1
RN HESI EXIT EXAM 2026/2027 WITH NGN |
COMPREHENSIVE NURSING ASSESSMENT |
MULTIPLE-CHOICE | EXPERT VERIFIED | 60 VERIFIED
Q&A | DETAILED RATIONALES | NGN-ALIGNED | PASS
GUARANTEED – A+ GRADED
SECTION 1: FUNDAMENTALS OF NURSING – Questions 1–10
Q1: Prioritization – Acute Change in Condition
A registered nurse (RN) is caring for four clients on a medical-surgical unit. Which client should the
RN assess first?
A. A client with a new order for a blood transfusion who is waiting for consent
B. A client who is 1 day postoperative and reports incisional pain of 5/10
C. A client with a history of heart failure who has new-onset confusion and oxygen saturation of 88%
on room air
D. A client who is scheduled for discharge in 2 hours and needs discharge teaching
Correct Answer: C
Rationale: New-onset confusion with hypoxia in a client with heart failure suggests worsening heart
failure, possibly pulmonary edema or decreased cerebral perfusion. This is an acute change requiring
immediate assessment. Option A is important but not urgent. Option B is expected postoperative
pain. Option D is routine. Clinical Pearl: Use ABCs and acute vs. chronic to prioritize. New confusion
is often the first sign of hypoxia in older adults. [100% CORRECT]
Q2: Ethical Principles – Autonomy vs. Beneficence
A client with terminal cancer refuses further chemotherapy. The family insists that the client
continue treatment. The RN should:
A. Respect the client's decision and support the family through the process
B. Follow the family's wishes since they are the decision-makers
C. Ask the provider to convince the client to continue
D. Administer the chemotherapy against the client's wishes
Correct Answer: A
Rationale: Autonomy gives the competent client the right to refuse treatment, even if it may be life-
sustaining. The RN must respect the client's decision and advocate for the client. The family's wishes
do not override the client's autonomy. The RN can provide support and education to the family.
[100% CORRECT]
,2
Q3: Delegation – RN Scope
Which task is appropriate for the RN to delegate to a licensed practical nurse (LPN)?
A. Administering IV push medications
B. Performing an initial assessment on a new admission
C. Developing the plan of care for a complex client
D. Administering oral medications to a stable client
Correct Answer: D
Rationale: LPNs can administer oral medications to stable clients. IV push medications, initial
assessments, and care planning require RN-level education and judgment. Delegation must follow
the Nurse Practice Act and facility policy. [100% CORRECT]
Q4: Postoperative Complications – Malignant Hyperthermia
A client undergoing surgery develops muscle rigidity, tachycardia, and a temperature of 104°F. The
RN should anticipate administering:
A. Dantrolene
B. Succinylcholine
C. Halothane
D. Atropine
Correct Answer: A
Rationale: Malignant hyperthermia is a life-threatening reaction to inhaled anesthetics and
succinylcholine. Dantrolene is the antidote. Stop triggering agents, cool the client, and provide
supportive care. [100% CORRECT]
Q5: Infection Control – Clostridioides difficile
A client is diagnosed with Clostridioides difficile infection. Which action should the RN take?
A. Use alcohol-based hand rub before and after care
B. Place the client in a negative-pressure room
C. Wear a gown and gloves when entering the room
D. Restrict all visitors
Correct Answer: C
Rationale: C. difficile requires contact precautions: gown and gloves. Hand hygiene must be with
soap and water (alcohol does not kill spores). A private room is preferred. Negative-pressure room is
for airborne precautions. Visitors are not restricted but should follow precautions. [100% CORRECT]
Q6: Vital Signs – Orthostatic Hypotension
A client's blood pressure drops from 128/76 supine to 102/62 upon standing. The RN should:
, 3
A. Document the finding as normal
B. Assist the client to lie down and notify the provider
C. Encourage the client to ambulate quickly
D. Administer an antihypertensive
Correct Answer: B
Rationale: A drop of ≥20 mmHg systolic or ≥10 mmHg diastolic within 3 minutes of standing
indicates orthostatic hypotension. The client is at risk for falls. Assist to lie down, monitor, and notify
provider. [100% CORRECT]
Q7: Medication Administration – High-Alert Medications
Which medication requires a double-check by two nurses before administration?
A. Acetaminophen
B. Insulin
C. Metformin
D. Lisinopril
Correct Answer: B
Rationale: Insulin is a high-alert medication requiring independent double-check. Other high-alert
medications include heparin, opioids, and chemotherapy. [100% CORRECT]
Q8: Skin Integrity – Braden Scale
A client has a Braden Scale score of 14. The RN interprets this as:
A. Low risk for pressure injury
B. Moderate risk for pressure injury
C. High risk for pressure injury
D. No risk
Correct Answer: B
Rationale: Braden Scale: ≤9 very high risk, 10–12 high risk, 13–14 moderate risk, 15–18 mild risk, 19–
23 no risk. Score of 14 indicates moderate risk. Implement prevention strategies. [100% CORRECT]
Q9: Nutrition – Dysphagia Precautions
A client with dysphagia is at risk for aspiration. The RN should:
A. Provide thin liquids
B. Place the client in a supine position for meals
C. Thicken liquids and teach chin-tuck technique
D. Encourage large bites
Correct Answer: C
RN HESI EXIT EXAM 2026/2027 WITH NGN |
COMPREHENSIVE NURSING ASSESSMENT |
MULTIPLE-CHOICE | EXPERT VERIFIED | 60 VERIFIED
Q&A | DETAILED RATIONALES | NGN-ALIGNED | PASS
GUARANTEED – A+ GRADED
SECTION 1: FUNDAMENTALS OF NURSING – Questions 1–10
Q1: Prioritization – Acute Change in Condition
A registered nurse (RN) is caring for four clients on a medical-surgical unit. Which client should the
RN assess first?
A. A client with a new order for a blood transfusion who is waiting for consent
B. A client who is 1 day postoperative and reports incisional pain of 5/10
C. A client with a history of heart failure who has new-onset confusion and oxygen saturation of 88%
on room air
D. A client who is scheduled for discharge in 2 hours and needs discharge teaching
Correct Answer: C
Rationale: New-onset confusion with hypoxia in a client with heart failure suggests worsening heart
failure, possibly pulmonary edema or decreased cerebral perfusion. This is an acute change requiring
immediate assessment. Option A is important but not urgent. Option B is expected postoperative
pain. Option D is routine. Clinical Pearl: Use ABCs and acute vs. chronic to prioritize. New confusion
is often the first sign of hypoxia in older adults. [100% CORRECT]
Q2: Ethical Principles – Autonomy vs. Beneficence
A client with terminal cancer refuses further chemotherapy. The family insists that the client
continue treatment. The RN should:
A. Respect the client's decision and support the family through the process
B. Follow the family's wishes since they are the decision-makers
C. Ask the provider to convince the client to continue
D. Administer the chemotherapy against the client's wishes
Correct Answer: A
Rationale: Autonomy gives the competent client the right to refuse treatment, even if it may be life-
sustaining. The RN must respect the client's decision and advocate for the client. The family's wishes
do not override the client's autonomy. The RN can provide support and education to the family.
[100% CORRECT]
,2
Q3: Delegation – RN Scope
Which task is appropriate for the RN to delegate to a licensed practical nurse (LPN)?
A. Administering IV push medications
B. Performing an initial assessment on a new admission
C. Developing the plan of care for a complex client
D. Administering oral medications to a stable client
Correct Answer: D
Rationale: LPNs can administer oral medications to stable clients. IV push medications, initial
assessments, and care planning require RN-level education and judgment. Delegation must follow
the Nurse Practice Act and facility policy. [100% CORRECT]
Q4: Postoperative Complications – Malignant Hyperthermia
A client undergoing surgery develops muscle rigidity, tachycardia, and a temperature of 104°F. The
RN should anticipate administering:
A. Dantrolene
B. Succinylcholine
C. Halothane
D. Atropine
Correct Answer: A
Rationale: Malignant hyperthermia is a life-threatening reaction to inhaled anesthetics and
succinylcholine. Dantrolene is the antidote. Stop triggering agents, cool the client, and provide
supportive care. [100% CORRECT]
Q5: Infection Control – Clostridioides difficile
A client is diagnosed with Clostridioides difficile infection. Which action should the RN take?
A. Use alcohol-based hand rub before and after care
B. Place the client in a negative-pressure room
C. Wear a gown and gloves when entering the room
D. Restrict all visitors
Correct Answer: C
Rationale: C. difficile requires contact precautions: gown and gloves. Hand hygiene must be with
soap and water (alcohol does not kill spores). A private room is preferred. Negative-pressure room is
for airborne precautions. Visitors are not restricted but should follow precautions. [100% CORRECT]
Q6: Vital Signs – Orthostatic Hypotension
A client's blood pressure drops from 128/76 supine to 102/62 upon standing. The RN should:
, 3
A. Document the finding as normal
B. Assist the client to lie down and notify the provider
C. Encourage the client to ambulate quickly
D. Administer an antihypertensive
Correct Answer: B
Rationale: A drop of ≥20 mmHg systolic or ≥10 mmHg diastolic within 3 minutes of standing
indicates orthostatic hypotension. The client is at risk for falls. Assist to lie down, monitor, and notify
provider. [100% CORRECT]
Q7: Medication Administration – High-Alert Medications
Which medication requires a double-check by two nurses before administration?
A. Acetaminophen
B. Insulin
C. Metformin
D. Lisinopril
Correct Answer: B
Rationale: Insulin is a high-alert medication requiring independent double-check. Other high-alert
medications include heparin, opioids, and chemotherapy. [100% CORRECT]
Q8: Skin Integrity – Braden Scale
A client has a Braden Scale score of 14. The RN interprets this as:
A. Low risk for pressure injury
B. Moderate risk for pressure injury
C. High risk for pressure injury
D. No risk
Correct Answer: B
Rationale: Braden Scale: ≤9 very high risk, 10–12 high risk, 13–14 moderate risk, 15–18 mild risk, 19–
23 no risk. Score of 14 indicates moderate risk. Implement prevention strategies. [100% CORRECT]
Q9: Nutrition – Dysphagia Precautions
A client with dysphagia is at risk for aspiration. The RN should:
A. Provide thin liquids
B. Place the client in a supine position for meals
C. Thicken liquids and teach chin-tuck technique
D. Encourage large bites
Correct Answer: C
