HESI RN Exit Exam
2026/2027 All Versions (V1–
V4)
150 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Management of Care
2 Safety & Infection Control
3 Health Promotion
4 Psychosocial Integrity
5 Basic Care & Comfort
6 Pharmacology
7 Reduction of Risk
8 Physiological Adaptation
Page 1
,Q1
A nurse is caring for four clients. Which client should the nurse assess first?
A) Client with a fractured femur requesting pain medication
B) Client with diabetes and a glucose of 190 mg/dL
C) *Client reporting crushing chest pain radiating to the jaw CORRECT
D) Client with COPD and SpO2 92% on 2 L/min
Rationale
Jaw-radiating chest pain suggests myocardial ischemia; this is a time-critical emergency.
Q2
A nurse is delegating to unlicensed assistive personnel. Which task is appropriate?
A) *Assisting a stable client with a bed bath CORRECT
B) Administering a PRN oral analgesic
C) Assessing a surgical incision
D) Reinforcing discharge teaching
Rationale
Hygiene tasks are within UAP scope; assessment, medication, and teaching require licensed
staff.
Q3
A client with schizophrenia says, "The voices tell me to cut myself." Which action is the
priority?
A) Ask what the voices are saying in detail
B) Tell the client the voices are not real
C) Administer a PRN antipsychotic and reassess in 1 hour
D) *Implement suicide precautions and notify the provider CORRECT
Page 2
, Rationale
Command hallucinations to self-harm require immediate safety interventions.
Q4
A nurse is preparing to administer digoxin. The apical pulse is 52 bpm. Which action
should the nurse take?
A) Administer the dose as ordered
B) *Hold the dose and notify the provider CORRECT
C) Give half the dose
D) Recheck the pulse in 30 minutes before deciding
Rationale
Digoxin is held for an adult apical pulse below 60 bpm due to toxicity risk.
Q5
A client receiving magnesium sulfate has a respiratory rate of 10 breaths/min. Which
medication should the nurse prepare?
A) *Calcium gluconate CORRECT
B) Naloxone
C) Protamine sulfate
D) Vitamin K
Rationale
Calcium gluconate reverses magnesium toxicity, including respiratory depression.
Q6
A nurse is mixing regular and NPH insulin. Which action is correct?
A) Draw up NPH first, then regular
B) Shake both vials vigorously
Page 3
, C) *Draw up regular insulin first, then NPH CORRECT
D) Mix glargine with regular insulin
Rationale
Clear insulin is drawn up before cloudy insulin to prevent vial contamination.
Q7
A client on warfarin asks about headache relief. Which statement requires further
teaching?
A) "I will use a soft toothbrush."
B) *"I will take ibuprofen for headaches." CORRECT
C) "I will keep my vitamin K intake consistent."
D) "I will have my INR checked regularly."
Rationale
NSAIDs increase bleeding risk with warfarin; acetaminophen is safer.
Q8
A nurse is preparing to start a blood transfusion. Which action is essential first?
A) Premedicate with acetaminophen
B) Warm the blood in a microwave
C) Prime the tubing with dextrose
D) *Verify the client and blood product with a second nurse CORRECT
Rationale
Two-nurse verification prevents ABO incompatibility and hemolytic reaction.
Page 4
2026/2027 All Versions (V1–
V4)
150 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Management of Care
2 Safety & Infection Control
3 Health Promotion
4 Psychosocial Integrity
5 Basic Care & Comfort
6 Pharmacology
7 Reduction of Risk
8 Physiological Adaptation
Page 1
,Q1
A nurse is caring for four clients. Which client should the nurse assess first?
A) Client with a fractured femur requesting pain medication
B) Client with diabetes and a glucose of 190 mg/dL
C) *Client reporting crushing chest pain radiating to the jaw CORRECT
D) Client with COPD and SpO2 92% on 2 L/min
Rationale
Jaw-radiating chest pain suggests myocardial ischemia; this is a time-critical emergency.
Q2
A nurse is delegating to unlicensed assistive personnel. Which task is appropriate?
A) *Assisting a stable client with a bed bath CORRECT
B) Administering a PRN oral analgesic
C) Assessing a surgical incision
D) Reinforcing discharge teaching
Rationale
Hygiene tasks are within UAP scope; assessment, medication, and teaching require licensed
staff.
Q3
A client with schizophrenia says, "The voices tell me to cut myself." Which action is the
priority?
A) Ask what the voices are saying in detail
B) Tell the client the voices are not real
C) Administer a PRN antipsychotic and reassess in 1 hour
D) *Implement suicide precautions and notify the provider CORRECT
Page 2
, Rationale
Command hallucinations to self-harm require immediate safety interventions.
Q4
A nurse is preparing to administer digoxin. The apical pulse is 52 bpm. Which action
should the nurse take?
A) Administer the dose as ordered
B) *Hold the dose and notify the provider CORRECT
C) Give half the dose
D) Recheck the pulse in 30 minutes before deciding
Rationale
Digoxin is held for an adult apical pulse below 60 bpm due to toxicity risk.
Q5
A client receiving magnesium sulfate has a respiratory rate of 10 breaths/min. Which
medication should the nurse prepare?
A) *Calcium gluconate CORRECT
B) Naloxone
C) Protamine sulfate
D) Vitamin K
Rationale
Calcium gluconate reverses magnesium toxicity, including respiratory depression.
Q6
A nurse is mixing regular and NPH insulin. Which action is correct?
A) Draw up NPH first, then regular
B) Shake both vials vigorously
Page 3
, C) *Draw up regular insulin first, then NPH CORRECT
D) Mix glargine with regular insulin
Rationale
Clear insulin is drawn up before cloudy insulin to prevent vial contamination.
Q7
A client on warfarin asks about headache relief. Which statement requires further
teaching?
A) "I will use a soft toothbrush."
B) *"I will take ibuprofen for headaches." CORRECT
C) "I will keep my vitamin K intake consistent."
D) "I will have my INR checked regularly."
Rationale
NSAIDs increase bleeding risk with warfarin; acetaminophen is safer.
Q8
A nurse is preparing to start a blood transfusion. Which action is essential first?
A) Premedicate with acetaminophen
B) Warm the blood in a microwave
C) Prime the tubing with dextrose
D) *Verify the client and blood product with a second nurse CORRECT
Rationale
Two-nurse verification prevents ABO incompatibility and hemolytic reaction.
Page 4
