HESI RN EXIT EXAM PREDICTOR 2026/2027 Complete Exit
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SECTION 1: FUNDAMENTALS OF NURSING (Questions 1-20)
Question 1: Delegation & Supervision
A charge nurse on a medical-surgical unit is assigning tasks for the upcoming shift. The
unit is staffed with two RNs, one LPN/LVN, and two unlicensed assistive personnel
(UAP). Which task is most appropriate to delegate to the UAP?
A. Administer oral medications to a client with stable heart failure
B. Assess a postoperative client's surgical incision for signs of infection
C. Assist a client who had a stroke with ambulation to the bathroom
D. Teach a newly diagnosed diabetic client how to perform blood glucose monitoring
Correct Answer: C
Rationale: Delegation decisions must be based on the scope of practice for each team
member. UAPs can assist with activities of daily living, ambulation, and basic hygiene
but cannot perform assessments, administer medications, or provide patient education.
● Option A: Incorrect. Medication administration requires nursing judgment and
licensure; this task cannot be delegated to UAP.
● Option B: Incorrect. Assessment is a nursing function that requires critical
thinking and clinical judgment; only RNs can perform assessments.
, ● Option C: Correct. Assisting with ambulation is within the UAP's scope of practice
and does not require nursing judgment or assessment skills.
● Option D: Incorrect. Patient education requires nursing knowledge and evaluation
of learning; this is an RN responsibility.
Test-Taking Strategy: Remember the "Five Rights of Delegation"—right task, right
circumstance, right person, right direction/communication, and right supervision. When
in doubt, ask: "Does this task require assessment, planning, or evaluation?" If yes, it
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 atrial fibrillation.
Before giving the medication, which action should the nurse take first?
A. Check the client's potassium level
B. Assess the client's apical heart rate for 1 full minute
C. Verify the medication administration record (MAR) against the original order
D. Ask the client if they have any allergies to medications
Correct Answer: B
Rationale: The "first" question requires prioritization using clinical judgment. While all
options are important steps in medication administration, digoxin is a cardiac glycoside
with a narrow therapeutic index that can cause serious bradycardia or heart block.
● Option A: Incorrect. While hypokalemia increases digoxin toxicity risk, checking
the potassium level is not the immediate first step before administration.
● Option B: Correct. The nurse must assess the apical pulse for a full minute; if the
rate is <60 bpm or >100 bpm, the medication should be held and the provider
notified. This is the priority safety check.
, ● Option C: Incorrect. While verification is essential, it is typically done before
entering the patient's room. The question asks what to do "first" upon preparing
to administer.
● Option D: Incorrect. Allergy verification is important but is usually completed
during the initial admission assessment and confirmed before the first dose.
Test-Taking Strategy: Use the ABCs (Airway, Breathing, Circulation) and patient safety
priorities. For cardiac medications, always assess the heart rate first. "First" questions
often involve immediate physiological safety concerns.
Question 3: Therapeutic Communication
A client newly diagnosed with breast cancer tells the nurse, "I don't know how I'm going
to tell my children. They're going to be so scared." Which response by the nurse
demonstrates therapeutic communication?
A. "Don't worry, children are more resilient than you think."
B. "Would you like to talk about how you might approach this conversation?"
C. "Many clients find it helpful to wait until they know more about their treatment plan."
D. "I know this is difficult, but you need to stay strong for your children."
Correct Answer: B
Rationale: Therapeutic communication focuses on the client's feelings, promotes
exploration of concerns, and avoids false reassurance or giving advice.
● Option A: Incorrect. This minimizes the client's concern and offers false
reassurance, which blocks further communication.
● Option B: Correct. This open-ended question allows the client to explore their
feelings and concerns while maintaining autonomy in decision-making.
● Option C: Incorrect. While potentially practical, this response gives unsolicited
advice and does not address the client's emotional needs.
, ● Option D: Incorrect. This response is non-therapeutic as it dismisses the client's
feelings and creates pressure to suppress emotions.
Test-Taking Strategy: Look for responses that are client-centered, open-ended, and
non-judgmental. Avoid options that begin with "Don't worry," "I know how you feel," or
"You should." The best therapeutic responses encourage the client to express feelings
and explore solutions.
Question 4: Cultural Competence
A nurse is caring for a client from a culture that believes illness is caused by an
imbalance in hot and cold elements. The client refuses to eat the hospital's cold fruit
tray. Which action by the nurse demonstrates cultural competence?
A. Explain that proper nutrition is essential for healing regardless of cultural beliefs
B. Ask the client which foods they consider "hot" and accommodate their preferences
C. Document the refusal and notify the healthcare provider of the nutritional concern
D. Request a psychiatric consultation to evaluate for disordered eating
Correct Answer: B
Rationale: Cultural competence requires respecting and accommodating health beliefs
while ensuring safe, effective care.
● Option A: Incorrect. This dismisses the client's cultural beliefs and may create
conflict rather than therapeutic alliance.
● Option B: Correct. This demonstrates cultural sensitivity by seeking to
understand the client's perspective and finding a mutually acceptable solution
that honors their beliefs.
● Option C: Incorrect. While documentation is important, this action does not
address the immediate cultural need or attempt collaborative problem-solving.
Exam Preparation | Actual Questions & Verified Predictor |
NCLEX-RN Readiness Assessment | Pass Guarantee
SECTION 1: FUNDAMENTALS OF NURSING (Questions 1-20)
Question 1: Delegation & Supervision
A charge nurse on a medical-surgical unit is assigning tasks for the upcoming shift. The
unit is staffed with two RNs, one LPN/LVN, and two unlicensed assistive personnel
(UAP). Which task is most appropriate to delegate to the UAP?
A. Administer oral medications to a client with stable heart failure
B. Assess a postoperative client's surgical incision for signs of infection
C. Assist a client who had a stroke with ambulation to the bathroom
D. Teach a newly diagnosed diabetic client how to perform blood glucose monitoring
Correct Answer: C
Rationale: Delegation decisions must be based on the scope of practice for each team
member. UAPs can assist with activities of daily living, ambulation, and basic hygiene
but cannot perform assessments, administer medications, or provide patient education.
● Option A: Incorrect. Medication administration requires nursing judgment and
licensure; this task cannot be delegated to UAP.
● Option B: Incorrect. Assessment is a nursing function that requires critical
thinking and clinical judgment; only RNs can perform assessments.
, ● Option C: Correct. Assisting with ambulation is within the UAP's scope of practice
and does not require nursing judgment or assessment skills.
● Option D: Incorrect. Patient education requires nursing knowledge and evaluation
of learning; this is an RN responsibility.
Test-Taking Strategy: Remember the "Five Rights of Delegation"—right task, right
circumstance, right person, right direction/communication, and right supervision. When
in doubt, ask: "Does this task require assessment, planning, or evaluation?" If yes, it
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 atrial fibrillation.
Before giving the medication, which action should the nurse take first?
A. Check the client's potassium level
B. Assess the client's apical heart rate for 1 full minute
C. Verify the medication administration record (MAR) against the original order
D. Ask the client if they have any allergies to medications
Correct Answer: B
Rationale: The "first" question requires prioritization using clinical judgment. While all
options are important steps in medication administration, digoxin is a cardiac glycoside
with a narrow therapeutic index that can cause serious bradycardia or heart block.
● Option A: Incorrect. While hypokalemia increases digoxin toxicity risk, checking
the potassium level is not the immediate first step before administration.
● Option B: Correct. The nurse must assess the apical pulse for a full minute; if the
rate is <60 bpm or >100 bpm, the medication should be held and the provider
notified. This is the priority safety check.
, ● Option C: Incorrect. While verification is essential, it is typically done before
entering the patient's room. The question asks what to do "first" upon preparing
to administer.
● Option D: Incorrect. Allergy verification is important but is usually completed
during the initial admission assessment and confirmed before the first dose.
Test-Taking Strategy: Use the ABCs (Airway, Breathing, Circulation) and patient safety
priorities. For cardiac medications, always assess the heart rate first. "First" questions
often involve immediate physiological safety concerns.
Question 3: Therapeutic Communication
A client newly diagnosed with breast cancer tells the nurse, "I don't know how I'm going
to tell my children. They're going to be so scared." Which response by the nurse
demonstrates therapeutic communication?
A. "Don't worry, children are more resilient than you think."
B. "Would you like to talk about how you might approach this conversation?"
C. "Many clients find it helpful to wait until they know more about their treatment plan."
D. "I know this is difficult, but you need to stay strong for your children."
Correct Answer: B
Rationale: Therapeutic communication focuses on the client's feelings, promotes
exploration of concerns, and avoids false reassurance or giving advice.
● Option A: Incorrect. This minimizes the client's concern and offers false
reassurance, which blocks further communication.
● Option B: Correct. This open-ended question allows the client to explore their
feelings and concerns while maintaining autonomy in decision-making.
● Option C: Incorrect. While potentially practical, this response gives unsolicited
advice and does not address the client's emotional needs.
, ● Option D: Incorrect. This response is non-therapeutic as it dismisses the client's
feelings and creates pressure to suppress emotions.
Test-Taking Strategy: Look for responses that are client-centered, open-ended, and
non-judgmental. Avoid options that begin with "Don't worry," "I know how you feel," or
"You should." The best therapeutic responses encourage the client to express feelings
and explore solutions.
Question 4: Cultural Competence
A nurse is caring for a client from a culture that believes illness is caused by an
imbalance in hot and cold elements. The client refuses to eat the hospital's cold fruit
tray. Which action by the nurse demonstrates cultural competence?
A. Explain that proper nutrition is essential for healing regardless of cultural beliefs
B. Ask the client which foods they consider "hot" and accommodate their preferences
C. Document the refusal and notify the healthcare provider of the nutritional concern
D. Request a psychiatric consultation to evaluate for disordered eating
Correct Answer: B
Rationale: Cultural competence requires respecting and accommodating health beliefs
while ensuring safe, effective care.
● Option A: Incorrect. This dismisses the client's cultural beliefs and may create
conflict rather than therapeutic alliance.
● Option B: Correct. This demonstrates cultural sensitivity by seeking to
understand the client's perspective and finding a mutually acceptable solution
that honors their beliefs.
● Option C: Incorrect. While documentation is important, this action does not
address the immediate cultural need or attempt collaborative problem-solving.
