,HESI RN Comprehensive Predictor Exit 2026 with NGN
1. A charge nurse is making assignments for a medical-surgical unit.
Which client should be assigned to the most experienced RN?
A. A 45-year-old with pneumonia requiring IV antibiotics
B. A 60-year-old post-cholecystectomy with a T-tube
C. A 70-year-old with acute renal failure and hyperkalemia
D. A 30-year-old with cellulitis receiving oral antibiotics
Correct Answer: C
Rationale: Acute renal failure with hyperkalemia is a complex, potentially
life-threatening condition requiring advanced assessment and clinical
judgment. The most experienced RN should manage unstable clients. Options
A, B, and D are more stable and appropriate for less experienced staff.
2. A nurse is delegating tasks to an unlicensed assistive personnel
(UAP). Which task is appropriate to delegate?
A. Assessing a postoperative incision
B. Administering a tube feeding
C. Measuring intake and output
D. Evaluating the effectiveness of pain medication
Correct Answer: C
Rationale: Measuring intake and output is a routine, non-invasive task within
the UAP scope of practice. Assessment (A), administration of tube feedings
(B), and evaluation (D) require licensed nursing judgment and cannot be
delegated.
,3. A client with a do-not-resuscitate (DNR) order becomes pulseless
and apneic. What is the nurse's best action?
A. Begin CPR immediately
B. Call a code blue
C. Verify the DNR order and do not initiate CPR
D. Administer epinephrine IV push
Correct Answer: C
Rationale: A valid DNR order means CPR should not be initiated. The nurse
must verify the order and respect the client's wishes. Initiating CPR (A, B, D)
would violate the DNR directive and is legally inappropriate.
4. A nurse is preparing a client for discharge after a stroke. Which
interprofessional team member should the nurse consult first for home
safety evaluation?
A. Physical therapist
B. Occupational therapist
C. Speech-language pathologist
D. Social worker
Correct Answer: B
Rationale: The occupational therapist evaluates the client's ability to perform
activities of daily living (ADLs) and recommends home modifications for
safety (grab bars, ramps, etc.). The physical therapist focuses on mobility,
speech on communication/swallowing, and social worker on
financial/placement resources.
, 5. A client refuses a prescribed medication. What is the nurse's priority
legal responsibility?
A. Document the refusal in the medical record
B. Notify the healthcare provider
C. Explain the risks of refusing the medication
D. Administer the medication by another route
Correct Answer: A
Rationale: Documentation of refusal is a legal requirement to protect the
nurse and facility. While notifying the provider (B) and educating the client
(C) are important, documentation is the priority legal action. Administering
against refusal (D) constitutes battery.
6. A nurse is caring for a client with a tracheostomy. Which action
indicates the nurse is practicing safely?
A. Suctioning the tracheostomy every 2 hours routinely
B. Using sterile technique during suctioning
C. Changing the tracheostomy ties every 24 hours
D. Deflating the cuff before suctioning
Correct Answer: B
Rationale: Sterile technique is required during tracheostomy suctioning to
prevent infection. Suctioning should be PRN, not routine (A). Ties are changed
when soiled or PRN (C). The cuff should remain inflated during suctioning to
prevent aspiration (D).
1. A charge nurse is making assignments for a medical-surgical unit.
Which client should be assigned to the most experienced RN?
A. A 45-year-old with pneumonia requiring IV antibiotics
B. A 60-year-old post-cholecystectomy with a T-tube
C. A 70-year-old with acute renal failure and hyperkalemia
D. A 30-year-old with cellulitis receiving oral antibiotics
Correct Answer: C
Rationale: Acute renal failure with hyperkalemia is a complex, potentially
life-threatening condition requiring advanced assessment and clinical
judgment. The most experienced RN should manage unstable clients. Options
A, B, and D are more stable and appropriate for less experienced staff.
2. A nurse is delegating tasks to an unlicensed assistive personnel
(UAP). Which task is appropriate to delegate?
A. Assessing a postoperative incision
B. Administering a tube feeding
C. Measuring intake and output
D. Evaluating the effectiveness of pain medication
Correct Answer: C
Rationale: Measuring intake and output is a routine, non-invasive task within
the UAP scope of practice. Assessment (A), administration of tube feedings
(B), and evaluation (D) require licensed nursing judgment and cannot be
delegated.
,3. A client with a do-not-resuscitate (DNR) order becomes pulseless
and apneic. What is the nurse's best action?
A. Begin CPR immediately
B. Call a code blue
C. Verify the DNR order and do not initiate CPR
D. Administer epinephrine IV push
Correct Answer: C
Rationale: A valid DNR order means CPR should not be initiated. The nurse
must verify the order and respect the client's wishes. Initiating CPR (A, B, D)
would violate the DNR directive and is legally inappropriate.
4. A nurse is preparing a client for discharge after a stroke. Which
interprofessional team member should the nurse consult first for home
safety evaluation?
A. Physical therapist
B. Occupational therapist
C. Speech-language pathologist
D. Social worker
Correct Answer: B
Rationale: The occupational therapist evaluates the client's ability to perform
activities of daily living (ADLs) and recommends home modifications for
safety (grab bars, ramps, etc.). The physical therapist focuses on mobility,
speech on communication/swallowing, and social worker on
financial/placement resources.
, 5. A client refuses a prescribed medication. What is the nurse's priority
legal responsibility?
A. Document the refusal in the medical record
B. Notify the healthcare provider
C. Explain the risks of refusing the medication
D. Administer the medication by another route
Correct Answer: A
Rationale: Documentation of refusal is a legal requirement to protect the
nurse and facility. While notifying the provider (B) and educating the client
(C) are important, documentation is the priority legal action. Administering
against refusal (D) constitutes battery.
6. A nurse is caring for a client with a tracheostomy. Which action
indicates the nurse is practicing safely?
A. Suctioning the tracheostomy every 2 hours routinely
B. Using sterile technique during suctioning
C. Changing the tracheostomy ties every 24 hours
D. Deflating the cuff before suctioning
Correct Answer: B
Rationale: Sterile technique is required during tracheostomy suctioning to
prevent infection. Suctioning should be PRN, not routine (A). Ties are changed
when soiled or PRN (C). The cuff should remain inflated during suctioning to
prevent aspiration (D).
