RN HESI Exit Exam 2026 Bundle with NGN – 180-Question Practice
Exam
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1–30)
Question 1 A nurse is preparing to delegate tasks to an unlicensed assistive personnel (UAP).
Which task is appropriate for the nurse to delegate?
A) Assessing a client's pain level
B) Administering oral medications
C) Ambulating a stable client
D) Evaluating the effectiveness of pain medication
Correct Answer: C – Ambulating a stable client
Rationale: Delegation follows the "Five Rights": right task, right circumstance, right person, right
direction/communication, and right supervision. UAP can ambulate stable clients, assist with
activities of daily living, and obtain vital signs on stable clients. Assessment, medication
administration, and evaluation are the responsibility of the licensed nurse.
Question 2 A nurse receives a telephone order from a provider for a client's pain medication.
What is the nurse's priority action?
A) Implement the order immediately
B) Write the order in the chart and sign "TO"
C) Read the order back to the provider for verification
D) Ask another nurse to listen to the order
Correct Answer: C – Read the order back to the provider for verification
Rationale: The "read back" process is a critical safety measure that ensures accurate
communication of verbal and telephone orders. After verification, the nurse should document
the order and implement it.
Question 3 The nurse is caring for a client with active pulmonary tuberculosis. Which type of
precautions should the nurse implement?
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Standard precautions only
Correct Answer: C – Airborne precautions
Rationale: Tuberculosis is transmitted via airborne droplet nuclei. Airborne precautions require
an N95 respirator and negative pressure room. Contact precautions are for multidrug-resistant
organisms (MDROs); droplet precautions are for influenza and meningitis.
Question 4 A nurse sustains a needlestick injury from a client known to be HIV positive. Which
action should the nurse take first?
A) Report the injury to occupational health
,B) Wash the site with soap and water
C) Start post-exposure prophylaxis
D) Test the client for viral load
Correct Answer: B – Wash the site with soap and water
Rationale: Immediate wound care (washing with soap and water) is the first step to reduce viral
transmission risk. Then report the injury, then initiate PEP within 72 hours.
Question 5 A client with Clostridioides difficile (C. diff) has frequent watery diarrhea. Which
type of precautions is required?
A) Airborne precautions
B) Droplet precautions
C) Contact precautions
D) Standard precautions only
Correct Answer: C – Contact precautions
Rationale: C. diff is transmitted via contact with contaminated surfaces or feces. Contact
precautions include gown and gloves, and handwashing with soap and water (alcohol-based
hand sanitizer is ineffective against C. diff spores).
Question 6 The nurse is preparing to insert a urinary catheter. Which technique is correct for
maintaining sterility?
A) Open the outer packaging and place on the bedside table
B) Use sterile gloves and a sterile field for all supplies
C) Clean the meatus from back to front
D) Insert the catheter fully into the vagina if misplaced
Correct Answer: B – Use sterile gloves and a sterile field for all supplies
Rationale: Urinary catheter insertion requires sterile technique including sterile gloves, sterile
field, and sterile supplies. Cleaning is front to back, and a catheter inserted into the vagina
should be discarded.
Question 7 A client with varicella (chickenpox) is admitted. Which roommate assignment is
appropriate?
A) A client with pneumonia
B) A client with a fractured hip
C) A client who has had chickenpox previously
D) A client who is immunocompromised
Correct Answer: C – A client who has had chickenpox previously
Rationale: Clients who have had chickenpox are immune to varicella and can safely room with
an infected client. Immunocompromised clients and those without immunity should not be
placed with a client with varicella.
Question 8 A nurse is caring for a client who is post-operative day 2 and has a platelet count of
20,000/mm³. Which intervention should the nurse implement?
,A) Use an electric razor for shaving
B) Administer IM pain medication
C) Apply warm compresses to IV sites
D) Encourage the client to floss teeth daily
Correct Answer: A – Use an electric razor for shaving
Rationale: With severe thrombocytopenia (platelets <50,000), bleeding precautions should be
implemented: electric razor (not straight razor), soft toothbrush (no flossing), no IM injections,
and avoid rectal temperatures.
Question 9 The nurse is preparing to administer a blood transfusion. Which action is most
important before starting the transfusion?
A) Verify the client's blood type with a second nurse
B) Warm the blood to body temperature
C) Administer an antihistamine prophylactically
D) Insert a urinary catheter
Correct Answer: A – Verify the client's blood type with a second nurse
Rationale: Two licensed nurses must verify the client's identity, blood type, Rh factor, and unit
number against the blood product before transfusion to prevent fatal hemolytic reactions.
Question 10 A client is placed in restraints after exhibiting violent behavior. Which action by the
nurse demonstrates appropriate restraint use?
A) Apply restraints tightly to prevent movement
B) Document the client's behavior every 4 hours
C) Remove restraints every 2 hours for range of motion
D) Obtain a provider's order within 1 hour of application
Correct Answer: C – Remove restraints every 2 hours for range of motion
Rationale: Restraints must be removed every 2 hours for skin assessment, range of motion, and
toileting. A provider's order must be obtained immediately (within 1 hour) and renewed every
24 hours. Restraints should never be applied tightly.
Question 11 A nurse is preparing a client for surgery. Which action is essential for informed
consent?
A) Have the client sign the consent form
B) Ensure the provider explained the procedure, risks, and benefits
C) Witness the client's signature on the consent form
D) Answer any questions the client has about the procedure
Correct Answer: B – Ensure the provider explained the procedure, risks, and benefits
Rationale: The provider is responsible for obtaining informed consent by explaining the
procedure, risks, benefits, and alternatives. The nurse's role is to witness the signature and
ensure the client understands but not to provide the detailed informed consent discussion.
, Question 12 A client reports that a medication was administered to the wrong client. What is
the nurse's priority action?
A) Complete an incident report
B) Notify the charge nurse
C) Assess the client for adverse effects
D) Document the error in the client's chart
Correct Answer: C – Assess the client for adverse effects
Rationale: Client safety is the priority. The nurse must first assess the client for any adverse
effects from the medication error, then notify the provider, and finally complete an incident
report.
Question 13 A nurse is caring for a client with a diagnosis of tuberculosis who requires airborne
precautions. Which personal protective equipment (PPE) is required when entering the room?
A) Surgical mask
B) N95 respirator
C) Face shield
D) Gown and gloves only
Correct Answer: B – N95 respirator
Rationale: Airborne precautions require an N95 respirator (or higher-level respirator) that has
been fit-tested. Surgical masks are for droplet precautions.
Question 14 A nurse is preparing to administer a high-alert medication. Which action is most
appropriate?
A) Administer the medication without a second check
B) Have a second nurse independently verify the dose
C) Dilute the medication in a large volume of fluid
D) Administer the medication via the fastest route possible
Correct Answer: B – Have a second nurse independently verify the dose
Rationale: High-alert medications (e.g., heparin, insulin, opioids) require independent double-
check verification by two licensed nurses to prevent medication errors.
Question 15 A client is on fall precautions. Which intervention should the nurse implement?
A) Keep the bed in the highest position
B) Place all personal items out of reach
C) Use bed alarms and non-skid socks
D) Restrain the client to prevent falls
Correct Answer: C – Use bed alarms and non-skid socks
Rationale: Fall precautions include bed alarms, non-skid footwear, low bed position, call light
within reach, and personal items within reach. Restraints are a last resort.
Question 16 A nurse is caring for a client on contact precautions for MRSA. Which action is
correct when providing care?
Exam
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1–30)
Question 1 A nurse is preparing to delegate tasks to an unlicensed assistive personnel (UAP).
Which task is appropriate for the nurse to delegate?
A) Assessing a client's pain level
B) Administering oral medications
C) Ambulating a stable client
D) Evaluating the effectiveness of pain medication
Correct Answer: C – Ambulating a stable client
Rationale: Delegation follows the "Five Rights": right task, right circumstance, right person, right
direction/communication, and right supervision. UAP can ambulate stable clients, assist with
activities of daily living, and obtain vital signs on stable clients. Assessment, medication
administration, and evaluation are the responsibility of the licensed nurse.
Question 2 A nurse receives a telephone order from a provider for a client's pain medication.
What is the nurse's priority action?
A) Implement the order immediately
B) Write the order in the chart and sign "TO"
C) Read the order back to the provider for verification
D) Ask another nurse to listen to the order
Correct Answer: C – Read the order back to the provider for verification
Rationale: The "read back" process is a critical safety measure that ensures accurate
communication of verbal and telephone orders. After verification, the nurse should document
the order and implement it.
Question 3 The nurse is caring for a client with active pulmonary tuberculosis. Which type of
precautions should the nurse implement?
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Standard precautions only
Correct Answer: C – Airborne precautions
Rationale: Tuberculosis is transmitted via airborne droplet nuclei. Airborne precautions require
an N95 respirator and negative pressure room. Contact precautions are for multidrug-resistant
organisms (MDROs); droplet precautions are for influenza and meningitis.
Question 4 A nurse sustains a needlestick injury from a client known to be HIV positive. Which
action should the nurse take first?
A) Report the injury to occupational health
,B) Wash the site with soap and water
C) Start post-exposure prophylaxis
D) Test the client for viral load
Correct Answer: B – Wash the site with soap and water
Rationale: Immediate wound care (washing with soap and water) is the first step to reduce viral
transmission risk. Then report the injury, then initiate PEP within 72 hours.
Question 5 A client with Clostridioides difficile (C. diff) has frequent watery diarrhea. Which
type of precautions is required?
A) Airborne precautions
B) Droplet precautions
C) Contact precautions
D) Standard precautions only
Correct Answer: C – Contact precautions
Rationale: C. diff is transmitted via contact with contaminated surfaces or feces. Contact
precautions include gown and gloves, and handwashing with soap and water (alcohol-based
hand sanitizer is ineffective against C. diff spores).
Question 6 The nurse is preparing to insert a urinary catheter. Which technique is correct for
maintaining sterility?
A) Open the outer packaging and place on the bedside table
B) Use sterile gloves and a sterile field for all supplies
C) Clean the meatus from back to front
D) Insert the catheter fully into the vagina if misplaced
Correct Answer: B – Use sterile gloves and a sterile field for all supplies
Rationale: Urinary catheter insertion requires sterile technique including sterile gloves, sterile
field, and sterile supplies. Cleaning is front to back, and a catheter inserted into the vagina
should be discarded.
Question 7 A client with varicella (chickenpox) is admitted. Which roommate assignment is
appropriate?
A) A client with pneumonia
B) A client with a fractured hip
C) A client who has had chickenpox previously
D) A client who is immunocompromised
Correct Answer: C – A client who has had chickenpox previously
Rationale: Clients who have had chickenpox are immune to varicella and can safely room with
an infected client. Immunocompromised clients and those without immunity should not be
placed with a client with varicella.
Question 8 A nurse is caring for a client who is post-operative day 2 and has a platelet count of
20,000/mm³. Which intervention should the nurse implement?
,A) Use an electric razor for shaving
B) Administer IM pain medication
C) Apply warm compresses to IV sites
D) Encourage the client to floss teeth daily
Correct Answer: A – Use an electric razor for shaving
Rationale: With severe thrombocytopenia (platelets <50,000), bleeding precautions should be
implemented: electric razor (not straight razor), soft toothbrush (no flossing), no IM injections,
and avoid rectal temperatures.
Question 9 The nurse is preparing to administer a blood transfusion. Which action is most
important before starting the transfusion?
A) Verify the client's blood type with a second nurse
B) Warm the blood to body temperature
C) Administer an antihistamine prophylactically
D) Insert a urinary catheter
Correct Answer: A – Verify the client's blood type with a second nurse
Rationale: Two licensed nurses must verify the client's identity, blood type, Rh factor, and unit
number against the blood product before transfusion to prevent fatal hemolytic reactions.
Question 10 A client is placed in restraints after exhibiting violent behavior. Which action by the
nurse demonstrates appropriate restraint use?
A) Apply restraints tightly to prevent movement
B) Document the client's behavior every 4 hours
C) Remove restraints every 2 hours for range of motion
D) Obtain a provider's order within 1 hour of application
Correct Answer: C – Remove restraints every 2 hours for range of motion
Rationale: Restraints must be removed every 2 hours for skin assessment, range of motion, and
toileting. A provider's order must be obtained immediately (within 1 hour) and renewed every
24 hours. Restraints should never be applied tightly.
Question 11 A nurse is preparing a client for surgery. Which action is essential for informed
consent?
A) Have the client sign the consent form
B) Ensure the provider explained the procedure, risks, and benefits
C) Witness the client's signature on the consent form
D) Answer any questions the client has about the procedure
Correct Answer: B – Ensure the provider explained the procedure, risks, and benefits
Rationale: The provider is responsible for obtaining informed consent by explaining the
procedure, risks, benefits, and alternatives. The nurse's role is to witness the signature and
ensure the client understands but not to provide the detailed informed consent discussion.
, Question 12 A client reports that a medication was administered to the wrong client. What is
the nurse's priority action?
A) Complete an incident report
B) Notify the charge nurse
C) Assess the client for adverse effects
D) Document the error in the client's chart
Correct Answer: C – Assess the client for adverse effects
Rationale: Client safety is the priority. The nurse must first assess the client for any adverse
effects from the medication error, then notify the provider, and finally complete an incident
report.
Question 13 A nurse is caring for a client with a diagnosis of tuberculosis who requires airborne
precautions. Which personal protective equipment (PPE) is required when entering the room?
A) Surgical mask
B) N95 respirator
C) Face shield
D) Gown and gloves only
Correct Answer: B – N95 respirator
Rationale: Airborne precautions require an N95 respirator (or higher-level respirator) that has
been fit-tested. Surgical masks are for droplet precautions.
Question 14 A nurse is preparing to administer a high-alert medication. Which action is most
appropriate?
A) Administer the medication without a second check
B) Have a second nurse independently verify the dose
C) Dilute the medication in a large volume of fluid
D) Administer the medication via the fastest route possible
Correct Answer: B – Have a second nurse independently verify the dose
Rationale: High-alert medications (e.g., heparin, insulin, opioids) require independent double-
check verification by two licensed nurses to prevent medication errors.
Question 15 A client is on fall precautions. Which intervention should the nurse implement?
A) Keep the bed in the highest position
B) Place all personal items out of reach
C) Use bed alarms and non-skid socks
D) Restrain the client to prevent falls
Correct Answer: C – Use bed alarms and non-skid socks
Rationale: Fall precautions include bed alarms, non-skid footwear, low bed position, call light
within reach, and personal items within reach. Restraints are a last resort.
Question 16 A nurse is caring for a client on contact precautions for MRSA. Which action is
correct when providing care?
