HESI Exit Exam 2026/2027 Comprehensive RN
Exit Review Official Practice Exam Actual
Exam 2026/2027 with Detailed Rationales |
Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
══════════════════════════════════════
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT Q1 – Q10
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Question 1 of 50
A 78-year-old client with a history of falls is admitted to a medical-surgical unit after hip
replacement surgery. The nurse reviews the admission orders and notes that the client is on
warfarin, has a bedside commode, and has been ordered ambulation with assistance twice
daily. During the initial safety assessment, the nurse discovers that the call light is on the
overbed table out of the client's reach and the floor has a small water spill near the
bathroom. Which action should the nurse take first?
A. Place the call light in the client's dominant hand and teach its use before leaving the room
B. Notify the physical therapy department to schedule the client's first ambulation session
C. Immediately clean the water spill and then place the call light within the client's reach
D. Contact the physician to discuss holding the next dose of warfarin due to fall risk
Correct Answer: A
Rationale: The call light is the most immediate safety priority because it empowers the client
to summon help and prevents unassisted attempts to get out of bed, which is the leading
cause of falls in hospitalized older adults. While cleaning the spill is important, it does not
address the client's immediate need to communicate distress or request assistance. Always
eliminate environmental hazards after ensuring the client has a reliable way to call for help.
Question 2 of 50
A nurse on a busy telemetry unit receives a phone call from the laboratory reporting a critical
potassium level of 6.8 mEq/L for a 62-year-old client with end-stage renal disease. The client
is currently alert, has a new onset of peaked T waves on the monitor, and is receiving a
scheduled dose of furosemide via IV push. What is the nurse's priority action at this time?
,A. Administer the scheduled furosemide immediately to promote potassium excretion
B. Notify the provider of the critical value and anticipate an order for IV calcium gluconate
C. Repeat the blood draw to confirm the potassium result before taking any action
D. Encourage the client to drink a glass of orange juice to shift potassium intracellularly
Correct Answer: B
Rationale: Peaked T waves with a potassium of 6.8 mEq/L indicate life-threatening
hyperkalemia with cardiotoxicity, so the provider must be notified immediately to initiate
protective cardiac interventions such as calcium gluconate. Furosemide is a loop diuretic
that does lower potassium, but it acts too slowly to address acute cardiac membrane
instability. Delaying treatment to repeat a critical lab or offering oral potassium-containing
fluids would worsen the client's condition.
Question 3 of 50
During a fire drill on a pediatric unit, a nurse smells smoke coming from a storage closet near
the nurses' station. The alarm has not yet sounded, but visible haze is developing. The nurse's
first action is to follow the RACE protocol. Which step should the nurse complete before any
other?
A. Pull the fire alarm and announce the code and location overhead
B. Close all doors and windows in the immediate area to contain smoke spread
C. Remove all clients from the unit using the nearest available elevator
D. Extinguish the fire with the nearest appropriate fire extinguisher
Correct Answer: C
Rationale: RACE stands for Rescue, Alarm, Contain, Extinguish, so the nurse must first rescue
clients in immediate danger by moving them away from the fire zone. Pulling the alarm is
critical but comes after ensuring that any person in the immediate vicinity of the fire is moved
to safety. Elevators should never be used during a fire; clients must be evacuated via stairs or
horizontal relocation to a safe zone.
Question 4 of 50
A 54-year-old client with a central venous catheter (CVC) in the right subclavian vein develops
sudden onset of dyspnea, tachycardia, and an oxygen saturation drop from 96% to 84% while
turning in bed. The nurse auscultates bilateral breath sounds and notes they are present but
diminished on the right side. The client is anxious and reports chest tightness. What is the
nurse's most appropriate immediate action?
A. Place the client in high-Fowler's position and prepare for emergency chest tube insertion
B. Administer a STAT dose of morphine sulfate to reduce anxiety and chest discomfort
C. Flush the CVC with 10 mL of normal saline to verify catheter patency and function
D. Obtain a STAT chest x-ray and remain at the bedside while awaiting the results
, Correct Answer: A
Rationale: Sudden dyspnea, unilateral diminished breath sounds, and hypoxia in a client with a
subclavian CVC strongly suggest an iatrogenic pneumothorax, which requires immediate
high-Fowler's positioning to maximize lung expansion and preparation for chest tube
decompression. Morphine would mask symptoms and depress respirations without treating
the underlying air leak. Flushing the catheter or waiting for imaging could allow a tension
pneumothorax to develop.
Question 5 of 50
A nurse is caring for a client with active tuberculosis who is on airborne precautions in a
negative-pressure room. The nurse needs to administer a scheduled intramuscular injection
of vitamin B12. After performing hand hygiene and donning an N95 respirator, which sequence
of PPE application is correct before entering the room?
A. Apply a gown, then gloves, then goggles, and enter the room to administer the injection
B. Apply goggles, then a gown, then gloves, and enter the room to administer the injection
C. Apply gloves first, then a gown, then goggles, and enter the room to administer the
injection
D. Apply a gown first, then gloves, and enter the room because goggles are unnecessary for
an IM injection
Correct Answer: B
Rationale: For airborne precautions, the correct PPE donning sequence is respirator first, then
eye protection, then gown, then gloves, ensuring that each layer covers the previous one to
prevent self-contamination. Goggles must be worn because tuberculosis is transmitted via
airborne droplet nuclei that can contact mucous membranes during close contact. Gloves
should always be donned last so that they cover the gown cuffs and can be removed first
during doffing.
Question 6 of 50
A 43-year-old client with a history of opioid use disorder is admitted for appendectomy.
Postoperatively, the client reports pain rated 8 out of 10 and requests medication. The nurse
reviews the medication administration record and sees orders for acetaminophen 1,000 mg
PO every 6 hours, ibuprofen 600 mg PO every 8 hours, and morphine 2 mg IV every 4 hours as
needed for severe pain. The client received acetaminophen 3 hours ago and ibuprofen 5 hours
ago. What is the nurse's best action?
A. Administer the morphine 2 mg IV as prescribed because nonpharmacologic measures
have already failed
B. Offer a nonpharmacologic intervention such as repositioning and ice application before
giving morphine
Exit Review Official Practice Exam Actual
Exam 2026/2027 with Detailed Rationales |
Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
══════════════════════════════════════
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 78-year-old client with a history of falls is admitted to a medical-surgical unit after hip
replacement surgery. The nurse reviews the admission orders and notes that the client is on
warfarin, has a bedside commode, and has been ordered ambulation with assistance twice
daily. During the initial safety assessment, the nurse discovers that the call light is on the
overbed table out of the client's reach and the floor has a small water spill near the
bathroom. Which action should the nurse take first?
A. Place the call light in the client's dominant hand and teach its use before leaving the room
B. Notify the physical therapy department to schedule the client's first ambulation session
C. Immediately clean the water spill and then place the call light within the client's reach
D. Contact the physician to discuss holding the next dose of warfarin due to fall risk
Correct Answer: A
Rationale: The call light is the most immediate safety priority because it empowers the client
to summon help and prevents unassisted attempts to get out of bed, which is the leading
cause of falls in hospitalized older adults. While cleaning the spill is important, it does not
address the client's immediate need to communicate distress or request assistance. Always
eliminate environmental hazards after ensuring the client has a reliable way to call for help.
Question 2 of 50
A nurse on a busy telemetry unit receives a phone call from the laboratory reporting a critical
potassium level of 6.8 mEq/L for a 62-year-old client with end-stage renal disease. The client
is currently alert, has a new onset of peaked T waves on the monitor, and is receiving a
scheduled dose of furosemide via IV push. What is the nurse's priority action at this time?
,A. Administer the scheduled furosemide immediately to promote potassium excretion
B. Notify the provider of the critical value and anticipate an order for IV calcium gluconate
C. Repeat the blood draw to confirm the potassium result before taking any action
D. Encourage the client to drink a glass of orange juice to shift potassium intracellularly
Correct Answer: B
Rationale: Peaked T waves with a potassium of 6.8 mEq/L indicate life-threatening
hyperkalemia with cardiotoxicity, so the provider must be notified immediately to initiate
protective cardiac interventions such as calcium gluconate. Furosemide is a loop diuretic
that does lower potassium, but it acts too slowly to address acute cardiac membrane
instability. Delaying treatment to repeat a critical lab or offering oral potassium-containing
fluids would worsen the client's condition.
Question 3 of 50
During a fire drill on a pediatric unit, a nurse smells smoke coming from a storage closet near
the nurses' station. The alarm has not yet sounded, but visible haze is developing. The nurse's
first action is to follow the RACE protocol. Which step should the nurse complete before any
other?
A. Pull the fire alarm and announce the code and location overhead
B. Close all doors and windows in the immediate area to contain smoke spread
C. Remove all clients from the unit using the nearest available elevator
D. Extinguish the fire with the nearest appropriate fire extinguisher
Correct Answer: C
Rationale: RACE stands for Rescue, Alarm, Contain, Extinguish, so the nurse must first rescue
clients in immediate danger by moving them away from the fire zone. Pulling the alarm is
critical but comes after ensuring that any person in the immediate vicinity of the fire is moved
to safety. Elevators should never be used during a fire; clients must be evacuated via stairs or
horizontal relocation to a safe zone.
Question 4 of 50
A 54-year-old client with a central venous catheter (CVC) in the right subclavian vein develops
sudden onset of dyspnea, tachycardia, and an oxygen saturation drop from 96% to 84% while
turning in bed. The nurse auscultates bilateral breath sounds and notes they are present but
diminished on the right side. The client is anxious and reports chest tightness. What is the
nurse's most appropriate immediate action?
A. Place the client in high-Fowler's position and prepare for emergency chest tube insertion
B. Administer a STAT dose of morphine sulfate to reduce anxiety and chest discomfort
C. Flush the CVC with 10 mL of normal saline to verify catheter patency and function
D. Obtain a STAT chest x-ray and remain at the bedside while awaiting the results
, Correct Answer: A
Rationale: Sudden dyspnea, unilateral diminished breath sounds, and hypoxia in a client with a
subclavian CVC strongly suggest an iatrogenic pneumothorax, which requires immediate
high-Fowler's positioning to maximize lung expansion and preparation for chest tube
decompression. Morphine would mask symptoms and depress respirations without treating
the underlying air leak. Flushing the catheter or waiting for imaging could allow a tension
pneumothorax to develop.
Question 5 of 50
A nurse is caring for a client with active tuberculosis who is on airborne precautions in a
negative-pressure room. The nurse needs to administer a scheduled intramuscular injection
of vitamin B12. After performing hand hygiene and donning an N95 respirator, which sequence
of PPE application is correct before entering the room?
A. Apply a gown, then gloves, then goggles, and enter the room to administer the injection
B. Apply goggles, then a gown, then gloves, and enter the room to administer the injection
C. Apply gloves first, then a gown, then goggles, and enter the room to administer the
injection
D. Apply a gown first, then gloves, and enter the room because goggles are unnecessary for
an IM injection
Correct Answer: B
Rationale: For airborne precautions, the correct PPE donning sequence is respirator first, then
eye protection, then gown, then gloves, ensuring that each layer covers the previous one to
prevent self-contamination. Goggles must be worn because tuberculosis is transmitted via
airborne droplet nuclei that can contact mucous membranes during close contact. Gloves
should always be donned last so that they cover the gown cuffs and can be removed first
during doffing.
Question 6 of 50
A 43-year-old client with a history of opioid use disorder is admitted for appendectomy.
Postoperatively, the client reports pain rated 8 out of 10 and requests medication. The nurse
reviews the medication administration record and sees orders for acetaminophen 1,000 mg
PO every 6 hours, ibuprofen 600 mg PO every 8 hours, and morphine 2 mg IV every 4 hours as
needed for severe pain. The client received acetaminophen 3 hours ago and ibuprofen 5 hours
ago. What is the nurse's best action?
A. Administer the morphine 2 mg IV as prescribed because nonpharmacologic measures
have already failed
B. Offer a nonpharmacologic intervention such as repositioning and ice application before
giving morphine
