HESI RN EXIT EXAM TEST BANK 2026/2027:
COMPLETE WITH VERIFIED ANSWERS &
RATIONALES
SECTION 1: Fundamentals & Safe Care
Q1: A nurse is preparing to insert an indwelling urinary catheter for a post-operative
client. Which action is most important to prevent healthcare-associated infection?
A. Cleanse the meatus with antiseptic solution before insertion
B. Maintain sterile technique throughout the procedure
C. Inflate the balloon with 30 mL of sterile water
D. Secure the catheter to the client’s inner thigh
Correct Answer: B
Rationale: Maintaining sterile technique (Implementation phase) is the single most
effective way to prevent introduction of pathogens during catheter insertion, directly
addressing the CDC’s evidence-based guideline for CAUTI prevention. Option A is
helpful but secondary to overall sterile technique. Option C is incorrect balloon volume
and could cause urethral tearing. Option D is appropriate after insertion but does not
prevent infection.
Q2: During shift report, the nurse learns a confused client has been trying to climb out of
bed. Which action should the nurse take first?
A. Apply wrist restraints
B. Raise all four side rails
C. Perform a fall-risk assessment
,D. Place the bed in the lowest position
Correct Answer: C
Rationale: Assessment precedes intervention. A valid fall-risk score (Analysis phase)
guides least-restrictive, evidence-based interventions and is required by The Joint
Commission. Restraints (A) require a physician order and are last resort; full side-rail use
(B) can be considered a restraint and may increase agitation; lowering the bed (D) is
appropriate later but must follow assessment.
Q3: The nurse discovers that an IV medication infused at twice the prescribed rate. The
client is stable and asymptomatic. What is the nurse’s priority action?
A. Complete an incident report
B. Notify the provider immediately
C. Document the error in the medical record
D. Re-program the pump to the correct rate
Correct Answer: B
Rationale: Even if stable, potential adverse effects require provider evaluation
(Implementation). Immediate notification allows monitoring orders and possible
antidotes. Documentation (C) and incident report (A) occur after client safety is secured.
Simply correcting the rate (D) omits required provider evaluation.
Q4: Which ethical principle is upheld when a nurse respects a competent client’s refusal
of blood products despite potential life-threatening consequences?
A. Beneficence
B. Non-maleficence
,C. Autonomy
D. Justice
Correct Answer: C
Rationale: Autonomy recognizes the client’s right to make informed decisions about their
own care. Beneficence (A) and non-maleficence (B) would support giving the
transfusion, but the client’s autonomous choice takes precedence. Justice (D) pertains to
fair allocation of resources and is unrelated.
Q5: A newly admitted client is drooling and reports sudden difficulty breathing after
eating lunch. What is the nurse’s priority action?
A. Auscultate lung sounds
B. Attempt to arouse the client
C. Perform abdominal thrusts
D. Obtain a pulse oximetry reading
Correct Answer: C
Rationale: Airway obstruction is an immediate threat to life (ABC framework).
Abdominal thrusts (Implementation) directly relieve obstruction. Assessment actions (A,
D) waste critical time; arousal (B) is unnecessary because the client is conscious.
Q6: The nurse notes a discrepancy between the medication administration record and the
narcotic count for a controlled substance. What action should the nurse take first?
A. Verify the count with the previous nurse
B. Notify the pharmacy immediately
C. Document the discrepancy in the log
, D. Report the finding to the nursing supervisor
Correct Answer: A
Rationale: The first step (Assessment) is to verify the count with the nurse who last
administered the drug to rule out mathematical error. Subsequent reporting (B, D) and
documentation (C) occur after verification.
Q7: A client on contact precautions asks why healthcare providers must wear gowns and
gloves. Which response by the nurse is best?
A. “This is hospital policy.”
B. “It prevents you from infecting staff and other patients.”
C. “It protects you from additional infections.”
D. “These precautions stop germ transmission to staff and visitors.”
Correct Answer: D
Rationale: Clients deserve an evidence-based explanation (Implementation—teaching).
Contact precautions prevent transmission of pathogens from the colonized/infected client
to others (two-way protection). Option B incorrectly implies the client is the sole source
of danger, while C understates the primary goal of preventing transmission to others.
Q8: While assessing a client’s oral cavity, the nurse notes a white, curd-like coating on
the tongue that bleeds when scraped. Which nursing diagnosis is most appropriate?
A. Impaired dentition
B. Risk for aspiration
C. Imbalanced nutrition
D. Oral mucous membrane impairment
COMPLETE WITH VERIFIED ANSWERS &
RATIONALES
SECTION 1: Fundamentals & Safe Care
Q1: A nurse is preparing to insert an indwelling urinary catheter for a post-operative
client. Which action is most important to prevent healthcare-associated infection?
A. Cleanse the meatus with antiseptic solution before insertion
B. Maintain sterile technique throughout the procedure
C. Inflate the balloon with 30 mL of sterile water
D. Secure the catheter to the client’s inner thigh
Correct Answer: B
Rationale: Maintaining sterile technique (Implementation phase) is the single most
effective way to prevent introduction of pathogens during catheter insertion, directly
addressing the CDC’s evidence-based guideline for CAUTI prevention. Option A is
helpful but secondary to overall sterile technique. Option C is incorrect balloon volume
and could cause urethral tearing. Option D is appropriate after insertion but does not
prevent infection.
Q2: During shift report, the nurse learns a confused client has been trying to climb out of
bed. Which action should the nurse take first?
A. Apply wrist restraints
B. Raise all four side rails
C. Perform a fall-risk assessment
,D. Place the bed in the lowest position
Correct Answer: C
Rationale: Assessment precedes intervention. A valid fall-risk score (Analysis phase)
guides least-restrictive, evidence-based interventions and is required by The Joint
Commission. Restraints (A) require a physician order and are last resort; full side-rail use
(B) can be considered a restraint and may increase agitation; lowering the bed (D) is
appropriate later but must follow assessment.
Q3: The nurse discovers that an IV medication infused at twice the prescribed rate. The
client is stable and asymptomatic. What is the nurse’s priority action?
A. Complete an incident report
B. Notify the provider immediately
C. Document the error in the medical record
D. Re-program the pump to the correct rate
Correct Answer: B
Rationale: Even if stable, potential adverse effects require provider evaluation
(Implementation). Immediate notification allows monitoring orders and possible
antidotes. Documentation (C) and incident report (A) occur after client safety is secured.
Simply correcting the rate (D) omits required provider evaluation.
Q4: Which ethical principle is upheld when a nurse respects a competent client’s refusal
of blood products despite potential life-threatening consequences?
A. Beneficence
B. Non-maleficence
,C. Autonomy
D. Justice
Correct Answer: C
Rationale: Autonomy recognizes the client’s right to make informed decisions about their
own care. Beneficence (A) and non-maleficence (B) would support giving the
transfusion, but the client’s autonomous choice takes precedence. Justice (D) pertains to
fair allocation of resources and is unrelated.
Q5: A newly admitted client is drooling and reports sudden difficulty breathing after
eating lunch. What is the nurse’s priority action?
A. Auscultate lung sounds
B. Attempt to arouse the client
C. Perform abdominal thrusts
D. Obtain a pulse oximetry reading
Correct Answer: C
Rationale: Airway obstruction is an immediate threat to life (ABC framework).
Abdominal thrusts (Implementation) directly relieve obstruction. Assessment actions (A,
D) waste critical time; arousal (B) is unnecessary because the client is conscious.
Q6: The nurse notes a discrepancy between the medication administration record and the
narcotic count for a controlled substance. What action should the nurse take first?
A. Verify the count with the previous nurse
B. Notify the pharmacy immediately
C. Document the discrepancy in the log
, D. Report the finding to the nursing supervisor
Correct Answer: A
Rationale: The first step (Assessment) is to verify the count with the nurse who last
administered the drug to rule out mathematical error. Subsequent reporting (B, D) and
documentation (C) occur after verification.
Q7: A client on contact precautions asks why healthcare providers must wear gowns and
gloves. Which response by the nurse is best?
A. “This is hospital policy.”
B. “It prevents you from infecting staff and other patients.”
C. “It protects you from additional infections.”
D. “These precautions stop germ transmission to staff and visitors.”
Correct Answer: D
Rationale: Clients deserve an evidence-based explanation (Implementation—teaching).
Contact precautions prevent transmission of pathogens from the colonized/infected client
to others (two-way protection). Option B incorrectly implies the client is the sole source
of danger, while C understates the primary goal of preventing transmission to others.
Q8: While assessing a client’s oral cavity, the nurse notes a white, curd-like coating on
the tongue that bleeds when scraped. Which nursing diagnosis is most appropriate?
A. Impaired dentition
B. Risk for aspiration
C. Imbalanced nutrition
D. Oral mucous membrane impairment
