HESI RN Exit Exam Comprehensive Practice Actual Exam
2026/2027 | NGN Test Bank | Questions with Verified
Answers | 100% Correct | Pass Guaranteed
SECTION 1: Fundamentals & Safety (15 Questions)
Q1: A nurse is caring for four patients. Which patient should the nurse assess FIRST?
A. A post-op day 2 patient with pain rated 6/10
B. A diabetic patient with blood glucose of 180 mg/dL
C. A post-op thyroidectomy patient with complaints of "tightness" in the neck
D. An elderly patient requesting assistance to the bathroom
Correct Answer: C
Rationale: Clinical Judgment: Prioritize Hypotheses using ABCs (Airway, Breathing,
Circulation). Analysis: Complaint of "tightness" after thyroidectomy suggests possible
hematoma formation, which can compromise the airway - an immediate threat to life.
Priority Framework: Airway trumps pain (A), hyperglycemia (B), and elimination needs
(D). Action: Immediate assessment for stridor, respiratory distress, and surgical site
inspection is required.
Q2 (Delegation): The charge nurse can delegate which task to an experienced UAP
(Unlicensed Assistive Personnel)?
A. Assist a stable patient with ambulation to the bathroom
B. Assess a new post-op patient's pain level
C. Teach a diabetic patient about insulin administration
,D. Change a sterile dressing on a central line
Correct Answer: A
Rationale: Delegation Principles: UAPs can perform non-invasive, routine tasks for
stable patients. Ambulation assistance is within their scope. RN-Only Tasks: Pain
assessment (B), patient education (C), and sterile procedures (D) require nursing
judgment and cannot be delegated.
Q3 (Infection Control): A patient is placed on Contact Precautions for MRSA in a wound.
Which action by the nurse is appropriate?
A. Wear an N95 respirator when entering the room
B. Perform hand hygiene with alcohol-based rub after glove removal
C. Keep the door closed at all times
D. Use a dedicated stethoscope that remains in the room
Correct Answer: B & D (Select all that apply - but for single best, D is most complete)
For Single Best: D. Use a dedicated stethoscope that remains in the room
Rationale: Clinical Judgment: Generate Solutions - prevent cross-transmission. Contact
precautions require gloves and gown, not N95 (A). Hand hygiene (B) is correct but D
represents equipment dedication - a key intervention. Dedicated equipment prevents
fomite transmission. Door closure (C) is airborne, not contact.
Q4 (Safety): A patient on Lithium 600 mg BID reports polyuria and polydipsia. Which lab
value is most important for the nurse to check?
A. Sodium 140 mEq/L
B. Lithium level 1.4 mEq/L (normal 0.6–1.2)
C. Creatinine 1.0 mg/dL
,D. Glucose 90 mg/dL
Correct Answer: B
Rationale: Clinical Judgment: Analyze Cues - recognize lithium toxicity. Polyuria and
polydipsia are early signs of lithium-induced nephrogenic diabetes insipidus. Level >1.2
mEq/L indicates toxicity requiring hold and notify provider. Normal Na (A) and Cr (C) are
expected; glucose (D) unrelated.
Q5 (Ethics): A patient refuses a blood transfusion due to religious beliefs. The patient's
Hgb is 7.8 g/dL. What is the nurse's initial action?
A. Respect the patient's decision and inform the provider
B. Obtain a court order to administer the transfusion
C. Ask the family to convince the patient
D. Document the refusal and do nothing else
Correct Answer: A
Rationale: Clinical Judgment: Take Action - uphold autonomy. Ethical Principle: Patients
have the right to refuse treatment. Nursing Action: Respect decision, notify provider for
alternative treatments (e.g., iron, EPO). Court order (B) is last resort for life-threatening
emergencies. Family pressure (C) violates autonomy. Document (D) is insufficient -
provider must be informed.
Q6 (Documentation): A nurse is documenting using the PIE format. Which information is
recorded in the "I" section?
A. Nursing interventions performed
B. Patient's subjective complaints
C. Medical diagnosis
, D. Evaluation of outcomes
Correct Answer: A
Rationale: PIE = Problem, Intervention, Evaluation. "I" = Interventions - actions taken. "P"
= Problem (nursing diagnosis), "E" = Evaluation. Medical diagnosis (C) is not part of
nursing documentation.
Q7 (Priority): A patient returns from surgery with a PCA pump (morphine). Which finding
requires immediate intervention?
A. Respiratory rate 10 breaths/min
B. Pain rating 4/10
C. Systolic BP 140 mmHg
D. Itching on face
Correct Answer: A
Rationale: Clinical Judgment: Recognize Cues - PCA complication. RR 10 = respiratory
depression, a life-threatening side effect of opioids. Action: Stop PCA, stimulate patient,
notify provider, consider naloxone. Pain 4/10 (B) is acceptable; itching (D) is side effect,
not emergency; BP 140 (C) is not priority over airway.
Q8 (Leadership): A new graduate nurse is consistently late to shift. Which action
demonstrates authentic leadership by the charge nurse?
A. Ignore the behavior to avoid conflict
B. Privately discuss the impact of tardiness on team and patient care
C. Publicly criticize the nurse during handoff
D. Immediately report to HR without discussion
2026/2027 | NGN Test Bank | Questions with Verified
Answers | 100% Correct | Pass Guaranteed
SECTION 1: Fundamentals & Safety (15 Questions)
Q1: A nurse is caring for four patients. Which patient should the nurse assess FIRST?
A. A post-op day 2 patient with pain rated 6/10
B. A diabetic patient with blood glucose of 180 mg/dL
C. A post-op thyroidectomy patient with complaints of "tightness" in the neck
D. An elderly patient requesting assistance to the bathroom
Correct Answer: C
Rationale: Clinical Judgment: Prioritize Hypotheses using ABCs (Airway, Breathing,
Circulation). Analysis: Complaint of "tightness" after thyroidectomy suggests possible
hematoma formation, which can compromise the airway - an immediate threat to life.
Priority Framework: Airway trumps pain (A), hyperglycemia (B), and elimination needs
(D). Action: Immediate assessment for stridor, respiratory distress, and surgical site
inspection is required.
Q2 (Delegation): The charge nurse can delegate which task to an experienced UAP
(Unlicensed Assistive Personnel)?
A. Assist a stable patient with ambulation to the bathroom
B. Assess a new post-op patient's pain level
C. Teach a diabetic patient about insulin administration
,D. Change a sterile dressing on a central line
Correct Answer: A
Rationale: Delegation Principles: UAPs can perform non-invasive, routine tasks for
stable patients. Ambulation assistance is within their scope. RN-Only Tasks: Pain
assessment (B), patient education (C), and sterile procedures (D) require nursing
judgment and cannot be delegated.
Q3 (Infection Control): A patient is placed on Contact Precautions for MRSA in a wound.
Which action by the nurse is appropriate?
A. Wear an N95 respirator when entering the room
B. Perform hand hygiene with alcohol-based rub after glove removal
C. Keep the door closed at all times
D. Use a dedicated stethoscope that remains in the room
Correct Answer: B & D (Select all that apply - but for single best, D is most complete)
For Single Best: D. Use a dedicated stethoscope that remains in the room
Rationale: Clinical Judgment: Generate Solutions - prevent cross-transmission. Contact
precautions require gloves and gown, not N95 (A). Hand hygiene (B) is correct but D
represents equipment dedication - a key intervention. Dedicated equipment prevents
fomite transmission. Door closure (C) is airborne, not contact.
Q4 (Safety): A patient on Lithium 600 mg BID reports polyuria and polydipsia. Which lab
value is most important for the nurse to check?
A. Sodium 140 mEq/L
B. Lithium level 1.4 mEq/L (normal 0.6–1.2)
C. Creatinine 1.0 mg/dL
,D. Glucose 90 mg/dL
Correct Answer: B
Rationale: Clinical Judgment: Analyze Cues - recognize lithium toxicity. Polyuria and
polydipsia are early signs of lithium-induced nephrogenic diabetes insipidus. Level >1.2
mEq/L indicates toxicity requiring hold and notify provider. Normal Na (A) and Cr (C) are
expected; glucose (D) unrelated.
Q5 (Ethics): A patient refuses a blood transfusion due to religious beliefs. The patient's
Hgb is 7.8 g/dL. What is the nurse's initial action?
A. Respect the patient's decision and inform the provider
B. Obtain a court order to administer the transfusion
C. Ask the family to convince the patient
D. Document the refusal and do nothing else
Correct Answer: A
Rationale: Clinical Judgment: Take Action - uphold autonomy. Ethical Principle: Patients
have the right to refuse treatment. Nursing Action: Respect decision, notify provider for
alternative treatments (e.g., iron, EPO). Court order (B) is last resort for life-threatening
emergencies. Family pressure (C) violates autonomy. Document (D) is insufficient -
provider must be informed.
Q6 (Documentation): A nurse is documenting using the PIE format. Which information is
recorded in the "I" section?
A. Nursing interventions performed
B. Patient's subjective complaints
C. Medical diagnosis
, D. Evaluation of outcomes
Correct Answer: A
Rationale: PIE = Problem, Intervention, Evaluation. "I" = Interventions - actions taken. "P"
= Problem (nursing diagnosis), "E" = Evaluation. Medical diagnosis (C) is not part of
nursing documentation.
Q7 (Priority): A patient returns from surgery with a PCA pump (morphine). Which finding
requires immediate intervention?
A. Respiratory rate 10 breaths/min
B. Pain rating 4/10
C. Systolic BP 140 mmHg
D. Itching on face
Correct Answer: A
Rationale: Clinical Judgment: Recognize Cues - PCA complication. RR 10 = respiratory
depression, a life-threatening side effect of opioids. Action: Stop PCA, stimulate patient,
notify provider, consider naloxone. Pain 4/10 (B) is acceptable; itching (D) is side effect,
not emergency; BP 140 (C) is not priority over airway.
Q8 (Leadership): A new graduate nurse is consistently late to shift. Which action
demonstrates authentic leadership by the charge nurse?
A. Ignore the behavior to avoid conflict
B. Privately discuss the impact of tardiness on team and patient care
C. Publicly criticize the nurse during handoff
D. Immediately report to HR without discussion
