HESI RN Adult Health 1 Proctored
Exam 2026 | 30 Questions with
Detailed Rationales
1. A client with psoriasis returns to the clinic reporting the persistence of
several silvery, scaly areas on the elbows and palms that frequently burn and
sometimes bleed. Which prescription should the nurse teach the client to use
for the skin condition?
A. Topical analgesics
B. Colloidal oatmeal–based lotion
C. Topical antifungal
D. Topical corticosteroids
✅ Correct Answer: D. Topical corticosteroids
Rationale: Psoriasis is an immune-mediated disorder characterized by keratinocyte
hyperproliferation and inflammation. Topical corticosteroids are first-line because they
decrease inflammation, slow epidermal growth, and reduce scaling and burning. Analgesics
and moisturizers may relieve discomfort but do not address the underlying inflammatory
process. Antifungals are not indicated since psoriasis is not a fungal infection.
2. A client with a history of chronic obstructive pulmonary disease (COPD)
receives a new prescription for an ipratropium inhaler. Which action indicates
to the nurse that additional teaching is needed?
A. Rinses the mouth after each use
B. Attaches spacer device to the inhaler
C. Primes the inhaler with 7 pumps
D. Stores the medication at room temperature
✅ Correct Answer: C. Primes the inhaler with 7 pumps
Rationale: Ipratropium inhalers require minimal priming (usually 2–3 sprays after not being
used), so 7 pumps shows misunderstanding and may waste medication. Spacers improve
medication delivery to the lungs. Rinsing the mouth is harmless (though usually indicated for
corticosteroid inhalers) and storing at room temperature preserves drug stability.
3. A client admitted with emphysema is having difficulty breathing. In which
position should the nurse place the client?
, A. Supine with legs elevated
B. Prone with head turned
C. Sitting upright and leaning forward
D. Left lateral with head elevated
✅ Correct Answer: C. Sitting upright and leaning forward
Rationale: Sitting upright with forward lean (tripod position) improves diaphragmatic
excursion and access to accessory muscles, enhancing ventilation. Supine or lateral positions
do not optimize respiratory mechanics in severe COPD. Prone positioning benefits ARDS but
is not first-line in emphysema.
4. Which method elicits the most accurate information during a physical
assessment of an older adult?
A. Use reliable assessment tools designed for older adults
B. Perform rapid sequential exams to save time
C. Rely mainly on family member reports
D. Focus solely on chief complaint
✅ Correct Answer: A. Use reliable assessment tools designed for older adults
Rationale: Standardized, validated tools enhance accuracy by accounting for age-related
changes in physiology. Rapid exams or only chief complaints can miss critical findings. Family
input is useful but should supplement, not replace, thorough objective assessment.
5. The primary goal of state boards of nursing is to:
A. Protect the safety of the public
B. Identify malpractice and negligence
C. Provide a channel for client advocacy
D. Control the cost of healthcare
✅ Correct Answer: A. Protect the safety of the public
Rationale: State boards regulate nursing practice licensure and standards to protect the
public. While identifying unsafe practice and promoting advocacy are roles, public safety is
foundational. Controlling cost is not a regulatory board function.
6. A client with eczema is using an OTC cream with urea 10%. Which finding
reflects the expected therapeutic response?
A. Hydration of affected dry skin areas
B. Healing with return to normal skin appearance
C. Reduced pain in eczematous areas
D. Decreased weeping of ulcerations
✅ Correct Answer: A. Hydration of affected dry skin areas
Rationale: Urea is a keratolytic and humectant that hydrates and softens dry, scaly skin. Full
healing or ulcer resolution is beyond the scope of simple urea therapy alone. Pain reduction
may occur but is secondary to improved hydration.
Exam 2026 | 30 Questions with
Detailed Rationales
1. A client with psoriasis returns to the clinic reporting the persistence of
several silvery, scaly areas on the elbows and palms that frequently burn and
sometimes bleed. Which prescription should the nurse teach the client to use
for the skin condition?
A. Topical analgesics
B. Colloidal oatmeal–based lotion
C. Topical antifungal
D. Topical corticosteroids
✅ Correct Answer: D. Topical corticosteroids
Rationale: Psoriasis is an immune-mediated disorder characterized by keratinocyte
hyperproliferation and inflammation. Topical corticosteroids are first-line because they
decrease inflammation, slow epidermal growth, and reduce scaling and burning. Analgesics
and moisturizers may relieve discomfort but do not address the underlying inflammatory
process. Antifungals are not indicated since psoriasis is not a fungal infection.
2. A client with a history of chronic obstructive pulmonary disease (COPD)
receives a new prescription for an ipratropium inhaler. Which action indicates
to the nurse that additional teaching is needed?
A. Rinses the mouth after each use
B. Attaches spacer device to the inhaler
C. Primes the inhaler with 7 pumps
D. Stores the medication at room temperature
✅ Correct Answer: C. Primes the inhaler with 7 pumps
Rationale: Ipratropium inhalers require minimal priming (usually 2–3 sprays after not being
used), so 7 pumps shows misunderstanding and may waste medication. Spacers improve
medication delivery to the lungs. Rinsing the mouth is harmless (though usually indicated for
corticosteroid inhalers) and storing at room temperature preserves drug stability.
3. A client admitted with emphysema is having difficulty breathing. In which
position should the nurse place the client?
, A. Supine with legs elevated
B. Prone with head turned
C. Sitting upright and leaning forward
D. Left lateral with head elevated
✅ Correct Answer: C. Sitting upright and leaning forward
Rationale: Sitting upright with forward lean (tripod position) improves diaphragmatic
excursion and access to accessory muscles, enhancing ventilation. Supine or lateral positions
do not optimize respiratory mechanics in severe COPD. Prone positioning benefits ARDS but
is not first-line in emphysema.
4. Which method elicits the most accurate information during a physical
assessment of an older adult?
A. Use reliable assessment tools designed for older adults
B. Perform rapid sequential exams to save time
C. Rely mainly on family member reports
D. Focus solely on chief complaint
✅ Correct Answer: A. Use reliable assessment tools designed for older adults
Rationale: Standardized, validated tools enhance accuracy by accounting for age-related
changes in physiology. Rapid exams or only chief complaints can miss critical findings. Family
input is useful but should supplement, not replace, thorough objective assessment.
5. The primary goal of state boards of nursing is to:
A. Protect the safety of the public
B. Identify malpractice and negligence
C. Provide a channel for client advocacy
D. Control the cost of healthcare
✅ Correct Answer: A. Protect the safety of the public
Rationale: State boards regulate nursing practice licensure and standards to protect the
public. While identifying unsafe practice and promoting advocacy are roles, public safety is
foundational. Controlling cost is not a regulatory board function.
6. A client with eczema is using an OTC cream with urea 10%. Which finding
reflects the expected therapeutic response?
A. Hydration of affected dry skin areas
B. Healing with return to normal skin appearance
C. Reduced pain in eczematous areas
D. Decreased weeping of ulcerations
✅ Correct Answer: A. Hydration of affected dry skin areas
Rationale: Urea is a keratolytic and humectant that hydrates and softens dry, scaly skin. Full
healing or ulcer resolution is beyond the scope of simple urea therapy alone. Pain reduction
may occur but is secondary to improved hydration.
