© BestSellerStuvia |
ELSEVIER | HEALTH EDUCATION SYSTEMS, INC. (HESI)
HESI RN | NCLEX-RN Readiness Competency Assessment
HESI-RN — Exit Comprehensive Exam
HESI RN Exit Comprehensive Examination
INSTITUTION Elsevier | Health Education Systems, Inc. (HESI)
PROGRAM Registered Nursing (RN)
EXAM TITLE HESI RN Exit Exam 2026/2027 Comprehensive | Verified Questions
COURSE TITLE HESI RN Exit Comprehensive Examination
COURSE CODE HESI-RN
ACADEMIC YEAR 2026/2027
TOTAL QUESTIONS 180 Questions
© BestSellerStuvia
Academic Year 2026/2027
HESI-RN | 2026/2027
ACTUAL QUESTIONS
Domain 1: Management of Care
Question 1. Which client should the nurse assess first after receiving shift report?
A. A client with COPD whose oxygen saturation has dropped to 88% on 2 L nasal cannula
B. A client with a blood pressure of 128/78 mm Hg requesting a PRN analgesic
C. A client scheduled for discharge later today who needs teaching reinforcement
D. A client with a healing stage 2 pressure injury who needs a dressing change
Correct Answer: A
Rationale: Acute hypoxemia in a client with COPD is an immediate physiological priority requiring prompt assessment
and intervention.
Question 2. Which task is most appropriate to assign to an unlicensed assistive personnel (UAP)?
A. Administering oral medications
B. Assisting a stable client with ambulation to the bathroom
C. Performing a sterile dressing change
D. Teaching a client about a new medication
Correct Answer: B
Rationale: Ambulation of a stable client is within the UAP scope; medication administration, sterile procedures, and
teaching require licensed personnel.
Question 3. A client refuses a prescribed medication. What is the nurse's most appropriate initial action?
A. Force the client to take the medication
B. Hide the medication in the client's food
© BestSellerStuvia | | HESI-RN | Academic Year 2026/2027
, © BestSellerStuvia |
C. Document the refusal and notify the provider according to facility protocol
D. Tell the client that refusal is not allowed
Correct Answer: C
Rationale: Clients have the right to refuse treatment. The nurse documents the refusal and notifies the appropriate
provider.
Question 4. Which action best supports continuity of care during shift handoff?
A. Providing a brief, structured report that includes current status, recent changes, and pending tasks
B. Discussing only the clients who are stable
C. Leaving the report for the oncoming nurse to read later without verbal communication
D. Omitting laboratory results to save time
Correct Answer: D
Rationale: Structured handoff communication reduces omissions and supports safe transitions of care.
Question 5. When receiving a telephone order from a provider, which action is essential?
A. Write down the order, read it back for confirmation, and obtain the provider's signature according to policy
B. Implement the order before reading it back
C. Ask another nurse to take the order instead
D. Document the order only after the provider visits
Correct Answer: A
Rationale: Read-back verification reduces medication and treatment errors associated with verbal or telephone orders.
Question 6. Which client is the best candidate for discharge teaching by the RN?
A. A client newly diagnosed with complex multi-organ failure who has not yet received initial teaching
B. A stable client with hypertension who needs reinforcement of lifestyle modifications previously taught
C. A client in acute respiratory distress
D. A client who just returned from the operating room
Correct Answer: B
Rationale: Reinforcement of previously taught material for a stable client is appropriate; complex initial teaching and
unstable clients require higher priority assessment.
Question 7. What is the primary purpose of an incident (occurrence) report?
A. To punish the staff member involved
B. To become part of the client's permanent medical record for billing
C. To document an unexpected event for quality improvement and risk management
D. To replace the need for notification of the provider
Correct Answer: C
Rationale: Incident reports support organizational learning and risk reduction; they are not used for discipline or as a
substitute for clinical notification.
Question 8. Which task should the RN perform rather than delegate to a UAP?
A. Taking routine vital signs on a stable client
B. Assisting with feeding a client without swallowing difficulties
C. Making an unoccupied bed
D. Performing a focused assessment of a client who reports new chest pain
Correct Answer: D
Rationale: New chest pain requires licensed assessment; routine tasks on stable clients may be delegated.
Question 9. A client asks the nurse to keep information about a new diagnosis confidential from the
family. What is the best response?
A. I will respect your wishes regarding confidentiality within the limits of the law and facility policy
B. I must tell your family everything
C. I will only tell your spouse
© BestSellerStuvia | | HESI-RN | Academic Year 2026/2027
, © BestSellerStuvia |
D. Confidentiality does not apply in the hospital
Correct Answer: A
Rationale: Nurses protect client confidentiality while adhering to legal and policy requirements for disclosure.
Question 10. Which situation requires the nurse to notify the charge nurse or provider immediately?
A. A client requests a different brand of soap
B. A client develops sudden shortness of breath and oxygen saturation of 86% on room air
C. A client asks what time meals are served
D. A client wants the television channel changed
Correct Answer: B
Rationale: Acute respiratory compromise requires prompt licensed assessment and intervention.
Question 11. What is the primary purpose of the nursing process?
A. To replace the need for provider orders
B. To diagnose medical conditions independently
C. To provide a systematic framework for assessment, diagnosis, planning, implementation, and evaluation of care
D. To bill for nursing services
Correct Answer: C
Rationale: The nursing process organizes nursing care delivery in a systematic, client-centered manner.
Question 12. Which statement about informed consent is correct for the RN role?
A. The RN may obtain informed consent for surgical procedures independently without provider involvement
B. The RN may alter the consent form if the client has questions
C. Informed consent is not required for any procedure
D. The RN may witness the client's signature on a consent form after the provider has explained the procedure
Correct Answer: D
Rationale: Witnessing a signature after the provider has obtained informed consent is within the RN role in many
settings.
Question 13. A client is being transferred to a long-term care facility. Which information is most
important to include in the transfer report?
A. Current medications, recent vital signs, code status, and open wounds or infections
B. The client's favorite television program
C. The number of family members who visited
D. The client's opinion of the hospital food
Correct Answer: A
Rationale: Clinical status, medications, code status, and infection or wound information are essential for safe continuity
of care.
Question 14. Which action by the nurse best demonstrates advocacy for a client?
A. Ignoring a client's request for pain medication
B. Reporting a client's unresolved pain to the provider and requesting reassessment of the analgesic plan
C. Telling the client that pain is expected and must be tolerated
D. Documenting pain without further action
Correct Answer: B
Rationale: Advocacy includes ensuring that the client's needs are communicated and addressed by the appropriate team
members.
Question 15. When contributing to quality improvement, which activity is appropriate for the RN?
A. Changing facility policy without approval
B. Discarding incident reports
C. Collecting data on fall occurrences and reporting trends to unit leadership
D. Refusing to participate in any safety initiatives
© BestSellerStuvia | | HESI-RN | Academic Year 2026/2027
, © BestSellerStuvia |
Correct Answer: C
Rationale: RNs contribute to quality and safety by collecting and reporting relevant data.
Question 16. Which client need should the nurse address first according to Maslow's hierarchy as applied
in prioritization?
A. A client who wants to talk about feelings of loneliness
B. A client who requests assistance with hair care
C. A client who asks about discharge plans for next week
D. A client with an oxygen saturation of 86% who is dyspneic
Correct Answer: D
Rationale: Physiological needs such as oxygenation take priority over psychosocial or lower-level needs.
Question 17. What is the most appropriate response when a family member asks for information about a
client's condition?
A. Verify the client's authorization for release of information before sharing protected health information
B. Share all details freely with any visitor
C. Refuse to speak with any family members
D. Provide information only in writing
Correct Answer: A
Rationale: HIPAA and privacy rules require authorization before disclosing protected health information.
Question 18. Which task is appropriate to assign to a UAP for a client who is postoperative day 1 after
abdominal surgery?
A. Assessing the surgical incision for signs of infection
B. Assisting the client to the chair with a gait belt if the client is stable and has been previously mobilized
C. Irrigating a nasogastric tube
D. Teaching the client about incentive spirometry
Correct Answer: B
Rationale: Assisting a stable, previously mobilized client with transfer is within UAP scope; assessment, sterile
procedures, and teaching are not.
Question 19. An RN is preparing a client for a diagnostic procedure. Which action is most important?
A. Assuming the client understands the procedure without verification
B. Beginning the procedure without checking identification
C. Confirming that informed consent has been obtained and that the client has no remaining questions for the
provider
D. Withholding all information to avoid anxiety
Correct Answer: C
Rationale: Verification of consent and opportunity for questions supports safe and ethical care.
Question 20. Which situation best illustrates the RN's role in case management support?
A. Independently arranging all post-discharge services without collaboration
B. Canceling the case manager's involvement
C. Making all financial decisions for the client
D. Providing the case manager with updated clinical data that affect discharge planning
Correct Answer: D
Rationale: RNs support case management by sharing timely clinical information that informs discharge and resource
planning.
Question 21. What is the primary purpose of a code status discussion in coordinated care?
A. To clarify the client's preferences regarding resuscitation and life-sustaining treatment
B. To determine the client's insurance coverage
C. To assign a room number
© BestSellerStuvia | | HESI-RN | Academic Year 2026/2027
ELSEVIER | HEALTH EDUCATION SYSTEMS, INC. (HESI)
HESI RN | NCLEX-RN Readiness Competency Assessment
HESI-RN — Exit Comprehensive Exam
HESI RN Exit Comprehensive Examination
INSTITUTION Elsevier | Health Education Systems, Inc. (HESI)
PROGRAM Registered Nursing (RN)
EXAM TITLE HESI RN Exit Exam 2026/2027 Comprehensive | Verified Questions
COURSE TITLE HESI RN Exit Comprehensive Examination
COURSE CODE HESI-RN
ACADEMIC YEAR 2026/2027
TOTAL QUESTIONS 180 Questions
© BestSellerStuvia
Academic Year 2026/2027
HESI-RN | 2026/2027
ACTUAL QUESTIONS
Domain 1: Management of Care
Question 1. Which client should the nurse assess first after receiving shift report?
A. A client with COPD whose oxygen saturation has dropped to 88% on 2 L nasal cannula
B. A client with a blood pressure of 128/78 mm Hg requesting a PRN analgesic
C. A client scheduled for discharge later today who needs teaching reinforcement
D. A client with a healing stage 2 pressure injury who needs a dressing change
Correct Answer: A
Rationale: Acute hypoxemia in a client with COPD is an immediate physiological priority requiring prompt assessment
and intervention.
Question 2. Which task is most appropriate to assign to an unlicensed assistive personnel (UAP)?
A. Administering oral medications
B. Assisting a stable client with ambulation to the bathroom
C. Performing a sterile dressing change
D. Teaching a client about a new medication
Correct Answer: B
Rationale: Ambulation of a stable client is within the UAP scope; medication administration, sterile procedures, and
teaching require licensed personnel.
Question 3. A client refuses a prescribed medication. What is the nurse's most appropriate initial action?
A. Force the client to take the medication
B. Hide the medication in the client's food
© BestSellerStuvia | | HESI-RN | Academic Year 2026/2027
, © BestSellerStuvia |
C. Document the refusal and notify the provider according to facility protocol
D. Tell the client that refusal is not allowed
Correct Answer: C
Rationale: Clients have the right to refuse treatment. The nurse documents the refusal and notifies the appropriate
provider.
Question 4. Which action best supports continuity of care during shift handoff?
A. Providing a brief, structured report that includes current status, recent changes, and pending tasks
B. Discussing only the clients who are stable
C. Leaving the report for the oncoming nurse to read later without verbal communication
D. Omitting laboratory results to save time
Correct Answer: D
Rationale: Structured handoff communication reduces omissions and supports safe transitions of care.
Question 5. When receiving a telephone order from a provider, which action is essential?
A. Write down the order, read it back for confirmation, and obtain the provider's signature according to policy
B. Implement the order before reading it back
C. Ask another nurse to take the order instead
D. Document the order only after the provider visits
Correct Answer: A
Rationale: Read-back verification reduces medication and treatment errors associated with verbal or telephone orders.
Question 6. Which client is the best candidate for discharge teaching by the RN?
A. A client newly diagnosed with complex multi-organ failure who has not yet received initial teaching
B. A stable client with hypertension who needs reinforcement of lifestyle modifications previously taught
C. A client in acute respiratory distress
D. A client who just returned from the operating room
Correct Answer: B
Rationale: Reinforcement of previously taught material for a stable client is appropriate; complex initial teaching and
unstable clients require higher priority assessment.
Question 7. What is the primary purpose of an incident (occurrence) report?
A. To punish the staff member involved
B. To become part of the client's permanent medical record for billing
C. To document an unexpected event for quality improvement and risk management
D. To replace the need for notification of the provider
Correct Answer: C
Rationale: Incident reports support organizational learning and risk reduction; they are not used for discipline or as a
substitute for clinical notification.
Question 8. Which task should the RN perform rather than delegate to a UAP?
A. Taking routine vital signs on a stable client
B. Assisting with feeding a client without swallowing difficulties
C. Making an unoccupied bed
D. Performing a focused assessment of a client who reports new chest pain
Correct Answer: D
Rationale: New chest pain requires licensed assessment; routine tasks on stable clients may be delegated.
Question 9. A client asks the nurse to keep information about a new diagnosis confidential from the
family. What is the best response?
A. I will respect your wishes regarding confidentiality within the limits of the law and facility policy
B. I must tell your family everything
C. I will only tell your spouse
© BestSellerStuvia | | HESI-RN | Academic Year 2026/2027
, © BestSellerStuvia |
D. Confidentiality does not apply in the hospital
Correct Answer: A
Rationale: Nurses protect client confidentiality while adhering to legal and policy requirements for disclosure.
Question 10. Which situation requires the nurse to notify the charge nurse or provider immediately?
A. A client requests a different brand of soap
B. A client develops sudden shortness of breath and oxygen saturation of 86% on room air
C. A client asks what time meals are served
D. A client wants the television channel changed
Correct Answer: B
Rationale: Acute respiratory compromise requires prompt licensed assessment and intervention.
Question 11. What is the primary purpose of the nursing process?
A. To replace the need for provider orders
B. To diagnose medical conditions independently
C. To provide a systematic framework for assessment, diagnosis, planning, implementation, and evaluation of care
D. To bill for nursing services
Correct Answer: C
Rationale: The nursing process organizes nursing care delivery in a systematic, client-centered manner.
Question 12. Which statement about informed consent is correct for the RN role?
A. The RN may obtain informed consent for surgical procedures independently without provider involvement
B. The RN may alter the consent form if the client has questions
C. Informed consent is not required for any procedure
D. The RN may witness the client's signature on a consent form after the provider has explained the procedure
Correct Answer: D
Rationale: Witnessing a signature after the provider has obtained informed consent is within the RN role in many
settings.
Question 13. A client is being transferred to a long-term care facility. Which information is most
important to include in the transfer report?
A. Current medications, recent vital signs, code status, and open wounds or infections
B. The client's favorite television program
C. The number of family members who visited
D. The client's opinion of the hospital food
Correct Answer: A
Rationale: Clinical status, medications, code status, and infection or wound information are essential for safe continuity
of care.
Question 14. Which action by the nurse best demonstrates advocacy for a client?
A. Ignoring a client's request for pain medication
B. Reporting a client's unresolved pain to the provider and requesting reassessment of the analgesic plan
C. Telling the client that pain is expected and must be tolerated
D. Documenting pain without further action
Correct Answer: B
Rationale: Advocacy includes ensuring that the client's needs are communicated and addressed by the appropriate team
members.
Question 15. When contributing to quality improvement, which activity is appropriate for the RN?
A. Changing facility policy without approval
B. Discarding incident reports
C. Collecting data on fall occurrences and reporting trends to unit leadership
D. Refusing to participate in any safety initiatives
© BestSellerStuvia | | HESI-RN | Academic Year 2026/2027
, © BestSellerStuvia |
Correct Answer: C
Rationale: RNs contribute to quality and safety by collecting and reporting relevant data.
Question 16. Which client need should the nurse address first according to Maslow's hierarchy as applied
in prioritization?
A. A client who wants to talk about feelings of loneliness
B. A client who requests assistance with hair care
C. A client who asks about discharge plans for next week
D. A client with an oxygen saturation of 86% who is dyspneic
Correct Answer: D
Rationale: Physiological needs such as oxygenation take priority over psychosocial or lower-level needs.
Question 17. What is the most appropriate response when a family member asks for information about a
client's condition?
A. Verify the client's authorization for release of information before sharing protected health information
B. Share all details freely with any visitor
C. Refuse to speak with any family members
D. Provide information only in writing
Correct Answer: A
Rationale: HIPAA and privacy rules require authorization before disclosing protected health information.
Question 18. Which task is appropriate to assign to a UAP for a client who is postoperative day 1 after
abdominal surgery?
A. Assessing the surgical incision for signs of infection
B. Assisting the client to the chair with a gait belt if the client is stable and has been previously mobilized
C. Irrigating a nasogastric tube
D. Teaching the client about incentive spirometry
Correct Answer: B
Rationale: Assisting a stable, previously mobilized client with transfer is within UAP scope; assessment, sterile
procedures, and teaching are not.
Question 19. An RN is preparing a client for a diagnostic procedure. Which action is most important?
A. Assuming the client understands the procedure without verification
B. Beginning the procedure without checking identification
C. Confirming that informed consent has been obtained and that the client has no remaining questions for the
provider
D. Withholding all information to avoid anxiety
Correct Answer: C
Rationale: Verification of consent and opportunity for questions supports safe and ethical care.
Question 20. Which situation best illustrates the RN's role in case management support?
A. Independently arranging all post-discharge services without collaboration
B. Canceling the case manager's involvement
C. Making all financial decisions for the client
D. Providing the case manager with updated clinical data that affect discharge planning
Correct Answer: D
Rationale: RNs support case management by sharing timely clinical information that informs discharge and resource
planning.
Question 21. What is the primary purpose of a code status discussion in coordinated care?
A. To clarify the client's preferences regarding resuscitation and life-sustaining treatment
B. To determine the client's insurance coverage
C. To assign a room number
© BestSellerStuvia | | HESI-RN | Academic Year 2026/2027
