A+ VERIFIED
BSN 366 | HESI RN EXIT V2 |
HESI RN Exit Exam V2
Comprehensive RN Readiness
Nightingale College | RN Licensure Preparation
GRADE A | VERIFIED
160
Questions
MCQ
Format
A
Grade
WHAT THIS COVERS
Fundamentals & Safety Mental Health
Pharmacology Leadership & Delegation
Medical-Surgical Nursing Prioritization & Triage
Maternal-Newborn Community Health
Pediatrics Professional & Ethical-Legal Standards
ABOUT THIS ASSESSMENT
This comprehensive assessment mirrors the breadth of the HESI RN Exit Examination across the core content
domains tested at licensure-readiness. Coverage spans fundamentals and safety, pharmacology, medical-surgical
nursing across all major body systems, maternal-newborn and pediatric nursing, mental health, leadership and
delegation, prioritization and mass-casualty triage, community and public health, nutrition, gerontology, and
professional ethical-legal standards.
Items are written in HESI application and analysis style: priority nursing actions, expected and unexpected
findings, teaching priorities, delegation decisions using the five rights, ABC triage sequencing, and interpretation
of laboratory values and diagnostic data. The assessment is designed to identify readiness gaps and reinforce
clinical judgment ahead of the NCLEX-RN.
This is an original study assessment. It is not affiliated with, endorsed by, or representative of any official HESI,
Elsevier, or institutional examination, and is intended for educational review only.
STUVIA ACTUAL EXAM
,BSN 366 | HESI RN EXIT V2 | Nightingale College | RN Licensure Preparation
FUNDAMENTALS: SAFETY & INFECTION CONTROL | Questions 1–6
1. An 82-year-old patient with dementia is admitted after a fall at home. The patient repeatedly tries to climb
out of bed and becomes agitated when redirected. Which intervention should the nurse implement first before
considering a physical restraint?
A. Ask a family member to sit with the patient and reorient as needed
B. Apply soft wrist restraints and obtain a renewal order within 24 hours
C. Place the patient in a geriatric chair with a lap belt locked in place
D. Administer a PRN dose of lorazepam to reduce the agitated behavior
CORRECT ANSWER: A — Ask a family member to sit with the patient and reorient as needed
Rationale: Option A is correct because least-restrictive measures, including family presence and reorientation, must be
attempted and documented before any physical or chemical restraint is considered. Option B is incorrect because restraints
require a current provider order before application, not within 24 hours, and are not the first-line intervention. Option C is
incorrect because a lap belt on a geriatric chair is still a restraint and should not be the initial choice for a reversible cause of
agitation. Option D is incorrect because administering a sedative is a chemical restraint and is inappropriate without assessing for
causes such as pain, infection, or hypoxia.
2. A nurse is preparing to insert a urinary catheter using sterile technique. After donning sterile gloves, the
nurse accidentally touches the patient's leg with the back of one gloved hand. Which action should the nurse
take?
A. Continue the procedure because only the back of the glove was contaminated
B. Discard both gloves, reglove, and set up a new sterile field before continuing
C. Remove the contaminated glove, replace it, and proceed with insertion
D. Clean the contaminated glove with chlorhexidine and continue the procedure
CORRECT ANSWER: B — Discard both gloves, reglove, and set up a new sterile field before
continuing
Rationale: Option B is correct because once a sterile glove contacts a nonsterile surface such as the patient's leg, sterility is
broken; the nurse must reglove and reestablish a sterile field to prevent introducing bacteria into the bladder. Option A is
incorrect because any part of the glove, including the back, is considered contaminated once it touches a nonsterile object.
Option C is incorrect because replacing only one glove does not address potential contamination of the sterile field or supplies.
Option D is incorrect because sterile gloves cannot be made sterile again by wiping with an antiseptic.
STUVIA ACTUAL EXAM Page 2
,BSN 366 | HESI RN EXIT V2 | Nightingale College | RN Licensure Preparation
3. A patient is admitted with active pulmonary tuberculosis in a standard private room with a hall bathroom.
Which observation requires the charge nurse to intervene immediately?
A. The nursing assistant offers the patient a regular surgical mask when leaving the room for a test
B. A visitor enters wearing a fit-tested N95 respirator before visiting the patient
C. The dietary aide delivers the meal tray without wearing respiratory protection
D. The housekeeper cleans the room wearing a gown, gloves, and an N95 respirator
CORRECT ANSWER: C — The dietary aide delivers the meal tray without wearing respiratory
protection
Rationale: Option C is correct because tuberculosis is spread via airborne droplet nuclei, so anyone entering the room must wear
an N95 respirator; the dietary aide's lack of protection requires immediate correction. Option A is incorrect because the patient
should wear a surgical mask during transport to trap larger droplets before they enter the air. Option B is incorrect because a
fit-tested N95 respirator is the correct protective device for visitors of airborne precaution patients. Option D is incorrect because
gowns, gloves, and an N95 respirator are appropriate PPE for cleaning an isolation room.
4. A fire starts in a patient's room when faulty electrical equipment ignites the bed linen. The patient is on 4
L/min oxygen via nasal cannula. After removing the patient to safety, which action should the nurse take
next?
A. Carry the burning linens into the hallway to contain the fire
B. Pour water from the bedside pitcher directly onto the burning linens
C. Pull the fire alarm and then unlock the oxygen shut-off valve
D. Close the door and windows to limit oxygen flow to the fire
CORRECT ANSWER: D — Close the door and windows to limit oxygen flow to the fire
Rationale: Option D is correct because closing the door and windows limits the oxygen supply to the fire and helps contain
smoke and flames to one area; this follows the RACE (Rescue, Alarm, Confine, Extinguish) sequence. Option A is incorrect
because moving burning materials spreads the fire and puts others at risk. Option B is incorrect because an oxygen-fed fire
should never be doused with water; electrical fires require the proper extinguisher. Option C is incorrect because the alarm
should have been pulled during the Alarm step, before confining, and oxygen valves are typically shut off at the wall, not
unlocked.
5. A nurse working on a medical unit sustains a needlestick injury while recapping a used insulin syringe.
Which action should the nurse take first?
A. Wash the puncture site thoroughly with soap and water
B. Report the incident to the employee health office for follow-up testing
C. Fill out an incident report and notify the unit manager of the exposure
D. Begin post-exposure prophylaxis within one hour of the injury
CORRECT ANSWER: A — Wash the puncture site thoroughly with soap and water
Rationale: Option A is correct because the immediate first action after a needlestick is to wash the wound with soap and water
to reduce viral load at the exposure site; reporting and treatment follow. Option B is incorrect because employee health
follow-up is necessary but comes after immediate first aid. Option C is incorrect because documentation and manager
notification occur after the nurse has addressed the exposure site. Option D is incorrect because post-exposure prophylaxis
decisions are made by a provider after source-patient testing and risk assessment, not started automatically by the nurse.
STUVIA ACTUAL EXAM Page 3
, BSN 366 | HESI RN EXIT V2 | Nightingale College | RN Licensure Preparation
6. An older adult patient is admitted with confusion and a history of three falls in the past month. The patient
pulls at the IV line frequently. Which measure is most appropriate to reduce this patient's fall and injury
risk?
A. Raise all four side rails to prevent the patient from climbing out unassisted
B. Apply bilateral wrist restraints to protect the IV site from being pulled
C. Keep the bed in the lowest position with side rails down and a bed alarm in place
D. Place the patient in a room furthest from the nurses' station for quiet
CORRECT ANSWER: C — Keep the bed in the lowest position with side rails down and a bed alarm
in place
Rationale: Option C is correct because keeping the bed low with side rails down reduces fall-related injuries and a bed alarm
alerts staff when the patient moves, which is the least restrictive approach. Option A is incorrect because four raised side rails are
considered a restraint and can increase the risk of entrapment or climbing falls. Option B is incorrect because restraints should
not be used as a fall prevention measure and require a thorough assessment and provider order. Option D is incorrect because
patients at high risk for falls should be placed near the nurses' station for closer observation, not further away.
FUNDAMENTALS: VITAL SIGNS & ASSESSMENT | Questions 7–12
7. A nurse is preparing to measure a patient's blood pressure but finds only a thigh cuff available. The
patient's upper arm circumference is appropriate for a standard adult cuff. Which effect will using the thigh
cuff most likely have on the reading?
A. It will produce a falsely high reading because the bladder is too narrow
B. It will produce a falsely low reading because the bladder covers too much of the arm
C. It will produce a falsely high reading because the bladder compresses too slowly
D. It will have no effect because all cuffs measure pressure equally
CORRECT ANSWER: B — It will produce a falsely low reading because the bladder covers too
much of the arm
Rationale: Option B is correct because a cuff that is too wide (oversized bladder) for the limb will result in a falsely low blood
pressure reading; the bladder should cover about 80% of the arm circumference. Option A is incorrect because a falsely high
reading occurs with a cuff that is too small, not too large. Option C is incorrect because slow compression is not the mechanism
for a falsely high reading with an oversized cuff. Option D is incorrect because cuff size significantly affects the accuracy of the
blood pressure measurement.
STUVIA ACTUAL EXAM Page 4
BSN 366 | HESI RN EXIT V2 |
HESI RN Exit Exam V2
Comprehensive RN Readiness
Nightingale College | RN Licensure Preparation
GRADE A | VERIFIED
160
Questions
MCQ
Format
A
Grade
WHAT THIS COVERS
Fundamentals & Safety Mental Health
Pharmacology Leadership & Delegation
Medical-Surgical Nursing Prioritization & Triage
Maternal-Newborn Community Health
Pediatrics Professional & Ethical-Legal Standards
ABOUT THIS ASSESSMENT
This comprehensive assessment mirrors the breadth of the HESI RN Exit Examination across the core content
domains tested at licensure-readiness. Coverage spans fundamentals and safety, pharmacology, medical-surgical
nursing across all major body systems, maternal-newborn and pediatric nursing, mental health, leadership and
delegation, prioritization and mass-casualty triage, community and public health, nutrition, gerontology, and
professional ethical-legal standards.
Items are written in HESI application and analysis style: priority nursing actions, expected and unexpected
findings, teaching priorities, delegation decisions using the five rights, ABC triage sequencing, and interpretation
of laboratory values and diagnostic data. The assessment is designed to identify readiness gaps and reinforce
clinical judgment ahead of the NCLEX-RN.
This is an original study assessment. It is not affiliated with, endorsed by, or representative of any official HESI,
Elsevier, or institutional examination, and is intended for educational review only.
STUVIA ACTUAL EXAM
,BSN 366 | HESI RN EXIT V2 | Nightingale College | RN Licensure Preparation
FUNDAMENTALS: SAFETY & INFECTION CONTROL | Questions 1–6
1. An 82-year-old patient with dementia is admitted after a fall at home. The patient repeatedly tries to climb
out of bed and becomes agitated when redirected. Which intervention should the nurse implement first before
considering a physical restraint?
A. Ask a family member to sit with the patient and reorient as needed
B. Apply soft wrist restraints and obtain a renewal order within 24 hours
C. Place the patient in a geriatric chair with a lap belt locked in place
D. Administer a PRN dose of lorazepam to reduce the agitated behavior
CORRECT ANSWER: A — Ask a family member to sit with the patient and reorient as needed
Rationale: Option A is correct because least-restrictive measures, including family presence and reorientation, must be
attempted and documented before any physical or chemical restraint is considered. Option B is incorrect because restraints
require a current provider order before application, not within 24 hours, and are not the first-line intervention. Option C is
incorrect because a lap belt on a geriatric chair is still a restraint and should not be the initial choice for a reversible cause of
agitation. Option D is incorrect because administering a sedative is a chemical restraint and is inappropriate without assessing for
causes such as pain, infection, or hypoxia.
2. A nurse is preparing to insert a urinary catheter using sterile technique. After donning sterile gloves, the
nurse accidentally touches the patient's leg with the back of one gloved hand. Which action should the nurse
take?
A. Continue the procedure because only the back of the glove was contaminated
B. Discard both gloves, reglove, and set up a new sterile field before continuing
C. Remove the contaminated glove, replace it, and proceed with insertion
D. Clean the contaminated glove with chlorhexidine and continue the procedure
CORRECT ANSWER: B — Discard both gloves, reglove, and set up a new sterile field before
continuing
Rationale: Option B is correct because once a sterile glove contacts a nonsterile surface such as the patient's leg, sterility is
broken; the nurse must reglove and reestablish a sterile field to prevent introducing bacteria into the bladder. Option A is
incorrect because any part of the glove, including the back, is considered contaminated once it touches a nonsterile object.
Option C is incorrect because replacing only one glove does not address potential contamination of the sterile field or supplies.
Option D is incorrect because sterile gloves cannot be made sterile again by wiping with an antiseptic.
STUVIA ACTUAL EXAM Page 2
,BSN 366 | HESI RN EXIT V2 | Nightingale College | RN Licensure Preparation
3. A patient is admitted with active pulmonary tuberculosis in a standard private room with a hall bathroom.
Which observation requires the charge nurse to intervene immediately?
A. The nursing assistant offers the patient a regular surgical mask when leaving the room for a test
B. A visitor enters wearing a fit-tested N95 respirator before visiting the patient
C. The dietary aide delivers the meal tray without wearing respiratory protection
D. The housekeeper cleans the room wearing a gown, gloves, and an N95 respirator
CORRECT ANSWER: C — The dietary aide delivers the meal tray without wearing respiratory
protection
Rationale: Option C is correct because tuberculosis is spread via airborne droplet nuclei, so anyone entering the room must wear
an N95 respirator; the dietary aide's lack of protection requires immediate correction. Option A is incorrect because the patient
should wear a surgical mask during transport to trap larger droplets before they enter the air. Option B is incorrect because a
fit-tested N95 respirator is the correct protective device for visitors of airborne precaution patients. Option D is incorrect because
gowns, gloves, and an N95 respirator are appropriate PPE for cleaning an isolation room.
4. A fire starts in a patient's room when faulty electrical equipment ignites the bed linen. The patient is on 4
L/min oxygen via nasal cannula. After removing the patient to safety, which action should the nurse take
next?
A. Carry the burning linens into the hallway to contain the fire
B. Pour water from the bedside pitcher directly onto the burning linens
C. Pull the fire alarm and then unlock the oxygen shut-off valve
D. Close the door and windows to limit oxygen flow to the fire
CORRECT ANSWER: D — Close the door and windows to limit oxygen flow to the fire
Rationale: Option D is correct because closing the door and windows limits the oxygen supply to the fire and helps contain
smoke and flames to one area; this follows the RACE (Rescue, Alarm, Confine, Extinguish) sequence. Option A is incorrect
because moving burning materials spreads the fire and puts others at risk. Option B is incorrect because an oxygen-fed fire
should never be doused with water; electrical fires require the proper extinguisher. Option C is incorrect because the alarm
should have been pulled during the Alarm step, before confining, and oxygen valves are typically shut off at the wall, not
unlocked.
5. A nurse working on a medical unit sustains a needlestick injury while recapping a used insulin syringe.
Which action should the nurse take first?
A. Wash the puncture site thoroughly with soap and water
B. Report the incident to the employee health office for follow-up testing
C. Fill out an incident report and notify the unit manager of the exposure
D. Begin post-exposure prophylaxis within one hour of the injury
CORRECT ANSWER: A — Wash the puncture site thoroughly with soap and water
Rationale: Option A is correct because the immediate first action after a needlestick is to wash the wound with soap and water
to reduce viral load at the exposure site; reporting and treatment follow. Option B is incorrect because employee health
follow-up is necessary but comes after immediate first aid. Option C is incorrect because documentation and manager
notification occur after the nurse has addressed the exposure site. Option D is incorrect because post-exposure prophylaxis
decisions are made by a provider after source-patient testing and risk assessment, not started automatically by the nurse.
STUVIA ACTUAL EXAM Page 3
, BSN 366 | HESI RN EXIT V2 | Nightingale College | RN Licensure Preparation
6. An older adult patient is admitted with confusion and a history of three falls in the past month. The patient
pulls at the IV line frequently. Which measure is most appropriate to reduce this patient's fall and injury
risk?
A. Raise all four side rails to prevent the patient from climbing out unassisted
B. Apply bilateral wrist restraints to protect the IV site from being pulled
C. Keep the bed in the lowest position with side rails down and a bed alarm in place
D. Place the patient in a room furthest from the nurses' station for quiet
CORRECT ANSWER: C — Keep the bed in the lowest position with side rails down and a bed alarm
in place
Rationale: Option C is correct because keeping the bed low with side rails down reduces fall-related injuries and a bed alarm
alerts staff when the patient moves, which is the least restrictive approach. Option A is incorrect because four raised side rails are
considered a restraint and can increase the risk of entrapment or climbing falls. Option B is incorrect because restraints should
not be used as a fall prevention measure and require a thorough assessment and provider order. Option D is incorrect because
patients at high risk for falls should be placed near the nurses' station for closer observation, not further away.
FUNDAMENTALS: VITAL SIGNS & ASSESSMENT | Questions 7–12
7. A nurse is preparing to measure a patient's blood pressure but finds only a thigh cuff available. The
patient's upper arm circumference is appropriate for a standard adult cuff. Which effect will using the thigh
cuff most likely have on the reading?
A. It will produce a falsely high reading because the bladder is too narrow
B. It will produce a falsely low reading because the bladder covers too much of the arm
C. It will produce a falsely high reading because the bladder compresses too slowly
D. It will have no effect because all cuffs measure pressure equally
CORRECT ANSWER: B — It will produce a falsely low reading because the bladder covers too
much of the arm
Rationale: Option B is correct because a cuff that is too wide (oversized bladder) for the limb will result in a falsely low blood
pressure reading; the bladder should cover about 80% of the arm circumference. Option A is incorrect because a falsely high
reading occurs with a cuff that is too small, not too large. Option C is incorrect because slow compression is not the mechanism
for a falsely high reading with an oversized cuff. Option D is incorrect because cuff size significantly affects the accuracy of the
blood pressure measurement.
STUVIA ACTUAL EXAM Page 4
