RN HESI FUNDAMENTALS EXIT EXAM
PRACTICE 2027 QUESTIONS AND
ANSWERS
1. A client is diagnosed with a massive pulmonary embolism. Which nursing action takes the
highest priority according to the ABC framework?
A. Initiating a peripheral IV line for fluid resuscitation.
B. Educating the client on the purpose of anticoagulant therapy.
C. Obtaining a STAT arterial blood gas (ABG) sample.
D. Administering high-flow oxygen via a non-rebreather mask.
Answer: D
Conceptual Explanation: According to the ABC (Airway, Breathing, Circulation) priority
framework, ensuring adequate oxygenation (Breathing) is the immediate priority for a
client with a pulmonary embolism to prevent hypoxia.
2. Which task is most appropriate for the Registered Nurse (RN) to delegate to an unlicensed
assistive personnel (UAP)?
A. Evaluating a client’s response to pain medication.
,B. Performing a sterile dressing change on a post-operative wound.
C. Assessing a client’s lung sounds after a breathing treatment.
D. Assisting a stable client with ambulation to the bathroom.
Answer: D
Conceptual Explanation: UAPs can perform routine tasks such as ADLs and ambulation
for stable clients. Assessment, evaluation, and sterile procedures are the responsibility of
the licensed nurse.
3. A nurse is caring for a client with a C. difficile infection. Which infection control measure is
mandatory?
A. Using alcohol-based hand sanitizer after exiting the room.
B. Wearing an N95 respirator during client contact.
C. Washing hands with soap and water after providing care.
D. Placing the client in a room with negative pressure.
Answer: C
Conceptual Explanation: C. difficile spores are resistant to alcohol-based sanitizers;
mechanical friction with soap and water is required to remove the spores from hands.
4. When assessing a client with hypokalemia, which clinical manifestation should the nurse
expect to find?
A. Peaked T waves on the ECG.
, B. Hyperactive deep tendon reflexes.
C. Muscle weakness and leg cramps.
D. Increased bowel sounds.
Answer: C
Conceptual Explanation: Hypokalemia affects muscle contraction, leading to weakness
and cramps. Peaked T waves are associated with hyperkalemia, not hypokalemia.
5. A client is scheduled for an elective surgery. Who is legally responsible for obtaining
informed consent?
A. The surgeon performing the procedure.
B. The nurse caring for the client.
C. The hospital administrator.
D. The surgical scrub technician.
Answer: A
Conceptual Explanation: It is the surgeon’s legal responsibility to explain the risks,
benefits, and alternatives of a procedure. The nurse’s role is usually limited to witnessing
the signature.
6. A nurse is performing a physical assessment on an older adult. Which finding is considered
a normal age-related change?
A. Sudden onset of confusion.
PRACTICE 2027 QUESTIONS AND
ANSWERS
1. A client is diagnosed with a massive pulmonary embolism. Which nursing action takes the
highest priority according to the ABC framework?
A. Initiating a peripheral IV line for fluid resuscitation.
B. Educating the client on the purpose of anticoagulant therapy.
C. Obtaining a STAT arterial blood gas (ABG) sample.
D. Administering high-flow oxygen via a non-rebreather mask.
Answer: D
Conceptual Explanation: According to the ABC (Airway, Breathing, Circulation) priority
framework, ensuring adequate oxygenation (Breathing) is the immediate priority for a
client with a pulmonary embolism to prevent hypoxia.
2. Which task is most appropriate for the Registered Nurse (RN) to delegate to an unlicensed
assistive personnel (UAP)?
A. Evaluating a client’s response to pain medication.
,B. Performing a sterile dressing change on a post-operative wound.
C. Assessing a client’s lung sounds after a breathing treatment.
D. Assisting a stable client with ambulation to the bathroom.
Answer: D
Conceptual Explanation: UAPs can perform routine tasks such as ADLs and ambulation
for stable clients. Assessment, evaluation, and sterile procedures are the responsibility of
the licensed nurse.
3. A nurse is caring for a client with a C. difficile infection. Which infection control measure is
mandatory?
A. Using alcohol-based hand sanitizer after exiting the room.
B. Wearing an N95 respirator during client contact.
C. Washing hands with soap and water after providing care.
D. Placing the client in a room with negative pressure.
Answer: C
Conceptual Explanation: C. difficile spores are resistant to alcohol-based sanitizers;
mechanical friction with soap and water is required to remove the spores from hands.
4. When assessing a client with hypokalemia, which clinical manifestation should the nurse
expect to find?
A. Peaked T waves on the ECG.
, B. Hyperactive deep tendon reflexes.
C. Muscle weakness and leg cramps.
D. Increased bowel sounds.
Answer: C
Conceptual Explanation: Hypokalemia affects muscle contraction, leading to weakness
and cramps. Peaked T waves are associated with hyperkalemia, not hypokalemia.
5. A client is scheduled for an elective surgery. Who is legally responsible for obtaining
informed consent?
A. The surgeon performing the procedure.
B. The nurse caring for the client.
C. The hospital administrator.
D. The surgical scrub technician.
Answer: A
Conceptual Explanation: It is the surgeon’s legal responsibility to explain the risks,
benefits, and alternatives of a procedure. The nurse’s role is usually limited to witnessing
the signature.
6. A nurse is performing a physical assessment on an older adult. Which finding is considered
a normal age-related change?
A. Sudden onset of confusion.
