcare provider to recommend first?
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Emollient
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Osmotic
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Bulk-forming
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Stimulant
Explanation
Correct Answer:
C. Bulk-forming.
Explanation of Correct Answer
C. Bulk-forming.
Bulk-forming laxatives, such as psyllium, are the first-line treatment for chronic constipation. They mimic the effect of dietary fiber by absorbing water into the stool, increasing its bulk, and stimulating normal peristalsis. Since the client is on a low-residue diet (which reduces fiber intake), adding a bulk-forming agent helps restore regular bowel function safely and effectively. These are considered the most natural and least irritating option.
Why Other Options Are Incorrect
A. Emollient.
Emollient (stool softener) laxatives, such as docusate, reduce stool surface tension and allow water to penetrate. They are useful for preventing straining but are less effective for established constipation caused by low dietary fiber.
B. Osmotic.
Osmotic laxatives draw water into the intestines to soften stool and promote motility. They are effective but may cause electrolyte imbalance if used long-term. They are not the first choice for chronic constipation related to low fiber intake.
D. Stimulant.
Stimulant laxatives, such as senna or bisacodyl, increase intestinal motility but can cause cramping and dependency with prolonged use. They are typically reserved for short-term or refractory constipation, not first-line management.
The public health nurse receives funding to initiate a primary prevention program in the community. Which program best fits the nurse's proposal
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Case management and screening for clients with HIV
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Regional relocation center for earthquake victims
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Vitamin supplements for high-risk pregnant women
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Lead screening for children in low-income housing
Explanation
Correct Answer C: Vitamin supplements for high-risk pregnant women
Explanation:
C) Vitamin supplements for high-risk pregnant women.
This is correct because primary prevention aims to prevent disease or injury before it occurs by reducing risk factors and promoting health. Providing vitamin supplements (such as folic acid) to pregnant women prevents neural tube defects and other complications before they develop. This fits the definition of primary prevention.
Why Other Options Are Wrong:
A) Case management and screening for clients with HIV.
Incorrect because screening and case management are forms of secondary prevention—they focus on early detection and managing an existing disease to prevent complications.
B) Regional relocation center for earthquake victims.
Incorrect because this represents tertiary prevention or disaster management, focused on reducing the long-term impact and helping victims recover after an event.
D) Lead screening for children in low-income housing.
Incorrect because screening is secondary prevention, since it aims to detect lead exposure early rather than preventing exposure in the first place.
When assessing a client who had a transurethral resection of the prostate (TURP) one day ago, the nurse observes that his scrotum and penis are edematous. Which intervention(s) should the nurse implement? Select all that apply.
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Remove the indwelling urinary catheter
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Notify the healthcare provider immediately.
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Obtain a specimen for urinalysis
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Put a pillow under the buttocks
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Apply a cold pack to the scrotal and penile areas
Explanation
Correct Answers:
D. Put a pillow under the buttocks. E. Apply a cold pack to the scrotal and penile areas.
Explanation of Correct Answers
D. Put a pillow under the buttocks
Elevating the scrotum with a pillow or rolled towel promotes venous return, reduces edema, and provides comfort. Supporting the area properly is a standard nursing intervention for scrotal swelling post-TURP.
E. Apply a cold pack to the scrotal and penile areas
Cold therapy is effective for reducing edema and relieving discomfort in the immediate postoperative period. Applying cold packs intermittently helps control swelling safely.
Which breakfast option is best for a 16-year-old who has diarrhea, according to the nurse?
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Sausage, poached eggs, and milk
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Granola, strawberries, and tea
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Oatmeal, banana, and herbal tea
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Buttered whole wheat toast and coffee
Explanation
Correct Answer:
C. Oatmeal, banana, and herbal tea.
Explanation of Correct Answer
C. Oatmeal, banana, and herbal tea.
For diarrhea, the recommended diet is bland, low in fat, and easy to digest. Bananas provide potassium to replace electrolytes lost in diarrhea, and oatmeal is gentle on the GI tract. Herbal tea helps with hydration. This choice supports recovery while avoiding foods that worsen symptoms.
While taking vital signs, a critically ill male client grabs the nurse's hand and asks the nurse not to leave. What action is best for the nurse to take?
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Allow the client to hold the nurse's hand until the vital signs can be completed
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Pull up a chair and sit beside the client's bed
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Tell the client that he must release the nurse's hand
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Reassure the client that the nurse will return after all vital signs are taken
Explanation
Correct Answer:
B. Pull up a chair and sit beside the client's bed.
Explanation of Correct Answer
Sitting beside the client demonstrates empathy, therapeutic presence, and emotional support. It reassures the client during a moment of vulnerability, reducing anxiety and fear. By pulling up a chair, the nurse can still complete vital sign assessment while also meeting the client’s emotional needs. This approach balances compassionate care with clinical responsibility, making it the most therapeutic action.
Why Other Options Are Incorrect
A. Allow the client to hold the nurse's hand until the vital signs can be completed.
While supportive, this provides only temporary comfort. It does not fully address the client’s underlying anxiety or foster long-term reassurance.
C. Tell the client that he must release the nurse's hand.
This response is dismissive and non-therapeutic. It may increase the client’s distress and damage the nurse-client relationship.
D. Reassure the client that the nurse will return after all vital signs are taken.
Although reassurance is valuable, leaving the client when they are fearful provides inadequate immediate support and may heighten anxiety.
An older adult client who fell at the store is admitted with a possible fracture of the right hip. Which assessment finding should the nurse report to the healthcare provider?
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Right leg externally rotated and shorter than left.
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Wiggles right toes when sole of right foot is tickled.
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Left lower extremity is warm to touch
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Bilateral pedal pulses present and strong
Explanation
Correct Answer:
A. Right leg externally rotated and shorter than left.
Explanation of Correct Answer
A. Right leg externally rotated and shorter than left.
These are classic signs of a hip fracture. Shortening and external rotation of the affected leg occur because of muscle spasm and displacement of the femoral head. This must be reported immediately so diagnostic imaging and treatment can be initiated.
After talking with her partner, a client voluntarily admitted herself to the substance abuse unit. After the second day on the unit the client states to the nurse, "My husband told me to get treatment or he would divorce me. I don't believe I really need treatment but I don't want my husband to leave me." Which response by the nurse would assist the client
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In early recovery, it's quite common to have mixed feelings, but unmotivated people can't get well.
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In early recovery, it's quite common to have mixed feelings, but I didn't know you had been pressured to come.
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In early recovery it's quite common to have mixed feelings, perhaps it would be best to seek treatment on an out client bases.
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In early recovery, it's quite common to have mixed feelings. Let's discuss the benefits of sobriety for you.
Explanation
Correct Answer D: In early recovery, it's quite common to have mixed feelings. Let's discuss the benefits of sobriety for you.
Explanation:
Clients in early recovery often struggle with ambivalence. The therapeutic approach is to acknowledge these mixed feelings while helping the client identify personal motivations for treatment. By encouraging the client to explore the benefits of sobriety for herself, the nurse promotes internal motivation rather than focusing on external pressure. This supports self-efficacy and engagement in treatment.
Why Other Options Are Wrong:
A) In early recovery, it's quite common to have mixed feelings, but unmotivated people can't get well.
This is non-therapeutic and judgmental, shutting down conversation instead of encouraging reflection.
B) In early recovery, it's quite common to have mixed feelings, but I didn't know you had been pressured to come.
This shifts focus away from the client and emphasizes external pressure, which doesn’t help her explore personal reasons for change.
C) In early recovery it's quite common to have mixed feelings, perhaps it would be best to seek treatment on an out client bases.
Suggesting outpatient care avoids addressing the client’s feelings and undermines the treatment plan, potentially encouraging resistance.
A 12-year-old client who had an appendectomy two days ago is receiving 0.9% normal saline at 50 ml/hour. The client’s urine specific gravity is 1.035. What action should the nurse implement
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Evaluate postural blood pressure measurements
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Obtain specimen for urinalysis
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Encourage popsicles and fluids of choice
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Assess bowel sounds in all quadrants
Explanation
Correct Answer C: Encourage popsicles and fluids of choice
Explanation:
C) Encourage popsicles and fluids of choice.
A urine specific gravity of 1.035 is above the normal range (1.005–1.030) and indicates that the child’s urine is highly concentrated, suggesting inadequate hydration. Since the client is postoperative and already on IV fluids, encouraging oral fluids (such as popsicles and other preferred fluids) helps improve hydration status, dilute the urine, and support recovery. This is the most appropriate nursing intervention at this time.
Why Other Options Are Wrong:
A) Evaluate postural blood pressure measurements.
Orthostatic vital signs may help detect dehydration, but the priority intervention is to address the hydration deficit by encouraging fluids.
B) Obtain specimen for urinalysis.
There is no indication of urinary tract infection. The problem here is concentrated urine due to insufficient fluid intake, not infection, so urinalysis is unnecessary at this time.
D) Assess bowel sounds in all quadrants.
Bowel assessment is important after abdominal surgery, but it does not directly address the concern revealed by the high urine specific gravity, which points to hydration status rather than bowel function.
A nurse is performing CPR on an adult who went into cardiopulmonary arrest. Another nurse enters the room in response to the call. After checking the client's pulse and respirations, what should be the function of the second nurse
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Relieve the nurse performing CPR
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Go get the code cart
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Participate with the compressions or breathing
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Validate the client's advanced directive
Explanation
Correct Answer C: Participate with the compressions or breathing
Explanation:
In a cardiac arrest, time is critical. When a second nurse arrives, the priority is to immediately assist in resuscitation efforts to maximize effectiveness. This means alternating compressions to prevent fatigue or taking over rescue breathing while the first nurse continues chest compressions. This teamwork ensures high-quality CPR with minimal interruptions in circulation. Only after resuscitation is stabilized should advanced directives or equipment considerations be addressed.
Why Other Options Are Wrong:
A) Relieve the nurse performing CPR
Not immediately. The best use of the second nurse is to assist rather than abruptly stop and switch. A proper handoff should only occur once rhythm and coordination are established.
B) Go get the code cart
This can be done by someone else (such as a third responder, tech, or staff nearby). The second nurse’s skills are better used in direct resuscitation at this moment.
D) Validate the client’s advanced directive
This is not a priority in an arrest situation. Unless a clear DNR order is already present and verified, the nurse must proceed with life-saving measures.
The nurse has been teaching a client with congestive heart failure about proper nutrition. The selection of which lunch indicates the client has learned about sodium restriction
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Cheese sandwich with a glass of 2% milk
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Sliced turkey sandwich and canned pineapple
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Cheeseburger and baked potato
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Mushroom pizza and ice cream
Explanation
Correct Answer B: Sliced turkey sandwich and canned pineapple
Explanation:
Clients with congestive heart failure must follow a low-sodium diet to prevent fluid retention and reduce cardiac workload. Fresh fruits like canned pineapple (in its own juice) are naturally low in sodium. A simple turkey sandwich (if made with fresh, unprocessed turkey and low-sodium bread) is a better choice compared to cheese, pizza, or processed foods, which are high in sodium.
Why Other Options Are Wrong:
A) Cheese sandwich with a glass of 2% milk
Both cheese and milk contain significant sodium, making this a poor choice.
C) Cheeseburger and baked potato
Cheeseburgers have high sodium from processed cheese and seasoned meat; unless the potato is plain, toppings may add more sodium.
D) Mushroom pizza and ice cream
Pizza is one of the highest-sodium foods (cheese, sauce, processed dough), making it inappropriate for sodium restriction. Ice cream also contains some sodium.
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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.