HESI RN Exit Exam 2025/2026 – Practice
Exam 80 Realistic Multiple-Choice
Questions with Correct Answers and
Detailed Rationales
Question 1: Safe and Effective Care Environment
A client with a history of falls is admitted to the medical-surgical unit. Which nursing
intervention is the priority to prevent further injury? A. Apply a wrist restraint during the night
shift. B. Place a bedside commode within reach. C. Administer a sed ative to promote sleep. D.
Encourage the client to use the call light for assistance.
D. Encourage the client to use the call light for assistance.
Rationale: Prioritizing client independence and safety, encouraging the use of the call light
promotes self-advocacy and reduces the risk of injury without restricting movement,
aligning with principles of least restrictive interventions. Restraints (A) are a last resort,
and sedatives (C) may increase fall risk.
Question 2: Health Promotion and Maintenance
A 28-year-old client asks about screening for breast cancer. What is the nurse's best response
regarding recommended guidelines? A. Begin monthly self-exams at age 20 and mammograms
at age 30. B. Clinical breast exams every 1-3 years starting at age 20, mammograms at age 40. C.
Annual mammograms starting at age 50 for all women. D. No screening needed until symptoms
appear.
B. Clinical breast exams every 1-3 years starting at age 20, mammograms at age 40.
Rationale: According to USPSTF guidelines, clinical breast exams are recommended every
1-3 years for women aged 20-39, and biennial mammograms begin at age 40 for average-
risk women. This promotes early detection without over-screening.
Question 3: Psychosocial Integrity
A client diagnosed with major depressive disorder states, "I just want to sleep all day." What is
the nurse's most therapeutic response? A. "That's a common symptom; let's talk about your sleep
patterns." B. "You need to get out of bed and exercise to feel better." C. "Depression makes
everything feel overwhelming; it's not your fault." D. "I'll increase your antidepressant dose right
away."
C. "Depression makes everything feel overwhelming; it's not your fault."
,Rationale: This response validates the client's feelings, reduces self-blame, and builds
rapport, which is essential in therapeutic communication for psychosocial support. Options
A and B are directive, and D is outside the nurse's scope without provider order.
Question 4: Physiological Integrity - Basic Care and Comfort
A client postoperative day 1 after a cholecystectomy complains of incisional pain rated 8/10.
What is the priority nursing action? A. Apply a warm compress to the incision. B. Administer
prescribed morphine 2 mg IV as ordered. C. Encourage deep breathing and coughing exercises.
D. Position the client in high Fowler's.
B. Administer prescribed morphine 2 mg IV as ordered.
Rationale: Pain management is a basic comfort need; administering analgesics promptly
controls pain, facilitating mobility and preventing complications like atelectasis. Other
options address adjunctive measures but do not directly target acute pain.
Question 5: Pharmacological and Parenteral Therapies
A client with hypertension is prescribed lisinopril 10 mg daily. The nurse teaches the client to
monitor for which potential side effect? A. Dry cough. B. Bradycardia. C. Hyperglycemia. D.
Constipation.
A. Dry cough.
Rationale: Lisinopril, an ACE inhibitor, commonly causes a nonproductive dry cough due
to bradykinin accumulation. Monitoring this promotes adherence and early intervention if
needed.
Question 6: Reduction of Risk Potential
During a routine prenatal visit, a client at 32 weeks gestation has a blood pressure of 150/95
mmHg. What is the nurse's next action? A. Reassure the client that this is normal in late
pregnancy. B. Notify the healthcare provider of possible preeclampsia. C. Schedule a non-stress
test for tomorrow. D. Advise increasing salt intake.
B. Notify the healthcare provider of possible preeclampsia.
Rationale: Blood pressure ≥140/90 mmHg after 20 weeks gestation indicates hypertensive
risk; prompt notification reduces maternal and fetal risks associated with preeclampsia.
Question 7: Physiological Adaptation
A client with chronic obstructive pulmonary disease (COPD) is experiencing acute dyspnea.
Arterial blood gases show pH 7.29, PaCO2 60 mmHg, PaO2 55 mmHg. What is the priority
, intervention? A. Administer high-flow oxygen at 6 L/min. B. Position the client in Tripod
position. C. Prepare for endotracheal intubation. D. Encourage pursed -lip breathing.
B. Position the client in Tripod position.
Rationale: ABGs indicate acute respiratory acidosis; tripod positioning optimizes accessory
muscle use for breathing, providing immediate relief in COPD exacerbations before
further interventions.
Question 8: Safe and Effective Care Environment
A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is appropriate
to delegate? A. Assessing a client's peripheral pulses. B. Ambulating a stable postoperative
client. C. Developing a care plan for a new admission. D. Teaching insulin injection technique.
B. Ambulating a stable postoperative client.
Rationale: Delegation principles allow UAPs to perform stable, routine ADLs like
ambulation under supervision. Assessment (A), planning (C), and teaching (D) require RN
judgment.
Question 9: Health Promotion and Maintenance
A 45-year-old client with type 2 diabetes asks about foot care. What instruction should the nurse
provide? A. Soak feet daily in hot water to improve circulation. B. Apply lotion between the toes
to prevent cracking. C. Inspect feet daily for cuts or blisters. D. Wear open-toed shoes for better
airflow.
C. Inspect feet daily for cuts or blisters.
Rationale: Daily foot inspection promotes early detection of neuropathy-related injuries,
preventing infections in diabetic clients. Hot soaks (A) risk burns, lotion between toes (B)
promotes fungal growth, and open-toed shoes (D) increase injury risk.
Question 10: Psychosocial Integrity
A client grieving the loss of a spouse exhibits anger toward the nurse. What is the best response?
A. "I understand you're upset; let's discuss what's bothering you." B. "Please don't speak to me
that way; it's unprofessional." C. Ignore the behavior and continue care. D. Document the
incident and report to the charge nurse.
A. "I understand you're upset; let's discuss what's bothering you."
Rationale: Therapeutic communication acknowledges emotions and redirects to problem-
solving, supporting grief processing. Confrontation (B) escalates, ignoring (C) dismisses
feelings, and reporting (D) is unnecessary unless safety is threatened.
Exam 80 Realistic Multiple-Choice
Questions with Correct Answers and
Detailed Rationales
Question 1: Safe and Effective Care Environment
A client with a history of falls is admitted to the medical-surgical unit. Which nursing
intervention is the priority to prevent further injury? A. Apply a wrist restraint during the night
shift. B. Place a bedside commode within reach. C. Administer a sed ative to promote sleep. D.
Encourage the client to use the call light for assistance.
D. Encourage the client to use the call light for assistance.
Rationale: Prioritizing client independence and safety, encouraging the use of the call light
promotes self-advocacy and reduces the risk of injury without restricting movement,
aligning with principles of least restrictive interventions. Restraints (A) are a last resort,
and sedatives (C) may increase fall risk.
Question 2: Health Promotion and Maintenance
A 28-year-old client asks about screening for breast cancer. What is the nurse's best response
regarding recommended guidelines? A. Begin monthly self-exams at age 20 and mammograms
at age 30. B. Clinical breast exams every 1-3 years starting at age 20, mammograms at age 40. C.
Annual mammograms starting at age 50 for all women. D. No screening needed until symptoms
appear.
B. Clinical breast exams every 1-3 years starting at age 20, mammograms at age 40.
Rationale: According to USPSTF guidelines, clinical breast exams are recommended every
1-3 years for women aged 20-39, and biennial mammograms begin at age 40 for average-
risk women. This promotes early detection without over-screening.
Question 3: Psychosocial Integrity
A client diagnosed with major depressive disorder states, "I just want to sleep all day." What is
the nurse's most therapeutic response? A. "That's a common symptom; let's talk about your sleep
patterns." B. "You need to get out of bed and exercise to feel better." C. "Depression makes
everything feel overwhelming; it's not your fault." D. "I'll increase your antidepressant dose right
away."
C. "Depression makes everything feel overwhelming; it's not your fault."
,Rationale: This response validates the client's feelings, reduces self-blame, and builds
rapport, which is essential in therapeutic communication for psychosocial support. Options
A and B are directive, and D is outside the nurse's scope without provider order.
Question 4: Physiological Integrity - Basic Care and Comfort
A client postoperative day 1 after a cholecystectomy complains of incisional pain rated 8/10.
What is the priority nursing action? A. Apply a warm compress to the incision. B. Administer
prescribed morphine 2 mg IV as ordered. C. Encourage deep breathing and coughing exercises.
D. Position the client in high Fowler's.
B. Administer prescribed morphine 2 mg IV as ordered.
Rationale: Pain management is a basic comfort need; administering analgesics promptly
controls pain, facilitating mobility and preventing complications like atelectasis. Other
options address adjunctive measures but do not directly target acute pain.
Question 5: Pharmacological and Parenteral Therapies
A client with hypertension is prescribed lisinopril 10 mg daily. The nurse teaches the client to
monitor for which potential side effect? A. Dry cough. B. Bradycardia. C. Hyperglycemia. D.
Constipation.
A. Dry cough.
Rationale: Lisinopril, an ACE inhibitor, commonly causes a nonproductive dry cough due
to bradykinin accumulation. Monitoring this promotes adherence and early intervention if
needed.
Question 6: Reduction of Risk Potential
During a routine prenatal visit, a client at 32 weeks gestation has a blood pressure of 150/95
mmHg. What is the nurse's next action? A. Reassure the client that this is normal in late
pregnancy. B. Notify the healthcare provider of possible preeclampsia. C. Schedule a non-stress
test for tomorrow. D. Advise increasing salt intake.
B. Notify the healthcare provider of possible preeclampsia.
Rationale: Blood pressure ≥140/90 mmHg after 20 weeks gestation indicates hypertensive
risk; prompt notification reduces maternal and fetal risks associated with preeclampsia.
Question 7: Physiological Adaptation
A client with chronic obstructive pulmonary disease (COPD) is experiencing acute dyspnea.
Arterial blood gases show pH 7.29, PaCO2 60 mmHg, PaO2 55 mmHg. What is the priority
, intervention? A. Administer high-flow oxygen at 6 L/min. B. Position the client in Tripod
position. C. Prepare for endotracheal intubation. D. Encourage pursed -lip breathing.
B. Position the client in Tripod position.
Rationale: ABGs indicate acute respiratory acidosis; tripod positioning optimizes accessory
muscle use for breathing, providing immediate relief in COPD exacerbations before
further interventions.
Question 8: Safe and Effective Care Environment
A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is appropriate
to delegate? A. Assessing a client's peripheral pulses. B. Ambulating a stable postoperative
client. C. Developing a care plan for a new admission. D. Teaching insulin injection technique.
B. Ambulating a stable postoperative client.
Rationale: Delegation principles allow UAPs to perform stable, routine ADLs like
ambulation under supervision. Assessment (A), planning (C), and teaching (D) require RN
judgment.
Question 9: Health Promotion and Maintenance
A 45-year-old client with type 2 diabetes asks about foot care. What instruction should the nurse
provide? A. Soak feet daily in hot water to improve circulation. B. Apply lotion between the toes
to prevent cracking. C. Inspect feet daily for cuts or blisters. D. Wear open-toed shoes for better
airflow.
C. Inspect feet daily for cuts or blisters.
Rationale: Daily foot inspection promotes early detection of neuropathy-related injuries,
preventing infections in diabetic clients. Hot soaks (A) risk burns, lotion between toes (B)
promotes fungal growth, and open-toed shoes (D) increase injury risk.
Question 10: Psychosocial Integrity
A client grieving the loss of a spouse exhibits anger toward the nurse. What is the best response?
A. "I understand you're upset; let's discuss what's bothering you." B. "Please don't speak to me
that way; it's unprofessional." C. Ignore the behavior and continue care. D. Document the
incident and report to the charge nurse.
A. "I understand you're upset; let's discuss what's bothering you."
Rationale: Therapeutic communication acknowledges emotions and redirects to problem-
solving, supporting grief processing. Confrontation (B) escalates, ignoring (C) dismisses
feelings, and reporting (D) is unnecessary unless safety is threatened.
