HESI RN Exit Exam Legacy V2 Study Guide

HESI RN Exit Exam Legacy V2 Study Guide with 150 Questions 2025/2026 Contents

• Introduction3
• Multiple-Choice Questions3

2.1 Priority Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2.2 Pharmacology Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 2.3 Medical-Surgical Questions . . . . . . . . . . . . . . . . . . . . . . . . . 5 2.4 Pediatric Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 2.5 Maternity Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

• Select-All-That-Apply Questions9

3.1 Infection Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 3.2 Pharmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

• NGN-Style Case Study Questions12

4.1 Case Study 1: Postpartum Care . . . . . . . . . . . . . . . . . . . . . . . 12 4.2 Case Study 2: Pediatric Asthma . . . . . . . . . . . . . . . . . . . . . . . 13 4.3 Case Study 3: Myocardial Infarction . . . . . . . . . . . . . . . . . . . . 15 4.4 Case Study 4: Diabetic Ketoacidosis . . . . . . . . . . . . . . . . . . . . 16

• Dosage Calculation Questions17

5.1 Fill-in-the-Blank . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 5.2 Calculation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

• Hot Spot Questions18

6.1 Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

• Psychiatric Nursing Questions19
• Additional Questions20

8.1 Medical-Surgical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 8.2 Pediatric . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 8.3 Maternity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 8.4 Psychiatric Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

• Additional Questions25

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9.1 Medical-Surgical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 9.2 Pediatric . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 9.3 Maternity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 9.4 Psychiatric Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 10 Additional Dosage Calculations30 11 Additional Hot Spot Questions30 12 Additional NGN Case Studies31 12.1 Case Study 5: Sepsis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 12.2 Case Study 6: Stroke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 12.3 Case Study 7: COPD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 12.4 Case Study 8: Renal Failure . . . . . . . . . . . . . . . . . . . . . . . . . 35 12.5 Additional Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 13 Study Tips36

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• Introduction

This study guide provides 150 practice questions designed to mimic the HESI RN Exit Exam Legacy V2, assessing readiness for the NCLEX-RN. Questions cover nursing process, client needs, pharmacology, medical-surgical, pediatrics, ma- ternity, psychiatric nursing, and Next Generation NCLEX (NGN)-style case stud- ies. Each question includes a detailed rationale to promote understanding. Use with reputable resources likeHESI Comprehensive Review for the NCLEX-RNor Mometrix HESI Study Guide 2024-2025.

• Multiple-Choice Questions

2.1 Priority Questions

Question 1:A client with heart failure develops dyspnea, crackles, and HR 110

bpm. What is the priority action?

• Administer oxygen at 2 L/min via nasal cannula
• Elevate the head of the bed to 45 degrees
• Notify the healthcare provider
• Check blood pressure

Answer:A

Rationale:Symptoms suggest acute pulmonary edema. Oxygen (A) addresses

hypoxia per ABCs.Reference: HESI Comprehensive Review

Question 2:A client with chest pain shows ST elevation on ECG. What is the pri-

ority?

• Administer aspirin
• Prepare for thrombolytic therapy
• Obtain another ECG
• Apply oxygen at 4 L/min

Answer:D

Rationale:Oxygen (D) reduces myocardial oxygen demand.

Question 3:A client with a head injury has unequal pupils and decreasing con-

sciousness. What is the priority?

• Administer mannitol
• Elevate the head of the bed
• Notify the neurologist

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• Check blood glucose

Answer:C

Rationale:Symptoms indicate increased intracranial pressure; notifying the

neurologist (C) is critical.

Question 4:A client with 30% burns is hypotensive. What is the priority?

• Administer IV fluids
• Apply sterile dressings
• Assess pain level
• Insert a urinary catheter

Answer:A

Rationale:IV fluids (A) correct hypovolemia.

Question 5:A client with anaphylaxis has stridor and wheezing. What is the

priority?

• Administer epinephrine
• Apply oxygen
• Start IV fluids
• Monitor vital signs

Answer:A

Rationale:Epinephrine (A) reverses anaphylaxis rapidly.

2.2 Pharmacology Questions

Question 6:A nurse administers digoxin 0.125 mg. Available is 0.25 mg/tablet.

How many tablets?

• 0.5 tablet
• 1 tablet
• 2 tablets
• 1.5 tablets

Answer:A

Rationale:(0.125 mg / 0.25 mg) = 0.5 tablet.

Question 7:A client is prescribed amoxicillin 500 mg. Available is 250 mg/5 mL.

How many mL?

• 5 mL
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