Page 1 of 54
HESI RN EXIT -PRACTICE EXAM BANK: 100
QUESTIONS WITH DETAILED
RATIONALES
Nursing / clinical / pharmacology
Exam coverage:
❖ Section 1 (Q1–15): Management of care, prioritization,
delegation, legal/ethical issues, and informed consent.
❖ Section 2 (Q16–30): Safety and infection control,
precautions, PPE, and error prevention.
❖ Section 3 (Q31–40): Health promotion and maintenance,
maternal-newborn, pediatrics, and older adult care.
❖ Section 4 (Q41–50): Psychosocial integrity, therapeutic
communication, crisis intervention, and mental health.
❖ Section 5 (Q51–60): Basic care and comfort, nutrition,
mobility, and elimination.
❖ Section 6 (Q61–75): Pharmacological and parenteral
therapies, medication administration and side effects.
❖ Section 7 (Q76–85): Reduction of risk potential, laboratory
values, and complications.
❖ Section 8 (Q86–100): Physiological adaptation, medical-
surgical pathophysiology, and emergency management.
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Section 1: Safe and Effective Care Environment –
Management of Care (Questions 1–15)
Question 1
A nurse is triaging clients in the emergency department
following a mass casualty incident. Using the START triage
system, the nurse must determine which client requires
immediate intervention. Which client should the nurse prioritize
for immediate care?
A. A client with a broken arm and mild bleeding
B. A client who is unconscious with a respiratory rate of 6/min
C. A client with a puncture wound to the chest and absent
breath sounds on the affected side
D. A client with a sprained ankle and minor abrasions
CORRECT ANSWER: C
RATIONALE: Using the START triage system, a client with a chest
wound and absent breath sounds (suspected tension
pneumothorax) requires immediate life-saving intervention. This
is a priority "red tag" (immediate) client. An unconscious client
with a respiratory rate of 6/min (B) is "black tag" (expectant) in a
mass casualty incident. A broken arm (A) and sprained ankle (D)
are "yellow" and "green" tags respectively.
Question 2
A nurse is delegating tasks to unlicensed assistive personnel
(UAP). The nurse understands the five rights of delegation and
must apply them appropriately. Which task should the nurse
delegate to the UAP?
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A. Administering a PRN pain medication
B. Obtaining a sterile urine specimen from a client
C. Changing a sterile wound dressing
D. Feeding a client who has difficulty swallowing
CORRECT ANSWER: B
RATIONALE: Obtaining a sterile urine specimen is within the
UAP's scope of practice with appropriate training. Administering
medications (A) and sterile wound care (C) require nursing
licensure. Feeding a client with difficulty swallowing (D) is a
high-risk activity requiring nursing assessment and judgment to
prevent aspiration.
Question 3
A nurse is preparing a client for surgery. The client asks, "Will the
doctor be performing the surgery?" Which of the following
responses by the nurse is appropriate?
A. "Yes, the doctor will be performing the surgery."
B. "The doctor will explain the procedure to you."
C. "You should ask the doctor that question."
D. "The surgeon will be assisted by a surgical team."
CORRECT ANSWER: B
RATIONALE: The nurse's role in informed consent is to ensure
the client understands the information provided by the
healthcare provider and to witness the signature. The nurse
should not provide medical information but should facilitate
communication between the client and the provider. The
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provider is responsible for explaining the procedure, risks,
benefits, and alternatives.
Question 4
A nurse is caring for a client who has a new diagnosis of terminal
cancer and is considering hospice care. Which of the following
statements by the nurse is appropriate?
A. "Hospice care means you will no longer receive any
treatments."
B. "Hospice care focuses on comfort and quality of life."
C. "You should continue aggressive treatment instead."
D. "Hospice care is only for the last few days of life."
CORRECT ANSWER: B
RATIONALE: Hospice care focuses on comfort, pain
management, and quality of life for terminally ill clients. Option
A is incorrect because hospice may include palliative
treatments. Option C imposes the nurse's values on the client.
Option D is incorrect because hospice can be provided for
months, not just days.
Question 5
A charge nurse is making client assignments for the oncoming
shift. Which of the following clients should the charge nurse
assign to a newly licensed practical nurse (LPN)?
A. A client who is 2 days postoperative and requires a sterile
dressing change
B. A client who is receiving a blood transfusion
C. A client who is newly admitted with an acute myocardial
HESI RN EXIT -PRACTICE EXAM BANK: 100
QUESTIONS WITH DETAILED
RATIONALES
Nursing / clinical / pharmacology
Exam coverage:
❖ Section 1 (Q1–15): Management of care, prioritization,
delegation, legal/ethical issues, and informed consent.
❖ Section 2 (Q16–30): Safety and infection control,
precautions, PPE, and error prevention.
❖ Section 3 (Q31–40): Health promotion and maintenance,
maternal-newborn, pediatrics, and older adult care.
❖ Section 4 (Q41–50): Psychosocial integrity, therapeutic
communication, crisis intervention, and mental health.
❖ Section 5 (Q51–60): Basic care and comfort, nutrition,
mobility, and elimination.
❖ Section 6 (Q61–75): Pharmacological and parenteral
therapies, medication administration and side effects.
❖ Section 7 (Q76–85): Reduction of risk potential, laboratory
values, and complications.
❖ Section 8 (Q86–100): Physiological adaptation, medical-
surgical pathophysiology, and emergency management.
, Page 2 of 54
Section 1: Safe and Effective Care Environment –
Management of Care (Questions 1–15)
Question 1
A nurse is triaging clients in the emergency department
following a mass casualty incident. Using the START triage
system, the nurse must determine which client requires
immediate intervention. Which client should the nurse prioritize
for immediate care?
A. A client with a broken arm and mild bleeding
B. A client who is unconscious with a respiratory rate of 6/min
C. A client with a puncture wound to the chest and absent
breath sounds on the affected side
D. A client with a sprained ankle and minor abrasions
CORRECT ANSWER: C
RATIONALE: Using the START triage system, a client with a chest
wound and absent breath sounds (suspected tension
pneumothorax) requires immediate life-saving intervention. This
is a priority "red tag" (immediate) client. An unconscious client
with a respiratory rate of 6/min (B) is "black tag" (expectant) in a
mass casualty incident. A broken arm (A) and sprained ankle (D)
are "yellow" and "green" tags respectively.
Question 2
A nurse is delegating tasks to unlicensed assistive personnel
(UAP). The nurse understands the five rights of delegation and
must apply them appropriately. Which task should the nurse
delegate to the UAP?
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A. Administering a PRN pain medication
B. Obtaining a sterile urine specimen from a client
C. Changing a sterile wound dressing
D. Feeding a client who has difficulty swallowing
CORRECT ANSWER: B
RATIONALE: Obtaining a sterile urine specimen is within the
UAP's scope of practice with appropriate training. Administering
medications (A) and sterile wound care (C) require nursing
licensure. Feeding a client with difficulty swallowing (D) is a
high-risk activity requiring nursing assessment and judgment to
prevent aspiration.
Question 3
A nurse is preparing a client for surgery. The client asks, "Will the
doctor be performing the surgery?" Which of the following
responses by the nurse is appropriate?
A. "Yes, the doctor will be performing the surgery."
B. "The doctor will explain the procedure to you."
C. "You should ask the doctor that question."
D. "The surgeon will be assisted by a surgical team."
CORRECT ANSWER: B
RATIONALE: The nurse's role in informed consent is to ensure
the client understands the information provided by the
healthcare provider and to witness the signature. The nurse
should not provide medical information but should facilitate
communication between the client and the provider. The
, Page 4 of 54
provider is responsible for explaining the procedure, risks,
benefits, and alternatives.
Question 4
A nurse is caring for a client who has a new diagnosis of terminal
cancer and is considering hospice care. Which of the following
statements by the nurse is appropriate?
A. "Hospice care means you will no longer receive any
treatments."
B. "Hospice care focuses on comfort and quality of life."
C. "You should continue aggressive treatment instead."
D. "Hospice care is only for the last few days of life."
CORRECT ANSWER: B
RATIONALE: Hospice care focuses on comfort, pain
management, and quality of life for terminally ill clients. Option
A is incorrect because hospice may include palliative
treatments. Option C imposes the nurse's values on the client.
Option D is incorrect because hospice can be provided for
months, not just days.
Question 5
A charge nurse is making client assignments for the oncoming
shift. Which of the following clients should the charge nurse
assign to a newly licensed practical nurse (LPN)?
A. A client who is 2 days postoperative and requires a sterile
dressing change
B. A client who is receiving a blood transfusion
C. A client who is newly admitted with an acute myocardial
