1
HESI Exit RN V1 Exam Comprehensive
Nursing Exit Review Actual 2026/2027
with Detailed Rationales | Complete
Exam-Style Questions – Pass Guaranteed
– A+ Graded
TABLE OF CONTENTS
Section 1 | Safe & Effective Care Environment | Q1 – Q10
Section 2 | Health Promotion & Maintenance | Q11 – Q15
Section 3 | Psychosocial Integrity | Q16 – Q20
Section 4 | Physiological Integrity — Basic Care & Comfort | Q21 –
Q30
Section 5 | Physiological Integrity — Pharmacological, Parenteral &
Physiological Adaptation | Q31 – Q50
Instructions: Choose the single best answer unless otherwise indicated
(SATA). Pass: 38/50 in 120 minutes.
══════════════════════════════════════
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT Q1 – Q10
══════════════════════════════════════
Question 1 of 50
,2
A registered nurse is assigned to care for four patients on a medical-
surgical unit: a post-operative cholecystectomy patient who is 4 hours
out of surgery with stable vital signs, an elderly patient with newly
diagnosed heart failure awaiting discharge teaching, a patient with type 2
diabetes mellitus reporting blood glucose of 65 mg/dL and feeling
shaky, and a patient admitted yesterday for pneumonia who has
developed new-onset confusion and oxygen saturation of 88% on room
air. The nurse should prioritize assessment of which patient first?
A. The post-operative cholecystectomy patient to ensure surgical site
integrity and pain control
B. The elderly heart failure patient to complete discharge education
before end of shift
C. The diabetic patient with hypoglycemia symptoms to provide rapid
glucose correction
D. The pneumonia patient with acute mental status change and
hypoxemia ✓ CORRECT
Correct Answer: D
Rationale: This patient demonstrates both neurological deterioration and
respiratory compromise, representing an immediate life-threatening
situation requiring urgent intervention per ABC prioritization
framework. While hypoglycemia requires prompt treatment, the
combination of altered mental status and significant desaturation
indicates potential respiratory failure or sepsis progression that takes
precedence. HESI frequently tests recognition of clinical deterioration
,3
patterns where multiple system involvement elevates acuity above
single-system concerns.
Question 2 of 50
The charge nurse on a busy telemetry unit receives report that one RN
called in sick, leaving three RNs and two LPNs to care for 24 patients.
Among today's assignments are a patient receiving a fresh blood
transfusion who needs monitoring, a patient with complex wound care
requiring sterile dressing changes, a stable patient who needs assistance
with bathing and ambulation, and a patient scheduled for discharge who
requires comprehensive medication education. Which task is most
appropriate to delegate to the LPN?
A. Monitoring the patient during the blood transfusion and documenting
vital signs per protocol
B. Performing the sterile wound dressing change using aseptic technique
C. Assisting the stable patient with bathing, feeding, and progressive
ambulation ✓ CORRECT
D. Providing comprehensive discharge medication education and written
instructions
Correct Answer: C
Rationale: LPN scope of practice includes assisting with activities of
daily living and basic mobility support for stable patients, which falls
within routine nursing care that does not require professional nursing
judgment. Blood transfusion monitoring involves ongoing assessment
, 4
for adverse reactions requiring RN-level critical thinking, sterile wound
care demands advanced clinical skills typically reserved for RNs, and
discharge education represents the teaching-coaching function that
cannot be delegated per the Five Rights of Delegation framework.
Question 3 of 50
A nurse is preparing to administer morning medications and notices that
the pharmacy sent furosemide 80 mg IV push instead of the prescribed
furosemide 40 mg oral tablet for a patient with chronic heart failure. The
nurse calls the pharmacy to clarify and is told the physician changed the
order yesterday evening but it was not updated in the electronic health
record. What is the nurse's best initial action?
A. Administer the IV furosemide as sent since the pharmacy confirmed
the order change
B. Hold the medication and contact the prescribing physician to verify
the current order ✓ CORRECT
C. Give the oral dose from the unit's automated dispensing cabinet while
waiting for clarification
D. Document the discrepancy and proceed with administration after
noting the communication
Correct Answer: B
Rationale: The nurse must verify any medication discrepancy directly
with the prescriber before administration because the Right Drug and
Right Dose principles require confirmation when orders conflict or seem
HESI Exit RN V1 Exam Comprehensive
Nursing Exit Review Actual 2026/2027
with Detailed Rationales | Complete
Exam-Style Questions – Pass Guaranteed
– A+ Graded
TABLE OF CONTENTS
Section 1 | Safe & Effective Care Environment | Q1 – Q10
Section 2 | Health Promotion & Maintenance | Q11 – Q15
Section 3 | Psychosocial Integrity | Q16 – Q20
Section 4 | Physiological Integrity — Basic Care & Comfort | Q21 –
Q30
Section 5 | Physiological Integrity — Pharmacological, Parenteral &
Physiological Adaptation | Q31 – Q50
Instructions: Choose the single best answer unless otherwise indicated
(SATA). Pass: 38/50 in 120 minutes.
══════════════════════════════════════
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT Q1 – Q10
══════════════════════════════════════
Question 1 of 50
,2
A registered nurse is assigned to care for four patients on a medical-
surgical unit: a post-operative cholecystectomy patient who is 4 hours
out of surgery with stable vital signs, an elderly patient with newly
diagnosed heart failure awaiting discharge teaching, a patient with type 2
diabetes mellitus reporting blood glucose of 65 mg/dL and feeling
shaky, and a patient admitted yesterday for pneumonia who has
developed new-onset confusion and oxygen saturation of 88% on room
air. The nurse should prioritize assessment of which patient first?
A. The post-operative cholecystectomy patient to ensure surgical site
integrity and pain control
B. The elderly heart failure patient to complete discharge education
before end of shift
C. The diabetic patient with hypoglycemia symptoms to provide rapid
glucose correction
D. The pneumonia patient with acute mental status change and
hypoxemia ✓ CORRECT
Correct Answer: D
Rationale: This patient demonstrates both neurological deterioration and
respiratory compromise, representing an immediate life-threatening
situation requiring urgent intervention per ABC prioritization
framework. While hypoglycemia requires prompt treatment, the
combination of altered mental status and significant desaturation
indicates potential respiratory failure or sepsis progression that takes
precedence. HESI frequently tests recognition of clinical deterioration
,3
patterns where multiple system involvement elevates acuity above
single-system concerns.
Question 2 of 50
The charge nurse on a busy telemetry unit receives report that one RN
called in sick, leaving three RNs and two LPNs to care for 24 patients.
Among today's assignments are a patient receiving a fresh blood
transfusion who needs monitoring, a patient with complex wound care
requiring sterile dressing changes, a stable patient who needs assistance
with bathing and ambulation, and a patient scheduled for discharge who
requires comprehensive medication education. Which task is most
appropriate to delegate to the LPN?
A. Monitoring the patient during the blood transfusion and documenting
vital signs per protocol
B. Performing the sterile wound dressing change using aseptic technique
C. Assisting the stable patient with bathing, feeding, and progressive
ambulation ✓ CORRECT
D. Providing comprehensive discharge medication education and written
instructions
Correct Answer: C
Rationale: LPN scope of practice includes assisting with activities of
daily living and basic mobility support for stable patients, which falls
within routine nursing care that does not require professional nursing
judgment. Blood transfusion monitoring involves ongoing assessment
, 4
for adverse reactions requiring RN-level critical thinking, sterile wound
care demands advanced clinical skills typically reserved for RNs, and
discharge education represents the teaching-coaching function that
cannot be delegated per the Five Rights of Delegation framework.
Question 3 of 50
A nurse is preparing to administer morning medications and notices that
the pharmacy sent furosemide 80 mg IV push instead of the prescribed
furosemide 40 mg oral tablet for a patient with chronic heart failure. The
nurse calls the pharmacy to clarify and is told the physician changed the
order yesterday evening but it was not updated in the electronic health
record. What is the nurse's best initial action?
A. Administer the IV furosemide as sent since the pharmacy confirmed
the order change
B. Hold the medication and contact the prescribing physician to verify
the current order ✓ CORRECT
C. Give the oral dose from the unit's automated dispensing cabinet while
waiting for clarification
D. Document the discrepancy and proceed with administration after
noting the communication
Correct Answer: B
Rationale: The nurse must verify any medication discrepancy directly
with the prescriber before administration because the Right Drug and
Right Dose principles require confirmation when orders conflict or seem
