HESI RN Exit Exam Comprehensive Practice Actual
Exam 2026/2027 | NGN Test Bank | Questions with
Verified Answers | 100% Correct | Pass Guaranteed
SECTION 1: Fundamentals & Safety (15 Questions)
Q1: A nurse is caring for four patients. Which patient should the nurse assess FIRST?
A. A post-op patient with pain rated 7/10
B. A diabetic patient with blood glucose of 210 mg/dL
C. A patient 4 hours post-abdominal surgery with rigid, board-like abdomen and absent
bowel sounds
D. An elderly patient requesting assistance to the bathroom
Correct Answer: C
Rationale: Clinical Judgment: Tests Recognize Cues and Prioritize Hypotheses using the
ABCs framework. A rigid, board-like abdomen indicates potential peritonitis or internal
hemorrhage—an acute, life-threatening surgical emergency requiring immediate
intervention. This takes priority over pain management (A), chronic hyperglycemia (B),
and elimination needs (D) because it threatens physiological stability and systemic
perfusion. Delayed recognition could lead to septic shock or death.
Q2: Which task can the RN delegate to an experienced UAP (Unlicensed Assistive
Personnel)?
A. Assist a stable post-op patient with ambulation to the bathroom
B. Assess a new post-op patient's pain level
C. Teach insulin administration techniques
D. Change a sterile wound dressing
Correct Answer: A
,Rationale: Clinical Judgment: Tests Generate Solutions through delegation
decision-making. Delegation must follow the Five Rights of Delegation (right task,
circumstance, person, direction/communication, supervision). Ambulation for a STABLE
patient is a routine, non-invasive task within UAP scope. Options B, C, and D require
nursing judgment, assessment, teaching, and sterile technique—actions that cannot be
delegated to UAP. Selecting B, C, or D demonstrates flawed understanding of scope of
practice and legal accountability.
Q3: A patient with suspected pulmonary tuberculosis is admitted. What is the priority
nursing action before initiating care?
A. Obtain sputum cultures
B. Start IV antibiotics
C. Initiate airborne precautions in a negative-pressure room
D. Administer antipyretics
Correct Answer: C
Rationale: Clinical Judgment: Tests Take Action with Safety/Infection Control priority.
Airborne precautions for TB protect healthcare workers and other patients—this is a
legal and ethical imperative that precedes diagnostic tests (A) or treatment (B, D). The
CDC mandates immediate isolation for suspected airborne diseases. Failure to isolate
first represents a serious safety violation and public health risk. Options A, B, and D are
important but secondary to breaking the chain of transmission.
Q4: A competent adult patient with terminal cancer refuses chemotherapy. What ethical
principle is the nurse demonstrating by supporting this decision?
A. Beneficence
B. Autonomy
C. Nonmaleficence
D. Justice
Correct Answer: B
,Rationale: Clinical Judgment: Tests Analyze Cues in ethical reasoning. Autonomy
respects a patient's right to self-determination and informed refusal, even if the decision
conflicts with medical recommendations. Beneficence (A) would be paternalism—doing
what the nurse thinks is "good." Nonmaleficence (C) is "do no harm," but forcing
treatment violates autonomy. Justice (D) concerns fair resource allocation. Supporting
refusal demonstrates understanding that patient autonomy supersedes provider
preference in competent adults.
Q5: The nurse documents a medication dose incorrectly. What is the appropriate
action?
A. Erase the entry and rewrite it correctly
B. Use correction fluid to cover the error
C. Draw a single line through the error, write "error," initial, date, and document correct
information
D. Leave the entry blank and rewrite on a new line
Correct Answer: C
Rationale: Clinical Judgment: Tests Take Action for legal documentation standards. Per
Joint Commission and State Nurse Practice Acts, the only acceptable method is a
single line through, "error" notation, and correction with authentication. This maintains
legal integrity and prevents altering records. Options A and B constitute illegal record
tampering/falsification. Option D creates incomplete documentation. All other options
demonstrate violations of professional and legal standards with potential licensure
consequences.
Q6: Which factor places a hospital patient at highest risk for falls?
A. Age 65 years with arthritis
B. History of two falls at home in past year
C. Current prescription for IV morphine PCA
D. Visual impairment requiring glasses
, Correct Answer: C
Rationale: Clinical Judgment: Tests Recognize Cues for safety risk assessment. Acute,
modifiable factors take priority over chronic conditions. IV morphine PCA causes
immediate sedation, orthostatic hypotension, and altered mental status—creating an
imminent fall risk. While age (A), history (B), and vision (D) are risk factors, opioid
administration is an active, reversible threat requiring immediate intervention like bed
alarm, frequent rounding, and possibly stopping the infusion. This demonstrates
prioritizing acute over chronic using the Safety framework.
Q7: A patient with dementia is attempting to climb out of bed repeatedly despite
supervision. What is the most appropriate initial intervention?
A. Apply soft wrist restraints
B. Implement a bed alarm and one-to-one sitter
C. Sedate with PRN antipsychotic
D. Use a vest restraint
Correct Answer: B
Rationale: Clinical Judgment: Tests Generate Solutions using least-restrictive restraint
principles. The Joint Commission and CMS require restraints as last resort after all
alternatives fail. Bed alarms and sitters maintain safety while preserving dignity and
mobility. Options A and D represent physical restraints requiring MD order and are
punitive without first trying alternatives. Option C is chemical restraint with serious side
effects (increased stroke/death risk in elderly). Option B demonstrates ethical clinical
judgment by prioritizing patient-centered care and regulatory compliance.
Q8: During shift report, the incoming nurse learns a patient's central line was inserted 48
hours ago without dressing change. What is the priority action?
A. Check the insertion site for redness
B. Review the patient's temperature trend
C. Perform immediate central line dressing change using sterile technique
D. Ask the previous nurse why it wasn't changed
Exam 2026/2027 | NGN Test Bank | Questions with
Verified Answers | 100% Correct | Pass Guaranteed
SECTION 1: Fundamentals & Safety (15 Questions)
Q1: A nurse is caring for four patients. Which patient should the nurse assess FIRST?
A. A post-op patient with pain rated 7/10
B. A diabetic patient with blood glucose of 210 mg/dL
C. A patient 4 hours post-abdominal surgery with rigid, board-like abdomen and absent
bowel sounds
D. An elderly patient requesting assistance to the bathroom
Correct Answer: C
Rationale: Clinical Judgment: Tests Recognize Cues and Prioritize Hypotheses using the
ABCs framework. A rigid, board-like abdomen indicates potential peritonitis or internal
hemorrhage—an acute, life-threatening surgical emergency requiring immediate
intervention. This takes priority over pain management (A), chronic hyperglycemia (B),
and elimination needs (D) because it threatens physiological stability and systemic
perfusion. Delayed recognition could lead to septic shock or death.
Q2: Which task can the RN delegate to an experienced UAP (Unlicensed Assistive
Personnel)?
A. Assist a stable post-op patient with ambulation to the bathroom
B. Assess a new post-op patient's pain level
C. Teach insulin administration techniques
D. Change a sterile wound dressing
Correct Answer: A
,Rationale: Clinical Judgment: Tests Generate Solutions through delegation
decision-making. Delegation must follow the Five Rights of Delegation (right task,
circumstance, person, direction/communication, supervision). Ambulation for a STABLE
patient is a routine, non-invasive task within UAP scope. Options B, C, and D require
nursing judgment, assessment, teaching, and sterile technique—actions that cannot be
delegated to UAP. Selecting B, C, or D demonstrates flawed understanding of scope of
practice and legal accountability.
Q3: A patient with suspected pulmonary tuberculosis is admitted. What is the priority
nursing action before initiating care?
A. Obtain sputum cultures
B. Start IV antibiotics
C. Initiate airborne precautions in a negative-pressure room
D. Administer antipyretics
Correct Answer: C
Rationale: Clinical Judgment: Tests Take Action with Safety/Infection Control priority.
Airborne precautions for TB protect healthcare workers and other patients—this is a
legal and ethical imperative that precedes diagnostic tests (A) or treatment (B, D). The
CDC mandates immediate isolation for suspected airborne diseases. Failure to isolate
first represents a serious safety violation and public health risk. Options A, B, and D are
important but secondary to breaking the chain of transmission.
Q4: A competent adult patient with terminal cancer refuses chemotherapy. What ethical
principle is the nurse demonstrating by supporting this decision?
A. Beneficence
B. Autonomy
C. Nonmaleficence
D. Justice
Correct Answer: B
,Rationale: Clinical Judgment: Tests Analyze Cues in ethical reasoning. Autonomy
respects a patient's right to self-determination and informed refusal, even if the decision
conflicts with medical recommendations. Beneficence (A) would be paternalism—doing
what the nurse thinks is "good." Nonmaleficence (C) is "do no harm," but forcing
treatment violates autonomy. Justice (D) concerns fair resource allocation. Supporting
refusal demonstrates understanding that patient autonomy supersedes provider
preference in competent adults.
Q5: The nurse documents a medication dose incorrectly. What is the appropriate
action?
A. Erase the entry and rewrite it correctly
B. Use correction fluid to cover the error
C. Draw a single line through the error, write "error," initial, date, and document correct
information
D. Leave the entry blank and rewrite on a new line
Correct Answer: C
Rationale: Clinical Judgment: Tests Take Action for legal documentation standards. Per
Joint Commission and State Nurse Practice Acts, the only acceptable method is a
single line through, "error" notation, and correction with authentication. This maintains
legal integrity and prevents altering records. Options A and B constitute illegal record
tampering/falsification. Option D creates incomplete documentation. All other options
demonstrate violations of professional and legal standards with potential licensure
consequences.
Q6: Which factor places a hospital patient at highest risk for falls?
A. Age 65 years with arthritis
B. History of two falls at home in past year
C. Current prescription for IV morphine PCA
D. Visual impairment requiring glasses
, Correct Answer: C
Rationale: Clinical Judgment: Tests Recognize Cues for safety risk assessment. Acute,
modifiable factors take priority over chronic conditions. IV morphine PCA causes
immediate sedation, orthostatic hypotension, and altered mental status—creating an
imminent fall risk. While age (A), history (B), and vision (D) are risk factors, opioid
administration is an active, reversible threat requiring immediate intervention like bed
alarm, frequent rounding, and possibly stopping the infusion. This demonstrates
prioritizing acute over chronic using the Safety framework.
Q7: A patient with dementia is attempting to climb out of bed repeatedly despite
supervision. What is the most appropriate initial intervention?
A. Apply soft wrist restraints
B. Implement a bed alarm and one-to-one sitter
C. Sedate with PRN antipsychotic
D. Use a vest restraint
Correct Answer: B
Rationale: Clinical Judgment: Tests Generate Solutions using least-restrictive restraint
principles. The Joint Commission and CMS require restraints as last resort after all
alternatives fail. Bed alarms and sitters maintain safety while preserving dignity and
mobility. Options A and D represent physical restraints requiring MD order and are
punitive without first trying alternatives. Option C is chemical restraint with serious side
effects (increased stroke/death risk in elderly). Option B demonstrates ethical clinical
judgment by prioritizing patient-centered care and regulatory compliance.
Q8: During shift report, the incoming nurse learns a patient's central line was inserted 48
hours ago without dressing change. What is the priority action?
A. Check the insertion site for redness
B. Review the patient's temperature trend
C. Perform immediate central line dressing change using sterile technique
D. Ask the previous nurse why it wasn't changed
