HESI Exit Exam (RN) – NCLEX
Predictor 2026 Exam, Multiple-Choice
Questions with Rationales Multiple
Correct Answers & Detailed Explanations
High-Yield Focus
TABLE OF CONTENTS
1. Safe & Effective Care Environment – Management of Care
(Questions 1–40)
2. Safe & Effective Care Environment – Safety & Infection
Control (Questions 41–70)
3. Health Promotion & Maintenance (Questions 71–100)
4. Psychosocial Integrity (Questions 101–130)
5. Basic Care & Comfort (Questions 131–160)
6. Pharmacological & Parenteral Therapies (Questions 161–200)
7. Reduction of Risk Potential (Questions 201–230)
8. Physiological Adaptation (Questions 231–260)
,SAFE & EFFECTIVE CARE ENVIRONMENT – MANAGEMENT
OF CARE (Questions 1–40)
Question 1 A nurse is caring for a client who has a prescription for a
physical restraint. Which of the following actions should the nurse take?
A. Apply the restraint for up to 4 hours before reassessing B. Obtain a
new restraint order every 24 hours C. Tie the restraint to the side rail of
the bed D. Remove the restraint every 2 hours for range of motion
Correct Answer: B Rationale: Restraint orders must be renewed every
24 hours (or per facility policy, often every 4-8 hours). Restraints should
be removed every 2 hours for ROM (D). Never tie to side rails (C).
Question 2 (Select all that apply) A charge nurse is delegating tasks on a
medical-surgical unit. Which tasks can be delegated to an LPN? (Select
all that apply)
A. Administer a tube feeding to a stable client B. Perform an initial
admission assessment C. Change a sterile dressing on a postoperative day
3 wound D. Develop a plan of care for a client with pneumonia E.
Monitor for side effects of a new antihypertensive medication
Correct Answers: A, C Rationale: LPNs can administer tube feedings
(A) and change sterile dressings on stable wounds (C). Initial assessment
(B) and care plan development (D) are RN responsibilities. Monitoring
for side effects (E) requires RN-level evaluation.
Question 3 A nurse is caring for a client who refuses a prescribed blood
transfusion due to religious beliefs. The client's family requests that the
nurse give the blood anyway. What should the nurse do?
A. Administer the blood transfusion as the family requests B. Contact the
facility's ethics committee C. Respect the client's refusal and document
it D. Ask the provider to override the client's decision
,Correct Answer: C Rationale: A competent adult client has the right to
refuse treatment. The nurse must respect the refusal and document it.
Ethics committee (B) may be consulted if competency is in question.
Question 4 A nurse is preparing to discharge a client who speaks a
limited amount of English. Which action is most appropriate?
A. Give written instructions in English only B. Use a certified medical
interpreter for discharge teaching C. Ask the client's 10-year-old child to
translate D. Speak loudly and slowly in English
Correct Answer: B Rationale: A certified medical interpreter is required
by federal law for meaningful communication. Family members (C) are
not reliable for medical information.
Question 5 (Select all that apply) A nurse is reviewing informed consent
with a group of new graduates. Which statements by a new graduate
indicate understanding? (Select all that apply)
A. "The nurse is responsible for obtaining written informed consent." B.
"A client can withdraw consent at any time before the procedure." C.
"Consent is valid if the client is under the influence of pain
medication." D. "Family members can sign consent if the client is
nervous." E. "The provider is responsible for explaining the procedure
and risks."
Correct Answers: B, E Rationale: The client can withdraw consent at
any time (B). The provider (not the nurse) is responsible for obtaining
consent (E). Pain medication (C) invalidates consent.
Question 6 A nurse is caring for a client who is being discharged but
refuses to leave because they feel unsafe at home. What should the nurse
do first?
, A. Call security to escort the client out B. Notify the provider and social
worker C. Tell the client they have no choice D. Arrange for temporary
shelter
Correct Answer: B Rationale: The nurse must first notify the provider
and social worker to assess safety concerns and legal options. Security
(A) is not appropriate.
Question 7 A nurse is preparing to transfer a client from the ICU to a
medical-surgical unit. Which information must be included in the handoff
report?
A. The client's full medical history since birth B. The name of the client's
primary care provider C. Current medications and recent vital signs D.
The client's preferred meal choices
Correct Answer: C Rationale: Handoff reports must include actionable,
current clinical data: medications, recent vital signs, pending labs, and
safety concerns.
Question 8 (Select all that apply) A charge nurse is reviewing HIPAA
compliance. Which actions violate HIPAA? (Select all that apply)
A. Discussing a client's condition in a public elevator B. Faxing records
to another facility with a cover sheet C. Leaving a client's printed lab
results on a shared desk D. Sharing login information with a colleague E.
Providing handoff report at the client's bedside
Correct Answers: A, C, D Rationale: Elevator discussion (A), leaving
results visible (C), and sharing logins (D) violate HIPAA. Faxing with
cover sheet (B) and bedside handoff (E) are acceptable.
Predictor 2026 Exam, Multiple-Choice
Questions with Rationales Multiple
Correct Answers & Detailed Explanations
High-Yield Focus
TABLE OF CONTENTS
1. Safe & Effective Care Environment – Management of Care
(Questions 1–40)
2. Safe & Effective Care Environment – Safety & Infection
Control (Questions 41–70)
3. Health Promotion & Maintenance (Questions 71–100)
4. Psychosocial Integrity (Questions 101–130)
5. Basic Care & Comfort (Questions 131–160)
6. Pharmacological & Parenteral Therapies (Questions 161–200)
7. Reduction of Risk Potential (Questions 201–230)
8. Physiological Adaptation (Questions 231–260)
,SAFE & EFFECTIVE CARE ENVIRONMENT – MANAGEMENT
OF CARE (Questions 1–40)
Question 1 A nurse is caring for a client who has a prescription for a
physical restraint. Which of the following actions should the nurse take?
A. Apply the restraint for up to 4 hours before reassessing B. Obtain a
new restraint order every 24 hours C. Tie the restraint to the side rail of
the bed D. Remove the restraint every 2 hours for range of motion
Correct Answer: B Rationale: Restraint orders must be renewed every
24 hours (or per facility policy, often every 4-8 hours). Restraints should
be removed every 2 hours for ROM (D). Never tie to side rails (C).
Question 2 (Select all that apply) A charge nurse is delegating tasks on a
medical-surgical unit. Which tasks can be delegated to an LPN? (Select
all that apply)
A. Administer a tube feeding to a stable client B. Perform an initial
admission assessment C. Change a sterile dressing on a postoperative day
3 wound D. Develop a plan of care for a client with pneumonia E.
Monitor for side effects of a new antihypertensive medication
Correct Answers: A, C Rationale: LPNs can administer tube feedings
(A) and change sterile dressings on stable wounds (C). Initial assessment
(B) and care plan development (D) are RN responsibilities. Monitoring
for side effects (E) requires RN-level evaluation.
Question 3 A nurse is caring for a client who refuses a prescribed blood
transfusion due to religious beliefs. The client's family requests that the
nurse give the blood anyway. What should the nurse do?
A. Administer the blood transfusion as the family requests B. Contact the
facility's ethics committee C. Respect the client's refusal and document
it D. Ask the provider to override the client's decision
,Correct Answer: C Rationale: A competent adult client has the right to
refuse treatment. The nurse must respect the refusal and document it.
Ethics committee (B) may be consulted if competency is in question.
Question 4 A nurse is preparing to discharge a client who speaks a
limited amount of English. Which action is most appropriate?
A. Give written instructions in English only B. Use a certified medical
interpreter for discharge teaching C. Ask the client's 10-year-old child to
translate D. Speak loudly and slowly in English
Correct Answer: B Rationale: A certified medical interpreter is required
by federal law for meaningful communication. Family members (C) are
not reliable for medical information.
Question 5 (Select all that apply) A nurse is reviewing informed consent
with a group of new graduates. Which statements by a new graduate
indicate understanding? (Select all that apply)
A. "The nurse is responsible for obtaining written informed consent." B.
"A client can withdraw consent at any time before the procedure." C.
"Consent is valid if the client is under the influence of pain
medication." D. "Family members can sign consent if the client is
nervous." E. "The provider is responsible for explaining the procedure
and risks."
Correct Answers: B, E Rationale: The client can withdraw consent at
any time (B). The provider (not the nurse) is responsible for obtaining
consent (E). Pain medication (C) invalidates consent.
Question 6 A nurse is caring for a client who is being discharged but
refuses to leave because they feel unsafe at home. What should the nurse
do first?
, A. Call security to escort the client out B. Notify the provider and social
worker C. Tell the client they have no choice D. Arrange for temporary
shelter
Correct Answer: B Rationale: The nurse must first notify the provider
and social worker to assess safety concerns and legal options. Security
(A) is not appropriate.
Question 7 A nurse is preparing to transfer a client from the ICU to a
medical-surgical unit. Which information must be included in the handoff
report?
A. The client's full medical history since birth B. The name of the client's
primary care provider C. Current medications and recent vital signs D.
The client's preferred meal choices
Correct Answer: C Rationale: Handoff reports must include actionable,
current clinical data: medications, recent vital signs, pending labs, and
safety concerns.
Question 8 (Select all that apply) A charge nurse is reviewing HIPAA
compliance. Which actions violate HIPAA? (Select all that apply)
A. Discussing a client's condition in a public elevator B. Faxing records
to another facility with a cover sheet C. Leaving a client's printed lab
results on a shared desk D. Sharing login information with a colleague E.
Providing handoff report at the client's bedside
Correct Answers: A, C, D Rationale: Elevator discussion (A), leaving
results visible (C), and sharing logins (D) violate HIPAA. Faxing with
cover sheet (B) and bedside handoff (E) are acceptable.
