HESI RN EXIT EXAM PREDICTOR 2026/2027 Complete Exit
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SECTION 1: Fundamentals (Questions 1-20)
1. A 78-year-old client is admitted with dehydration. The nurse receives the
following orders:
● Insert 18-gauge IV
● Start 0.9 % NS at 150 mL/h
● Obtain serum electrolytes now and in 4 h
● Apply SCDs bilaterally
● Strict I&O
2. Which order should the nurse implement first?
A. Start 0.9 % NS at 150 mL/h
B. Obtain serum electrolytes
C. Insert 18-gauge IV
D. Apply SCDs
Correct Answer: C
Rationale: Vascular access is prerequisite for fluid resuscitation and blood draws;
without an IV line, fluids and some labs cannot be obtained.
Test-Taking Tip: When several tasks are required, identify the action that enables
others (Maslow’s ABCs & fundamentals of access).
2. The nurse is delegating morning hygiene care for four clients. Which client is
most appropriate to assign to the unlicensed assistive personnel (UAP)?
A. 65-year-old post-MI day 2, on telemetry, O₂ at 2 L/min
, B. 58-year-old 8 h post-OR for craniotomy, drowsy but arousable
C. 40-year-old admitted for cellulitis, receiving IV antibiotics, ambulatory
D. 72-year-old newly admitted with chest pain, awaiting cardiac catheterization
Correct Answer: C
Rationale: UAPs may perform routine hygiene for stable, independent clients.
Options A, B, and D require assessment or have potential for acute changes.
Test-Taking Tip: Use the “stable & predictable” rule for delegation to UAP.
3. A client is receiving 1 L 0.9 % NS over 8 h. The drop factor is 15 gtt/mL. What is
the drip rate in gtt/min? (Fill-in-the-blank, round to nearest whole number)
Correct Answer: 31
Rationale:
1 L = 1000 mL; 8 h = 480 min
mL/min = 1000 ÷ 480 = 2.08
gtt/min = 2.08 × 15 = 31.25 → 31 gtt/min
Tip: Always verify pump vs gravity; round only at final step.
4. A client’s Foley catheter bag has been empty for 4 h. The client’s vitals are
stable, and the last recorded output was 120 mL. Which action should the nurse
take first?
A. Increase IV fluids
B. Palpate the suprapubic area and check tubing for kinks
C. Notify the provider immediately
D. Recheck vitals every 15 min
Correct Answer: B
Rationale: First assess for mechanical obstruction (kinks, dependent loops, or
client position) before assuming oliguria or notifying provider.
Tip: Follow the nursing process—assess before intervening/referring.
5. When performing hand hygiene with an alcohol-based rub, the nurse should rub
hands together for at least:
, A. 10 s
B. 15 s
C. 20 s
D. 30 s
Correct Answer: C
Rationale: CDC and WHO recommend ≥20 s contact time for alcohol hand rubs.
Tip: Remember 20 s for rub; 40–60 s for soap-and-water surgical scrub.
6. A client is on contact precautions for VRE. Which action by the nurse is
appropriate?
A. Wear an N95 respirator when entering room
B. Don gloves and gown only when touching intact skin
C. Keep stethoscope in room for dedicated use
D. Remove gloves first, then gown, when leaving
Correct Answer: C
Rationale: Dedicated equipment prevents cross-transmission; contact
precautions do not require N95; gown/gloves needed for any contact with
patient/environment; remove gown before gloves to prevent contamination.
Tip: Sequence—gloves off last inside-out.
7. A post-op client reports sudden onset of shortness of breath and chest pain. O₂
sat is 89 % on room air. Which assessment should the nurse perform
immediately?
A. Auscultate lung sounds
B. Obtain temperature
C. Check capillary refill
D. Review morning labs
Correct Answer: A
Rationale: Sudden SOB + chest pain + hypoxemia suggests pulmonary
complication (atelectasis, PE, pneumothorax); lung auscultation provides
immediate data guiding urgent interventions.
Tip: Use ABC framework—Airway/Breathing first.
, 8. A client is to receive 40 mEq KCl IV to correct hypokalemia. The bag contains
1000 mL NS with 40 mEq KCl. What is the concentration of KCl in mEq/mL?
(Fill-in-the-blank)
Correct Answer: 0.04
Rationale: 40 mEq ÷ 1000 mL = 0.04 mEq/mL
Tip: Concentration = total solute ÷ total volume; watch decimal placement.
9. The nurse notes a new graduate documenting: “Client appears to be in pain.”
Which revision best follows accurate documentation principles?
A. “Client states pain is 8/10, grimacing, guarding abdomen.”
B. “Client is exaggerating pain.”
C. “Pain seems mild.”
D. “Client probably has pain.”
Correct Answer: A
Rationale: Objective, descriptive data (subjective quote + observable signs) avoid
judgment and inference.
Tip: Document factual, measurable, client-specific information.
10. A client’s Braden Scale score is 14. Which action is most appropriate?
A. Reassess in 1 week
B. Apply transparent film dressing to heels
C. Implement every-2-hour turning schedule
D. Place on pressure-relieving mattress only
Correct Answer: C
Rationale: Score 14 indicates moderate risk; turning q2h is foundational
prevention along with support surface.
Tip: Braden ≤ 14 → moderate risk; ≤ 12 → high risk; turning is always indicated.
11. A client is receiving sliding-scale insulin. Blood glucose is 250 mg/dL. The scale
reads:
● 150–199 → 2 units
Exam Preparation | Actual Questions & Verified Predictor |
NCLEX-RN Readiness Assessment | Pass Guarantee
SECTION 1: Fundamentals (Questions 1-20)
1. A 78-year-old client is admitted with dehydration. The nurse receives the
following orders:
● Insert 18-gauge IV
● Start 0.9 % NS at 150 mL/h
● Obtain serum electrolytes now and in 4 h
● Apply SCDs bilaterally
● Strict I&O
2. Which order should the nurse implement first?
A. Start 0.9 % NS at 150 mL/h
B. Obtain serum electrolytes
C. Insert 18-gauge IV
D. Apply SCDs
Correct Answer: C
Rationale: Vascular access is prerequisite for fluid resuscitation and blood draws;
without an IV line, fluids and some labs cannot be obtained.
Test-Taking Tip: When several tasks are required, identify the action that enables
others (Maslow’s ABCs & fundamentals of access).
2. The nurse is delegating morning hygiene care for four clients. Which client is
most appropriate to assign to the unlicensed assistive personnel (UAP)?
A. 65-year-old post-MI day 2, on telemetry, O₂ at 2 L/min
, B. 58-year-old 8 h post-OR for craniotomy, drowsy but arousable
C. 40-year-old admitted for cellulitis, receiving IV antibiotics, ambulatory
D. 72-year-old newly admitted with chest pain, awaiting cardiac catheterization
Correct Answer: C
Rationale: UAPs may perform routine hygiene for stable, independent clients.
Options A, B, and D require assessment or have potential for acute changes.
Test-Taking Tip: Use the “stable & predictable” rule for delegation to UAP.
3. A client is receiving 1 L 0.9 % NS over 8 h. The drop factor is 15 gtt/mL. What is
the drip rate in gtt/min? (Fill-in-the-blank, round to nearest whole number)
Correct Answer: 31
Rationale:
1 L = 1000 mL; 8 h = 480 min
mL/min = 1000 ÷ 480 = 2.08
gtt/min = 2.08 × 15 = 31.25 → 31 gtt/min
Tip: Always verify pump vs gravity; round only at final step.
4. A client’s Foley catheter bag has been empty for 4 h. The client’s vitals are
stable, and the last recorded output was 120 mL. Which action should the nurse
take first?
A. Increase IV fluids
B. Palpate the suprapubic area and check tubing for kinks
C. Notify the provider immediately
D. Recheck vitals every 15 min
Correct Answer: B
Rationale: First assess for mechanical obstruction (kinks, dependent loops, or
client position) before assuming oliguria or notifying provider.
Tip: Follow the nursing process—assess before intervening/referring.
5. When performing hand hygiene with an alcohol-based rub, the nurse should rub
hands together for at least:
, A. 10 s
B. 15 s
C. 20 s
D. 30 s
Correct Answer: C
Rationale: CDC and WHO recommend ≥20 s contact time for alcohol hand rubs.
Tip: Remember 20 s for rub; 40–60 s for soap-and-water surgical scrub.
6. A client is on contact precautions for VRE. Which action by the nurse is
appropriate?
A. Wear an N95 respirator when entering room
B. Don gloves and gown only when touching intact skin
C. Keep stethoscope in room for dedicated use
D. Remove gloves first, then gown, when leaving
Correct Answer: C
Rationale: Dedicated equipment prevents cross-transmission; contact
precautions do not require N95; gown/gloves needed for any contact with
patient/environment; remove gown before gloves to prevent contamination.
Tip: Sequence—gloves off last inside-out.
7. A post-op client reports sudden onset of shortness of breath and chest pain. O₂
sat is 89 % on room air. Which assessment should the nurse perform
immediately?
A. Auscultate lung sounds
B. Obtain temperature
C. Check capillary refill
D. Review morning labs
Correct Answer: A
Rationale: Sudden SOB + chest pain + hypoxemia suggests pulmonary
complication (atelectasis, PE, pneumothorax); lung auscultation provides
immediate data guiding urgent interventions.
Tip: Use ABC framework—Airway/Breathing first.
, 8. A client is to receive 40 mEq KCl IV to correct hypokalemia. The bag contains
1000 mL NS with 40 mEq KCl. What is the concentration of KCl in mEq/mL?
(Fill-in-the-blank)
Correct Answer: 0.04
Rationale: 40 mEq ÷ 1000 mL = 0.04 mEq/mL
Tip: Concentration = total solute ÷ total volume; watch decimal placement.
9. The nurse notes a new graduate documenting: “Client appears to be in pain.”
Which revision best follows accurate documentation principles?
A. “Client states pain is 8/10, grimacing, guarding abdomen.”
B. “Client is exaggerating pain.”
C. “Pain seems mild.”
D. “Client probably has pain.”
Correct Answer: A
Rationale: Objective, descriptive data (subjective quote + observable signs) avoid
judgment and inference.
Tip: Document factual, measurable, client-specific information.
10. A client’s Braden Scale score is 14. Which action is most appropriate?
A. Reassess in 1 week
B. Apply transparent film dressing to heels
C. Implement every-2-hour turning schedule
D. Place on pressure-relieving mattress only
Correct Answer: C
Rationale: Score 14 indicates moderate risk; turning q2h is foundational
prevention along with support surface.
Tip: Braden ≤ 14 → moderate risk; ≤ 12 → high risk; turning is always indicated.
11. A client is receiving sliding-scale insulin. Blood glucose is 250 mg/dL. The scale
reads:
● 150–199 → 2 units
