HESI RN Exit Exam
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Free HESI RN Exit Exam Questions
A new member joins the nursing team, spreads a book on the table, puts items on two chairs, and sits on a third chair. The members of the group are forced to move closer and remove their possessions from the table. What action should the nurse leader take
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Move to welcome and accommodate a new person
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Ask the new person to move belongings to accommodate others
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Tell the new person to move belongings because of limited space
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Bring in additional chairs so that all staff members can be seated
Explanation
Correct Answer B: Ask the new person to move belongings to accommodate others
Explanation:
B) Ask the new person to move belongings to accommodate others.
The nurse leader must address the situation directly but professionally by guiding the new member to demonstrate respect for the group and shared space. Asking the new person to move their belongings sets a standard for fairness, courtesy, and collaboration while avoiding unnecessary conflict. It teaches appropriate behavior in a constructive manner.
Why Other Options Are Wrong:
A) Move to welcome and accommodate a new person.
While welcoming is important, this response ignores the inconsiderate behavior and does not address the disruption to the team’s dynamic.
C) Tell the new person to move belongings because of limited space.
This phrasing is too directive and potentially confrontational. It risks embarrassing the new member rather than fostering a cooperative team environment.
D) Bring in additional chairs so that all staff members can be seated.
This solves the seating issue temporarily but does not address the underlying behavior. The team member must learn to respect shared space without creating inconvenience for others.
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.
The nurse-manager is involved in agency restructuring. During this re-engineering process, it is most important for the nurse to address which employee concern?
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Potential changes in employee benefits.
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Changes in job descriptions
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New management's expectations
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Employees' job security.
Explanation
Correct Answer:
D. Employees' job security
Explanation
During organizational restructuring or re-engineering, employees’ greatest concern is usually about whether they will still have a job. Fear of job loss creates high levels of stress, anxiety, and resistance to change. Addressing job security first helps reduce fear, promotes trust, and increases employee willingness to adapt to new processes or expectations. Once staff feel secure about employment, other concerns such as benefits, roles, and expectations can be addressed effectively.
Why Other Options Are Wrong
A. Potential changes in employee benefits
While important, benefits are a secondary concern compared to job security. If employees fear losing their jobs, benefit discussions become irrelevant.
B. Changes in job descriptions
Job roles may shift with restructuring, but employees must first feel reassured that they will retain employment before focusing on new responsibilities.
C. New management's expectations
Expectations are important for performance, but until concerns about job security are addressed, employees are unlikely to engage with management’s vision or goals.
A client arrives to the emergency department with chest pain after taking sildenafil. Based on the client's history, which medication should the nurse withhold?
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Morphine
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Nitroglycerin
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Aspirin
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Heparin
Explanation
Correct Answer:
B. Nitroglycerin.
Explanation of Correct Answer
B. Nitroglycerin.
Sildenafil (Viagra) is a phosphodiesterase-5 inhibitor used for erectile dysfunction. When combined with nitrates such as nitroglycerin, it can cause profound, life-threatening hypotension due to synergistic vasodilation. For this reason, nitroglycerin must be withheld if the client has taken sildenafil within the past 24–48 hours, and the healthcare provider should be notified immediately.
Why Other Options Are Incorrect
A. Morphine
Morphine is commonly used to relieve chest pain and anxiety in acute coronary syndrome. It does not interact with sildenafil.
C. Aspirin
Aspirin is standard therapy for suspected myocardial infarction to inhibit platelet aggregation. It does not have a contraindication with sildenafil.
D. Heparin
Heparin is used to prevent clot formation in acute coronary events. It does not interact with sildenafil and is safe to administer.
A 35 year-old client with sickle cell crisis is talking on the telephone but stops as the nurse enters the room to request something for pain. The nurse should
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Administer a placebo
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Encourage increased fluid intake
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Administer the prescribed analgesia
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Recommend relaxation exercises for pain control
Explanation
Correct Answer C. Administer the prescribed analgesia
Explanation:
C. Administer the prescribed analgesia
Clients experiencing a sickle cell crisis suffer from severe pain caused by vascular occlusion and tissue ischemia. The appropriate nursing action is to promptly administer the prescribed analgesic as ordered, usually opioids. Pain management is the priority in a crisis to reduce suffering, prevent complications, and support mobility and oxygenation. Although fluids and relaxation techniques are helpful adjuncts, they do not replace the immediate need for pharmacological pain relief.
Why Other Options Are Incorrect:
A. Administer a placebo
Administering a placebo is unethical and violates patient trust. It disregards the real physiological pain associated with sickle cell crisis and undermines therapeutic communication.
B. Encourage increased fluid intake
Hydration is important in sickle cell management because it reduces blood viscosity and helps prevent further sickling. However, it does not address the client’s immediate need for pain control. Fluids are supportive but not the primary action when pain is acute and severe.
D. Recommend relaxation exercises for pain control
Relaxation and distraction techniques can assist in coping with pain, but they are supplemental methods. They are inappropriate as the sole response during a crisis when the client requires prompt pharmacological intervention to relieve intense pain.
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.
A newly hired unlicensed assistive personnel (UAP) is assigned to a home healthcare team along with two experienced UAPs. Which intervention should the home health nurse implement to ensure adequate care for all clients?
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Assign the newly hired UAP to clients who require the least complex level of care
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Review the UAP's skills checklist and experience with the person who hired the UAP.
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Ask the most experienced UAP on the team to partner with the newly hired UAP.
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Evaluate the newly hired UAP's level of competency by observing the UAP deliver care.
Explanation
Correct Answer:
D. Evaluate the newly hired UAP's level of competency by observing the UAP deliver care.
Explanation of Correct Answer
The nurse is ultimately responsible for client care and delegation. To ensure client safety and appropriate delegation, the nurse must directly assess the competency of the newly hired UAP. Observation allows the nurse to verify actual skills and determine if the UAP can safely perform tasks within their scope. Relying solely on reports or assignments without personal assessment does not provide adequate assurance of safe care. Direct evaluation is evidence-based and aligns with the nurse’s accountability.
Why Other Options Are Incorrect
A. Assign the newly hired UAP to clients who require the least complex level of care.
Although giving simpler tasks may reduce risk, this does not ensure competency or safety. The nurse cannot assume ability without first assessing the UAP’s skills. Delegation requires validation of competence, not assumptions.
B. Review the UAP's skills checklist and experience with the person who hired the UAP.
A checklist or hiring report may provide background information, but it does not replace firsthand observation of skills. Paper records alone cannot guarantee safe performance in real care settings.
C. Ask the most experienced UAP on the team to partner with the newly hired UAP.
Pairing with an experienced UAP may provide guidance, but it does not relieve the nurse of responsibility for evaluating the new employee’s competency. Peer supervision is not a substitute for direct nursing oversight.
The nurse has been teaching a client with Insulin Dependent Diabetes Mellitus. Which statement by the client indicates a need for further teaching
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I use a sliding scale to adjust regular insulin to my sugar level.
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Since my eyesight is so bad, I ask the nurse to fill several syringes.
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I keep my regular insulin bottle in the refrigerator.
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I always make sure to shake the NPH bottle hard to mix it well.
Explanation
Correct Answer D: I always make sure to shake the NPH bottle hard to mix it well.
Explanation:
NPH insulin is a suspension and should be gently rolled between the hands to mix, not shaken vigorously. Shaking can cause frothing and lead to clumping of insulin particles, which may alter its effectiveness and dosing accuracy. This statement indicates a knowledge deficit and a need for reinforcement.
Why Other Options Are Wrong:
A) I use a sliding scale to adjust regular insulin to my sugar level.
This is appropriate—sliding scale insulin regimens are used to adjust short-acting insulin based on blood glucose levels.
B) Since my eyesight is so bad, I ask the nurse to fill several syringes.
Pre-filling syringes by a nurse for a visually impaired patient is a safe and acceptable practice, provided they are stored correctly.
C) I keep my regular insulin bottle in the refrigerator.
This is correct—insulin not in use should be refrigerated to maintain potency.
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.
A client admitted to the psychiatric unit diagnosed with major depression wants to sleep during the day, refuses to take a bath, and refuses to eat. Which nursing intervention should the nurse implement first?
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Arrange a meeting with the family to discuss the client's situation
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Establish a structured routine for the client to follow.
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Administer the client's antidepressant medication as prescribed.
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Assess the client's ability to communicate with the other staff members
Explanation
Correct Answer:
B. Establish a structured routine for the client to follow.
Explanation of Correct Answer
B. Establish a structured routine for the client to follow
Clients with major depression often feel overwhelmed and lack motivation for daily activities. A structured routine helps reduce decision-making burden, promotes consistency, and provides gentle encouragement to participate in self-care, eating, and rest at appropriate times. This supportive framework is the best first nursing action to address immediate functional needs while waiting for medication to take therapeutic effect.
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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.