HESI COMPREHENSIVE REVIEW QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Leadership and Management
Advanced Clinical Concepts
Medical-Surgical Nursing
Pediatric Nursing
Maternity Nursing
Psychiatric Nursing
Gerontologic Nursing
Pharmacology and Safety
Clinical Decision-Making
Ethics and Professional Standards
Introduction
,This comprehensive assessment evaluates critical nursing knowledge and clinical judgment essential for safe,
effective practice as a registered nurse. The exam covers foundational theory, applied professional
knowledge, regulatory compliance, ethics, and real-world clinical scenarios requiring critical thinking and
decision-making. Questions include traditional multiple-choice and scenario-based formats that mirror the
Next-Generation NCLEX-RN structure, emphasizing prioritization, delegation, safety, pharmacological
therapies, physiological adaptation, and health promotion. Success on this assessment demonstrates
readiness for nursing school exit exams and the NCLEX-RN licensing examination.
Section One: Questions 1–100
Question 1
A nurse is delegating tasks to a licensed practical nurse (LPN) on a medical-surgical unit. Which task is most
appropriate for the LPN?
A. Assessing a new patient with chest pain
B. Administering IV push medications
C. Providing wound care to a stable postoperative patient
D. Developing a discharge plan for a patient with heart failure
🟢 C. Providing wound care to a stable postoperative patient
🔴 RATIONALE: LPNs can perform standardized procedures on stable patients, including wound care.
Assessment of new patients, IV push medications, and discharge planning require RN-level knowledge and
clinical judgment.
,Question 2
A patient with type 2 diabetes asks why their blood glucose is high despite taking metformin. The nurse explains
that metformin primarily works by:
A. Stimulating insulin release from pancreatic beta cells
B. Decreasing hepatic glucose production and improving insulin sensitivity
C. Increasing renal excretion of glucose
D. Delaying carbohydrate absorption in the gastrointestinal tract
🟢 B. Decreasing hepatic glucose production and improving insulin sensitivity
🔴 RATIONALE: Metformin is a biguanide that decreases gluconeogenesis in the liver and increases peripheral
insulin sensitivity. It does not stimulate insulin secretion (unlike sulfonylureas) or directly affect renal glucose
excretion.
Question 3
During a shift, the nurse notices a patient's oxygen saturation has dropped from 95% to 88%. What is the FIRST
action the nurse should take?
, A. Notify the healthcare provider immediately
B. Apply supplemental oxygen and reassess
C. Obtain a chest X-ray order
D. Prepare for intubation
🟢 B. Apply supplemental oxygen and reassess
🔴 RATIONALE: The priority is to address the immediate hypoxemia by applying oxygen and reassessing.
Notification and diagnostic testing follow after stabilizing the patient.
Question 4
A 7-year-old child with acute lymphoblastic leukemia has a platelet count of 18,000/mm³. Which intervention
is MOST appropriate?
A. Encourage active play to maintain mobility
B. Implement bleeding precautions and avoid invasive procedures
C. Administer aspirin for pain management
D. Prepare for platelet transfusion immediately without provider order
🟢 B. Implement bleeding precautions and avoid invasive procedures
🔴 RATIONALE: Platelets below 20,000/mm³ indicate severe thrombocytopenia with high bleeding risk.
Bleeding precautions are essential. Platelet transfusion requires a provider order, and aspirin increases bleeding
risk.
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Leadership and Management
Advanced Clinical Concepts
Medical-Surgical Nursing
Pediatric Nursing
Maternity Nursing
Psychiatric Nursing
Gerontologic Nursing
Pharmacology and Safety
Clinical Decision-Making
Ethics and Professional Standards
Introduction
,This comprehensive assessment evaluates critical nursing knowledge and clinical judgment essential for safe,
effective practice as a registered nurse. The exam covers foundational theory, applied professional
knowledge, regulatory compliance, ethics, and real-world clinical scenarios requiring critical thinking and
decision-making. Questions include traditional multiple-choice and scenario-based formats that mirror the
Next-Generation NCLEX-RN structure, emphasizing prioritization, delegation, safety, pharmacological
therapies, physiological adaptation, and health promotion. Success on this assessment demonstrates
readiness for nursing school exit exams and the NCLEX-RN licensing examination.
Section One: Questions 1–100
Question 1
A nurse is delegating tasks to a licensed practical nurse (LPN) on a medical-surgical unit. Which task is most
appropriate for the LPN?
A. Assessing a new patient with chest pain
B. Administering IV push medications
C. Providing wound care to a stable postoperative patient
D. Developing a discharge plan for a patient with heart failure
🟢 C. Providing wound care to a stable postoperative patient
🔴 RATIONALE: LPNs can perform standardized procedures on stable patients, including wound care.
Assessment of new patients, IV push medications, and discharge planning require RN-level knowledge and
clinical judgment.
,Question 2
A patient with type 2 diabetes asks why their blood glucose is high despite taking metformin. The nurse explains
that metformin primarily works by:
A. Stimulating insulin release from pancreatic beta cells
B. Decreasing hepatic glucose production and improving insulin sensitivity
C. Increasing renal excretion of glucose
D. Delaying carbohydrate absorption in the gastrointestinal tract
🟢 B. Decreasing hepatic glucose production and improving insulin sensitivity
🔴 RATIONALE: Metformin is a biguanide that decreases gluconeogenesis in the liver and increases peripheral
insulin sensitivity. It does not stimulate insulin secretion (unlike sulfonylureas) or directly affect renal glucose
excretion.
Question 3
During a shift, the nurse notices a patient's oxygen saturation has dropped from 95% to 88%. What is the FIRST
action the nurse should take?
, A. Notify the healthcare provider immediately
B. Apply supplemental oxygen and reassess
C. Obtain a chest X-ray order
D. Prepare for intubation
🟢 B. Apply supplemental oxygen and reassess
🔴 RATIONALE: The priority is to address the immediate hypoxemia by applying oxygen and reassessing.
Notification and diagnostic testing follow after stabilizing the patient.
Question 4
A 7-year-old child with acute lymphoblastic leukemia has a platelet count of 18,000/mm³. Which intervention
is MOST appropriate?
A. Encourage active play to maintain mobility
B. Implement bleeding precautions and avoid invasive procedures
C. Administer aspirin for pain management
D. Prepare for platelet transfusion immediately without provider order
🟢 B. Implement bleeding precautions and avoid invasive procedures
🔴 RATIONALE: Platelets below 20,000/mm³ indicate severe thrombocytopenia with high bleeding risk.
Bleeding precautions are essential. Platelet transfusion requires a provider order, and aspirin increases bleeding
risk.
