HESI RN EXIT EXAM V1-V7{questions and answers}
Latest UPDATED VERSION 2022/2023
SECTION I: MANAGEMENT OF CARE (Questions 1–20)
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client 2 days postoperative reporting incisional pain rated 6/10
B. A client with COPD reporting a headache and confusion
C. A client requesting assistance to ambulate for the first time
D. A client with a urinary tract infection requesting cranberry juice
Rationale: Headache and confusion in a COPD client suggest carbon dioxide retention
(hypercapnia) and possible respiratory failure — a life-threatening emergency. Pain, ambulation,
and dietary requests are non-urgent.
2. A nurse is delegating tasks. Which task is appropriate to delegate to a nursing assistant
(UAP)?
A. Administering a scheduled oral medication
B. Teaching a client about a new insulin regimen
C. Measuring and recording a client's intake and output
D. Performing an initial admission assessment
Rationale: I&O measurement is a routine, non-invasive task within UAP scope. Medication
administration, teaching, and assessment require an RN.
3. A nurse receives a telephone order from a provider. Which action should the nurse take first?
A. Read back the order to the provider for verification
B. Document the order in the medical record
C. Ask another nurse to witness the order
D. Administer the medication immediately
Rationale: Read-back verification prevents errors and is required for telephone orders.
Documentation follows verification.
,4. (SATA) A nurse is preparing to transfer a client to a rehabilitation facility. Which information
must be included in the hand-off report? Select all that apply.
A. Current medication list
B. Client's preferred food preferences
C. Code status
D. Allergies
E. Recent lab values
F. Client's room number at the previous facility
Rationale: Hand-off reports include medications, code status, allergies, and significant labs.
Food preferences and old room numbers are not essential for safe transfer.
5. A nurse is working as a charge nurse and must assign clients. Which client should be assigned
to the most experienced nurse?
A. A client with a stable fracture awaiting discharge
B. A client with new-onset atrial fibrillation on a heparin drip
C. A client requesting pain medication after a knee replacement
D. A client with a UTI receiving oral antibiotics
Rationale: New-onset a-fib with anticoagulation requires complex assessment and
monitoring — best for the most experienced nurse.
6. A nurse suspects a coworker is diverting controlled substances. What is the
nurse's priority action?
A. Confront the coworker directly
B. Report the suspicion to the nurse manager or appropriate authority
C. Ignore it to avoid conflict
D. Document the suspicion in the client's chart
Rationale: Suspected diversion must be reported through the chain of
command/appropriate authority. Confrontation may compromise safety and investigation.
7. A client asks the nurse to explain advance directives. Which statement by the nurse is most
accurate?
,A. "Advance directives allow you to state your wishes for end-of-life care."
B. "Advance directives are only for clients over 65."
C. "Advance directives must be signed by a judge."
D. "Advance directives allow your family to make all decisions."
Rationale: Advance directives document a client's wishes for care when they cannot speak
for themselves. They are not age-restricted or court-ordered.
8. A nurse is reviewing a client's chart and notes a discrepancy in the medication record. What
should the nurse do first?
A. Ask the client what medications they take
B. Clarify the discrepancy with the prescriber before administering
C. Administer the medication as written
D. Document the discrepancy and move on
Rationale: Any medication discrepancy must be clarified with the prescriber before
administration to prevent error.
9. (SATA) Which actions demonstrate advocacy by the nurse? Select all that apply.
A. Respecting a client's refusal of treatment
B. Speaking on behalf of a client who cannot communicate
C. Making decisions for the client without consultation
D. Ensuring the client understands their rights
E. Reporting unsafe care practices
F. Ignoring a client's cultural preferences
Rationale: Advocacy includes respecting autonomy, speaking for those unable, ensuring
understanding of rights, and reporting unsafe care. Making decisions without consultation and
ignoring culture are not advocacy.
10. A nurse is prioritizing care for a group of clients. Using Maslow's hierarchy, which need
should the nurse address first?
A. A client reporting loneliness
B. A client with an oxygen saturation of 88%
, C. A client requesting help with self-esteem issues
D. A client asking about discharge planning
Rationale: Oxygenation is a physiological need and takes priority over psychosocial needs
per Maslow.
11. A nurse is preparing to discharge a client who speaks limited English. Which action is most
appropriate?
A. Ask the client's family member to interpret
B. Use a certified medical interpreter
C. Provide written instructions in English only
D. Speak loudly and slowly in English
Rationale: Certified medical interpreters ensure accurate communication. Family members
may misinterpret or filter information.
12. A nurse manager is reviewing staffing. Which factor is most important when making
assignments?
A. Client acuity and nurse competency
B. Nurse seniority only
C. Client room proximity only
D. Nurse preference only
Rationale: Safe assignments match client acuity with nurse competency. Seniority and
preference are secondary.
13. A client's family asks the nurse about the client's prognosis. The client has not authorized
disclosure. What should the nurse do?
A. Provide the information since they are family
B. Explain that information cannot be shared without the client's consent
C. Tell them to ask the doctor
D. Give a vague answer
Rationale: HIPAA prohibits disclosure without client authorization, even to family, unless the
client has consented.
Latest UPDATED VERSION 2022/2023
SECTION I: MANAGEMENT OF CARE (Questions 1–20)
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client 2 days postoperative reporting incisional pain rated 6/10
B. A client with COPD reporting a headache and confusion
C. A client requesting assistance to ambulate for the first time
D. A client with a urinary tract infection requesting cranberry juice
Rationale: Headache and confusion in a COPD client suggest carbon dioxide retention
(hypercapnia) and possible respiratory failure — a life-threatening emergency. Pain, ambulation,
and dietary requests are non-urgent.
2. A nurse is delegating tasks. Which task is appropriate to delegate to a nursing assistant
(UAP)?
A. Administering a scheduled oral medication
B. Teaching a client about a new insulin regimen
C. Measuring and recording a client's intake and output
D. Performing an initial admission assessment
Rationale: I&O measurement is a routine, non-invasive task within UAP scope. Medication
administration, teaching, and assessment require an RN.
3. A nurse receives a telephone order from a provider. Which action should the nurse take first?
A. Read back the order to the provider for verification
B. Document the order in the medical record
C. Ask another nurse to witness the order
D. Administer the medication immediately
Rationale: Read-back verification prevents errors and is required for telephone orders.
Documentation follows verification.
,4. (SATA) A nurse is preparing to transfer a client to a rehabilitation facility. Which information
must be included in the hand-off report? Select all that apply.
A. Current medication list
B. Client's preferred food preferences
C. Code status
D. Allergies
E. Recent lab values
F. Client's room number at the previous facility
Rationale: Hand-off reports include medications, code status, allergies, and significant labs.
Food preferences and old room numbers are not essential for safe transfer.
5. A nurse is working as a charge nurse and must assign clients. Which client should be assigned
to the most experienced nurse?
A. A client with a stable fracture awaiting discharge
B. A client with new-onset atrial fibrillation on a heparin drip
C. A client requesting pain medication after a knee replacement
D. A client with a UTI receiving oral antibiotics
Rationale: New-onset a-fib with anticoagulation requires complex assessment and
monitoring — best for the most experienced nurse.
6. A nurse suspects a coworker is diverting controlled substances. What is the
nurse's priority action?
A. Confront the coworker directly
B. Report the suspicion to the nurse manager or appropriate authority
C. Ignore it to avoid conflict
D. Document the suspicion in the client's chart
Rationale: Suspected diversion must be reported through the chain of
command/appropriate authority. Confrontation may compromise safety and investigation.
7. A client asks the nurse to explain advance directives. Which statement by the nurse is most
accurate?
,A. "Advance directives allow you to state your wishes for end-of-life care."
B. "Advance directives are only for clients over 65."
C. "Advance directives must be signed by a judge."
D. "Advance directives allow your family to make all decisions."
Rationale: Advance directives document a client's wishes for care when they cannot speak
for themselves. They are not age-restricted or court-ordered.
8. A nurse is reviewing a client's chart and notes a discrepancy in the medication record. What
should the nurse do first?
A. Ask the client what medications they take
B. Clarify the discrepancy with the prescriber before administering
C. Administer the medication as written
D. Document the discrepancy and move on
Rationale: Any medication discrepancy must be clarified with the prescriber before
administration to prevent error.
9. (SATA) Which actions demonstrate advocacy by the nurse? Select all that apply.
A. Respecting a client's refusal of treatment
B. Speaking on behalf of a client who cannot communicate
C. Making decisions for the client without consultation
D. Ensuring the client understands their rights
E. Reporting unsafe care practices
F. Ignoring a client's cultural preferences
Rationale: Advocacy includes respecting autonomy, speaking for those unable, ensuring
understanding of rights, and reporting unsafe care. Making decisions without consultation and
ignoring culture are not advocacy.
10. A nurse is prioritizing care for a group of clients. Using Maslow's hierarchy, which need
should the nurse address first?
A. A client reporting loneliness
B. A client with an oxygen saturation of 88%
, C. A client requesting help with self-esteem issues
D. A client asking about discharge planning
Rationale: Oxygenation is a physiological need and takes priority over psychosocial needs
per Maslow.
11. A nurse is preparing to discharge a client who speaks limited English. Which action is most
appropriate?
A. Ask the client's family member to interpret
B. Use a certified medical interpreter
C. Provide written instructions in English only
D. Speak loudly and slowly in English
Rationale: Certified medical interpreters ensure accurate communication. Family members
may misinterpret or filter information.
12. A nurse manager is reviewing staffing. Which factor is most important when making
assignments?
A. Client acuity and nurse competency
B. Nurse seniority only
C. Client room proximity only
D. Nurse preference only
Rationale: Safe assignments match client acuity with nurse competency. Seniority and
preference are secondary.
13. A client's family asks the nurse about the client's prognosis. The client has not authorized
disclosure. What should the nurse do?
A. Provide the information since they are family
B. Explain that information cannot be shared without the client's consent
C. Tell them to ask the doctor
D. Give a vague answer
Rationale: HIPAA prohibits disclosure without client authorization, even to family, unless the
client has consented.
