⭐ 2026 HESI RN Exit Exam – Questions with
Correct Answers & Rationales |
Comprehensive Predictor Study Guide | Latest
Updated | Next Gen NCLEX Aligned | Instant
Download | Grade A+
Section 1: Management of Care (Questions 1–25)
Question 1
A charge nurse is assigning clients on a medical-surgical unit. Which client should be
assigned to the LPN/LVN?
A. Client with acute asthma requiring q2h albuterol nebulizer treatments
B. Client with a stable ileostomy requiring stoma care and pouch change
C. Client newly diagnosed with diabetes mellitus requiring initial insulin teaching
D. Client 2 hours post-cardiac catheterization with a femoral sheath in place
Correct Answer: B
Rationale: LPNs/LVNs can perform stable, routine procedures like ostomy care. Option A
requires respiratory assessment (RN responsibility). Option C requires initial teaching (RN
,responsibility). Option D requires critical assessment for bleeding or hematoma formation
(RN responsibility) .
Question 2
An emergency department nurse is triaging after a mass casualty event (MCE). Which client
should receive care FIRST?
A. Ambulatory client with a minor scalp laceration
B. Client with severe chest wound, able to follow commands but with labored breathing
C. Client with no pulse, no respirations, and fixed dilated pupils
D. Client with a simple femur fracture and capillary refill <3 seconds
Correct Answer: B
Rationale: In MCE triage (START system), Option B is "Immediate" (Red tag) – life-
threatening but survivable. Option A is "Minor" (Green tag). Option C is "Expectant" (Black
tag) – deceased/unsalvageable. Option D is "Delayed" (Yellow tag) .
Question 3
A nurse on a busy telemetry unit receives report. Which client should the nurse assess
FIRST?
A. Client with heart failure reporting mild shortness of breath while walking to the bathroom
B. Client with a potassium level of 5.2 mEq/L who is asymptomatic
,C. Client with new-onset atrial fibrillation with a ventricular rate of 140 bpm and BP 90/60
mm Hg
D. Client who had a pacemaker insertion yesterday and has a heart rate of 72 bpm
Correct Answer: C
Rationale: Option C shows unstable atrial fibrillation with rapid ventricular response causing
hypotension. This is a priority for possible cardioversion. Option A is stable exertional
dyspnea. Option B requires monitoring but is stable. Option D is a normal post-op finding .
Question 4
A nurse manager is delegating tasks to unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A. Perform a sterile dressing change for a post-op day 3 abdominal wound
B. Obtain a clean-catch midstream urine specimen from a client with dysuria
C. Teach a client how to use an incentive spirometer after surgery
D. Assess the pain level of a client receiving morphine PCA
Correct Answer: B
Rationale: UAP can collect non-sterile specimens (clean catch). Option A requires sterile
technique (LPN/RN). Option C requires teaching (RN). Option D requires assessment (RN) .
Question 5
, A nurse is caring for four clients. Which client should the nurse see immediately after
receiving shift report?
A. Client with pneumonia who has an oxygen saturation of 94% on 2 L O2
B. Client with cellulitis who has an oral temperature of 100.4°F (38°C)
C. Client with a tracheostomy who has thick, green secretions and a respiratory rate of
32/min
D. Client with a fractured hip who reports pain 6/10 after receiving morphine
Correct Answer: C
Rationale: Option C indicates possible respiratory infection or mucus plug; tachypnea and
purulent secretions require immediate airway assessment. Option A is acceptable. Option B
is low-grade fever. Option D requires pain reassessment but is not immediately life-
threatening .
Question 6
A nurse is preparing to administer medications to a client. Which action should the nurse
take FIRST to ensure client safety?
A. Check the client's allergy band
B. Verify the client's identity using two identifiers
C. Review the medication administration record (MAR)
D. Perform hand hygiene
Correct Answer: B
Correct Answers & Rationales |
Comprehensive Predictor Study Guide | Latest
Updated | Next Gen NCLEX Aligned | Instant
Download | Grade A+
Section 1: Management of Care (Questions 1–25)
Question 1
A charge nurse is assigning clients on a medical-surgical unit. Which client should be
assigned to the LPN/LVN?
A. Client with acute asthma requiring q2h albuterol nebulizer treatments
B. Client with a stable ileostomy requiring stoma care and pouch change
C. Client newly diagnosed with diabetes mellitus requiring initial insulin teaching
D. Client 2 hours post-cardiac catheterization with a femoral sheath in place
Correct Answer: B
Rationale: LPNs/LVNs can perform stable, routine procedures like ostomy care. Option A
requires respiratory assessment (RN responsibility). Option C requires initial teaching (RN
,responsibility). Option D requires critical assessment for bleeding or hematoma formation
(RN responsibility) .
Question 2
An emergency department nurse is triaging after a mass casualty event (MCE). Which client
should receive care FIRST?
A. Ambulatory client with a minor scalp laceration
B. Client with severe chest wound, able to follow commands but with labored breathing
C. Client with no pulse, no respirations, and fixed dilated pupils
D. Client with a simple femur fracture and capillary refill <3 seconds
Correct Answer: B
Rationale: In MCE triage (START system), Option B is "Immediate" (Red tag) – life-
threatening but survivable. Option A is "Minor" (Green tag). Option C is "Expectant" (Black
tag) – deceased/unsalvageable. Option D is "Delayed" (Yellow tag) .
Question 3
A nurse on a busy telemetry unit receives report. Which client should the nurse assess
FIRST?
A. Client with heart failure reporting mild shortness of breath while walking to the bathroom
B. Client with a potassium level of 5.2 mEq/L who is asymptomatic
,C. Client with new-onset atrial fibrillation with a ventricular rate of 140 bpm and BP 90/60
mm Hg
D. Client who had a pacemaker insertion yesterday and has a heart rate of 72 bpm
Correct Answer: C
Rationale: Option C shows unstable atrial fibrillation with rapid ventricular response causing
hypotension. This is a priority for possible cardioversion. Option A is stable exertional
dyspnea. Option B requires monitoring but is stable. Option D is a normal post-op finding .
Question 4
A nurse manager is delegating tasks to unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A. Perform a sterile dressing change for a post-op day 3 abdominal wound
B. Obtain a clean-catch midstream urine specimen from a client with dysuria
C. Teach a client how to use an incentive spirometer after surgery
D. Assess the pain level of a client receiving morphine PCA
Correct Answer: B
Rationale: UAP can collect non-sterile specimens (clean catch). Option A requires sterile
technique (LPN/RN). Option C requires teaching (RN). Option D requires assessment (RN) .
Question 5
, A nurse is caring for four clients. Which client should the nurse see immediately after
receiving shift report?
A. Client with pneumonia who has an oxygen saturation of 94% on 2 L O2
B. Client with cellulitis who has an oral temperature of 100.4°F (38°C)
C. Client with a tracheostomy who has thick, green secretions and a respiratory rate of
32/min
D. Client with a fractured hip who reports pain 6/10 after receiving morphine
Correct Answer: C
Rationale: Option C indicates possible respiratory infection or mucus plug; tachypnea and
purulent secretions require immediate airway assessment. Option A is acceptable. Option B
is low-grade fever. Option D requires pain reassessment but is not immediately life-
threatening .
Question 6
A nurse is preparing to administer medications to a client. Which action should the nurse
take FIRST to ensure client safety?
A. Check the client's allergy band
B. Verify the client's identity using two identifiers
C. Review the medication administration record (MAR)
D. Perform hand hygiene
Correct Answer: B
