HESI RN Exit Exam
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Free HESI RN Exit Exam Questions
When caring for a client with a post right thoracotomy who has undergone an upper lobectomy, the nurse focuses on pain management to promote
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Relaxation and sleep
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Deep breathing and coughing
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Incisional healing
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Range of motion exercises
Explanation
Correct Answer B: Deep breathing and coughing
Explanation:
After a thoracotomy and lobectomy, pain control is essential so the client can perform deep breathing and coughing exercises. These activities expand the lungs, clear secretions, and prevent atelectasis or pneumonia. Without adequate pain relief, the client will avoid breathing deeply or coughing because of discomfort, which can lead to respiratory complications. Thus, pain management directly supports effective ventilation and airway clearance, making it the priority.
Why Other Options Are Wrong:
A) Relaxation and sleep
Although rest is beneficial for recovery, pain management in this context is not primarily aimed at promoting sleep but at preventing respiratory complications.
C) Incisional healing
Pain control improves comfort, but healing of the incision depends more on proper surgical care, nutrition, and infection prevention than pain management.
D) Range of motion exercises
While ROM is important for overall mobility and preventing stiffness, the immediate concern after thoracic surgery is maintaining adequate respiratory function, not mobility.
The nurse is responsible for several elderly clients, including a client on bed rest with a skin tear and hematoma from a fall 2 days ago. What is the best care assignment for this client
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Assign an RN to provide total care of the client
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Assign a nursing assistant to help the client with self-care activities
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Delegate complete care to an unlicensed assistive personnel
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Supervise a nursing assistant for skin care
Explanation
Correct Answer D: Supervise a nursing assistant for skin care
Explanation:
A client with a skin tear and hematoma requires careful monitoring to prevent infection, promote healing, and avoid further injury. While a nursing assistant can provide routine hygiene and mobility support, the nurse must supervise to ensure proper technique and skin protection. This ensures safe delegation and maintains accountability for the client’s condition.
Why Other Options Are Wrong:
A) Assign an RN to provide total care of the client
This is unnecessary. The RN should not provide all care personally but rather prioritize tasks, supervise, and delegate appropriately.
B) Assign a nursing assistant to help the client with self-care activities
While this supports independence, it doesn’t directly address the specific need for close supervision of skin care after a fall injury.
C) Delegate complete care to an unlicensed assistive personnel
This is unsafe. Skin assessment and ongoing monitoring are nursing responsibilities and cannot be fully delegated.
An older client's spouse reports to the nurse that there has been a behavior change in the client for the past several days. The client was recently seen by the healthcare provider at the clinic and was treated for seasonal allergies and insomnia. Which action is most important for the nurse to implement?
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Encourage the client to engage in social activities
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Review medications for drug and food interactions
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Appraise light sensitivity, tiredness, and dizzy spells
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Observe carefully for extrapyramidal symptoms (EPS)
Explanation
Correct Answer:
B. Review medications for drug and food interactions.
Explanation of Correct Answer
Older adults are highly susceptible to adverse drug effects, especially when prescribed medications for conditions like allergies (antihistamines) and insomnia (sedatives or hypnotics). Polypharmacy and altered drug metabolism can lead to confusion, agitation, or behavioral changes. Reviewing the client’s medications for potential drug–drug or drug–food interactions is the most important priority because it directly addresses the likely cause of the behavior change and guides safe intervention.
Why Other Options Are Incorrect
A. Encourage the client to engage in social activities.
While social activity is beneficial for mental health, this does not address the acute behavior change that may be medication-induced. The priority is investigating potentially harmful drug effects.
C. Appraise light sensitivity, tiredness, and dizzy spells.
These assessments may reveal side effects but are less important than a full medication review to identify harmful interactions causing behavioral changes.
D. Observe carefully for extrapyramidal symptoms (EPS).
EPS are side effects associated with antipsychotics, not typical antihistamines or sedatives prescribed for allergies and insomnia. This assessment is not the most relevant priority in this situation.
The nurse assesses delayed gross motor development in a 3 year-old child. The inability of the child to do which action confirms this finding
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Stand on 1 foot
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Catch a ball
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Skip on alternate feet
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Ride a bicycle
Explanation
Correct Answer A: Stand on 1 foot
Explanation:
By age 3, a child is typically able to stand on one foot for at least a second or two as part of normal gross motor development. Failure to achieve this milestone suggests delayed gross motor development. Standing on one foot demonstrates balance, coordination, and muscular control appropriate for this age.
Why Other Options Are Wrong:
B) Catch a ball
Catching a ball with control generally develops closer to age 4. A 3-year-old may attempt but is not expected to master this skill.
C) Skip on alternate feet
Skipping usually develops around age 5, not at age 3, so it is not an expected milestone at this age.
D) Ride a bicycle
Riding a bicycle without training wheels is typically expected around age 6 or later, so inability at age 3 is normal.
The nurse is preparing to administer a histamine 2-receptor antagonist to a client with peptic ulcer disease. What is the primary purpose of this drug classification
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Neutralize hydrochloric (HCl) acid in the stomach
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Decrease the amount of HCl secretion by the parietal cells in the stomach
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Inhibit the action of acetylcholine by blocking parasympathetic nerve endings
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Destroy microorganisms causing stomach inflammation
Explanation
Correct Answer B. Decrease the amount of HCl secretion by the parietal cells in the stomach
Explanation:
Histamine 2-receptor antagonists (e.g., ranitidine, famotidine) work by blocking H2 receptors in the parietal cells of the stomach lining. This reduces the secretion of hydrochloric acid, lowering gastric acidity, and allowing ulcers to heal while preventing further mucosal damage.
Why the other options are incorrect:
A. Neutralize hydrochloric (HCl) acid in the stomach
This is the action of antacids, not H2-receptor antagonists. Antacids directly neutralize existing stomach acid but do not reduce its production.
C. Inhibit the action of acetylcholine by blocking parasympathetic nerve endings
This describes the action of anticholinergics, not H2 blockers. Anticholinergics reduce gastric secretions by blocking vagal stimulation but are rarely used today due to side effects.
D. Destroy microorganisms causing stomach inflammation
This describes antibiotics used for Helicobacter pylori infections in peptic ulcer disease. H2-receptor antagonists do not have antibacterial properties.
Post-procedure nursing interventions for electroconvulsive therapy include
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Applying hard restraints if seizure occurs
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Expecting client to sleep for 4 to 6 hours
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Remaining with client until oriented
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Expecting long-term memory loss
Explanation
Correct Answer C: Remaining with client until oriented
Explanation:
After electroconvulsive therapy (ECT), the client often experiences temporary disorientation and confusion. The nurse’s priority is to remain with the client to provide reassurance, ensure safety, and reorient them until they are fully awake and stable. This intervention helps reduce anxiety, promotes safety, and meets the client’s immediate psychological needs.
Why Other Options Are Wrong:
A) Applying hard restraints if seizure occurs
Seizures during ECT are expected and controlled by anesthesia and muscle relaxants. Hard restraints are unnecessary and could cause injury.
B) Expecting client to sleep for 4 to 6 hours
Most clients recover from anesthesia within 30–60 minutes, not hours. Prolonged sleep is not a standard expectation.
D) Expecting long-term memory loss
ECT may cause short-term memory loss or difficulty with recent recall, but long-term memory loss is not typical. This option exaggerates the usual side effects.
A client with chronic obstructive pulmonary disease (COPD) reports increased shortness of breath with activity. Which test should the nurse schedule the client for evaluation of the symptoms?
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Lung biopsy.
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Sweat test
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Antibody testing
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Spirometry
Explanation
Correct Answer:
D. Spirometry.
Explanation of Correct Answer
D. Spirometry.
Spirometry is the primary pulmonary function test used to evaluate COPD. It measures lung volumes, airway flow, and expiratory capacity, helping assess the severity of airflow limitation and progression of the disease. It is the most appropriate test for increased shortness of breath with activity.
Which information is a priority for the RN to reinforce to an older client after intravenous pyelography
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Eat a light diet for the rest of the day
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Rest for the next 24 hours since the preparation and the test is tiring
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During waking hours drink at least 1 8-ounce glass of fluid every hour for the next 2 days
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Measure the urine output for the next day and immediately notify the health care provider if it should decrease
Explanation
Correct Answer C: During waking hours drink at least 1 8-ounce glass of fluid every hour for the next 2 days
Explanation:
Intravenous pyelography (IVP) uses an iodine-based contrast medium that is excreted by the kidneys. The priority teaching for an older client is to increase fluid intake after the test to help flush the dye from the kidneys and reduce the risk of renal complications, especially contrast-induced nephropathy. Drinking one 8-ounce glass of fluid every hour while awake for 48 hours ensures adequate hydration and promotes renal clearance.
Why the other options are incorrect:
A) Eat a light diet for the rest of the day
Dietary changes are not required following IVP. Normal eating can usually be resumed.
B) Rest for the next 24 hours since the preparation and the test is tiring
Rest may be beneficial if the client feels tired, but it is not the priority. Hydration takes precedence to protect kidney function.
D) Measure the urine output for the next day and immediately notify the health care provider if it should decrease
While monitoring urine output is important, it is not the primary instruction. Promoting hydration proactively helps prevent urine output from decreasing.
A client who weighs 22 pounds receives a prescription for amoxicillin 50 mg/kg/day PO in divided doses every 8 hours. The bottle is labeled "Amoxicillin for Oral Suspension, USP 250 mg per 5 mL". How many mL should the nurse administer with each dose?
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2.5 mL
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3.3 mL
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4.5 mL
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6.0 mL
Explanation
Correct Answer:
B. 3.3 mL
Explanation of Correct Answer
B. 3.3 mL
The client weighs 22 lbs, which equals 10 kg. At 50 mg/kg/day, the daily dose is 500 mg. Divided into three doses, that equals 166.7 mg per dose. The concentration is 250 mg per 5 mL (50 mg/mL). 166.7 ÷ 50 = 3.3 mL. Rounded to the nearest tenth, the correct dose is 3.3 mL.
The mother of a 15 month-old child asks the nurse to explain her child's lab results and how they show her child has iron deficiency anemia. The nurse's best response is
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Although the results are here, your doctor will explain them later.
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Your child has less red blood cells that carry oxygen
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The blood cells that carry nutrients to the cells are too large.
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There are not enough blood cells in your child's circulation.
Explanation
Correct Answer B: Your child has less red blood cells that carry oxygen.
Explanation:
Iron deficiency anemia is characterized by low hemoglobin and fewer functional red blood cells to carry oxygen throughout the body. In children, this may result in fatigue, pallor, irritability, and delayed development if untreated. Explaining it in simple terms — fewer oxygen-carrying blood cells — helps the mother understand without medical jargon.
Why Other Options Are Wrong:
A) Although the results are here, your doctor will explain them later.
This response is dismissive and does not provide health teaching. Nurses are responsible for reinforcing and explaining information in understandable terms.
C) The blood cells that carry nutrients to the cells are too large.
This describes macrocytic anemia (e.g., folate or B12 deficiency), not iron deficiency anemia.
D) There are not enough blood cells in your child's circulation.
This describes aplastic anemia or blood loss, not iron deficiency, which is due to small, pale red blood cells lacking hemoglobin, not a total absence of cells.
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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.