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HESI COMPREHENSIVE/EXIT EXAM 2026
QUESTIONS LATEST VERSION QUESTIONS AND
ANSWERS
HESI COMPREHENSIVE/EXIT EXAM
250 Practice Questions with Rationales
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1-65)
1. A charge nurse is making shift assignments on a medical-surgical unit. Which client
should the charge nurse assign to the most experienced registered nurse?
A. A 65-year-old client who is 2 days post-operative following a total knee replacement and
is stable
B. A 72-year-old client who has a new diagnosis of heart failure and is receiving a titratable
IV infusion of dobutamine
C. A 45-year-old client with diabetes who requires insulin administration before meals
D. A 58-year-old client with a surgical wound who requires a sterile dressing change
Correct Answer: B
Rationale: Clients receiving titratable IV infusions (vasoactive medications like dobutamine)
require the most experienced RN due to the complexity and potential for adverse effects. The
other clients are stable and can be assigned to less experienced RNs or LPNs.
2. A nurse is delegating tasks to an assistive personnel (AP). Which of the following
tasks is appropriate for the RN to delegate to the AP?
A. Performing an initial admission assessment on a newly admitted client
B. Assisting a client with a bath and hair care
C. Developing a plan of care for a client with diabetes
D. Administering a subcutaneous injection of heparin
Correct Answer: B
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Rationale: The RN can delegate activities of daily living (ADLs), such as bathing, to
assistive personnel. Initial assessments and plan of care development require the RN's
assessment and clinical judgment and cannot be delegated. Medication administration is not
within the AP's scope of practice.
3. A charge nurse is making assignments for the shift. Which principle should guide
delegation?
A. Delegate only tasks that are within the scope of practice of the delegatee
B. Delegate the most complex tasks to the newest staff members
C. Delegate all tasks to the staff member with the most experience
D. Delegate tasks based on the staff member's personal preference
Correct Answer: A
Rationale: The first and most important principle of delegation is to ensure the task is within
the delegatee's scope of practice and competency. Delegation should be based on the right
task, right circumstance, right person, right direction/communication, and right
supervision/evaluation.
4. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client who is 1 day post-operative and requesting pain medication
B. A client with diabetes who has a blood glucose level of 55 mg/dL and is diaphoretic and
confused
C. A client with pneumonia who has a temperature of 101.2°F (38.4°C)
D. A client with a new colostomy who is asking for assistance with changing the appliance
Correct Answer: B
Rationale: The client with a blood glucose of 55 mg/dL, diaphoresis, and confusion is
experiencing symptomatic hypoglycemia, which is an acute, potentially life-threatening
condition requiring immediate intervention.
5. A nurse is delegating tasks to a licensed practical nurse (LPN). Which of the following
tasks is appropriate for the RN to delegate to the LPN?
A. Administering a scheduled oral antibiotic to a stable client
B. Performing a comprehensive admission assessment
C. Developing the initial nursing plan of care
D. Providing discharge teaching to a client and family
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Correct Answer: A
Rationale: LPNs can administer medications to stable clients, as this falls within their scope
of practice. Comprehensive assessments, care plan development, and discharge teaching
require the RN's assessment and clinical judgment.
6. A nurse manager is implementing a new scheduling system. The manager should
identify which of the following as a priority when making staffing assignments?
A. Staff members' personal preferences
B. Client acuity and staffing mix
C. Staff members' years of experience only
D. The number of staff available, regardless of skill mix
Correct Answer: B
Rationale: The priority when making staffing assignments is to match client acuity with the
appropriate staffing mix and competency levels. Client safety requires that the right nurse
with the right skills cares for the right client.
7. A nurse is preparing to delegate a task to an AP. Which of the following should the
nurse include in the delegation process?
A. Provide clear, concise instructions and expected outcomes
B. Delegate the task without supervision
C. Delegate the task and leave the unit
D. Delegate the task without providing feedback
Correct Answer: A
Rationale: The five rights of delegation include the right direction/communication, which
requires providing clear, concise instructions and expected outcomes. Supervision is always
required.
8. A nurse is caring for a client who has a new tracheostomy. Which of the following
tasks is appropriate to delegate to an LPN?
A. Assessing the tracheostomy site for signs of infection
B. Suctioning the tracheostomy
C. Developing the client's plan of care
D. Performing tracheostomy tube change
Correct Answer: B
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Rationale: Suctioning a tracheostomy is within the LPN's scope of practice for a stable
client. Initial assessment and plan of care development require RN-level assessment and
judgment.
9. A charge nurse on a busy medical-surgical unit has an RN, an LPN, and an AP on the
shift. Which client assignment is most appropriate for the LPN?
A. A client who is 1 hour post-operative and is unstable
B. A client who is stable and requires wound care and medication administration
C. A client who requires a comprehensive admission assessment
D. A client who requires discharge teaching
Correct Answer: B
Rationale: LPNs can provide care to stable clients, including wound care and medication
administration. Unstable clients, comprehensive admissions, and discharge teaching require
RN-level assessment and clinical judgment.
10. A nurse is delegating a task to an AP. Which of the following should the nurse do to
ensure safe delegation?
A. Assess the AP's competency and skill level
B. Delegate the task without providing supervision
C. Delegate the task and assume the AP will ask questions if needed
D. Delegate the task without providing feedback
Correct Answer: A
Rationale: Before delegating, the nurse must assess the AP's competency and skill level to
ensure the task can be performed safely. Supervision is always required.
11. A nurse is making assignments for the shift. Which client should the nurse assign to
the most experienced RN?
A. A client with diabetes who requires insulin administration
B. A client with heart failure who is receiving a titratable IV infusion of dobutamine
C. A client with COPD who requires oxygen therapy
D. A client with a surgical wound who requires dressing change
Correct Answer: B
HESI COMPREHENSIVE/EXIT EXAM 2026
QUESTIONS LATEST VERSION QUESTIONS AND
ANSWERS
HESI COMPREHENSIVE/EXIT EXAM
250 Practice Questions with Rationales
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1-65)
1. A charge nurse is making shift assignments on a medical-surgical unit. Which client
should the charge nurse assign to the most experienced registered nurse?
A. A 65-year-old client who is 2 days post-operative following a total knee replacement and
is stable
B. A 72-year-old client who has a new diagnosis of heart failure and is receiving a titratable
IV infusion of dobutamine
C. A 45-year-old client with diabetes who requires insulin administration before meals
D. A 58-year-old client with a surgical wound who requires a sterile dressing change
Correct Answer: B
Rationale: Clients receiving titratable IV infusions (vasoactive medications like dobutamine)
require the most experienced RN due to the complexity and potential for adverse effects. The
other clients are stable and can be assigned to less experienced RNs or LPNs.
2. A nurse is delegating tasks to an assistive personnel (AP). Which of the following
tasks is appropriate for the RN to delegate to the AP?
A. Performing an initial admission assessment on a newly admitted client
B. Assisting a client with a bath and hair care
C. Developing a plan of care for a client with diabetes
D. Administering a subcutaneous injection of heparin
Correct Answer: B
, Page 2 of 73
Rationale: The RN can delegate activities of daily living (ADLs), such as bathing, to
assistive personnel. Initial assessments and plan of care development require the RN's
assessment and clinical judgment and cannot be delegated. Medication administration is not
within the AP's scope of practice.
3. A charge nurse is making assignments for the shift. Which principle should guide
delegation?
A. Delegate only tasks that are within the scope of practice of the delegatee
B. Delegate the most complex tasks to the newest staff members
C. Delegate all tasks to the staff member with the most experience
D. Delegate tasks based on the staff member's personal preference
Correct Answer: A
Rationale: The first and most important principle of delegation is to ensure the task is within
the delegatee's scope of practice and competency. Delegation should be based on the right
task, right circumstance, right person, right direction/communication, and right
supervision/evaluation.
4. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client who is 1 day post-operative and requesting pain medication
B. A client with diabetes who has a blood glucose level of 55 mg/dL and is diaphoretic and
confused
C. A client with pneumonia who has a temperature of 101.2°F (38.4°C)
D. A client with a new colostomy who is asking for assistance with changing the appliance
Correct Answer: B
Rationale: The client with a blood glucose of 55 mg/dL, diaphoresis, and confusion is
experiencing symptomatic hypoglycemia, which is an acute, potentially life-threatening
condition requiring immediate intervention.
5. A nurse is delegating tasks to a licensed practical nurse (LPN). Which of the following
tasks is appropriate for the RN to delegate to the LPN?
A. Administering a scheduled oral antibiotic to a stable client
B. Performing a comprehensive admission assessment
C. Developing the initial nursing plan of care
D. Providing discharge teaching to a client and family
, Page 3 of 73
Correct Answer: A
Rationale: LPNs can administer medications to stable clients, as this falls within their scope
of practice. Comprehensive assessments, care plan development, and discharge teaching
require the RN's assessment and clinical judgment.
6. A nurse manager is implementing a new scheduling system. The manager should
identify which of the following as a priority when making staffing assignments?
A. Staff members' personal preferences
B. Client acuity and staffing mix
C. Staff members' years of experience only
D. The number of staff available, regardless of skill mix
Correct Answer: B
Rationale: The priority when making staffing assignments is to match client acuity with the
appropriate staffing mix and competency levels. Client safety requires that the right nurse
with the right skills cares for the right client.
7. A nurse is preparing to delegate a task to an AP. Which of the following should the
nurse include in the delegation process?
A. Provide clear, concise instructions and expected outcomes
B. Delegate the task without supervision
C. Delegate the task and leave the unit
D. Delegate the task without providing feedback
Correct Answer: A
Rationale: The five rights of delegation include the right direction/communication, which
requires providing clear, concise instructions and expected outcomes. Supervision is always
required.
8. A nurse is caring for a client who has a new tracheostomy. Which of the following
tasks is appropriate to delegate to an LPN?
A. Assessing the tracheostomy site for signs of infection
B. Suctioning the tracheostomy
C. Developing the client's plan of care
D. Performing tracheostomy tube change
Correct Answer: B
, Page 4 of 73
Rationale: Suctioning a tracheostomy is within the LPN's scope of practice for a stable
client. Initial assessment and plan of care development require RN-level assessment and
judgment.
9. A charge nurse on a busy medical-surgical unit has an RN, an LPN, and an AP on the
shift. Which client assignment is most appropriate for the LPN?
A. A client who is 1 hour post-operative and is unstable
B. A client who is stable and requires wound care and medication administration
C. A client who requires a comprehensive admission assessment
D. A client who requires discharge teaching
Correct Answer: B
Rationale: LPNs can provide care to stable clients, including wound care and medication
administration. Unstable clients, comprehensive admissions, and discharge teaching require
RN-level assessment and clinical judgment.
10. A nurse is delegating a task to an AP. Which of the following should the nurse do to
ensure safe delegation?
A. Assess the AP's competency and skill level
B. Delegate the task without providing supervision
C. Delegate the task and assume the AP will ask questions if needed
D. Delegate the task without providing feedback
Correct Answer: A
Rationale: Before delegating, the nurse must assess the AP's competency and skill level to
ensure the task can be performed safely. Supervision is always required.
11. A nurse is making assignments for the shift. Which client should the nurse assign to
the most experienced RN?
A. A client with diabetes who requires insulin administration
B. A client with heart failure who is receiving a titratable IV infusion of dobutamine
C. A client with COPD who requires oxygen therapy
D. A client with a surgical wound who requires dressing change
Correct Answer: B
