HESI Exit Exam Nursing Review

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Sample questions from HESI Exit Exam Nursing Review

This material has 20 questions with answers and rationales. Here are the first 5.

1. 1.The RN receives reports on four clients. Which client should the RN assess first?

   • A.A. A client with chronic heart failure whose weight increased 0.5 kg over 3 days without dyspnea
   • B.B. A client with pneumonia who is newly confused and has a respiratory rate of 32/min
   • C.C. A client 1 day after surgery reporting incisional pain of 6/10 with stable vital signs
   • D.D. A client with diabetes who requests discharge teaching before lunch

   Rationale: B is correct because new confusion and tachypnea suggest acute oxygenation or perfusion deterioration. A requires follow-up but lacks current instability. C needs pain assessment and treatment, but the findings do not outrank possible respiratory compromise. D is important but can wait until urgent needs are addressed.

2. 2.A client receiving packed red blood cells develops chills, back pain, and dyspnea. What should the nurse do first?

   • A.A. Slow the infusion and reassess in 15 minutes
   • B.B. Obtain a urine specimen before changing the infusion
   • C.C. Stop the transfusion
   • D.D. Administer the next scheduled antipyretic

   Rationale: C is correct because the suspected reaction requires immediate removal of the exposure. The nurse then supports the client, maintains appropriate IV access, and follows the reaction protocol. A continues exposure to the suspected cause. B may be part of later investigation but must not delay stopping the blood. D does not address the potentially life-threatening reaction.

3. 3.A conscious adult with diabetes is shaky and diaphoretic. Glucose is 58 mg/dL, and swallowing is intact. Which action is best?

   • A.A. Give 15 g of rapid-acting carbohydrate and recheck glucose in 15 minutes
   • B.B. Give scheduled rapid-acting insulin and then provide lunch
   • C.C. Wait 30 minutes to see whether symptoms resolve
   • D.D. Offer only a high-fat snack and recheck at bedtime

   Rationale: A is correct because the client has hypoglycemia and can safely receive oral treatment. B would worsen hypoglycemia. C delays necessary treatment. D provides slower glucose absorption and an unsafe reassessment interval; additional nutrition may be needed after initial correction, but it does not replace rapid treatment.

4. 4.Which potassium order requires clarification before administration?

   • A.A. Oral potassium chloride with food for a client who can swallow
   • B.B. Diluted IV potassium chloride by infusion pump with ordered monitoring
   • C.C. Repeat potassium measurement after a hemolyzed specimen in a stable client
   • D.D. Potassium chloride 20 mEq by IV push

   Answer and rationale are in the full material.

5. 5.Which task is most appropriate for the RN to delegate to trained unlicensed assistive personnel?

   • A.A. Interpret new crackles in a client receiving IV fluids
   • B.B. Obtain and report a routine daily weight for a stable client
   • C.C. Decide whether a client's swallowing has improved after a stroke
   • D.D. Teach a newly diagnosed client how to adjust insulin doses

   Answer and rationale are in the full material.