2026/2027 HESI RN Exit Exam V6 Complete Certification Prep and Advanced Study Guide: Detailed Topic Modules, Extensive Test Bank Review, Practice Questions, and Final Exam Readiness Manual

1. A nurse is caring for a newly admitted client diagnosed with severe depression. Which nursing diagnosis should take priority in the initial plan of care? A. Imbalanced nutrition: less than body requirements B. Disturbed sleep pattern C. Impaired social interaction D. Risk for self-directed violence Correct Answer: D. Risk for self-directed violence Rationale: Clients with severe depression are at significantly increased risk of self-harm or suicide, so safety is the highest priority. 2. A nurse is teaching a 10-year-old child about an illness. Which cognitive developmental characteristic should the nurse consider when planning the teaching session? A. Thinking is primarily egocentric and self-centered B. Ability to logically organize and interpret information C. Reliance on magical thinking to explain illness D. Inability to understand cause-and-effect relationships Correct Answer: B. Ability to logically organize and interpret information Rationale: A 10-year-old is typically in the concrete operational stage and can think logically about concrete events. 3. A nurse enters a room where a 3-year-old child is experiencing a generalized seizure. What is the nurse’s first priority action? A. Apply oxygen via face mask B. Turn the child onto their side C. Insert a tongue depressor to prevent airway obstruction D. Restrain the child to prevent injury Correct Answer: B. Turn the child onto their side Rationale: Turning the child on the side helps maintain airway patency and reduces aspiration risk. 4. A nurse documents that a client with depression is experiencing anhedonia. What does this term indicate? A. Difficulty falling asleep B. Persistent suicidal ideation C. Loss of ability to experience pleasure D. Decreased appetite and weight loss Correct Answer: C. Loss of ability to experience pleasure Rationale: Anhedonia is the inability to feel pleasure in previously enjoyable activities. 5. A client returns to the unit after a segmental lung resection. After initial assessment, what is the nurse’s priority action? A. Administer prescribed analgesics B. Encourage deep breathing and coughing C. Monitor oxygen saturation continuously D. Suction excessive tracheobronchial secretions Correct Answer: D. Suction excessive tracheobronchial secretions Rationale: Airway clearance is the immediate priority after thoracic surgery. 6. A client with panic disorder reports symptoms during assessment. Which finding is most clinically significant? A. Compulsive handwashing behaviors B. Sense of impending doom C. Fear of social situations D. Predictable episodic anxiety attacks Correct Answer: B. Sense of impending doom Rationale: A sense of impending doom is a hallmark symptom of acute panic attacks. 7. A 16-month-old toddler is admitted to the hospital and clings to the mother, crying when the nurse approaches. What is the nurse’s best initial response? A. Reassign the child to another nurse B. Explain that this behavior is developmentally expected C. Encourage the mother to leave temporarily D. Begin immediate distraction techniques Correct Answer: B. Explain that this behavior is developmentally expected Rationale: Toddlers commonly show separation anxiety in unfamiliar environments. 8. A 15-year-old client has been hospitalized for a prolonged illness. Which developmental risk is most concerning? A. Loss of autonomy B. Increased dependency C. Disturbed identity formation D. Delayed trust development Correct Answer: B. Increased dependency Rationale: Prolonged illness can lead to regression and increased dependency, interfering with adolescent developmental tasks. 9. Which activity is most appropriate for a group of 7-year-old hospitalized children in a playroom? A. Team sports with simple rules B. Finger painting and water play C. Dress-up role play D. Solitary board games Correct Answer: A. Team sports with simple rules Rationale: School-age children enjoy structured, rule-based activities that promote teamwork and competition. 10. A nurse advises an adolescent with acne about diet. What is the most appropriate nursing response? A. Avoid all fatty foods completely B. Increase vitamin A intake significantly C. Maintain a balanced diet appropriate for age D. Eliminate chocolate and caffeine entirely Correct Answer: C. Maintain a balanced diet appropriate for age Rationale: Current evidence does not support strict dietary restrictions as a primary treatment for acne. 11. A nurse is teaching a client about AIDS diagnosis criteria. Which laboratory finding confirms progression to AIDS? A. CD4 count above 500 cells/mm³ B. Presence of opportunistic infection only C. CD4 count below 200 cells/mm³ D. Positive HIV antibody test Correct Answer: C. CD4 count below 200 cells/mm³ Rationale: AIDS is diagnosed when the CD4 count falls below 200 cells/mm³ or when AIDS-defining opportunistic infections occur. 12. After a tonsillectomy, what is the most important nursing observation? A. Presence of nausea B. Frequent swallowing C. Complaints of sore throat D. Ability to drink fluids Correct Answer: B. Frequent swallowing Rationale: Frequent swallowing may indicate postoperative bleeding, which is a serious complication after tonsillectomy. 13. A pregnant woman at 33 weeks gestation expresses readiness for childbirth. Which emotional response is she demonstrating? A. Ambivalence B. Acceptance C. Anticipation D. Rejection Correct Answer: C. Anticipation 14. Which intervention is most effective for mobilizing respiratory secretions in pneumonia? A. Cough suppressants B. Increased oral fluid intake C. Strict bed rest D. Oxygen therapy alone Correct Answer: B. Increased oral fluid intake Rationale: Adequate hydration helps thin respiratory secretions and makes them easier to expectorate. 15. Which toddler requires further developmental evaluation? A. 13-month-old not walking independently B. 20-month-old using 2–3 word phrases C. 24-month-old crying during exam 16. What is the best method to evaluate mastery of insulin injection technique? A. Written examination B. Verbal questioning C. Return demonstration D. Peer teaching Correct Answer: C. Return demonstration Rationale: Return demonstration allows the nurse to directly assess psychomotor skill performance. 17. A client with thrombophlebitis of the leg is admitted. What is the priority intervention? A. Apply warm compresses B. Elevate the affected limb C. Encourage ambulation 18. A child with prolonged hypoxemia is least appropriate for assignment to a newly reassigned pediatric nurse because this condition places the child at risk for: A. Infection B. Cardiac arrest C. Dehydration D. Malnutrition Correct Answer: B. Cardiac arrest Rationale: Prolonged hypoxemia severely compromises oxygen delivery and increases the risk of fatal dysrhythmias and cardiac arrest.