HESI RN EXIT EXAM PRACTICE QUESTIONS —
SET D: 200 ORIGINAL MULTIPLE-CHOICE
QUESTIONS WITH ANSWERS AND RATIONALES
SECTION 1: MANAGEMENT OF CARE, LEADERSHIP, AND
LEGAL/ETHICAL (1–40)
1. The charge nurse is making assignments. Which client should be
assigned to the most experienced RN?
A) A client requesting discharge teaching
B) A client with new-onset chest pain and diaphoresis
C) A client needing a dressing change
D) A client requesting pain medication
Answer: B
Rationale: New-onset chest pain with diaphoresis indicates possible
myocardial infarction and requires the most experienced RN.
2. An RN is delegating to a UAP. Which task is appropriate?
A) Assessing a client’s lung sounds
B) Teaching a client about a new medication
C) Obtaining a blood pressure on a stable client
D) Interpreting a client’s lab results
Answer: C
Rationale: Obtaining vital signs on a stable client is within UAP scope.
3. A client asks the RN to witness an advance directive. What is the RN’s
responsibility?
A) Advise the client which choices to make
,B) Confirm the client is competent and acting voluntarily
C) Sign as the healthcare proxy
D) Change the document to reflect nursing preferences
Answer: B
Rationale: The RN witnesses that the client is competent and acting
voluntarily.
4. The RN discovers a medication error. What is the priority action?
A) Complete an incident report
B) Assess the client and notify the provider
C) Document the error in the chart
D) Notify the charge nurse
Answer: B
Rationale: Client safety first; assess and notify the provider.
5. Which situation requires mandatory reporting?
A) A client refusing chemotherapy
B) Suspected child abuse
C) A client requesting a second opinion
D) A client with a do-not-resuscitate order
Answer: B
Rationale: Suspected child abuse is a mandatory report.
6. An RN is caring for a client who speaks limited English. Which action is
best?
A) Ask a family member to interpret
B) Use a trained medical interpreter
C) Speak louder and slower
D) Provide written instructions only
Answer: B
Rationale: Trained medical interpreters ensure accurate communication.
,7. A client is discharged against medical advice. What should the RN do?
A) Restrain the client until the provider arrives
B) Document the client’s decision and teaching provided
C) Refuse to provide discharge instructions
D) Notify security to stop the client
Answer: B
Rationale: Document the refusal and teaching; the competent client has the
right to leave.
8. The RN is teaching a client about HIPAA. Which statement indicates
understanding?
A) “My family can access my records without my permission.”
B) “I can request a copy of my medical record.”
C) “My employer can see my records anytime.”
D) “I cannot restrict who sees my information.”
Answer: B
Rationale: Clients have the right to access their medical records.
9. Which client should the RN see first?
A) A client with a blood glucose of 180 mg/dL
B) A client with a new onset of confusion and blood pressure 80/50 mm Hg
C) A client requesting a snack
D) A client with mild incisional pain
Answer: B
Rationale: Hypotension with confusion indicates shock and requires
immediate assessment.
10. The RN is preparing to administer a medication. Which action violates
the “rights” of medication administration?
A) Checking the client’s ID band
B) Leaving the medication at the bedside for a client who is asleep
C) Verifying the dose with the order
D) Documenting immediately after administration
, Answer: B
Rationale: Medications should not be left at the bedside; the nurse must
observe the client take it.
11. Which task can the RN delegate to an LPN/LVN?
A) Performing an initial assessment
B) Developing the care plan
C) Administering a scheduled oral medication to a stable client
D) Teaching a client about a new diagnosis
Answer: C
Rationale: LPNs can administer medications to stable clients.
12. The RN is making a referral. Which client should be referred to a social
worker?
A) A client needing wound care
B) A client with financial concerns about medications
C) A client requesting pain medication
D) A client needing physical therapy
Answer: B
Rationale: Social workers address financial and resource concerns.
13. A client is confused and attempting to climb out of bed. What is the
RN’s best initial action?
A) Apply restraints
B) Stay with the client and use least restrictive measures
C) Give a sedative
D) Raise all four side rails
Answer: B
Rationale: Least restrictive measures first; stay with the client.
14. Which finding should the RN report to the provider immediately?
A) A client refusing breakfast
B) A client with a new onset of slurred speech
SET D: 200 ORIGINAL MULTIPLE-CHOICE
QUESTIONS WITH ANSWERS AND RATIONALES
SECTION 1: MANAGEMENT OF CARE, LEADERSHIP, AND
LEGAL/ETHICAL (1–40)
1. The charge nurse is making assignments. Which client should be
assigned to the most experienced RN?
A) A client requesting discharge teaching
B) A client with new-onset chest pain and diaphoresis
C) A client needing a dressing change
D) A client requesting pain medication
Answer: B
Rationale: New-onset chest pain with diaphoresis indicates possible
myocardial infarction and requires the most experienced RN.
2. An RN is delegating to a UAP. Which task is appropriate?
A) Assessing a client’s lung sounds
B) Teaching a client about a new medication
C) Obtaining a blood pressure on a stable client
D) Interpreting a client’s lab results
Answer: C
Rationale: Obtaining vital signs on a stable client is within UAP scope.
3. A client asks the RN to witness an advance directive. What is the RN’s
responsibility?
A) Advise the client which choices to make
,B) Confirm the client is competent and acting voluntarily
C) Sign as the healthcare proxy
D) Change the document to reflect nursing preferences
Answer: B
Rationale: The RN witnesses that the client is competent and acting
voluntarily.
4. The RN discovers a medication error. What is the priority action?
A) Complete an incident report
B) Assess the client and notify the provider
C) Document the error in the chart
D) Notify the charge nurse
Answer: B
Rationale: Client safety first; assess and notify the provider.
5. Which situation requires mandatory reporting?
A) A client refusing chemotherapy
B) Suspected child abuse
C) A client requesting a second opinion
D) A client with a do-not-resuscitate order
Answer: B
Rationale: Suspected child abuse is a mandatory report.
6. An RN is caring for a client who speaks limited English. Which action is
best?
A) Ask a family member to interpret
B) Use a trained medical interpreter
C) Speak louder and slower
D) Provide written instructions only
Answer: B
Rationale: Trained medical interpreters ensure accurate communication.
,7. A client is discharged against medical advice. What should the RN do?
A) Restrain the client until the provider arrives
B) Document the client’s decision and teaching provided
C) Refuse to provide discharge instructions
D) Notify security to stop the client
Answer: B
Rationale: Document the refusal and teaching; the competent client has the
right to leave.
8. The RN is teaching a client about HIPAA. Which statement indicates
understanding?
A) “My family can access my records without my permission.”
B) “I can request a copy of my medical record.”
C) “My employer can see my records anytime.”
D) “I cannot restrict who sees my information.”
Answer: B
Rationale: Clients have the right to access their medical records.
9. Which client should the RN see first?
A) A client with a blood glucose of 180 mg/dL
B) A client with a new onset of confusion and blood pressure 80/50 mm Hg
C) A client requesting a snack
D) A client with mild incisional pain
Answer: B
Rationale: Hypotension with confusion indicates shock and requires
immediate assessment.
10. The RN is preparing to administer a medication. Which action violates
the “rights” of medication administration?
A) Checking the client’s ID band
B) Leaving the medication at the bedside for a client who is asleep
C) Verifying the dose with the order
D) Documenting immediately after administration
, Answer: B
Rationale: Medications should not be left at the bedside; the nurse must
observe the client take it.
11. Which task can the RN delegate to an LPN/LVN?
A) Performing an initial assessment
B) Developing the care plan
C) Administering a scheduled oral medication to a stable client
D) Teaching a client about a new diagnosis
Answer: C
Rationale: LPNs can administer medications to stable clients.
12. The RN is making a referral. Which client should be referred to a social
worker?
A) A client needing wound care
B) A client with financial concerns about medications
C) A client requesting pain medication
D) A client needing physical therapy
Answer: B
Rationale: Social workers address financial and resource concerns.
13. A client is confused and attempting to climb out of bed. What is the
RN’s best initial action?
A) Apply restraints
B) Stay with the client and use least restrictive measures
C) Give a sedative
D) Raise all four side rails
Answer: B
Rationale: Least restrictive measures first; stay with the client.
14. Which finding should the RN report to the provider immediately?
A) A client refusing breakfast
B) A client with a new onset of slurred speech
