HESI Exit RN Exam V1–V7 (2026/2027 Update, Graded
A+) | Actual Exam 2026/2027 | Complete Exam-Style
Questions with Detailed Rationales | 100% Verified – Pass
Guaranteed – A+ Graded
Version 1 — 160 Questions
Management of Care (Q1–Q24)
Q1: A nurse is assigning tasks to unlicensed assistive personnel (UAP) on a medical-surgical
unit. Which task is appropriate to delegate?
A. Evaluating a client's pain level 30 minutes after IV morphine
B. Turning and repositioning a stable client on bed rest every 2 hours [CORRECT]
C. Teaching crutch walking to a client being discharged tomorrow
D. Assessing the output of a newly placed surgical drain
Correct Answer: B
Rationale: Turning and repositioning a stable client is routine, non-assessment care that falls
within UAP scope; the other tasks all require nursing judgment or teaching, which must
remain with licensed staff.
Q2: The nurse receives report on four clients. Which client should be assessed first?
A. A client requesting PRN pain medication rated 6/10
B. A client due for a scheduled oral antibiotic
C. A client with chest pain radiating to the left arm and diaphoresis [CORRECT]
D. A client anxious about discharge scheduled for tomorrow
Correct Answer: C
Rationale: Chest pain with radiation and sweating suggests a possible myocardial infarction,
and a potentially unstable cardiac client always outranks comfort measures, routine
medications, and education.
Q3: A pre-operative client has signed the consent form but states, "I'm still not sure what
the surgeon is actually planning to do." What is the nurse's best action?
A. Explain the surgical procedure step by step
B. Have the client sign a second form since the first is complete
C. Call the surgeon to return and clarify the procedure with the client [CORRECT]
D. Document the client's uncertainty in the chart and proceed to the OR
Correct Answer: C
Rationale: The surgeon is responsible for explaining the procedure, and consent is not truly
informed if the client doesn't understand — so the nurse notifies the provider rather than
teaching it herself or sending the client ahead.
Q4: A charge nurse is working with a float LPN from another unit. Which assignment is most
appropriate?
A. Performing the initial head-to-toe assessment on a new admission
,B. Administering oral medications and documenting on stable clients [CORRECT]
C. Triaging incoming clients in the emergency department
D. Initiating a blood transfusion on a hemodynamically unstable client
Correct Answer: B
Rationale: LPNs can safely administer routine medications to stable clients, while admission
assessments, triage, and unstable clients require RN-level assessment and judgment.
Q5: Two hours after a total knee replacement, a client suddenly becomes dyspneic and
tachycardic. What should the nurse do first?
A. Obtain full vital signs and call the surgeon afterward
B. Lower the head of the bed for the client's comfort
C. Raise the head of the bed and apply oxygen [CORRECT]
D. Encourage coughing and deep breathing exercises
Correct Answer: C
Rationale: Sudden dyspnea after orthopedic surgery points to pulmonary embolism, so
supporting oxygenation by sitting the client up and applying oxygen takes priority before
calling or reassessing further.
Q6: A Jehovah's Witness client scheduled for surgery refuses blood products. What is the
nurse's best action?
A. Explain the risks repeatedly until the client agrees
B. Ask the family to talk the client into accepting
C. Document the refusal and notify the provider [CORRECT]
D. Direct anesthesia to transfuse discreetly if needed intraoperatively
Correct Answer: C
Rationale: A competent adult's informed refusal must be respected and communicated to
the surgical team — coercing or bypassing the client violates client autonomy and the
client's legal rights.
Q7: Which statement about incident reports reflects correct nursing practice?
A. File the report and document in the nurse's note that one was completed
B. The report is filed but is never referenced in the client's medical record [CORRECT]
C. A copy of the report is placed in the client's chart
D. The report is skipped if the client was not injured
Correct Answer: B
Rationale: Incident reports are internal risk-management documents kept out of the chart
for legal reasons, and they are filed even when no injury occurred.
Q8: A nurse begins a shift with four assigned clients. What is the first task of the shift?
A. Administer the 0800 medications on time
B. Read all new provider orders before seeing clients
C. Briefly assess each client to establish priorities [CORRECT]
D. Update every client's care plan for the day
Correct Answer: C
Rationale: A quick assessment of each assigned client reveals who is stable and who is
deteriorating, allowing the nurse to prioritize; medications and paperwork follow once
acuity is established.
,Q9: Two staff nurses begin arguing loudly about an assignment at the nurses' station in front
of clients. What is the charge nurse's best action?
A. Ignore it, since they will work it out on their own
B. Ask them to continue the discussion privately and offer to mediate [CORRECT]
C. Reassign both nurses to different units immediately
D. Report both nurses to the manager for unprofessionalism
Correct Answer: B
Rationale: Conflict should be moved away from the therapeutic environment, and the
charge nurse's role is to facilitate resolution rather than escalate or ignore the situation.
Q10: When does discharge planning for a hospitalized client begin?
A. When the provider writes the discharge order
B. On admission [CORRECT]
C. Forty-eight hours before the anticipated discharge
D. During discharge teaching on the final day
Correct Answer: B
Rationale: Discharge planning starts at admission so barriers, home needs, and teaching can
be addressed throughout the entire stay rather than rushed at the end.
Q11: Which task is appropriate to assign to an LPN/LVN?
A. Developing the initial teaching plan for a client starting insulin
B. Giving oral antibiotics to a stable medical client [CORRECT]
C. Completing the admission assessment for a new client
D. Triaging clients arriving in the emergency department
Correct Answer: B
Rationale: Routine oral medications for a stable client are within LPN scope of practice;
initial teaching plans, admission assessments, and triage are RN responsibilities.
Q12: Which client should the nurse see first?
A. A client 1 hour post-operative with HR 118 and BP 90/54 [CORRECT]
B. A client on post-op day 2 requesting pain medication
C. A client whose lunch tray is waiting on the table
D. A client with routine IV antibiotics due at 1200
Correct Answer: A
Rationale: Tachycardia with hypotension shortly after surgery suggests bleeding or shock,
and an unstable hemodynamic status always takes precedence over comfort care and
scheduled tasks.
Q13: A provider orders wrist restraints for a confused client pulling at IV lines. The nurse
knows the restraint order must be:
A. Renewed every 24 hours [CORRECT]
B. Written as a PRN standing order
C. Renewed weekly for long-term clients
D. Verbal only, without a written copy
Correct Answer: A
, Rationale: Restraint orders are never PRN or standing and must be renewed each 24 hours,
with ongoing assessment of circulation, sensation, and skin integrity.
Q14: What is the correct way to document a late entry in a client's record?
A. Squeeze the information into the previous entry
B. Label it as a "late entry" with the current date and time, referencing the original event
[CORRECT]
C. Use correction fluid and rewrite the original entry
D. Backdate the note to the time of the event
Correct Answer: B
Rationale: Late entries must be identified as such with the actual time of writing, since
backdating or altering records appears as falsification.
Q15: A client with limited English proficiency needs teaching about a new medication. What
is the best approach?
A. Ask the client's teenage son to interpret
B. Use a certified medical interpreter [CORRECT]
C. Provide written instructions in English
D. Speak slowly and loudly in English
Correct Answer: B
Rationale: Certified interpreters ensure accuracy and confidentiality, while family members
may filter information, misunderstand medical terms, or feel uncomfortable translating
sensitive content.
Q16: After receiving morning report, which client does the nurse visit first?
A. A post-op day 2 client requesting pain medication
B. A client with heart failure reporting new orthopnea and crackles [CORRECT]
C. A client whose insulin is due with the meal tray
D. A stable pneumonia client awaiting breakfast
Correct Answer: B
Rationale: New difficulty breathing with crackles in a client with heart failure signals
worsening fluid overload, and a breathing problem always outranks routine scheduled care.
Q17: Which situation constitutes negligence?
A. A nurse documents vital signs after verifying them with the UAP
B. A nurse fails to check a documented penicillin allergy before administration, causing
anaphylaxis [CORRECT]
C. A nurse delegates meal feeding of a stable client to UAP
D. A nurse uses a gait belt to ambulate a weak client
Correct Answer: B
Rationale: Negligence requires a breached duty resulting in harm — ignoring a documented
allergy and causing anaphylaxis meets that standard, while the other actions reflect safe,
appropriate practice.
Q18: A client with a valid, documented DNR order deteriorates during the shift. What should
the nurse do?
A. Call a full code despite the order
A+) | Actual Exam 2026/2027 | Complete Exam-Style
Questions with Detailed Rationales | 100% Verified – Pass
Guaranteed – A+ Graded
Version 1 — 160 Questions
Management of Care (Q1–Q24)
Q1: A nurse is assigning tasks to unlicensed assistive personnel (UAP) on a medical-surgical
unit. Which task is appropriate to delegate?
A. Evaluating a client's pain level 30 minutes after IV morphine
B. Turning and repositioning a stable client on bed rest every 2 hours [CORRECT]
C. Teaching crutch walking to a client being discharged tomorrow
D. Assessing the output of a newly placed surgical drain
Correct Answer: B
Rationale: Turning and repositioning a stable client is routine, non-assessment care that falls
within UAP scope; the other tasks all require nursing judgment or teaching, which must
remain with licensed staff.
Q2: The nurse receives report on four clients. Which client should be assessed first?
A. A client requesting PRN pain medication rated 6/10
B. A client due for a scheduled oral antibiotic
C. A client with chest pain radiating to the left arm and diaphoresis [CORRECT]
D. A client anxious about discharge scheduled for tomorrow
Correct Answer: C
Rationale: Chest pain with radiation and sweating suggests a possible myocardial infarction,
and a potentially unstable cardiac client always outranks comfort measures, routine
medications, and education.
Q3: A pre-operative client has signed the consent form but states, "I'm still not sure what
the surgeon is actually planning to do." What is the nurse's best action?
A. Explain the surgical procedure step by step
B. Have the client sign a second form since the first is complete
C. Call the surgeon to return and clarify the procedure with the client [CORRECT]
D. Document the client's uncertainty in the chart and proceed to the OR
Correct Answer: C
Rationale: The surgeon is responsible for explaining the procedure, and consent is not truly
informed if the client doesn't understand — so the nurse notifies the provider rather than
teaching it herself or sending the client ahead.
Q4: A charge nurse is working with a float LPN from another unit. Which assignment is most
appropriate?
A. Performing the initial head-to-toe assessment on a new admission
,B. Administering oral medications and documenting on stable clients [CORRECT]
C. Triaging incoming clients in the emergency department
D. Initiating a blood transfusion on a hemodynamically unstable client
Correct Answer: B
Rationale: LPNs can safely administer routine medications to stable clients, while admission
assessments, triage, and unstable clients require RN-level assessment and judgment.
Q5: Two hours after a total knee replacement, a client suddenly becomes dyspneic and
tachycardic. What should the nurse do first?
A. Obtain full vital signs and call the surgeon afterward
B. Lower the head of the bed for the client's comfort
C. Raise the head of the bed and apply oxygen [CORRECT]
D. Encourage coughing and deep breathing exercises
Correct Answer: C
Rationale: Sudden dyspnea after orthopedic surgery points to pulmonary embolism, so
supporting oxygenation by sitting the client up and applying oxygen takes priority before
calling or reassessing further.
Q6: A Jehovah's Witness client scheduled for surgery refuses blood products. What is the
nurse's best action?
A. Explain the risks repeatedly until the client agrees
B. Ask the family to talk the client into accepting
C. Document the refusal and notify the provider [CORRECT]
D. Direct anesthesia to transfuse discreetly if needed intraoperatively
Correct Answer: C
Rationale: A competent adult's informed refusal must be respected and communicated to
the surgical team — coercing or bypassing the client violates client autonomy and the
client's legal rights.
Q7: Which statement about incident reports reflects correct nursing practice?
A. File the report and document in the nurse's note that one was completed
B. The report is filed but is never referenced in the client's medical record [CORRECT]
C. A copy of the report is placed in the client's chart
D. The report is skipped if the client was not injured
Correct Answer: B
Rationale: Incident reports are internal risk-management documents kept out of the chart
for legal reasons, and they are filed even when no injury occurred.
Q8: A nurse begins a shift with four assigned clients. What is the first task of the shift?
A. Administer the 0800 medications on time
B. Read all new provider orders before seeing clients
C. Briefly assess each client to establish priorities [CORRECT]
D. Update every client's care plan for the day
Correct Answer: C
Rationale: A quick assessment of each assigned client reveals who is stable and who is
deteriorating, allowing the nurse to prioritize; medications and paperwork follow once
acuity is established.
,Q9: Two staff nurses begin arguing loudly about an assignment at the nurses' station in front
of clients. What is the charge nurse's best action?
A. Ignore it, since they will work it out on their own
B. Ask them to continue the discussion privately and offer to mediate [CORRECT]
C. Reassign both nurses to different units immediately
D. Report both nurses to the manager for unprofessionalism
Correct Answer: B
Rationale: Conflict should be moved away from the therapeutic environment, and the
charge nurse's role is to facilitate resolution rather than escalate or ignore the situation.
Q10: When does discharge planning for a hospitalized client begin?
A. When the provider writes the discharge order
B. On admission [CORRECT]
C. Forty-eight hours before the anticipated discharge
D. During discharge teaching on the final day
Correct Answer: B
Rationale: Discharge planning starts at admission so barriers, home needs, and teaching can
be addressed throughout the entire stay rather than rushed at the end.
Q11: Which task is appropriate to assign to an LPN/LVN?
A. Developing the initial teaching plan for a client starting insulin
B. Giving oral antibiotics to a stable medical client [CORRECT]
C. Completing the admission assessment for a new client
D. Triaging clients arriving in the emergency department
Correct Answer: B
Rationale: Routine oral medications for a stable client are within LPN scope of practice;
initial teaching plans, admission assessments, and triage are RN responsibilities.
Q12: Which client should the nurse see first?
A. A client 1 hour post-operative with HR 118 and BP 90/54 [CORRECT]
B. A client on post-op day 2 requesting pain medication
C. A client whose lunch tray is waiting on the table
D. A client with routine IV antibiotics due at 1200
Correct Answer: A
Rationale: Tachycardia with hypotension shortly after surgery suggests bleeding or shock,
and an unstable hemodynamic status always takes precedence over comfort care and
scheduled tasks.
Q13: A provider orders wrist restraints for a confused client pulling at IV lines. The nurse
knows the restraint order must be:
A. Renewed every 24 hours [CORRECT]
B. Written as a PRN standing order
C. Renewed weekly for long-term clients
D. Verbal only, without a written copy
Correct Answer: A
, Rationale: Restraint orders are never PRN or standing and must be renewed each 24 hours,
with ongoing assessment of circulation, sensation, and skin integrity.
Q14: What is the correct way to document a late entry in a client's record?
A. Squeeze the information into the previous entry
B. Label it as a "late entry" with the current date and time, referencing the original event
[CORRECT]
C. Use correction fluid and rewrite the original entry
D. Backdate the note to the time of the event
Correct Answer: B
Rationale: Late entries must be identified as such with the actual time of writing, since
backdating or altering records appears as falsification.
Q15: A client with limited English proficiency needs teaching about a new medication. What
is the best approach?
A. Ask the client's teenage son to interpret
B. Use a certified medical interpreter [CORRECT]
C. Provide written instructions in English
D. Speak slowly and loudly in English
Correct Answer: B
Rationale: Certified interpreters ensure accuracy and confidentiality, while family members
may filter information, misunderstand medical terms, or feel uncomfortable translating
sensitive content.
Q16: After receiving morning report, which client does the nurse visit first?
A. A post-op day 2 client requesting pain medication
B. A client with heart failure reporting new orthopnea and crackles [CORRECT]
C. A client whose insulin is due with the meal tray
D. A stable pneumonia client awaiting breakfast
Correct Answer: B
Rationale: New difficulty breathing with crackles in a client with heart failure signals
worsening fluid overload, and a breathing problem always outranks routine scheduled care.
Q17: Which situation constitutes negligence?
A. A nurse documents vital signs after verifying them with the UAP
B. A nurse fails to check a documented penicillin allergy before administration, causing
anaphylaxis [CORRECT]
C. A nurse delegates meal feeding of a stable client to UAP
D. A nurse uses a gait belt to ambulate a weak client
Correct Answer: B
Rationale: Negligence requires a breached duty resulting in harm — ignoring a documented
allergy and causing anaphylaxis meets that standard, while the other actions reflect safe,
appropriate practice.
Q18: A client with a valid, documented DNR order deteriorates during the shift. What should
the nurse do?
A. Call a full code despite the order
