HESI RN EXIT EXAM 2026/2027 |
COMPREHENSIVE PRACTICE EXAM | HIGH-
YIELD QUESTIONS, VERIFIED ANSWERS &
DETAILED RATIONALES | V1–V7 NGN-
ALIGNED | JUST RELEASED PDF
MANAGEMENT OF CARE
Question 1
A nurse is preparing to delegate tasks to an unlicensed assistive personnel (UAP).
Which task is appropriate to delegate to a UAP?
A) Assessing a client's surgical wound
B) Administering oral medications
C) Assisting a client with ambulation
D) Developing a nursing care plan
Correct Answer: C
Rationale: The RN can delegate tasks that do not require nursing judgment to UAPs,
such as assisting with ambulation, bathing, feeding, and taking vital signs.
Assessment, medication administration, and care planning require nursing judgment
and cannot be delegated .
Question 2
A nurse is caring for a client who refuses a blood transfusion due to religious beliefs.
Which action is most appropriate?
A) Administer the blood transfusion without consent
B) Respect the client's refusal and document it
C) Notify the healthcare provider to override the client's decision
D) Inform the family of the client's decision
Correct Answer: B
Rationale: Clients have the right to refuse treatment based on religious or personal
beliefs. The nurse should respect the client's decision, document the refusal, and
explore alternative treatments .
Question 3
A nurse is using the SBAR communication tool to report a change in a patient's
condition to the provider. Which component would the nurse include first?
A) Assessment findings
B) Recommendation for intervention
,C) Situation (what is happening now)
D) Background information
Correct Answer: C
Rationale: SBAR stands for Situation, Background, Assessment, and
Recommendation. The "Situation" is presented first and describes the current
concern or change in condition .
Question 4
A charge nurse is implementing a "just culture" approach to error reporting. Which
statement reflects this approach?
A) "All medication errors will result in immediate termination."
B) "We will focus on identifying system failures rather than blaming individuals."
C) "Errors should be reported only if they cause patient harm."
D) "Staff should avoid reporting errors to protect their colleagues."
Correct Answer: B
Rationale: A just culture recognizes that errors often result from system failures
rather than individual negligence. It encourages reporting and learning from errors
without fear of punishment .
Question 5
A nurse is preparing a client for discharge. What is the priority action?
A) Provide written discharge instructions
B) Use the teach-back method to ensure the client understands the discharge plan
C) Call the pharmacy to order medications
D) Schedule a follow-up appointment
Correct Answer: B
Rationale: Ensuring the client understands the discharge plan is the priority. The
teach-back method, where the client explains the instructions in their own words,
confirms comprehension and is a key safety strategy .
Question 6
A nurse discovers that a colleague has been documenting medications as given when
they were not administered. What is the nurse's best initial action?
A) Ignore the incident to avoid conflict
B) Report the incident to the nurse manager
C) Confront the colleague privately
D) Discuss the incident with the colleague and report if necessary
Correct Answer: D
Rationale: The nurse should first discuss the incident with the colleague to address
the issue. If the colleague is unresponsive or the behavior continues, the nurse
should report it to the nurse manager .
,Question 7
A nurse is caring for a client who has an advance directive. Which statement indicates
understanding of the advance directive?
A) "The advance directive must be followed regardless of the client's current wishes."
B) "The advance directive is a legal document that guides care if the client cannot
speak."
C) "The advance directive can only be created by a lawyer."
D) "The advance directive overrides the client's current verbal wishes."
Correct Answer: B
Rationale: An advance directive is a legal document that guides medical care if the
client becomes unable to make decisions. It includes living wills and durable powers
of attorney for healthcare .
Question 8
A nurse is preparing to administer medications. What is the FIRST action the nurse
should take to ensure client safety?
A) Check the client's allergy band
B) Verify the client's identity using two identifiers
C) Review the medication administration record (MAR)
D) Perform hand hygiene
Correct Answer: B
Rationale: According to National Patient Safety Goals, verifying client identity using
two unique identifiers (e.g., name and date of birth) is the first critical step before any
medication administration to prevent wrong-patient errors .
Question 9
A charge nurse is assigning clients to nursing staff. Which factor is most important in
making assignments?
A) Staff preferences
B) Room location
C) Client acuity and staff competency
D) Staff seniority
Correct Answer: C
Rationale: Client acuity must be matched with staff competency to ensure safe
patient care. Assigning clients based on acuity ensures the right nurse is caring for
the right patient .
Question 10
A nurse is providing a handoff report using SBAR. Which statement is an example of
the "Recommendation" component?
A) "The patient's heart rate is 110 beats per minute."
B) "I recommend that we increase the oxygen to 4 L and notify the provider."
, C) "The patient was admitted 2 days ago with pneumonia."
D) "The patient is experiencing shortness of breath."
Correct Answer: B
Rationale: The recommendation component includes specific actions or suggestions
for the next steps in patient care. It is the final component of SBAR .
Question 11
A nurse is caring for a client who is a candidate for organ donation. The family is
reluctant to discuss organ donation. What is the best response?
A) "You need to make a decision quickly."
B) "I understand this is difficult. I will provide resources for you to consider."
C) "Organ donation is the right thing to do."
D) "If you don't decide, the organs will go to waste."
Correct Answer: B
Rationale: The nurse should provide emotional support and resources without
pressuring the family. Organ donation is a sensitive topic, and families should be
given time and support to make their decision .
Question 12
A nurse is caring for a client who is leaving the hospital against medical advice
(AMA). Which action should the nurse take?
A) Restrain the client to prevent leaving
B) Notify the provider, explain risks, and have the client sign the AMA form
C) Call security to stop the client
D) Document that the client left without notifying staff
Correct Answer: B
Rationale: When a client leaves AMA, the nurse should notify the provider, explain
the risks of leaving, have the client sign the AMA form, and document all
communication .
Question 13
A nurse is triaging clients after a mass casualty event. Which client should receive
priority care?
A) A client with a minor laceration who is ambulatory
B) A client who is unresponsive with a patent airway
C) A client with a broken arm who is in severe pain
D) A client who is alert but has a large bleeding wound
Correct Answer: D
Rationale: In triage, clients with life-threatening but potentially treatable conditions
(like hemorrhage) are the priority. Unresponsive clients may be beyond help, while
minor injuries can wait .
COMPREHENSIVE PRACTICE EXAM | HIGH-
YIELD QUESTIONS, VERIFIED ANSWERS &
DETAILED RATIONALES | V1–V7 NGN-
ALIGNED | JUST RELEASED PDF
MANAGEMENT OF CARE
Question 1
A nurse is preparing to delegate tasks to an unlicensed assistive personnel (UAP).
Which task is appropriate to delegate to a UAP?
A) Assessing a client's surgical wound
B) Administering oral medications
C) Assisting a client with ambulation
D) Developing a nursing care plan
Correct Answer: C
Rationale: The RN can delegate tasks that do not require nursing judgment to UAPs,
such as assisting with ambulation, bathing, feeding, and taking vital signs.
Assessment, medication administration, and care planning require nursing judgment
and cannot be delegated .
Question 2
A nurse is caring for a client who refuses a blood transfusion due to religious beliefs.
Which action is most appropriate?
A) Administer the blood transfusion without consent
B) Respect the client's refusal and document it
C) Notify the healthcare provider to override the client's decision
D) Inform the family of the client's decision
Correct Answer: B
Rationale: Clients have the right to refuse treatment based on religious or personal
beliefs. The nurse should respect the client's decision, document the refusal, and
explore alternative treatments .
Question 3
A nurse is using the SBAR communication tool to report a change in a patient's
condition to the provider. Which component would the nurse include first?
A) Assessment findings
B) Recommendation for intervention
,C) Situation (what is happening now)
D) Background information
Correct Answer: C
Rationale: SBAR stands for Situation, Background, Assessment, and
Recommendation. The "Situation" is presented first and describes the current
concern or change in condition .
Question 4
A charge nurse is implementing a "just culture" approach to error reporting. Which
statement reflects this approach?
A) "All medication errors will result in immediate termination."
B) "We will focus on identifying system failures rather than blaming individuals."
C) "Errors should be reported only if they cause patient harm."
D) "Staff should avoid reporting errors to protect their colleagues."
Correct Answer: B
Rationale: A just culture recognizes that errors often result from system failures
rather than individual negligence. It encourages reporting and learning from errors
without fear of punishment .
Question 5
A nurse is preparing a client for discharge. What is the priority action?
A) Provide written discharge instructions
B) Use the teach-back method to ensure the client understands the discharge plan
C) Call the pharmacy to order medications
D) Schedule a follow-up appointment
Correct Answer: B
Rationale: Ensuring the client understands the discharge plan is the priority. The
teach-back method, where the client explains the instructions in their own words,
confirms comprehension and is a key safety strategy .
Question 6
A nurse discovers that a colleague has been documenting medications as given when
they were not administered. What is the nurse's best initial action?
A) Ignore the incident to avoid conflict
B) Report the incident to the nurse manager
C) Confront the colleague privately
D) Discuss the incident with the colleague and report if necessary
Correct Answer: D
Rationale: The nurse should first discuss the incident with the colleague to address
the issue. If the colleague is unresponsive or the behavior continues, the nurse
should report it to the nurse manager .
,Question 7
A nurse is caring for a client who has an advance directive. Which statement indicates
understanding of the advance directive?
A) "The advance directive must be followed regardless of the client's current wishes."
B) "The advance directive is a legal document that guides care if the client cannot
speak."
C) "The advance directive can only be created by a lawyer."
D) "The advance directive overrides the client's current verbal wishes."
Correct Answer: B
Rationale: An advance directive is a legal document that guides medical care if the
client becomes unable to make decisions. It includes living wills and durable powers
of attorney for healthcare .
Question 8
A nurse is preparing to administer medications. What is the FIRST action the nurse
should take to ensure client safety?
A) Check the client's allergy band
B) Verify the client's identity using two identifiers
C) Review the medication administration record (MAR)
D) Perform hand hygiene
Correct Answer: B
Rationale: According to National Patient Safety Goals, verifying client identity using
two unique identifiers (e.g., name and date of birth) is the first critical step before any
medication administration to prevent wrong-patient errors .
Question 9
A charge nurse is assigning clients to nursing staff. Which factor is most important in
making assignments?
A) Staff preferences
B) Room location
C) Client acuity and staff competency
D) Staff seniority
Correct Answer: C
Rationale: Client acuity must be matched with staff competency to ensure safe
patient care. Assigning clients based on acuity ensures the right nurse is caring for
the right patient .
Question 10
A nurse is providing a handoff report using SBAR. Which statement is an example of
the "Recommendation" component?
A) "The patient's heart rate is 110 beats per minute."
B) "I recommend that we increase the oxygen to 4 L and notify the provider."
, C) "The patient was admitted 2 days ago with pneumonia."
D) "The patient is experiencing shortness of breath."
Correct Answer: B
Rationale: The recommendation component includes specific actions or suggestions
for the next steps in patient care. It is the final component of SBAR .
Question 11
A nurse is caring for a client who is a candidate for organ donation. The family is
reluctant to discuss organ donation. What is the best response?
A) "You need to make a decision quickly."
B) "I understand this is difficult. I will provide resources for you to consider."
C) "Organ donation is the right thing to do."
D) "If you don't decide, the organs will go to waste."
Correct Answer: B
Rationale: The nurse should provide emotional support and resources without
pressuring the family. Organ donation is a sensitive topic, and families should be
given time and support to make their decision .
Question 12
A nurse is caring for a client who is leaving the hospital against medical advice
(AMA). Which action should the nurse take?
A) Restrain the client to prevent leaving
B) Notify the provider, explain risks, and have the client sign the AMA form
C) Call security to stop the client
D) Document that the client left without notifying staff
Correct Answer: B
Rationale: When a client leaves AMA, the nurse should notify the provider, explain
the risks of leaving, have the client sign the AMA form, and document all
communication .
Question 13
A nurse is triaging clients after a mass casualty event. Which client should receive
priority care?
A) A client with a minor laceration who is ambulatory
B) A client who is unresponsive with a patent airway
C) A client with a broken arm who is in severe pain
D) A client who is alert but has a large bleeding wound
Correct Answer: D
Rationale: In triage, clients with life-threatening but potentially treatable conditions
(like hemorrhage) are the priority. Unresponsive clients may be beyond help, while
minor injuries can wait .
