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HESI EXIT EXAM V1–V8: 200 High-Yield Practice
Questions with Detailed Rationales | Best
Q&A of the 2026 Edition
SECTION 1: MANAGEMENT OF CARE (Questions 1–30)
1. A charge nurse on a medical-surgical unit is assigning clients to a team of one RN, one
LPN/LVN, and one assistive personnel (AP). Which client should the charge nurse assign to the
LPN/LVN?
A. A client who is 1 hour post-hip arthroplasty with a blood pressure of 88/50 mm Hg
B. A client with a new tracheostomy who requires suctioning every 2 hours
C. A client who is stable with a chronic wound requiring a dressing change
D. A client requiring teaching about a new colostomy appliance
Correct Answer: C
Rationale: LPN/LVNs can perform routine dressing changes on stable, chronic wounds. The
unstable post-operative client (A) requires RN assessment, the new tracheostomy (B) requires
RN assessment of airway, and client teaching (D) is an RN responsibility. Scope of practice
determines safe delegation.
2. A nurse receives change-of-shift report on four clients. Which client should the nurse assess
FIRST?
A. A client with COPD whose oxygen saturation is 88% on room air
B. A client with diabetes whose fasting glucose is 142 mg/dL
C. A client 2 days post-op reporting incisional pain of 5/10
D. A client with heart failure who has 1+ pitting edema bilaterally
Correct Answer: A
Rationale: Using ABC prioritization, hypoxia (SpO₂ 88%) is an immediate life threat requiring
assessment and intervention. The glucose (B) and pain (C) are second-level priorities;
dependent edema (D) can be assessed later.
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3. A nurse is witnessing a client's signature on an informed consent form for a surgical
procedure. Which action is the nurse's responsibility?
A. Explain the risks and benefits of the procedure to the client
B. Verify that the client understands the procedure and is signing voluntarily
C. Obtain the surgeon's signature before the client signs
D. Determine whether the client has the legal capacity to consent
Correct Answer: B
Rationale: The nurse's role is to verify voluntary signing and that the client understands what
was explained. The surgeon is responsible for explaining risks/benefits (A). The provider
determines legal capacity (D), though the nurse may report concerns.
4. A client with a valid DNR order becomes pulseless. The client's family arrives and demands
that everything be done. What should the nurse do?
A. Begin CPR immediately per family request
B. Respect the DNR and provide comfort measures while supporting the family
C. Call the provider to suspend the DNR over the phone
D. Ask the family to sign a revocation of the DNR before acting
Correct Answer: B
Rationale: A valid DNR order must be honored. The nurse should support the family and
provide comfort care. The DNR can only be revoked by the client (or the legal surrogate if the
client lacks capacity) — a verbal request from family does not automatically void it.
5. A nurse suspects that a colleague is working while impaired. What is the priority action?
A. Confront the colleague privately to avoid embarrassment
B. Document the observation and report to the nurse manager immediately
C. Ask the colleague to leave the unit and go home
D. Monitor the colleague for the rest of the shift before reporting
Correct Answer: B
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Rationale: Patient safety is paramount. The nurse must report suspected impairment to the
manager immediately and document objectively. Confrontation (A) or sending the colleague
home (C) without reporting is unsafe and outside the nurse's authority.
6. A nurse is preparing to delegate vital signs collection to an AP. Which statement indicates
an understanding of delegation?
A. "I will delegate vital signs on all clients, including the unstable ones."
B. "I will delegate vital signs on stable clients and verify the results."
C. "The AP may interpret and document abnormal findings."
D. "I will delegate vital signs but not review the results."
Correct Answer: B
Rationale: Delegation requires the right task, circumstance, person, direction, and supervision.
APs may collect vital signs on stable clients, but the RN retains accountability for interpretation
and follow-up.
7. A nurse is caring for a client who speaks a language other than English. Which action best
ensures informed consent?
A. Have a bilingual family member interpret the consent
B. Use a certified medical interpreter for the discussion
C. Provide written materials in the client's language only
D. Ask the client to sign in English if they nod in agreement
Correct Answer: B
Rationale: Certified interpreters protect accuracy and confidentiality. Family members may
misinterpret or filter information (A). Nodding does not establish understanding (D). Written
materials alone (C) are insufficient.
8. A nurse is triaging four clients after a mass casualty event. Which client should receive care
FIRST?
A. A client with an open femur fracture and a pulse of 120/min
B. A client with a sucking chest wound and stridor
C. A client with a sprained ankle who is ambulatory
D. A client with a closed head injury who is awake and oriented
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Correct Answer: B
Rationale: Using disaster triage (emergent/red tag), airway and breathing compromise take
priority. The sucking chest wound with stridor is immediately life-threatening.
9. A nurse is reviewing the plan of care for a client and notes an order that appears outside
the standard of care. What should the nurse do?
A. Implement the order as written
B. Clarify the order with the provider and document the clarification
C. Ask another nurse to implement the order
D. Refuse to care for the client
Correct Answer: B
Rationale: The nurse has a duty to clarify questionable orders. Implementing an unsafe order
(A) breaches the standard of care. Delegating the questionable order (C) is also unsafe.
10. A nurse is preparing discharge teaching for a client. Which action best promotes learning?
A. Providing all instructions at the end of the visit
B. Using a teach-back method to confirm understanding
C. Giving the client a printed handout without discussion
D. Waiting until the client asks questions
Correct Answer: B
Rationale: Teach-back confirms comprehension and retention. Providing everything at once (A),
only a handout (C), or waiting (D) are less effective teaching strategies.
11. A nurse is providing care for a client with a new diagnosis of terminal cancer. Which
member of the interprofessional team should the nurse consult first for end-of-life planning?
A. Physical therapist
B. Social worker
C. Respiratory therapist
D. Dietitian
Correct Answer: B
HESI EXIT EXAM V1–V8: 200 High-Yield Practice
Questions with Detailed Rationales | Best
Q&A of the 2026 Edition
SECTION 1: MANAGEMENT OF CARE (Questions 1–30)
1. A charge nurse on a medical-surgical unit is assigning clients to a team of one RN, one
LPN/LVN, and one assistive personnel (AP). Which client should the charge nurse assign to the
LPN/LVN?
A. A client who is 1 hour post-hip arthroplasty with a blood pressure of 88/50 mm Hg
B. A client with a new tracheostomy who requires suctioning every 2 hours
C. A client who is stable with a chronic wound requiring a dressing change
D. A client requiring teaching about a new colostomy appliance
Correct Answer: C
Rationale: LPN/LVNs can perform routine dressing changes on stable, chronic wounds. The
unstable post-operative client (A) requires RN assessment, the new tracheostomy (B) requires
RN assessment of airway, and client teaching (D) is an RN responsibility. Scope of practice
determines safe delegation.
2. A nurse receives change-of-shift report on four clients. Which client should the nurse assess
FIRST?
A. A client with COPD whose oxygen saturation is 88% on room air
B. A client with diabetes whose fasting glucose is 142 mg/dL
C. A client 2 days post-op reporting incisional pain of 5/10
D. A client with heart failure who has 1+ pitting edema bilaterally
Correct Answer: A
Rationale: Using ABC prioritization, hypoxia (SpO₂ 88%) is an immediate life threat requiring
assessment and intervention. The glucose (B) and pain (C) are second-level priorities;
dependent edema (D) can be assessed later.
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3. A nurse is witnessing a client's signature on an informed consent form for a surgical
procedure. Which action is the nurse's responsibility?
A. Explain the risks and benefits of the procedure to the client
B. Verify that the client understands the procedure and is signing voluntarily
C. Obtain the surgeon's signature before the client signs
D. Determine whether the client has the legal capacity to consent
Correct Answer: B
Rationale: The nurse's role is to verify voluntary signing and that the client understands what
was explained. The surgeon is responsible for explaining risks/benefits (A). The provider
determines legal capacity (D), though the nurse may report concerns.
4. A client with a valid DNR order becomes pulseless. The client's family arrives and demands
that everything be done. What should the nurse do?
A. Begin CPR immediately per family request
B. Respect the DNR and provide comfort measures while supporting the family
C. Call the provider to suspend the DNR over the phone
D. Ask the family to sign a revocation of the DNR before acting
Correct Answer: B
Rationale: A valid DNR order must be honored. The nurse should support the family and
provide comfort care. The DNR can only be revoked by the client (or the legal surrogate if the
client lacks capacity) — a verbal request from family does not automatically void it.
5. A nurse suspects that a colleague is working while impaired. What is the priority action?
A. Confront the colleague privately to avoid embarrassment
B. Document the observation and report to the nurse manager immediately
C. Ask the colleague to leave the unit and go home
D. Monitor the colleague for the rest of the shift before reporting
Correct Answer: B
, 3
Rationale: Patient safety is paramount. The nurse must report suspected impairment to the
manager immediately and document objectively. Confrontation (A) or sending the colleague
home (C) without reporting is unsafe and outside the nurse's authority.
6. A nurse is preparing to delegate vital signs collection to an AP. Which statement indicates
an understanding of delegation?
A. "I will delegate vital signs on all clients, including the unstable ones."
B. "I will delegate vital signs on stable clients and verify the results."
C. "The AP may interpret and document abnormal findings."
D. "I will delegate vital signs but not review the results."
Correct Answer: B
Rationale: Delegation requires the right task, circumstance, person, direction, and supervision.
APs may collect vital signs on stable clients, but the RN retains accountability for interpretation
and follow-up.
7. A nurse is caring for a client who speaks a language other than English. Which action best
ensures informed consent?
A. Have a bilingual family member interpret the consent
B. Use a certified medical interpreter for the discussion
C. Provide written materials in the client's language only
D. Ask the client to sign in English if they nod in agreement
Correct Answer: B
Rationale: Certified interpreters protect accuracy and confidentiality. Family members may
misinterpret or filter information (A). Nodding does not establish understanding (D). Written
materials alone (C) are insufficient.
8. A nurse is triaging four clients after a mass casualty event. Which client should receive care
FIRST?
A. A client with an open femur fracture and a pulse of 120/min
B. A client with a sucking chest wound and stridor
C. A client with a sprained ankle who is ambulatory
D. A client with a closed head injury who is awake and oriented
, 4
Correct Answer: B
Rationale: Using disaster triage (emergent/red tag), airway and breathing compromise take
priority. The sucking chest wound with stridor is immediately life-threatening.
9. A nurse is reviewing the plan of care for a client and notes an order that appears outside
the standard of care. What should the nurse do?
A. Implement the order as written
B. Clarify the order with the provider and document the clarification
C. Ask another nurse to implement the order
D. Refuse to care for the client
Correct Answer: B
Rationale: The nurse has a duty to clarify questionable orders. Implementing an unsafe order
(A) breaches the standard of care. Delegating the questionable order (C) is also unsafe.
10. A nurse is preparing discharge teaching for a client. Which action best promotes learning?
A. Providing all instructions at the end of the visit
B. Using a teach-back method to confirm understanding
C. Giving the client a printed handout without discussion
D. Waiting until the client asks questions
Correct Answer: B
Rationale: Teach-back confirms comprehension and retention. Providing everything at once (A),
only a handout (C), or waiting (D) are less effective teaching strategies.
11. A nurse is providing care for a client with a new diagnosis of terminal cancer. Which
member of the interprofessional team should the nurse consult first for end-of-life planning?
A. Physical therapist
B. Social worker
C. Respiratory therapist
D. Dietitian
Correct Answer: B
