RN HESI EXIT EXAM 2026 NGN - VERSION 1 + 2 – EXAM-STYLE QUESTIONS
AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES
| GUARANTEED PASS | 2026/27 LATEST UPDATE | EXAM PREP | STUDY GUIDE |
PRACTICE TEST
SECTION ONE: QUESTIONS 1-50
1. A nurse is caring for a client who is 12 hours post- operative following a total
hip arthroplasty. Which of the following actions should the nurse prioritize to
prevent dislocation of the prosthetic joint?
A. Maintain the client in a high-Fowler's position for meals.
B. Keep a pillow between the client's legs while in bed.
C. Encourage active range of motion of the affected extremity.
D. Position the client on the operative side for comfort.
Correct Answer: B. Keep a pillow between the client's legs while in bed.
Rationale: Maintaining abduction of the hip with a pillow between the legs prevents
adduction past the midline, which is the primary cause of dislocation for a posterior
approach hip arthroplasty. High-Fowler's position (A) does not directly prevent
dislocation; active ROM (C) is restricted initially; and positioning on the operative
side (D) could compromise the surgical site and increase dislocation risk.
2. A client with a history of chronic obstructive pulmonary disease (COPD) is
receiving supplemental oxygen at 2 L/min via nasal cannula. The nurse enters
the room and finds the client's respiratory rate is 8 breaths per minute and the
client is difficult to arouse. Which of the following actions should the nurse
take first?
A. Place the client in a supine position.
,B. Decrease the oxygen flow rate to 1 L/min.
C. Prepare for immediate intubation.
D. Check the client's oxygen saturation level.
Correct Answer: D. Check the client's oxygen saturation level.
Rationale: The first step in the nursing process is assessment. The nurse must
confirm the client's oxygenation status before any interventions. The client's
decreased respiratory rate could be due to oxygen-induced hypoventilation (loss of
hypoxic drive), but this is a rare phenomenon. Assessment guides the next action.
Simply repositioning (A), decreasing O2 (B), or preparing for intubation (C) without
assessing the client's oxygen saturation is premature and could lead to
inappropriate care.
3. A nurse is preparing to administer an intramuscular (IM) injection to a client.
To ensure the safest and most effective injection, which of the following needle
gauges and lengths is appropriate for administering a viscous medication into
the ventrogluteal site of an average-sized adult?
A. 18-gauge, 1-inch needle
B. 21-gauge, 1.5-inch needle
C. 25-gauge, 5/8-inch needle
D. 27-gauge, 1.5-inch needle
Correct Answer: B. 21-gauge, 1.5-inch needle
Rationale: A 21-gauge, 1.5-inch needle is appropriate for a deep IM injection into
the ventrogluteal site for an average adult, as it is large enough in diameter to
accommodate viscous medication and long enough to reach the muscle mass. An
18-gauge (A) is too large and painful; a 25-gauge (C) is too small for a viscous
,solution; a 27-gauge (D) is typically used for intradermal or subcutaneous
injections.
4. A charge nurse is observing a newly licensed nurse perform a sterile dressing
change. Which of the following actions by the newly licensed nurse requires
the charge nurse to intervene?
A. The nurse sets up the sterile field before putting on sterile gloves.
B. The nurse places the sterile drape on the bedside table, allowing a 2.5 cm (1-
inch) border over the edge.
C. The nurse opens the sterile kit by unfolding the top flap away from the body.
D. The nurse holds the sterile gauze with ungloved fingers to pack the wound.
Correct Answer: D. The nurse holds the sterile gauze with ungloved fingers to
pack the wound.
Rationale: The sterile field should be set up (A) before applying sterile gloves to
prevent contamination of the gloves; a 1-inch border (B) is standard for a sterile
field; opening the kit away from the body (C) is proper technique. However, packing
a wound requires sterile gloves or sterile forceps. Holding sterile gauze with
ungloved fingers contaminates it and introduces infection risk.
5. A nurse is administering a blood transfusion to a client. Fifteen minutes after
the transfusion begins, the client reports low back pain and chills. What is the
nurse's priority action?
A. Administer diphenhydramine as prescribed.
B. Stop the transfusion and disconnect the tubing.
C. Slow the transfusion rate and monitor the client closely.
D. Stop the transfusion and keep the IV line open with normal saline.
, Correct Answer: D. Stop the transfusion and keep the IV line open with normal
saline.
Rationale: The client is exhibiting signs of a possible acute hemolytic transfusion
reaction. The priority action is to stop the transfusion immediately to prevent
further infusion of the incompatible blood. The IV line must be kept patent with
normal saline (D) to have access for emergency medications. Administering
diphenhydramine (A) without stopping the transfusion is insufficient. Slowing the
rate (C) is unsafe as it continues to infuse the blood product, which can worsen the
reaction.
6. A client who is in active labor is receiving an epidural block. The nurse
should monitor the client for which of the following priority complications?
A. Urinary incontinence
B. Maternal hypotension
C. Inadequate pain relief
D. Fetal bradycardia
Correct Answer: B. Maternal hypotension
Rationale: Epidural blocks can cause sympathetic blockade, leading to vasodilation
and significant maternal hypotension. This is a serious complication that can
reduce placental perfusion and cause fetal distress. While fetal bradycardia (D) can
be a consequence of maternal hypotension, the priority is to monitor the mother for
hypotension to prevent it. Urinary incontinence (A) is common due to bladder
distension; inadequate pain relief (C) is a side effect but not the priority
complication.
7. A nurse is providing teaching to a client who is prescribed warfarin for atrial
fibrillation. Which of the following client statements indicates a need for
AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES
| GUARANTEED PASS | 2026/27 LATEST UPDATE | EXAM PREP | STUDY GUIDE |
PRACTICE TEST
SECTION ONE: QUESTIONS 1-50
1. A nurse is caring for a client who is 12 hours post- operative following a total
hip arthroplasty. Which of the following actions should the nurse prioritize to
prevent dislocation of the prosthetic joint?
A. Maintain the client in a high-Fowler's position for meals.
B. Keep a pillow between the client's legs while in bed.
C. Encourage active range of motion of the affected extremity.
D. Position the client on the operative side for comfort.
Correct Answer: B. Keep a pillow between the client's legs while in bed.
Rationale: Maintaining abduction of the hip with a pillow between the legs prevents
adduction past the midline, which is the primary cause of dislocation for a posterior
approach hip arthroplasty. High-Fowler's position (A) does not directly prevent
dislocation; active ROM (C) is restricted initially; and positioning on the operative
side (D) could compromise the surgical site and increase dislocation risk.
2. A client with a history of chronic obstructive pulmonary disease (COPD) is
receiving supplemental oxygen at 2 L/min via nasal cannula. The nurse enters
the room and finds the client's respiratory rate is 8 breaths per minute and the
client is difficult to arouse. Which of the following actions should the nurse
take first?
A. Place the client in a supine position.
,B. Decrease the oxygen flow rate to 1 L/min.
C. Prepare for immediate intubation.
D. Check the client's oxygen saturation level.
Correct Answer: D. Check the client's oxygen saturation level.
Rationale: The first step in the nursing process is assessment. The nurse must
confirm the client's oxygenation status before any interventions. The client's
decreased respiratory rate could be due to oxygen-induced hypoventilation (loss of
hypoxic drive), but this is a rare phenomenon. Assessment guides the next action.
Simply repositioning (A), decreasing O2 (B), or preparing for intubation (C) without
assessing the client's oxygen saturation is premature and could lead to
inappropriate care.
3. A nurse is preparing to administer an intramuscular (IM) injection to a client.
To ensure the safest and most effective injection, which of the following needle
gauges and lengths is appropriate for administering a viscous medication into
the ventrogluteal site of an average-sized adult?
A. 18-gauge, 1-inch needle
B. 21-gauge, 1.5-inch needle
C. 25-gauge, 5/8-inch needle
D. 27-gauge, 1.5-inch needle
Correct Answer: B. 21-gauge, 1.5-inch needle
Rationale: A 21-gauge, 1.5-inch needle is appropriate for a deep IM injection into
the ventrogluteal site for an average adult, as it is large enough in diameter to
accommodate viscous medication and long enough to reach the muscle mass. An
18-gauge (A) is too large and painful; a 25-gauge (C) is too small for a viscous
,solution; a 27-gauge (D) is typically used for intradermal or subcutaneous
injections.
4. A charge nurse is observing a newly licensed nurse perform a sterile dressing
change. Which of the following actions by the newly licensed nurse requires
the charge nurse to intervene?
A. The nurse sets up the sterile field before putting on sterile gloves.
B. The nurse places the sterile drape on the bedside table, allowing a 2.5 cm (1-
inch) border over the edge.
C. The nurse opens the sterile kit by unfolding the top flap away from the body.
D. The nurse holds the sterile gauze with ungloved fingers to pack the wound.
Correct Answer: D. The nurse holds the sterile gauze with ungloved fingers to
pack the wound.
Rationale: The sterile field should be set up (A) before applying sterile gloves to
prevent contamination of the gloves; a 1-inch border (B) is standard for a sterile
field; opening the kit away from the body (C) is proper technique. However, packing
a wound requires sterile gloves or sterile forceps. Holding sterile gauze with
ungloved fingers contaminates it and introduces infection risk.
5. A nurse is administering a blood transfusion to a client. Fifteen minutes after
the transfusion begins, the client reports low back pain and chills. What is the
nurse's priority action?
A. Administer diphenhydramine as prescribed.
B. Stop the transfusion and disconnect the tubing.
C. Slow the transfusion rate and monitor the client closely.
D. Stop the transfusion and keep the IV line open with normal saline.
, Correct Answer: D. Stop the transfusion and keep the IV line open with normal
saline.
Rationale: The client is exhibiting signs of a possible acute hemolytic transfusion
reaction. The priority action is to stop the transfusion immediately to prevent
further infusion of the incompatible blood. The IV line must be kept patent with
normal saline (D) to have access for emergency medications. Administering
diphenhydramine (A) without stopping the transfusion is insufficient. Slowing the
rate (C) is unsafe as it continues to infuse the blood product, which can worsen the
reaction.
6. A client who is in active labor is receiving an epidural block. The nurse
should monitor the client for which of the following priority complications?
A. Urinary incontinence
B. Maternal hypotension
C. Inadequate pain relief
D. Fetal bradycardia
Correct Answer: B. Maternal hypotension
Rationale: Epidural blocks can cause sympathetic blockade, leading to vasodilation
and significant maternal hypotension. This is a serious complication that can
reduce placental perfusion and cause fetal distress. While fetal bradycardia (D) can
be a consequence of maternal hypotension, the priority is to monitor the mother for
hypotension to prevent it. Urinary incontinence (A) is common due to bladder
distension; inadequate pain relief (C) is a side effect but not the priority
complication.
7. A nurse is providing teaching to a client who is prescribed warfarin for atrial
fibrillation. Which of the following client statements indicates a need for
