HESI RN EXIT EXAM PREDICTOR 2026/2027 Complete Exit
Exam Preparation | Actual Questions & Verified Predictor |
NCLEX-RN Readiness Assessment | Pass Guarantee
EXAM OVERVIEW
● Total Questions: 110
● Time: Approximately 4 hours (recommended pace: 2-3 minutes per question)
● Passing Standard: 850 (HESI scale) or approximately 75-80% correct
● Subjects Covered: Fundamentals, Medical-Surgical, Pediatrics, Maternity,
Psychiatric/Mental Health, Pharmacology
SECTION 1: FUNDAMENTALS OF NURSING (Questions 1-20)
Question 1: Delegation & Supervision
The charge nurse on a medical-surgical unit is delegating tasks to unlicensed assistive
personnel (UAP). Which task is most appropriate to delegate to the UAP?
A. Assessing a client's postoperative pain level using a 0-10 scale
B. Ambulating a client who is 1 day post-op after total knee replacement
C. Feeding a client with dysphagia who requires thickened liquids
D. Obtaining vital signs on a client receiving a blood transfusion for the first 15 minutes
Correct Answer: B
Rationale:
,The task of ambulating a stable postoperative client is within the scope of UAP practice.
This client is 1 day post-op, indicating they have been assessed by the nurse and
cleared for ambulation. The UAP can safely assist with this activity of daily living under
nurse supervision.
● Option A: Pain assessment requires clinical judgment and is a registered nurse
responsibility. The UAP can report observations but cannot perform formal
assessments.
● Option C: Clients with dysphagia require specialized feeding techniques and
close monitoring for aspiration; this requires RN-level assessment and
intervention.
● Option D: The first 15 minutes of a blood transfusion require intensive monitoring
for acute hemolytic reactions, including assessment of vital signs AND clinical
status; this is RN-only responsibility.
Test-Taking Tip: When evaluating delegation questions, apply the "right task, right
circumstance, right person, right direction/communication, right supervision"
framework. Tasks requiring assessment, judgment, or teaching cannot be delegated to
UAP.
Question 2: Patient Safety & Error Prevention
A nurse is preparing to administer digoxin 0.25 mg PO to a client with heart failure. The
client's current vital signs are: HR 58, BP 112/68, RR 16, SpO2 94% on room air. Which
action should the nurse take first?
A. Administer the medication as ordered
B. Hold the medication and notify the provider
C. Recheck the heart rate in 30 minutes
D. Check the client's potassium level
,Correct Answer: B
Rationale:
Digoxin is contraindicated when the apical heart rate is below 60 beats per minute due
to the risk of severe bradycardia and heart block. The nurse must hold the medication
and notify the provider immediately. Digoxin slows AV nodal conduction and can cause
life-threatening bradycardia, especially in toxic levels.
● Option A: Administering with a heart rate of 58 could precipitate dangerous
bradycardia or asystole.
● Option C: Waiting 30 minutes delays necessary intervention and places the client
at risk.
● Option D: While hypokalemia increases digoxin toxicity risk, the immediate
concern is the bradycardia; potassium levels should be checked but the priority is
holding the dose.
Test-Taking Tip: Use the "First" priority strategy: When asked what to do "first," identify
the option that addresses the most immediate threat to patient safety. In medication
administration, always check vital signs and contraindications before giving the drug.
Question 3: Therapeutic Communication
A client newly diagnosed with type 2 diabetes states, "I don't understand why this
happened to me. I don't eat that much sugar." Which response by the nurse
demonstrates therapeutic communication?
A. "Type 2 diabetes isn't caused by eating sugar. It's genetic and related to obesity."
B. "You're feeling confused about your diagnosis. Can you tell me more about what you
understand?"
C. "Don't worry, with proper diet and medication, you'll be fine."
D. "Many people misunderstand diabetes. Let me explain the pathophysiology to you."
, Correct Answer: B
Rationale:
Therapeutic communication involves acknowledging feelings, using open-ended
questions, and encouraging the client to express concerns. This response validates the
client's emotional state ("feeling confused") and invites further dialogue to assess
knowledge gaps.
● Option A: Provides information but is defensive and dismissive of the client's
feelings; uses medical jargon ("genetic," "obesity").
● Option C: False reassurance minimizes the client's concerns and blocks further
communication.
● Option D: Focuses on teaching before assessing the client's current
understanding and emotional needs.
Test-Taking Tip: In therapeutic communication questions, select responses that are
client-centered, open-ended, and non-judgmental. Avoid options that give advice, false
reassurance, or change the subject.
Question 4: Cultural Competence
A nurse is caring for a client from a culture that practices traditional healing methods.
The client wants to use herbal remedies alongside prescribed medications. Which
action should the nurse take?
A. Explain that herbal remedies are not evidence-based and should be avoided
B. Respectfully ask about the specific herbs and check for drug interactions
C. Allow the use of herbs but document that the client is noncompliant
D. Notify the provider that the client is refusing treatment
Correct Answer: B
Exam Preparation | Actual Questions & Verified Predictor |
NCLEX-RN Readiness Assessment | Pass Guarantee
EXAM OVERVIEW
● Total Questions: 110
● Time: Approximately 4 hours (recommended pace: 2-3 minutes per question)
● Passing Standard: 850 (HESI scale) or approximately 75-80% correct
● Subjects Covered: Fundamentals, Medical-Surgical, Pediatrics, Maternity,
Psychiatric/Mental Health, Pharmacology
SECTION 1: FUNDAMENTALS OF NURSING (Questions 1-20)
Question 1: Delegation & Supervision
The charge nurse on a medical-surgical unit is delegating tasks to unlicensed assistive
personnel (UAP). Which task is most appropriate to delegate to the UAP?
A. Assessing a client's postoperative pain level using a 0-10 scale
B. Ambulating a client who is 1 day post-op after total knee replacement
C. Feeding a client with dysphagia who requires thickened liquids
D. Obtaining vital signs on a client receiving a blood transfusion for the first 15 minutes
Correct Answer: B
Rationale:
,The task of ambulating a stable postoperative client is within the scope of UAP practice.
This client is 1 day post-op, indicating they have been assessed by the nurse and
cleared for ambulation. The UAP can safely assist with this activity of daily living under
nurse supervision.
● Option A: Pain assessment requires clinical judgment and is a registered nurse
responsibility. The UAP can report observations but cannot perform formal
assessments.
● Option C: Clients with dysphagia require specialized feeding techniques and
close monitoring for aspiration; this requires RN-level assessment and
intervention.
● Option D: The first 15 minutes of a blood transfusion require intensive monitoring
for acute hemolytic reactions, including assessment of vital signs AND clinical
status; this is RN-only responsibility.
Test-Taking Tip: When evaluating delegation questions, apply the "right task, right
circumstance, right person, right direction/communication, right supervision"
framework. Tasks requiring assessment, judgment, or teaching cannot be delegated to
UAP.
Question 2: Patient Safety & Error Prevention
A nurse is preparing to administer digoxin 0.25 mg PO to a client with heart failure. The
client's current vital signs are: HR 58, BP 112/68, RR 16, SpO2 94% on room air. Which
action should the nurse take first?
A. Administer the medication as ordered
B. Hold the medication and notify the provider
C. Recheck the heart rate in 30 minutes
D. Check the client's potassium level
,Correct Answer: B
Rationale:
Digoxin is contraindicated when the apical heart rate is below 60 beats per minute due
to the risk of severe bradycardia and heart block. The nurse must hold the medication
and notify the provider immediately. Digoxin slows AV nodal conduction and can cause
life-threatening bradycardia, especially in toxic levels.
● Option A: Administering with a heart rate of 58 could precipitate dangerous
bradycardia or asystole.
● Option C: Waiting 30 minutes delays necessary intervention and places the client
at risk.
● Option D: While hypokalemia increases digoxin toxicity risk, the immediate
concern is the bradycardia; potassium levels should be checked but the priority is
holding the dose.
Test-Taking Tip: Use the "First" priority strategy: When asked what to do "first," identify
the option that addresses the most immediate threat to patient safety. In medication
administration, always check vital signs and contraindications before giving the drug.
Question 3: Therapeutic Communication
A client newly diagnosed with type 2 diabetes states, "I don't understand why this
happened to me. I don't eat that much sugar." Which response by the nurse
demonstrates therapeutic communication?
A. "Type 2 diabetes isn't caused by eating sugar. It's genetic and related to obesity."
B. "You're feeling confused about your diagnosis. Can you tell me more about what you
understand?"
C. "Don't worry, with proper diet and medication, you'll be fine."
D. "Many people misunderstand diabetes. Let me explain the pathophysiology to you."
, Correct Answer: B
Rationale:
Therapeutic communication involves acknowledging feelings, using open-ended
questions, and encouraging the client to express concerns. This response validates the
client's emotional state ("feeling confused") and invites further dialogue to assess
knowledge gaps.
● Option A: Provides information but is defensive and dismissive of the client's
feelings; uses medical jargon ("genetic," "obesity").
● Option C: False reassurance minimizes the client's concerns and blocks further
communication.
● Option D: Focuses on teaching before assessing the client's current
understanding and emotional needs.
Test-Taking Tip: In therapeutic communication questions, select responses that are
client-centered, open-ended, and non-judgmental. Avoid options that give advice, false
reassurance, or change the subject.
Question 4: Cultural Competence
A nurse is caring for a client from a culture that practices traditional healing methods.
The client wants to use herbal remedies alongside prescribed medications. Which
action should the nurse take?
A. Explain that herbal remedies are not evidence-based and should be avoided
B. Respectfully ask about the specific herbs and check for drug interactions
C. Allow the use of herbs but document that the client is noncompliant
D. Notify the provider that the client is refusing treatment
Correct Answer: B
