HESI RN Exit Exam 2026 — Original NGN-Style
Prac ce Test with Ra onales
1. The nurse receives report on four clients. Which client should be assessed
first?
A. A client with chronic arthritis requesting an analgesic
B. A postoperative client with oxygen saturation of 88% on room air
C. A client awaiting discharge teaching
D. A client with blood pressure of 148/88 mm Hg
Correct Answer: B
Rationale: An oxygen saturation of 88% indicates impaired oxygenation. Airway and breathing
problems take priority over nonurgent pain management, teaching, and stable hypertension.
2. Which task is appropriate for the RN to delegate to an experienced UAP?
A. Assess a client's postoperative incision
B. Teach a client about insulin administration
C. Obtain routine vital signs for a stable client
D. Evaluate the effectiveness of pain medication
Correct Answer: C
Rationale: UAPs may perform routine, predictable tasks such as obtaining vital signs.
Assessment, teaching, and evaluation remain the responsibility of the RN.
3. Which client assignment is most appropriate for an LPN/LVN?
A. A newly admitted client with chest pain
B. A stable client requiring routine dressing changes
C. A client receiving the first blood transfusion
D. A client with newly developed confusion
Correct Answer: B
,Rationale: Stable clients with predictable outcomes are generally appropriate for LPN/LVN
assignment, according to local scope-of-practice regulations.
4. A competent adult refuses a recommended surgical procedure. Which action
should the nurse take?
A. Ask the family to override the decision
B. Explain the consequences and respect the client's decision
C. Obtain consent from the spouse
D. Schedule the procedure anyway
Correct Answer: B
Rationale: Competent adults have the right to refuse treatment. The nurse should ensure the
client is informed and communicate the refusal to the healthcare team.
5. Which client requires immediate intervention?
A. A client reporting nausea after eating
B. A client with potassium of 6.4 mEq/L
C. A client requesting a sleeping medication
D. A client with a temperature of 37.8°C (100°F)
Correct Answer: B
Rationale: Severe hyperkalemia can cause life-threatening cardiac dysrhythmias and requires
immediate intervention.
6. The nurse suspects that a colleague is impaired while providing client care.
What is the priority action?
A. Ignore the behavior
B. Report concerns according to facility policy
C. Discuss the situation with other staff members
D. Wait until the next shift
Correct Answer: B
Rationale: Protecting clients is the priority. Suspected impairment should be reported promptly
through appropriate channels.
,7. Which intervention best prevents medication errors?
A. Administer medications quickly
B. Use two client identifiers before administration
C. Prepare medications for several clients simultaneously
D. Skip identification when familiar with the client
Correct Answer: B
Rationale: Using two approved client identifiers helps prevent wrong-client medication errors.
8. A nurse receives a prescription that appears unsafe. What should the nurse do
first?
A. Administer the medication
B. Clarify the prescription with the prescriber
C. Ask another nurse to administer it
D. Ignore the prescription
Correct Answer: B
Rationale: The nurse should question and clarify prescriptions that appear incorrect or unsafe
before implementation.
9. Which situation requires an incident report?
A. A client falls without apparent injury
B. A client refuses breakfast
C. A visitor arrives late
D. A medication is administered correctly
Correct Answer: A
Rationale: Falls and other unexpected events should be documented according to facility policy,
even when no injury is apparent.
10. Which action demonstrates client advocacy?
, A. Making decisions for the client
B. Supporting the client's informed choices
C. Withholding information to prevent anxiety
D. Following family wishes instead of the client's wishes
Correct Answer: B
Rationale: Advocacy includes protecting the client's rights and supporting informed decision-
making.
11. A client is being discharged with multiple new medications. Which action is
most important?
A. Provide written information only
B. Ask the client to repeat the instructions using teach-back
C. Give instructions rapidly
D. Ask a family member to sign the instructions
Correct Answer: B
Rationale: Teach-back helps verify that the client understands important discharge instructions.
12. Which client should the nurse assess first?
A. A client with COPD and oxygen saturation of 91%
B. A client with diabetes and blood glucose of 65 mg/dL
C. A client requesting assistance to the bathroom
D. A client reporting chronic back pain
Correct Answer: B
Rationale: Hypoglycemia can rapidly progress to neurological impairment and requires prompt
treatment.
13. A nurse is caring for a client with a language barrier. Which intervention is
best?
A. Use a family member as the interpreter
B. Speak louder
Prac ce Test with Ra onales
1. The nurse receives report on four clients. Which client should be assessed
first?
A. A client with chronic arthritis requesting an analgesic
B. A postoperative client with oxygen saturation of 88% on room air
C. A client awaiting discharge teaching
D. A client with blood pressure of 148/88 mm Hg
Correct Answer: B
Rationale: An oxygen saturation of 88% indicates impaired oxygenation. Airway and breathing
problems take priority over nonurgent pain management, teaching, and stable hypertension.
2. Which task is appropriate for the RN to delegate to an experienced UAP?
A. Assess a client's postoperative incision
B. Teach a client about insulin administration
C. Obtain routine vital signs for a stable client
D. Evaluate the effectiveness of pain medication
Correct Answer: C
Rationale: UAPs may perform routine, predictable tasks such as obtaining vital signs.
Assessment, teaching, and evaluation remain the responsibility of the RN.
3. Which client assignment is most appropriate for an LPN/LVN?
A. A newly admitted client with chest pain
B. A stable client requiring routine dressing changes
C. A client receiving the first blood transfusion
D. A client with newly developed confusion
Correct Answer: B
,Rationale: Stable clients with predictable outcomes are generally appropriate for LPN/LVN
assignment, according to local scope-of-practice regulations.
4. A competent adult refuses a recommended surgical procedure. Which action
should the nurse take?
A. Ask the family to override the decision
B. Explain the consequences and respect the client's decision
C. Obtain consent from the spouse
D. Schedule the procedure anyway
Correct Answer: B
Rationale: Competent adults have the right to refuse treatment. The nurse should ensure the
client is informed and communicate the refusal to the healthcare team.
5. Which client requires immediate intervention?
A. A client reporting nausea after eating
B. A client with potassium of 6.4 mEq/L
C. A client requesting a sleeping medication
D. A client with a temperature of 37.8°C (100°F)
Correct Answer: B
Rationale: Severe hyperkalemia can cause life-threatening cardiac dysrhythmias and requires
immediate intervention.
6. The nurse suspects that a colleague is impaired while providing client care.
What is the priority action?
A. Ignore the behavior
B. Report concerns according to facility policy
C. Discuss the situation with other staff members
D. Wait until the next shift
Correct Answer: B
Rationale: Protecting clients is the priority. Suspected impairment should be reported promptly
through appropriate channels.
,7. Which intervention best prevents medication errors?
A. Administer medications quickly
B. Use two client identifiers before administration
C. Prepare medications for several clients simultaneously
D. Skip identification when familiar with the client
Correct Answer: B
Rationale: Using two approved client identifiers helps prevent wrong-client medication errors.
8. A nurse receives a prescription that appears unsafe. What should the nurse do
first?
A. Administer the medication
B. Clarify the prescription with the prescriber
C. Ask another nurse to administer it
D. Ignore the prescription
Correct Answer: B
Rationale: The nurse should question and clarify prescriptions that appear incorrect or unsafe
before implementation.
9. Which situation requires an incident report?
A. A client falls without apparent injury
B. A client refuses breakfast
C. A visitor arrives late
D. A medication is administered correctly
Correct Answer: A
Rationale: Falls and other unexpected events should be documented according to facility policy,
even when no injury is apparent.
10. Which action demonstrates client advocacy?
, A. Making decisions for the client
B. Supporting the client's informed choices
C. Withholding information to prevent anxiety
D. Following family wishes instead of the client's wishes
Correct Answer: B
Rationale: Advocacy includes protecting the client's rights and supporting informed decision-
making.
11. A client is being discharged with multiple new medications. Which action is
most important?
A. Provide written information only
B. Ask the client to repeat the instructions using teach-back
C. Give instructions rapidly
D. Ask a family member to sign the instructions
Correct Answer: B
Rationale: Teach-back helps verify that the client understands important discharge instructions.
12. Which client should the nurse assess first?
A. A client with COPD and oxygen saturation of 91%
B. A client with diabetes and blood glucose of 65 mg/dL
C. A client requesting assistance to the bathroom
D. A client reporting chronic back pain
Correct Answer: B
Rationale: Hypoglycemia can rapidly progress to neurological impairment and requires prompt
treatment.
13. A nurse is caring for a client with a language barrier. Which intervention is
best?
A. Use a family member as the interpreter
B. Speak louder
