ELSEVIER HESI
HESI 799 RN Exit Exam
Complete Study Guide
All Practice Questions with Detailed Rationales
Topic Focus: Medical-Surgical, Pediatrics, Maternity, Mental Health,
Pharmacology, Leadership & Critical Care
Edition 1 · August 2026 · All Questions Complete
Table of Contents
1. Instructions for Use 2
2. Medical-Surgical Nursing (Questions 1–85) 2
3. Pharmacology & Medication Administration (Questions 86–120) 6
4. Pediatrics & Maternity (Questions 121–160) 8
,5. Mental Health & Psychiatric Nursing (Questions 161–185) 10
6. Leadership, Delegation & Ethics (Questions 186–210) 12
7. Critical Care & Emergency (Questions 211–230) 14
HESI 799 RN Exit Exam Page 1
,HESI 799 RN EXIT EXAM STUDY GUIDE MEDICAL-SURGICAL — Q1–85
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is. All questions are derived directly from the source material and verified for
accuracy.
Category: Medical-Surgical Nursing — Questions 1–85
1 A client in the intensive care unit is being mechanically ventilated, has an indwelling
urinary catheter in place, and is exhibiting signs of restlessness. Which action should
the nurse take first?
A Review the heart rhythm on cardiac monitors
B Check urinary catheter for obstruction
C Auscultate bilateral breath sounds
D Give PRN dose of lorazepam (Ativan)
Why C is correct: Restlessness often results from decreased oxygenation, so breath sounds
should be assessed first. Giving an anxiolytic such as lorazepam might be indicated, but first
the client should be assessed for the cause of the restlessness.
A — Cardiac rhythm should be assessed after airway.
B — Urinary obstruction can cause restlessness but airway is priority.
D — Medicating without assessment is inappropriate.
, 2 The nurse observes that a postoperative client with a continuous bladder irrigation
has a large blood clot in the urinary drainage tubing. What action should the nurse
perform first?
A Determine the client's blood pressure and apical pulse
B Observe the amount of urine in the client's urinary drainage bag
C Obtain a pulse oximeter to assess the client's oxygen saturation
D Review the medication record for recently administered medications
Why B is correct: If blood clots are present, the nurse should first determine if urinary
output has become obstructed by observing the amount of urine in the urinary drainage
bag. Continuous bladder irrigation is performed to prevent blood clots that may form and
obstruct the outflow of urine.
A — Vital signs are important but not the first action.
C — Oxygen saturation is not the priority.
D — Medication review is not the priority.
3 The nurse makes a supervisory home visit to observe an unlicensed assistive
personnel (UAP) who is providing personal care for a client with Alzheimer's disease.
The nurse observes that whenever the client gets upset, the UAP changes the
subject. What action should the nurse take in response to this observation?
A Tell the UAP to offer more choices during the personal care to prevent anxiety
B Meet with the UAP later to role model more assertive communication techniques
C Assume care of the client to ensure that effective communication is maintained
D Affirm that the UAP is using an effective strategy to reduce the client's anxiety
Why D is correct: Redirection is an effective technique in managing the anxiety of clients
with Alzheimer's disease, so the nurse should affirm the UAP is using an effective strategy.
A — Offering more choices may increase agitation.
B — The UAP is using an effective technique.
C — Assuming care is not necessary as the UAP is using redirection.
HESI 799 RN Exit Exam
Complete Study Guide
All Practice Questions with Detailed Rationales
Topic Focus: Medical-Surgical, Pediatrics, Maternity, Mental Health,
Pharmacology, Leadership & Critical Care
Edition 1 · August 2026 · All Questions Complete
Table of Contents
1. Instructions for Use 2
2. Medical-Surgical Nursing (Questions 1–85) 2
3. Pharmacology & Medication Administration (Questions 86–120) 6
4. Pediatrics & Maternity (Questions 121–160) 8
,5. Mental Health & Psychiatric Nursing (Questions 161–185) 10
6. Leadership, Delegation & Ethics (Questions 186–210) 12
7. Critical Care & Emergency (Questions 211–230) 14
HESI 799 RN Exit Exam Page 1
,HESI 799 RN EXIT EXAM STUDY GUIDE MEDICAL-SURGICAL — Q1–85
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is. All questions are derived directly from the source material and verified for
accuracy.
Category: Medical-Surgical Nursing — Questions 1–85
1 A client in the intensive care unit is being mechanically ventilated, has an indwelling
urinary catheter in place, and is exhibiting signs of restlessness. Which action should
the nurse take first?
A Review the heart rhythm on cardiac monitors
B Check urinary catheter for obstruction
C Auscultate bilateral breath sounds
D Give PRN dose of lorazepam (Ativan)
Why C is correct: Restlessness often results from decreased oxygenation, so breath sounds
should be assessed first. Giving an anxiolytic such as lorazepam might be indicated, but first
the client should be assessed for the cause of the restlessness.
A — Cardiac rhythm should be assessed after airway.
B — Urinary obstruction can cause restlessness but airway is priority.
D — Medicating without assessment is inappropriate.
, 2 The nurse observes that a postoperative client with a continuous bladder irrigation
has a large blood clot in the urinary drainage tubing. What action should the nurse
perform first?
A Determine the client's blood pressure and apical pulse
B Observe the amount of urine in the client's urinary drainage bag
C Obtain a pulse oximeter to assess the client's oxygen saturation
D Review the medication record for recently administered medications
Why B is correct: If blood clots are present, the nurse should first determine if urinary
output has become obstructed by observing the amount of urine in the urinary drainage
bag. Continuous bladder irrigation is performed to prevent blood clots that may form and
obstruct the outflow of urine.
A — Vital signs are important but not the first action.
C — Oxygen saturation is not the priority.
D — Medication review is not the priority.
3 The nurse makes a supervisory home visit to observe an unlicensed assistive
personnel (UAP) who is providing personal care for a client with Alzheimer's disease.
The nurse observes that whenever the client gets upset, the UAP changes the
subject. What action should the nurse take in response to this observation?
A Tell the UAP to offer more choices during the personal care to prevent anxiety
B Meet with the UAP later to role model more assertive communication techniques
C Assume care of the client to ensure that effective communication is maintained
D Affirm that the UAP is using an effective strategy to reduce the client's anxiety
Why D is correct: Redirection is an effective technique in managing the anxiety of clients
with Alzheimer's disease, so the nurse should affirm the UAP is using an effective strategy.
A — Offering more choices may increase agitation.
B — The UAP is using an effective technique.
C — Assuming care is not necessary as the UAP is using redirection.
