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HESI Exit Exam Practice Questions
(2025-2026)
Introduction This document provides 100 NCLEX-style multiple-choice questions to prepare for the HESI Exit Exam (RN) 2025-2026. The questions are distributed across
seven categories: Medical-Surgical Nursing (25), Pharmacology (15), Maternity
Nursing (10), Pediatric Nursing (10), Psychiatric/Mental Health Nursing (10), Lead- ership and Management (10), and NCLEX Readiness/Critical Thinking/Delegation/Priority Setting (20). Each question includes a clinical scenario, four answer options, the correct answer, and a detailed rationale. These questions are designed to mimic the exam’s rigor, focusing on clinical judgment, patient safety, and evidence- based practice.Medical-Surgical Nursing (25 Questions)
- A client with acute pancreatitis reports severe epigastric pain radiating to
- Administer morphine as ordered.
- Encourage oral fluid intake.
- Place the client in a supine position.
- Apply a heating pad to the abdomen.
- A client post-myocardial infarction reports sudden chest pain and dyspnea.
- Administer aspirin 325 mg.
- Obtain a 12-lead ECG and notify the provider.
- Encourage deep breathing exercises.
the back. Which intervention should the nurse prioritize?
Answer: A. Administer morphine as ordered.Rationale: Morphine re- lieves severe pain in pancreatitis, improving patient comfort.Bis incor- rect because oral intake is restricted to reduce pancreatic stimulation.Cis incorrect as the supine position may worsen pain; a semi-Fowler’s position is preferred.Dis incorrect because heat can exacerbate inflammation.
What should the nurse do first?
1 1 / 4
- Administer nitroglycerin sublingually.
- A client with a pulmonary embolism is receiving heparin. The nurse notes
- Continue the infusion and monitor.
- Stop the infusion and notify the provider.
- Reduce the infusion rate.
- Administer vitamin K.
- A client with COPD has an oxygen saturation of 86
- Increase oxygen to 6 L/min.
- Administer a bronchodilator.
- Assess respiratory status and notify the provider.
- Place the client in a prone position.
- A client with a suspected stroke has left-sided weakness. What should the
- Administer thrombolytics.
- Perform a neurological assessment.
- Encourage ambulation.
- Administer oxygen at 4 L/min.
Answer: B. Obtain a 12-lead ECG and notify the provider.Rationale: Chest pain and dyspnea suggest possible reinfarction, requiring immediate ECG to assess ischemia and provider notification for urgent intervention.Ais incorrect as aspirin is for initial MI, not recurrent symptoms.Cis incor- rect as it does not address the emergency.Dis incorrect without ruling out contraindications like hypotension.
hematuria. What should the nurse do?
Answer: B. Stop the infusion and notify the provider.Rationale: Hema- turia indicates possible heparin-induced bleeding, requiring immediate ces- sation and provider consultation.Ais incorrect as continuing risks further bleeding.Cis incorrect as reducing the rate does not address the emer- gency.Dis incorrect as vitamin K is used for warfarin, not heparin.
Answer: C. Assess respiratory status and notify the provider.Rationale: Hypoxemia requires assessment of respiratory distress and provider input to adjust oxygen or therapy safely.Ais incorrect as high-flow oxygen may suppress respiratory drive in COPD.Bis incorrect without assessing the cause of hypoxemia.Dis incorrect as prone positioning is not standard for COPD.
nurse do first?
Answer: B. Perform a neurological assessment.Rationale: A neurologi- cal assessment (e.g., NIH Stroke Scale) confirms stroke severity and guides treatment.Ais incorrect as thrombolytics require confirmation of ischemic
2 2 / 4
stroke.Cis incorrect as ambulation risks falls.Dis incorrect without as- sessing oxygenation needs.
- A client with heart failure has 3+ pitting edema. What should the nurse
- Increase sodium intake.
- Elevate legs and monitor daily weight.
- Restrict fluids to 500 mL/day.
- Avoid diuretics.
- A client with a closed head injury has increased intracranial pressure. What
- Lower the head of the bed.
- Elevate the head to 30 degrees.
- Encourage coughing.
- Administer a sedative.
- A client with diabetes has a foot ulcer. What should the nurse teach?
- Soak the foot in hot water.
- Inspect feet daily for injuries.
- Wear tight shoes.
- Apply lotion between toes.
- A client with a spinal cord injury reports a severe headache and flushing.
- Administer oxygen.
- Sit the client upright and check for bladder distention.
- Apply a warm compress.
teach?
Answer: B. Elevate legs and monitor daily weight.Rationale: Leg eleva- tion reduces edema, and daily weight monitoring tracks fluid status.Ais incorrect as sodium worsens fluid retention.Cis incorrect as fluid restric- tion is typically 1.5–2 L/day unless specified.Dis incorrect as diuretics are standard in heart failure.
should the nurse do?
Answer: B. Elevate the head to 30 degrees.Rationale: Elevation promotes venous drainage, reducing ICP.Ais incorrect as lowering the head increases ICP.Cis incorrect as coughing raises ICP.Dis incorrect as sedatives may mask neurological changes.
Answer: B. Inspect feet daily for injuries.Rationale: Daily inspection pre- vents complications in diabetic neuropathy.Ais incorrect as hot water risks burns.Cis incorrect as tight shoes impair circulation.Dis incorrect as lotion between toes promotes infection.
What should the nurse do first?
3 3 / 4
- Administer a beta-blocker.
Answer: B. Sit the client upright and check for bladder distention.Ratio-
nale: Symptoms suggest autonomic dysreflexia, often triggered by bladder
distention; sitting upright reduces hypertension.Ais incorrect as oxygen does not address the cause.Cis incorrect as warmth may worsen symp- toms.Dis incorrect without addressing the trigger.
- A client with a burn injury is at risk for which complication?
- Hyperglycemia
- Infection
- Hypokalemia
- Hypertension
- A client with cirrhosis has ascites. What should the nurse monitor?
- Blood glucose
- Abdominal girth
- Platelet count
- Thyroid function
- A client with a fractured femur reports severe pain despite analgesics. What
- Compartment syndrome
- Blood glucose
- Respiratory rate
- Liver function
- A client with a gastrointestinal bleed has a hemoglobin of 6 g/dL. What
- Blood transfusion
- IV antibiotics
- / 4
Answer: B. Infection.Rationale: Burns compromise the skin barrier, in- creasing infection risk.Ais incorrect as burns do not directly cause hy- perglycemia.Cis incorrect as hyperkalemia is more common due to tissue damage.Dis incorrect as burns typically cause hypotension.
Answer: B. Abdominal girth.Rationale: Measuring girth tracks ascites progression.Ais incorrect as glucose is not directly related.Cis relevant but secondary to fluid status.Dis unrelated to ascites.
should the nurse assess?
Answer: A. Compartment syndrome.Rationale: Persistent pain may indi- cate compartment syndrome, a surgical emergency.B,C, andDare incor- rect as they do not directly relate to fracture complications.
should the nurse prepare for?
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