The Ultimate 2026 HESI RN Exit Exam
Prep: NGN-Style Questions, Answers,
and Evidence-Based Rationales for
NCLEX Readiness
Questions 1–20: Fundamentals & Safety
1. A nurse is preparing to insert a Foley catheter. Which
technique is correct?
A. Use sterile gloves only
B. Use clean gloves and sterile equipment
C. Use sterile gloves, sterile drapes, and sterile solution
D. Use non-sterile gloves and clean equipment
Answer: C – Rationale: Indwelling catheter insertion is a sterile
procedure requiring full sterile field, drapes, gloves, and solution.
2. A patient is on fall precautions. Which intervention is most
appropriate?
A. Keep bed in high position
B. Place all four side rails up
C. Keep call light within reach
D. Apply wrist restraints
Answer: C – Rationale: Call light access promotes independence.
High beds and four rails increase fall risk; restraints are a last
resort.
,3. A nurse observes a colleague open a sterile pack and the
outer 1-inch border touches a non-sterile surface. What is the
correct action?
A. Continue using it, avoiding the border
B. Discard the entire pack
C. Cut off the contaminated border
D. Use sterile gloves to handle the border
Answer: B – Rationale: The 1-inch border of a sterile field is
considered contaminated; the entire field is compromised.
4. Which food should a patient on a low-sodium diet avoid?
A. Fresh apples
B. Grilled chicken
C. Canned tomato soup
D. Steamed rice
Answer: C – Rationale: Canned soups are high in sodium (up to
800+ mg per serving).
5. A nurse is applying restraints. How often must the nurse
assess circulation and neurovascular status?
A. Every hour
B. Every 2 hours
C. Every 4 hours
D. Every shift
Answer: B – Rationale: Restraint checks (circulation, skin integrity,
ROM, toileting) must occur at least every 2 hours.
6. A client reports difficulty sleeping. Which non-
pharmacologic intervention is best?
A. Drink warm milk before bed
B. Exercise vigorously before bed
,C. Keep the room brightly lit
D. Take a daytime nap
Answer: A – Rationale: Warm milk contains tryptophan and
promotes sleep; exercise should be earlier, and naps disrupt
nighttime sleep.
7. A nurse is performing hand hygiene. Which action is most
effective?
A. Using cold water
B. Rubbing with soap for at least 20 seconds
C. Using only water
D. Drying with a cloth towel
Answer: B – Rationale: 20 seconds with friction mechanically
removes pathogens.
8. A patient with a PEG tube requires feeding. What is the
priority prior to administration?
A. Flush with 50 mL of air
B. Check gastric residual volume
C. Warm the formula to body temperature
D. Place patient in supine position
Answer: B – Rationale: Checking residual prevents aspiration and
confirms tube placement; aspirating gastric contents is the
primary safety check.
9. A client is receiving oxygen via nasal cannula at 4 L/min.
Which complication should the nurse monitor?
A. Carbon dioxide narcosis
B. Oxygen toxicity
C. Nasal mucosa dryness
D. Pneumothorax
, Answer: C – Rationale: Nasal cannula dries mucous membranes;
humidification may be needed. Oxygen toxicity occurs at high
concentrations >50% for extended periods.
10. A nurse is teaching a patient about incentive spirometry.
Which instruction is correct?
A. Exhale forcefully into the device
B. Inhale slowly and deeply, then hold breath for 3–5 seconds
C. Use it only once daily
D. Cough immediately after each use
Answer: B – Rationale: Sustained inhalation opens alveoli and
prevents atelectasis.
11. A postoperative patient has a Jackson-Pratt (JP) drain.
The nurse should:
A. Empty and compress it once per shift
B. Strip the tubing toward the patient
C. Empty and compress it every 4 hours
D. Keep it below the incision site
Answer: D – Rationale: Gravity drainage requires the bulb below
the wound; stripping is done away from patient to create suction,
and emptying frequency depends on output.
12. A patient with a new colostomy reports a dark purple
stoma. What is the priority action?
A. Document as expected finding
B. Notify the provider immediately
C. Apply a warm compress
D. Re-measure the stoma size
Answer: B – Rationale: Purple/blue indicates ischemia or necrosis
– an emergency.
Prep: NGN-Style Questions, Answers,
and Evidence-Based Rationales for
NCLEX Readiness
Questions 1–20: Fundamentals & Safety
1. A nurse is preparing to insert a Foley catheter. Which
technique is correct?
A. Use sterile gloves only
B. Use clean gloves and sterile equipment
C. Use sterile gloves, sterile drapes, and sterile solution
D. Use non-sterile gloves and clean equipment
Answer: C – Rationale: Indwelling catheter insertion is a sterile
procedure requiring full sterile field, drapes, gloves, and solution.
2. A patient is on fall precautions. Which intervention is most
appropriate?
A. Keep bed in high position
B. Place all four side rails up
C. Keep call light within reach
D. Apply wrist restraints
Answer: C – Rationale: Call light access promotes independence.
High beds and four rails increase fall risk; restraints are a last
resort.
,3. A nurse observes a colleague open a sterile pack and the
outer 1-inch border touches a non-sterile surface. What is the
correct action?
A. Continue using it, avoiding the border
B. Discard the entire pack
C. Cut off the contaminated border
D. Use sterile gloves to handle the border
Answer: B – Rationale: The 1-inch border of a sterile field is
considered contaminated; the entire field is compromised.
4. Which food should a patient on a low-sodium diet avoid?
A. Fresh apples
B. Grilled chicken
C. Canned tomato soup
D. Steamed rice
Answer: C – Rationale: Canned soups are high in sodium (up to
800+ mg per serving).
5. A nurse is applying restraints. How often must the nurse
assess circulation and neurovascular status?
A. Every hour
B. Every 2 hours
C. Every 4 hours
D. Every shift
Answer: B – Rationale: Restraint checks (circulation, skin integrity,
ROM, toileting) must occur at least every 2 hours.
6. A client reports difficulty sleeping. Which non-
pharmacologic intervention is best?
A. Drink warm milk before bed
B. Exercise vigorously before bed
,C. Keep the room brightly lit
D. Take a daytime nap
Answer: A – Rationale: Warm milk contains tryptophan and
promotes sleep; exercise should be earlier, and naps disrupt
nighttime sleep.
7. A nurse is performing hand hygiene. Which action is most
effective?
A. Using cold water
B. Rubbing with soap for at least 20 seconds
C. Using only water
D. Drying with a cloth towel
Answer: B – Rationale: 20 seconds with friction mechanically
removes pathogens.
8. A patient with a PEG tube requires feeding. What is the
priority prior to administration?
A. Flush with 50 mL of air
B. Check gastric residual volume
C. Warm the formula to body temperature
D. Place patient in supine position
Answer: B – Rationale: Checking residual prevents aspiration and
confirms tube placement; aspirating gastric contents is the
primary safety check.
9. A client is receiving oxygen via nasal cannula at 4 L/min.
Which complication should the nurse monitor?
A. Carbon dioxide narcosis
B. Oxygen toxicity
C. Nasal mucosa dryness
D. Pneumothorax
, Answer: C – Rationale: Nasal cannula dries mucous membranes;
humidification may be needed. Oxygen toxicity occurs at high
concentrations >50% for extended periods.
10. A nurse is teaching a patient about incentive spirometry.
Which instruction is correct?
A. Exhale forcefully into the device
B. Inhale slowly and deeply, then hold breath for 3–5 seconds
C. Use it only once daily
D. Cough immediately after each use
Answer: B – Rationale: Sustained inhalation opens alveoli and
prevents atelectasis.
11. A postoperative patient has a Jackson-Pratt (JP) drain.
The nurse should:
A. Empty and compress it once per shift
B. Strip the tubing toward the patient
C. Empty and compress it every 4 hours
D. Keep it below the incision site
Answer: D – Rationale: Gravity drainage requires the bulb below
the wound; stripping is done away from patient to create suction,
and emptying frequency depends on output.
12. A patient with a new colostomy reports a dark purple
stoma. What is the priority action?
A. Document as expected finding
B. Notify the provider immediately
C. Apply a warm compress
D. Re-measure the stoma size
Answer: B – Rationale: Purple/blue indicates ischemia or necrosis
– an emergency.
