HESI Exit Exam (21 Versions, 2500 + Q and
A, Latest-2023)/ Exit HESI Exam |Real +
Practice Exam
SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT
Management of Care (1–18)
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client 2 days post-appendectomy requesting pain medication
B. A client with a new onset of confusion and a heart rate of 118
C. A client awaiting discharge teaching for warfarin
D. A client with a BP of 138/86 asking about diet
Correct: B
New-onset confusion with tachycardia suggests hypoxia, infection, or a cardiac event — an
acute change requiring immediate assessment. The other clients are stable or have non-urgent
needs.
2. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is most
appropriate to delegate?
A. Teaching a client how to self-administer insulin
B. Assessing a client's surgical incision
C. Obtaining a client's vital signs and reporting abnormalities
D. Administering a PRN antiemetic
Correct: C
UAP can perform routine, stable tasks like vital signs. Assessment, teaching, and medication
administration require a licensed nurse.
3. A client refuses a prescribed blood transfusion. Which action should the nurse take first?
A. Administer the transfusion anyway since it is life-saving
B. Notify the provider and document the refusal
,C. Ask the family to convince the client
D. Restrain the client and proceed
Correct: B
Clients have the right to refuse treatment. The nurse must respect autonomy, notify the
provider, and document. Proceeding without consent is battery.
4. The nurse is preparing to administer a blood transfusion. Which IV solution should be used to
prime the tubing?
A. Lactated Ringer's
B. 5% Dextrose in water
C. 0.9% Sodium chloride
D. 0.45% Sodium chloride
Correct: C
Only 0.9% sodium chloride is compatible with blood products. LR contains calcium (clotting
risk) and dextrose causes hemolysis.
5. A nurse is reviewing informed consent. Which statement indicates the client understands?
A. "The nurse will explain the risks before I sign."
B. "The surgeon will explain the procedure, risks, and alternatives before I sign."
C. "I can sign the consent even if I don't understand it."
D. "My family can sign for me even though I'm competent."
Correct: B
Informed consent requires the provider performing the procedure to explain risks, benefits,
and alternatives. The nurse witnesses the signature.
6. A nurse is assigned to care for a client with active pulmonary tuberculosis. Which type of
precautions are required?
A. Standard precautions only
B. Contact precautions
C. Airborne precautions with N95 respirator
D. Droplet precautions with surgical mask
, Correct: C
TB requires airborne precautions: negative-pressure room and N95 respirator.
7. A nurse is caring for a client with a DNR order who develops respiratory distress. Which
action is appropriate?
A. Begin CPR immediately
B. Provide comfort measures and notify the provider/family
C. Call a code blue
D. Intubate the client
Correct: B
A DNR order means no CPR/intubation. Comfort measures and symptom management are
appropriate.
8. Which client should the nurse see first after receiving handoff?
A. Client with COPD reporting a headache
B. Client with a new onset of slurred speech and facial droop
C. Client requesting a sleeping pill
D. Client with a BP of 150/90
Correct: B
Slurred speech and facial droop are stroke warning signs — a time-critical emergency.
9. A nurse is preparing discharge teaching for a client on warfarin. Which statement indicates a
need for further teaching?
A. "I will use a soft toothbrush."
B. "I will increase my intake of green leafy vegetables."
C. "I will avoid aspirin unless my provider approves."
D. "I will report any unusual bruising."
Correct: B
Green leafy vegetables are high in vitamin K, which antagonizes warfarin. Intake should be
consistent, not increased.
, 10. A nurse is caring for a client receiving chemotherapy. Which precaution is most important?
A. Neutropenic precautions when WBC is low
B. Strict bed rest at all times
C. Fluid restriction
D. High-fiber diet
Correct: A
Chemotherapy can cause neutropenia; neutropenic precautions reduce infection risk.
11. A nurse is reviewing a medication order: "Heparin 5,000 units SUBQ q12h." Which action is
appropriate?
A. Give IV push
B. Administer subcutaneously in the abdomen
C. Hold if platelet count is 300,000
D. Give IM
Correct: B
Subcutaneous heparin is given in the abdomen; rotate sites. Avoid IM (bleeding risk).
12. A nurse is preparing to administer digoxin. The apical pulse is 52. Which action should the
nurse take?
A. Administer the dose as ordered
B. Hold the dose and notify the provider
C. Give half the dose
D. Recheck the pulse after 30 minutes and then give
Correct: B
Digoxin is held for apical pulse <60 in adults. Notify the provider.
13. A client is admitted with suspected meningitis. Which type of precautions should the nurse
initiate?
A. Airborne
B. Droplet
A, Latest-2023)/ Exit HESI Exam |Real +
Practice Exam
SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT
Management of Care (1–18)
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client 2 days post-appendectomy requesting pain medication
B. A client with a new onset of confusion and a heart rate of 118
C. A client awaiting discharge teaching for warfarin
D. A client with a BP of 138/86 asking about diet
Correct: B
New-onset confusion with tachycardia suggests hypoxia, infection, or a cardiac event — an
acute change requiring immediate assessment. The other clients are stable or have non-urgent
needs.
2. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is most
appropriate to delegate?
A. Teaching a client how to self-administer insulin
B. Assessing a client's surgical incision
C. Obtaining a client's vital signs and reporting abnormalities
D. Administering a PRN antiemetic
Correct: C
UAP can perform routine, stable tasks like vital signs. Assessment, teaching, and medication
administration require a licensed nurse.
3. A client refuses a prescribed blood transfusion. Which action should the nurse take first?
A. Administer the transfusion anyway since it is life-saving
B. Notify the provider and document the refusal
,C. Ask the family to convince the client
D. Restrain the client and proceed
Correct: B
Clients have the right to refuse treatment. The nurse must respect autonomy, notify the
provider, and document. Proceeding without consent is battery.
4. The nurse is preparing to administer a blood transfusion. Which IV solution should be used to
prime the tubing?
A. Lactated Ringer's
B. 5% Dextrose in water
C. 0.9% Sodium chloride
D. 0.45% Sodium chloride
Correct: C
Only 0.9% sodium chloride is compatible with blood products. LR contains calcium (clotting
risk) and dextrose causes hemolysis.
5. A nurse is reviewing informed consent. Which statement indicates the client understands?
A. "The nurse will explain the risks before I sign."
B. "The surgeon will explain the procedure, risks, and alternatives before I sign."
C. "I can sign the consent even if I don't understand it."
D. "My family can sign for me even though I'm competent."
Correct: B
Informed consent requires the provider performing the procedure to explain risks, benefits,
and alternatives. The nurse witnesses the signature.
6. A nurse is assigned to care for a client with active pulmonary tuberculosis. Which type of
precautions are required?
A. Standard precautions only
B. Contact precautions
C. Airborne precautions with N95 respirator
D. Droplet precautions with surgical mask
, Correct: C
TB requires airborne precautions: negative-pressure room and N95 respirator.
7. A nurse is caring for a client with a DNR order who develops respiratory distress. Which
action is appropriate?
A. Begin CPR immediately
B. Provide comfort measures and notify the provider/family
C. Call a code blue
D. Intubate the client
Correct: B
A DNR order means no CPR/intubation. Comfort measures and symptom management are
appropriate.
8. Which client should the nurse see first after receiving handoff?
A. Client with COPD reporting a headache
B. Client with a new onset of slurred speech and facial droop
C. Client requesting a sleeping pill
D. Client with a BP of 150/90
Correct: B
Slurred speech and facial droop are stroke warning signs — a time-critical emergency.
9. A nurse is preparing discharge teaching for a client on warfarin. Which statement indicates a
need for further teaching?
A. "I will use a soft toothbrush."
B. "I will increase my intake of green leafy vegetables."
C. "I will avoid aspirin unless my provider approves."
D. "I will report any unusual bruising."
Correct: B
Green leafy vegetables are high in vitamin K, which antagonizes warfarin. Intake should be
consistent, not increased.
, 10. A nurse is caring for a client receiving chemotherapy. Which precaution is most important?
A. Neutropenic precautions when WBC is low
B. Strict bed rest at all times
C. Fluid restriction
D. High-fiber diet
Correct: A
Chemotherapy can cause neutropenia; neutropenic precautions reduce infection risk.
11. A nurse is reviewing a medication order: "Heparin 5,000 units SUBQ q12h." Which action is
appropriate?
A. Give IV push
B. Administer subcutaneously in the abdomen
C. Hold if platelet count is 300,000
D. Give IM
Correct: B
Subcutaneous heparin is given in the abdomen; rotate sites. Avoid IM (bleeding risk).
12. A nurse is preparing to administer digoxin. The apical pulse is 52. Which action should the
nurse take?
A. Administer the dose as ordered
B. Hold the dose and notify the provider
C. Give half the dose
D. Recheck the pulse after 30 minutes and then give
Correct: B
Digoxin is held for apical pulse <60 in adults. Notify the provider.
13. A client is admitted with suspected meningitis. Which type of precautions should the nurse
initiate?
A. Airborne
B. Droplet
