1
HESI EXIT PRACTICE TEST WITH ACTUAL
PRACTICE EXAM QUESTIONS AND ANSWERS
2026-27 MOST RECENT VERSION
The nurse plans a teaching session with a client but postpones the planned session based on which nursing problem?
Activity intolerance related to postoperative pain.
Noncompliance with prescribed exercise plan.
Ineffective management of treatment regimen.
Knowledge deficit regarding impending surgery.
Rationale
Pain, fatigue, or anxiety can interfere with the ability to pay attention and participate in learning, so the nursing diagnosis in
indicates a need to postpone teaching. the other choices indicate a need for instruction.
During the assessment of a 21-year-old female client with bipolar disorder, the client tells the nurse that she has not taken
her medication for three years, her mother will not let her return home, and she does not have transportation or a job.
Which client goal is most important for this client?
Taking medication, with community follow-up.
Obtain housing, with possibility of returning home.
Become familiar with public transportation.
Begin vocational rehabilitation.
Rationale
The most important goal for discharge is for the client to take medications, which will stabilize her mood and promote an
optimum level of functioning. The other choices are important goals, but first the client needs to be stabilized on her
medication.
A young adult female arrives at the emergency department with a black right eye and is bleeding from the left side of her
head. She reports that her boyfriend has been abusing her physically. The nurse performs a history and physical
examination. How should the nurse document these findings?
Client alleges that her boyfriend beat her up. Client is bleeding from the left side of the face.
Client reports her boyfriend hit her in the eye and on the head. Bruises and lacerations present on face.
Client presents with a right black eye and a cut on the left side of her head that is bleeding. Reports abusive boyfriend
responsible for injuries. Needs referral to a safe place to stay.
Young adult female presents with periorbital ecchymosis on right side, 3 cm laceration on left parietal area, approximately
1 cm deep with tissue bridging. States her boyfriend is abusive.
Rationale
Proper documentation of abuse as reported by the victim is crucial, and the nurse should document specific and objective
data that gives an accurate depiction of the events without documentation of judgmental inferences. All the other choices
lack specificity and important details related to the event.
A client is admitted to the hospital for alcohol dependency. What is the priority nursing intervention during the first 48
hours following admission?
Administer thiamine (B1) to prevent Korsakoff's syndrome.
Monitor for increased blood pressure and pulse.
Administer a PRN benzodiazepine as needed for anxiety.
Encourage fluid intake of non-caffeinated beverages.
Rationale
Clients with alcohol dependency experience withdrawal symptoms, which include elevated blood pressure, pulse, and
,2
temperature, so monitoring these physical parameters has the highest priority. Administering thamine will prevent
Korsakoff's syndrome (secondary dementia caused by thiamine deficiency, associated with malnutrition secondary to
excessive alcohol intake, but this intervention does not have the priority of monitoring vital signs.
,3
The nurse dons gown, mask with eyeshield, and gloves before entering a client's room that has airborne precautions.
Upon leaving the client's room, in which sequence should the nurse remove the personal protective equipment (PPE)?
(Place the first action on top and last action on the bottom.)
Correct Answer:
● 1.
Remove gloves.
● 2.
Remove gown.
● 3.
Remove mask.
● 4.
Wash hands.
Rationale
Correct order is Gloves, Gown, Mask, Wash. The nurse should first remove the contaminated gloves by grasping the cuff
and pulling the glove inside out over the hands. Then, untie the gown waist and neck strings, remove the gown without the
hands touching the outside of the gown, and fold inside out to discard. Because the client is on airborne precautions, the
nurse should then remove the mask . Handwashing should be done after all the PPE is removed. Handwashing may be
recommended at other times as well, however in this sequence, it should always be done at the end--before leaving the
room and after leaving the room.
A male client who had abdominal surgery has a nasogastric tube to suction, oxygen per nasal cannula, and complains of
dry mouth. Which action should the nurse implement?
Put petroleum jelly on the lips and around the nasogastric tube.
Allow the client to drink water and record on the I and O record.
Offer the client ice chips and instruct client to spit out the water.
Apply a water soluble lubricant to the lips, oral mucosa and nares.
Rationale
To ease the client's discomfort, a water soluble lubricant to the lips and nares assists to keep the mucous membranes
moist. A petroleum-based product should not be used because it is flammable. Oral intake of any kind should not be
given to the client with a nasogastric tube to suction because it can cause further distension and interfere with fluid and
electrolyte balance.
A nurse takes a female client to the examination room and asks her to remove her clothes and put on an examination
gown with the front open. The woman states, "I have special undergarments that I do not remove for religious reasons."
How should the nurse respond?
"I will ask the healthcare provider to modify the examination."
"All clothing must be removed before the examination to provide full access to the area to be assessed."
"What type of undergarments are you wearing?"
"Tell me about your undergarments so we can discuss how you can have your examination comfortably."
Rationale
It is important that a nurse have respect for the unique qualities that cultural diversity brings to individuals. Asking about
undergarments and how they can accomodate the examination reflects cultural competence by the nurse and displays
respect for the woman’s religious practices. The examination may not be able to be modified. Insisting clothing be
removed or asking what she is wearing are both dictatorial and do not show respect for different cultures or religions.
The nurse is assessing a client and identifies the presence of petechiae. Which documentation best describes this
finding?
Purplish-red pinpoint lesions of the skin.
, 4
Purple to bluish discoloration of the skin.
Small circumscribed elevations containing purulent fluid.
Generalized reddish discoloration of an area of skin.
Rationale
Petechiae are described as purplish to red, non-blanchable, pinpoint lesions that are tiny hemorrhages within the dermal or
submucosal layers. Purplish skin discoloration describes ecchymosis caused by trauma to the underlying blood vessels.
Small elevations conting pus describes pustules. Generalize red skin area is nonspecific and incomplete.
The nurse is planning a wellness program aimed at primary prevention in the community. Which action should the
nurse implement?
Immunizations that decrease occurrences of many contagious diseases.
Blood pressure screenings to identify persons with high blood pressure.
Breast self-examination (BSE) for young women instead of a mammogram.
Home care monitoring for clients who are high-risk due to pregnancy.
Rationale
Primary prevention involves health promotion and disease prevention activities to decrease the occurrence of illness and
enhance general health and quality of life, such as immunization. Health screenings are the mainstay of secondary
prevention and include interventions designed to increase the probability that disease is diagnosed early when treatment is
likely to result in cure. Tertiary prevention like home monitoring of high-risk pregnancies includes interventions aimed at
disability limitation from disease, injury, or disability.
The scope of professional nursing practice is determined by rules promulgated by which organization?
State's Board of Nursing.
State Nursing Associations.
American Nurses Association (ANA).
National Labor Relations Board (NLRB).
Rationale
Each state's Board of Nursing is authorized to promulgate rules and regulations that carry the weight of law. The State
Legislature delegates its law-making authority to this administrative law body. State nursing organizations and the ANA
are influential in defining and describing nursing standards of care, but neither have the authority to pass laws that legally
define the professional scope of nursing practice. Although NLRB may rule on issues important to nursing practice, the
scope of professional nursing practice is determined by the laws, rules, and regulations promulgated by state Boards of
Nursing.
The nurse is assessing a client and identifies a bruit over the thyroid. This finding is consistent with which interpretation?
Thyroid cyst.
Thyroid cancer.
Hypothyroidism.
Hyperthyroidism.
Rationale
Hyperthyroidism is an enlargement of the thyroid gland, often referred to as a goiter, and a bruit may be auscultated over
the goiter due to an increase in glandular vascularity which increases as the thyroid gland becomes hyperactive. A bruit is
not common with thyroid cancer, cyst, or hypothroidism.
Prior to the discharge of a healthy 4-day-old newborn, the nurse is collecting the blood specimens to screen for
phenylketonuria (PKU), the Guthrie inhibition assay blood test. What action should the nurse implement to ensure the
validity of the test?
Collect the blood prior to the next 4-hour feeding to obtain a fasting specimen.
Instruct the mother to bring the newborn back in one week to have this test completed.
Assess the newborn's feeding patterns of formula or breast milk which has "come in."
Obtain venipuncture specimens to prevent hemolysis when expressed from capillaries.
Rationale
PKU screening is mandatory in most states and requires that the newborn has ingested adequate amounts (2 to 3
HESI EXIT PRACTICE TEST WITH ACTUAL
PRACTICE EXAM QUESTIONS AND ANSWERS
2026-27 MOST RECENT VERSION
The nurse plans a teaching session with a client but postpones the planned session based on which nursing problem?
Activity intolerance related to postoperative pain.
Noncompliance with prescribed exercise plan.
Ineffective management of treatment regimen.
Knowledge deficit regarding impending surgery.
Rationale
Pain, fatigue, or anxiety can interfere with the ability to pay attention and participate in learning, so the nursing diagnosis in
indicates a need to postpone teaching. the other choices indicate a need for instruction.
During the assessment of a 21-year-old female client with bipolar disorder, the client tells the nurse that she has not taken
her medication for three years, her mother will not let her return home, and she does not have transportation or a job.
Which client goal is most important for this client?
Taking medication, with community follow-up.
Obtain housing, with possibility of returning home.
Become familiar with public transportation.
Begin vocational rehabilitation.
Rationale
The most important goal for discharge is for the client to take medications, which will stabilize her mood and promote an
optimum level of functioning. The other choices are important goals, but first the client needs to be stabilized on her
medication.
A young adult female arrives at the emergency department with a black right eye and is bleeding from the left side of her
head. She reports that her boyfriend has been abusing her physically. The nurse performs a history and physical
examination. How should the nurse document these findings?
Client alleges that her boyfriend beat her up. Client is bleeding from the left side of the face.
Client reports her boyfriend hit her in the eye and on the head. Bruises and lacerations present on face.
Client presents with a right black eye and a cut on the left side of her head that is bleeding. Reports abusive boyfriend
responsible for injuries. Needs referral to a safe place to stay.
Young adult female presents with periorbital ecchymosis on right side, 3 cm laceration on left parietal area, approximately
1 cm deep with tissue bridging. States her boyfriend is abusive.
Rationale
Proper documentation of abuse as reported by the victim is crucial, and the nurse should document specific and objective
data that gives an accurate depiction of the events without documentation of judgmental inferences. All the other choices
lack specificity and important details related to the event.
A client is admitted to the hospital for alcohol dependency. What is the priority nursing intervention during the first 48
hours following admission?
Administer thiamine (B1) to prevent Korsakoff's syndrome.
Monitor for increased blood pressure and pulse.
Administer a PRN benzodiazepine as needed for anxiety.
Encourage fluid intake of non-caffeinated beverages.
Rationale
Clients with alcohol dependency experience withdrawal symptoms, which include elevated blood pressure, pulse, and
,2
temperature, so monitoring these physical parameters has the highest priority. Administering thamine will prevent
Korsakoff's syndrome (secondary dementia caused by thiamine deficiency, associated with malnutrition secondary to
excessive alcohol intake, but this intervention does not have the priority of monitoring vital signs.
,3
The nurse dons gown, mask with eyeshield, and gloves before entering a client's room that has airborne precautions.
Upon leaving the client's room, in which sequence should the nurse remove the personal protective equipment (PPE)?
(Place the first action on top and last action on the bottom.)
Correct Answer:
● 1.
Remove gloves.
● 2.
Remove gown.
● 3.
Remove mask.
● 4.
Wash hands.
Rationale
Correct order is Gloves, Gown, Mask, Wash. The nurse should first remove the contaminated gloves by grasping the cuff
and pulling the glove inside out over the hands. Then, untie the gown waist and neck strings, remove the gown without the
hands touching the outside of the gown, and fold inside out to discard. Because the client is on airborne precautions, the
nurse should then remove the mask . Handwashing should be done after all the PPE is removed. Handwashing may be
recommended at other times as well, however in this sequence, it should always be done at the end--before leaving the
room and after leaving the room.
A male client who had abdominal surgery has a nasogastric tube to suction, oxygen per nasal cannula, and complains of
dry mouth. Which action should the nurse implement?
Put petroleum jelly on the lips and around the nasogastric tube.
Allow the client to drink water and record on the I and O record.
Offer the client ice chips and instruct client to spit out the water.
Apply a water soluble lubricant to the lips, oral mucosa and nares.
Rationale
To ease the client's discomfort, a water soluble lubricant to the lips and nares assists to keep the mucous membranes
moist. A petroleum-based product should not be used because it is flammable. Oral intake of any kind should not be
given to the client with a nasogastric tube to suction because it can cause further distension and interfere with fluid and
electrolyte balance.
A nurse takes a female client to the examination room and asks her to remove her clothes and put on an examination
gown with the front open. The woman states, "I have special undergarments that I do not remove for religious reasons."
How should the nurse respond?
"I will ask the healthcare provider to modify the examination."
"All clothing must be removed before the examination to provide full access to the area to be assessed."
"What type of undergarments are you wearing?"
"Tell me about your undergarments so we can discuss how you can have your examination comfortably."
Rationale
It is important that a nurse have respect for the unique qualities that cultural diversity brings to individuals. Asking about
undergarments and how they can accomodate the examination reflects cultural competence by the nurse and displays
respect for the woman’s religious practices. The examination may not be able to be modified. Insisting clothing be
removed or asking what she is wearing are both dictatorial and do not show respect for different cultures or religions.
The nurse is assessing a client and identifies the presence of petechiae. Which documentation best describes this
finding?
Purplish-red pinpoint lesions of the skin.
, 4
Purple to bluish discoloration of the skin.
Small circumscribed elevations containing purulent fluid.
Generalized reddish discoloration of an area of skin.
Rationale
Petechiae are described as purplish to red, non-blanchable, pinpoint lesions that are tiny hemorrhages within the dermal or
submucosal layers. Purplish skin discoloration describes ecchymosis caused by trauma to the underlying blood vessels.
Small elevations conting pus describes pustules. Generalize red skin area is nonspecific and incomplete.
The nurse is planning a wellness program aimed at primary prevention in the community. Which action should the
nurse implement?
Immunizations that decrease occurrences of many contagious diseases.
Blood pressure screenings to identify persons with high blood pressure.
Breast self-examination (BSE) for young women instead of a mammogram.
Home care monitoring for clients who are high-risk due to pregnancy.
Rationale
Primary prevention involves health promotion and disease prevention activities to decrease the occurrence of illness and
enhance general health and quality of life, such as immunization. Health screenings are the mainstay of secondary
prevention and include interventions designed to increase the probability that disease is diagnosed early when treatment is
likely to result in cure. Tertiary prevention like home monitoring of high-risk pregnancies includes interventions aimed at
disability limitation from disease, injury, or disability.
The scope of professional nursing practice is determined by rules promulgated by which organization?
State's Board of Nursing.
State Nursing Associations.
American Nurses Association (ANA).
National Labor Relations Board (NLRB).
Rationale
Each state's Board of Nursing is authorized to promulgate rules and regulations that carry the weight of law. The State
Legislature delegates its law-making authority to this administrative law body. State nursing organizations and the ANA
are influential in defining and describing nursing standards of care, but neither have the authority to pass laws that legally
define the professional scope of nursing practice. Although NLRB may rule on issues important to nursing practice, the
scope of professional nursing practice is determined by the laws, rules, and regulations promulgated by state Boards of
Nursing.
The nurse is assessing a client and identifies a bruit over the thyroid. This finding is consistent with which interpretation?
Thyroid cyst.
Thyroid cancer.
Hypothyroidism.
Hyperthyroidism.
Rationale
Hyperthyroidism is an enlargement of the thyroid gland, often referred to as a goiter, and a bruit may be auscultated over
the goiter due to an increase in glandular vascularity which increases as the thyroid gland becomes hyperactive. A bruit is
not common with thyroid cancer, cyst, or hypothroidism.
Prior to the discharge of a healthy 4-day-old newborn, the nurse is collecting the blood specimens to screen for
phenylketonuria (PKU), the Guthrie inhibition assay blood test. What action should the nurse implement to ensure the
validity of the test?
Collect the blood prior to the next 4-hour feeding to obtain a fasting specimen.
Instruct the mother to bring the newborn back in one week to have this test completed.
Assess the newborn's feeding patterns of formula or breast milk which has "come in."
Obtain venipuncture specimens to prevent hemolysis when expressed from capillaries.
Rationale
PKU screening is mandatory in most states and requires that the newborn has ingested adequate amounts (2 to 3
