Page 1 of 89
HESI EXIT RN V1 EXAM 2026 QUESTIONS LATEST VERSION
QUESTIONS AND ANSWERS
HESI EXIT RN V1 EXAM: 250 PRACTICE QUESTIONS WITH RATIONALES
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1-30)
1. The nurse is assigning care for a group of clients on a medical-surgical unit. Which
client should the nurse assign to the licensed practical nurse (LPN) rather than the
unlicensed assistive personnel (UAP) to ensure safe and appropriate delegation of care?
A) A 68-year-old client who requires assistance with ambulation using a walker
B) A 45-year-old client who needs vital signs checked every 4 hours
C) A 72-year-old client who has an indwelling urinary catheter requiring daily care
D) A 55-year-old client with diabetes who needs insulin administration before meals
Rationale: Insulin administration is a medication task that requires nursing knowledge and
skill, making it appropriate for delegation to an LPN . The LPN's scope includes
administration of oral, subcutaneous, and intramuscular medications in stable patients.
Assisting with ambulation (A), measuring vital signs (B), and providing catheter care (C) are
tasks that can be safely delegated to UAP.
2. The nurse is preparing a client for a scheduled surgical procedure. The client asks the
nurse, "Why do I have to sign this consent form?" Which response by the nurse is most
appropriate regarding the informed consent process?
A) "Your signature confirms you understand the procedure and its risks"
B) "The consent form is a hospital requirement for all surgical patients"
C) "Your surgeon will explain everything you need to know about the surgery"
D) "The form protects the hospital from liability if complications occur"
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Rationale: The nurse's signature on the consent form confirms that the client voluntarily
gave permission after receiving information about the procedure . The surgeon is responsible
for providing information about risks, benefits, and alternatives, but the nurse's role includes
witnessing the signature and ensuring understanding. Option A correctly identifies the nurse's
responsibility in the consent process.
3. A client is placed in wrist restraints after repeatedly attempting to remove their
nasogastric tube. Which nursing action is essential to ensure the safety of this client who
is in restraints?
A) Document the reason for restraint use and the client's behavior
B) Tie the restraints securely to the bed frame rather than the side rails
C) Remove the restraints every 4 hours for range-of-motion exercises
D) Obtain a PRN order for restraints to use as needed
Rationale: Restraints must be tied to the bed frame, not the side rails, to prevent injury if the
side rail is lowered . Documentation of the reason for restraint use (A) is important but not
the most essential safety action. Restraints should be removed every 2 hours (not 4 hours) for
range-of-motion and skin assessment . Restraints require a specific order, not a PRN order
(D).
4. The nurse is providing hand-off communication using the SBAR format when
transferring a client to the intensive care unit. Which component belongs in the
"Situation" section of the SBAR communication?
A) The client's current vital signs and recent changes in condition
B) The nurse's recommendation for the receiving unit to implement
C) The client's history and reason for admission to the hospital
D) The nurse's assessment findings and clinical concern
Rationale: The "Situation" in SBAR includes the client's history and reason for admission or
the current problem requiring attention . Vital signs and changes belong in the "Background"
section (A). Recommendations belong in the "Recommendation" section (B). Assessment
findings and concern belong in the "Assessment" section (D).
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5. A client with a "Do Not Resuscitate" (DNR) order begins to show signs of impending
death. After notifying the family of the client's status, what priority action should the
nurse implement?
A) Document the signs of impending death in the medical record
B) Convey the client's status to the hospital chaplain for spiritual support
C) Determine the client's need for pain medication and symptom management
D) Update the nurse manager on the client's changing condition
Rationale: The priority action is to assess and address the client's need for pain medication
and symptom management to ensure comfort at the end of life . While documentation (A),
spiritual support (B), and updating the nurse manager (D) are appropriate, comfort measures
are the priority.
6. A nurse is caring for a client who threatens to harm themselves and others. The nurse
is legally obligated to breach confidentiality in which situation related to client
information?
A) When a family member offers information about their loved one's condition
B) When the client threatens self-harm and harm to others
C) When the healthcare provider decides the family has a right to know the diagnosis
D) When a visitor insists that permission has been granted by the client
Rationale: Privacy and confidentiality are legally protected, but an exception is made when
the client poses a threat to themselves or others . The duty to protect outweighs the duty to
maintain confidentiality in cases of imminent harm. Family members (A), healthcare
providers (C), and visitors (D) do not override confidentiality requirements.
7. The nurse is preparing to administer a blood transfusion of packed red blood cells.
Which IV solution should the nurse use to prime the blood tubing?
A) 5% dextrose in water
B) 0.45% sodium chloride
C) Lactated Ringer's solution
D) 0.9% sodium chloride
, Page 4 of 89
Rationale: Only 0.9% sodium chloride (normal saline) is compatible with packed red blood
cells; dextrose causes hemolysis, and lactated Ringer's contains calcium which can cause
clotting in the tubing .
8. The nurse is assessing a client with a new prescription for wrist restraints. Which
action is most important for the nurse to implement?
A) Document the reason for restraint use in the medical record
B) Tie the restraints to the bed frame, not the side rails
C) Remove restraints every 4 hours for range of motion
D) Obtain a PRN order for restraint use as needed
Rationale: Restraints must be tied to the bed frame, not the side rails, to prevent injury if the
side rail is lowered . Documentation (A) is required but not the most important safety action.
Restraints should be removed every 2 hours (not 4 hours) for range of motion (C). Restraints
require a specific order, not a PRN order (D).
9. The nurse is assessing a client in a long-term care facility who is at highest risk for
development of decubitus ulcers. Which client would the nurse identify as being at
greatest risk?
A) A 79-year-old malnourished client on bed rest
B) An obese client who uses a wheelchair for mobility
C) A client who had 3 incontinent diarrheal stools
D) An 80-year-old ambulatory diabetic client
Rationale: The client who had 3 incontinent diarrheal stools is at highest risk because
moisture from incontinence contributes to skin breakdown, and diarrhea is a significant risk
factor for pressure injury development . While malnutrition (A), obesity (B), and diabetes (D)
are risk factors, incontinence with diarrhea poses a more immediate risk.
10. The nurse is caring for a client who is scheduled for a spiral CT scan with contrast.
Which information in the client's history requires follow up by the nurse before the
procedure?
A) History of asthma
B) Takes metformin for type 2 diabetes
HESI EXIT RN V1 EXAM 2026 QUESTIONS LATEST VERSION
QUESTIONS AND ANSWERS
HESI EXIT RN V1 EXAM: 250 PRACTICE QUESTIONS WITH RATIONALES
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1-30)
1. The nurse is assigning care for a group of clients on a medical-surgical unit. Which
client should the nurse assign to the licensed practical nurse (LPN) rather than the
unlicensed assistive personnel (UAP) to ensure safe and appropriate delegation of care?
A) A 68-year-old client who requires assistance with ambulation using a walker
B) A 45-year-old client who needs vital signs checked every 4 hours
C) A 72-year-old client who has an indwelling urinary catheter requiring daily care
D) A 55-year-old client with diabetes who needs insulin administration before meals
Rationale: Insulin administration is a medication task that requires nursing knowledge and
skill, making it appropriate for delegation to an LPN . The LPN's scope includes
administration of oral, subcutaneous, and intramuscular medications in stable patients.
Assisting with ambulation (A), measuring vital signs (B), and providing catheter care (C) are
tasks that can be safely delegated to UAP.
2. The nurse is preparing a client for a scheduled surgical procedure. The client asks the
nurse, "Why do I have to sign this consent form?" Which response by the nurse is most
appropriate regarding the informed consent process?
A) "Your signature confirms you understand the procedure and its risks"
B) "The consent form is a hospital requirement for all surgical patients"
C) "Your surgeon will explain everything you need to know about the surgery"
D) "The form protects the hospital from liability if complications occur"
, Page 2 of 89
Rationale: The nurse's signature on the consent form confirms that the client voluntarily
gave permission after receiving information about the procedure . The surgeon is responsible
for providing information about risks, benefits, and alternatives, but the nurse's role includes
witnessing the signature and ensuring understanding. Option A correctly identifies the nurse's
responsibility in the consent process.
3. A client is placed in wrist restraints after repeatedly attempting to remove their
nasogastric tube. Which nursing action is essential to ensure the safety of this client who
is in restraints?
A) Document the reason for restraint use and the client's behavior
B) Tie the restraints securely to the bed frame rather than the side rails
C) Remove the restraints every 4 hours for range-of-motion exercises
D) Obtain a PRN order for restraints to use as needed
Rationale: Restraints must be tied to the bed frame, not the side rails, to prevent injury if the
side rail is lowered . Documentation of the reason for restraint use (A) is important but not
the most essential safety action. Restraints should be removed every 2 hours (not 4 hours) for
range-of-motion and skin assessment . Restraints require a specific order, not a PRN order
(D).
4. The nurse is providing hand-off communication using the SBAR format when
transferring a client to the intensive care unit. Which component belongs in the
"Situation" section of the SBAR communication?
A) The client's current vital signs and recent changes in condition
B) The nurse's recommendation for the receiving unit to implement
C) The client's history and reason for admission to the hospital
D) The nurse's assessment findings and clinical concern
Rationale: The "Situation" in SBAR includes the client's history and reason for admission or
the current problem requiring attention . Vital signs and changes belong in the "Background"
section (A). Recommendations belong in the "Recommendation" section (B). Assessment
findings and concern belong in the "Assessment" section (D).
, Page 3 of 89
5. A client with a "Do Not Resuscitate" (DNR) order begins to show signs of impending
death. After notifying the family of the client's status, what priority action should the
nurse implement?
A) Document the signs of impending death in the medical record
B) Convey the client's status to the hospital chaplain for spiritual support
C) Determine the client's need for pain medication and symptom management
D) Update the nurse manager on the client's changing condition
Rationale: The priority action is to assess and address the client's need for pain medication
and symptom management to ensure comfort at the end of life . While documentation (A),
spiritual support (B), and updating the nurse manager (D) are appropriate, comfort measures
are the priority.
6. A nurse is caring for a client who threatens to harm themselves and others. The nurse
is legally obligated to breach confidentiality in which situation related to client
information?
A) When a family member offers information about their loved one's condition
B) When the client threatens self-harm and harm to others
C) When the healthcare provider decides the family has a right to know the diagnosis
D) When a visitor insists that permission has been granted by the client
Rationale: Privacy and confidentiality are legally protected, but an exception is made when
the client poses a threat to themselves or others . The duty to protect outweighs the duty to
maintain confidentiality in cases of imminent harm. Family members (A), healthcare
providers (C), and visitors (D) do not override confidentiality requirements.
7. The nurse is preparing to administer a blood transfusion of packed red blood cells.
Which IV solution should the nurse use to prime the blood tubing?
A) 5% dextrose in water
B) 0.45% sodium chloride
C) Lactated Ringer's solution
D) 0.9% sodium chloride
, Page 4 of 89
Rationale: Only 0.9% sodium chloride (normal saline) is compatible with packed red blood
cells; dextrose causes hemolysis, and lactated Ringer's contains calcium which can cause
clotting in the tubing .
8. The nurse is assessing a client with a new prescription for wrist restraints. Which
action is most important for the nurse to implement?
A) Document the reason for restraint use in the medical record
B) Tie the restraints to the bed frame, not the side rails
C) Remove restraints every 4 hours for range of motion
D) Obtain a PRN order for restraint use as needed
Rationale: Restraints must be tied to the bed frame, not the side rails, to prevent injury if the
side rail is lowered . Documentation (A) is required but not the most important safety action.
Restraints should be removed every 2 hours (not 4 hours) for range of motion (C). Restraints
require a specific order, not a PRN order (D).
9. The nurse is assessing a client in a long-term care facility who is at highest risk for
development of decubitus ulcers. Which client would the nurse identify as being at
greatest risk?
A) A 79-year-old malnourished client on bed rest
B) An obese client who uses a wheelchair for mobility
C) A client who had 3 incontinent diarrheal stools
D) An 80-year-old ambulatory diabetic client
Rationale: The client who had 3 incontinent diarrheal stools is at highest risk because
moisture from incontinence contributes to skin breakdown, and diarrhea is a significant risk
factor for pressure injury development . While malnutrition (A), obesity (B), and diabetes (D)
are risk factors, incontinence with diarrhea poses a more immediate risk.
10. The nurse is caring for a client who is scheduled for a spiral CT scan with contrast.
Which information in the client's history requires follow up by the nurse before the
procedure?
A) History of asthma
B) Takes metformin for type 2 diabetes
