HESI RN Exit Exam
(2025/2026) | Verified 100%
Correct Questions &
Rationales
Safe and Effective Care Environment (Questions 1–30)
1. Management of Care: A charge nurse is delegating tasks on a med-surg
unit. Which task should be delegated to an unlicensed assistive personnel
(UAP)? A) Assessing a newly admitted client's pain level B) Ambulating a
stable post-op client C) Developing a discharge teaching plan D) Evaluating
the effectiveness of a client's IV fluids B) Ambulating a stable post-op client
Rationale: Delegation to UAP is appropriate for stable, routine ADLs like
ambulation (NCSBN Five Rights of Delegation: right task, circumstance,
person). A is incorrect as assessment requires RN judgment. C and D
involve planning/evaluation, RN-only functions. Critical thinking: Ensures
efficient resource use while maintaining safety; assess client stability first.
2. Safety and Infection Control: A nurse is preparing to insert a peripheral IV
catheter. Which action best prevents infection? A) Clean the site with
alcohol for 15 seconds B) Use a chlorhexidine gluconate (CHG) swab for 30
seconds C) Apply an antibiotic ointment before insertion D) Insert without
gloves to assess vein B) Use a chlorhexidine gluconate (CHG) swab for 30
seconds Rationale: CHG is the CDC-recommended antiseptic for IV
insertion, reducing skin flora more effectively than alcohol (2025
guidelines). A is suboptimal; C risks resistance; D violates asepsis. Critical
thinking: Prioritizes evidence-based infection prevention to reduce
CLABSI/CAUTI rates.
3. Management of Care: A client with a DNR order experiences respiratory
arrest. The nurse's priority action is: A) Initiate CPR immediately B) Verify
the DNR order and withhold resuscitation C) Administer oxygen via non -
rebreather mask D) Call the rapid response team B) Verify the DNR order
and withhold resuscitation Rationale: DNR respects client autonomy and
advance directives (ANA Code of Ethics). A violates the order; C and D
, delay honoring it. Critical thinking: Balances ethical principles (autonomy
vs. beneficence); confirm order validity to avoid legal issues.
4. Safety and Infection Control: During a pandemic outbreak, a nurse
identifies a client's mask is below the nose. The best response is: A) Ignore it
to avoid confrontation B) Politely remind the client to adjust the mask C)
Replace the mask with a new one D) Escalate to security B) Politely remind
the client to adjust the mask Rationale: Therapeutic communication
promotes compliance with PPE protocols (CDC 2025 droplet precautions).
A risks transmission; C is unnecessary; D is disproportionate. Critical
thinking: Uses assertiveness to ensure safety without alienating the client.
5. Management of Care: A nurse manager is conducting performance
appraisals. Which approach best fosters professional growth? A) Focus
solely on weaknesses B) Use SMART goals for improvement C) Provide
feedback quarterly only D) Compare to peers' performance B) Use SMART
goals for improvement Rationale: SMART (Specific, Measurable,
Achievable, Relevant, Time-bound) goals align with transformational
leadership, promoting accountability (AACN standards). A demotivates; C
lacks frequency; D fosters competition. Critical thinking: Encourages self-
reflection and measurable progress.
6. Safety and Infection Control: A client with MRSA is on contact
precautions. Which PPE should the nurse don first upon entry? A) Gown B)
Gloves C) Mask D) Eyewear A) Gown Rationale: Donning order (gown
first) prevents contamination (CDC sequence: gown, mask/eye, hand
hygiene, gloves). B risks self-contamination; C/D not primary for contact.
Critical thinking: Applies chain of infection principles to break
transmission.
7. Management of Care: In a sentinel event review, the root cause analysis
identifies communication breakdown. The priority intervention is: A)
Mandatory staff retraining B) Implement SBAR tool unit-wide C) Increase
staffing ratios D) Change EHR vendor B) Implement SBAR tool unit-wide
Rationale: SBAR (Situation, Background, Assessment, Recommendation)
standardizes handoffs, reducing errors (Joint Commission 2025). A is
broad; C/D address symptoms. Critical thinking: Targets systems issues for
sustainable safety improvements.
8. Safety and Infection Control: A nurse suspects a needlestick injury
exposure to HBV. Immediate action? A) Continue shift without reporting B)
Wash with soap/water, report to occupational health C) Apply bleach to the
site D) Self-administer HBIG B) Wash with soap/water, report to
occupational health Rationale: OSHA protocol: immediate flush/report for
post-exposure prophylaxis (PEP) within 72 hours. A risks progression; C
, causes tissue damage; D is unauthorized. Critical thinking: Prioritizes rapid
intervention to prevent seroconversion.
9. Management of Care: A client refuses blood transfusion due to religious
beliefs. The nurse's best response is: A) Proceed with transfusion for
beneficence B) Document refusal and explore alternatives C) Consult ethics
committee immediately D) Discharge the client B) Document refusal and
explore alternatives Rationale: Informed refusal upholds autonomy (ANA);
explore options like volume expanders. A violates rights; C/D premature.
Critical thinking: Integrates ethics (autonomy > nonmaleficence) with
advocacy.
10.Safety and Infection Control: For a client with C. difficile, the nurse
selects which precaution? A) Droplet B) Airborne C) Contact D) Standard
only C) Contact Rationale: C. diff spores require contact precautions +
hypochlorite bleach cleaning (CDC). A/B for respiratory; D insufficient.
Critical thinking: Applies transmission-based precautions to contain
outbreaks.
11.Management of Care: A nurse is advocating for a client denied insurance
coverage for home health. Best action? A) Accept the denial B) Appeal with
clinical documentation C) Switch providers D) Self-pay arrangement B)
Appeal with clinical documentation Rationale: Advocacy involves
navigating systems (ANA); evidence supports appeals' success. A passive;
C/D not first-line. Critical thinking: Uses data to ensure equitable care
access.
12.Safety and Infection Control: During hand hygiene audit, compliance is
60%. Priority intervention? A) Disciplinary action B) Education sessions
with feedback C) Change sanitizer brand D) Reduce audit frequency B)
Education sessions with feedback Rationale: WHO multimodal strategy
emphasizes education/behavior change over punishment. A demotivates;
C/D ineffective. Critical thinking: Addresses root causes like knowledge
gaps for sustained HAI reduction.
13.Management of Care: In disaster triage, a client with minor fractures but
stable vitals is classified as: A) Black (expectant) B) Red (immediate) C)
Yellow (delayed) D) Green (minimal) D) Green (minimal) Rationale:
START triage: Green for ambulatory, minor injuries (FEMA 2025). A for
moribund; B critical ABCs; C urgent but stable. Critical thinking:
Maximizes resources in mass casualty.
14.Safety and Infection Control: A nurse uses a central line kit. Which step
indicates proper sterile technique? A) Touching the catheter tip briefly B)
Maintaining a sterile field above waist C) Wearing street clothes under gown
D) Talking over the field B) Maintaining a sterile field above waist
(2025/2026) | Verified 100%
Correct Questions &
Rationales
Safe and Effective Care Environment (Questions 1–30)
1. Management of Care: A charge nurse is delegating tasks on a med-surg
unit. Which task should be delegated to an unlicensed assistive personnel
(UAP)? A) Assessing a newly admitted client's pain level B) Ambulating a
stable post-op client C) Developing a discharge teaching plan D) Evaluating
the effectiveness of a client's IV fluids B) Ambulating a stable post-op client
Rationale: Delegation to UAP is appropriate for stable, routine ADLs like
ambulation (NCSBN Five Rights of Delegation: right task, circumstance,
person). A is incorrect as assessment requires RN judgment. C and D
involve planning/evaluation, RN-only functions. Critical thinking: Ensures
efficient resource use while maintaining safety; assess client stability first.
2. Safety and Infection Control: A nurse is preparing to insert a peripheral IV
catheter. Which action best prevents infection? A) Clean the site with
alcohol for 15 seconds B) Use a chlorhexidine gluconate (CHG) swab for 30
seconds C) Apply an antibiotic ointment before insertion D) Insert without
gloves to assess vein B) Use a chlorhexidine gluconate (CHG) swab for 30
seconds Rationale: CHG is the CDC-recommended antiseptic for IV
insertion, reducing skin flora more effectively than alcohol (2025
guidelines). A is suboptimal; C risks resistance; D violates asepsis. Critical
thinking: Prioritizes evidence-based infection prevention to reduce
CLABSI/CAUTI rates.
3. Management of Care: A client with a DNR order experiences respiratory
arrest. The nurse's priority action is: A) Initiate CPR immediately B) Verify
the DNR order and withhold resuscitation C) Administer oxygen via non -
rebreather mask D) Call the rapid response team B) Verify the DNR order
and withhold resuscitation Rationale: DNR respects client autonomy and
advance directives (ANA Code of Ethics). A violates the order; C and D
, delay honoring it. Critical thinking: Balances ethical principles (autonomy
vs. beneficence); confirm order validity to avoid legal issues.
4. Safety and Infection Control: During a pandemic outbreak, a nurse
identifies a client's mask is below the nose. The best response is: A) Ignore it
to avoid confrontation B) Politely remind the client to adjust the mask C)
Replace the mask with a new one D) Escalate to security B) Politely remind
the client to adjust the mask Rationale: Therapeutic communication
promotes compliance with PPE protocols (CDC 2025 droplet precautions).
A risks transmission; C is unnecessary; D is disproportionate. Critical
thinking: Uses assertiveness to ensure safety without alienating the client.
5. Management of Care: A nurse manager is conducting performance
appraisals. Which approach best fosters professional growth? A) Focus
solely on weaknesses B) Use SMART goals for improvement C) Provide
feedback quarterly only D) Compare to peers' performance B) Use SMART
goals for improvement Rationale: SMART (Specific, Measurable,
Achievable, Relevant, Time-bound) goals align with transformational
leadership, promoting accountability (AACN standards). A demotivates; C
lacks frequency; D fosters competition. Critical thinking: Encourages self-
reflection and measurable progress.
6. Safety and Infection Control: A client with MRSA is on contact
precautions. Which PPE should the nurse don first upon entry? A) Gown B)
Gloves C) Mask D) Eyewear A) Gown Rationale: Donning order (gown
first) prevents contamination (CDC sequence: gown, mask/eye, hand
hygiene, gloves). B risks self-contamination; C/D not primary for contact.
Critical thinking: Applies chain of infection principles to break
transmission.
7. Management of Care: In a sentinel event review, the root cause analysis
identifies communication breakdown. The priority intervention is: A)
Mandatory staff retraining B) Implement SBAR tool unit-wide C) Increase
staffing ratios D) Change EHR vendor B) Implement SBAR tool unit-wide
Rationale: SBAR (Situation, Background, Assessment, Recommendation)
standardizes handoffs, reducing errors (Joint Commission 2025). A is
broad; C/D address symptoms. Critical thinking: Targets systems issues for
sustainable safety improvements.
8. Safety and Infection Control: A nurse suspects a needlestick injury
exposure to HBV. Immediate action? A) Continue shift without reporting B)
Wash with soap/water, report to occupational health C) Apply bleach to the
site D) Self-administer HBIG B) Wash with soap/water, report to
occupational health Rationale: OSHA protocol: immediate flush/report for
post-exposure prophylaxis (PEP) within 72 hours. A risks progression; C
, causes tissue damage; D is unauthorized. Critical thinking: Prioritizes rapid
intervention to prevent seroconversion.
9. Management of Care: A client refuses blood transfusion due to religious
beliefs. The nurse's best response is: A) Proceed with transfusion for
beneficence B) Document refusal and explore alternatives C) Consult ethics
committee immediately D) Discharge the client B) Document refusal and
explore alternatives Rationale: Informed refusal upholds autonomy (ANA);
explore options like volume expanders. A violates rights; C/D premature.
Critical thinking: Integrates ethics (autonomy > nonmaleficence) with
advocacy.
10.Safety and Infection Control: For a client with C. difficile, the nurse
selects which precaution? A) Droplet B) Airborne C) Contact D) Standard
only C) Contact Rationale: C. diff spores require contact precautions +
hypochlorite bleach cleaning (CDC). A/B for respiratory; D insufficient.
Critical thinking: Applies transmission-based precautions to contain
outbreaks.
11.Management of Care: A nurse is advocating for a client denied insurance
coverage for home health. Best action? A) Accept the denial B) Appeal with
clinical documentation C) Switch providers D) Self-pay arrangement B)
Appeal with clinical documentation Rationale: Advocacy involves
navigating systems (ANA); evidence supports appeals' success. A passive;
C/D not first-line. Critical thinking: Uses data to ensure equitable care
access.
12.Safety and Infection Control: During hand hygiene audit, compliance is
60%. Priority intervention? A) Disciplinary action B) Education sessions
with feedback C) Change sanitizer brand D) Reduce audit frequency B)
Education sessions with feedback Rationale: WHO multimodal strategy
emphasizes education/behavior change over punishment. A demotivates;
C/D ineffective. Critical thinking: Addresses root causes like knowledge
gaps for sustained HAI reduction.
13.Management of Care: In disaster triage, a client with minor fractures but
stable vitals is classified as: A) Black (expectant) B) Red (immediate) C)
Yellow (delayed) D) Green (minimal) D) Green (minimal) Rationale:
START triage: Green for ambulatory, minor injuries (FEMA 2025). A for
moribund; B critical ABCs; C urgent but stable. Critical thinking:
Maximizes resources in mass casualty.
14.Safety and Infection Control: A nurse uses a central line kit. Which step
indicates proper sterile technique? A) Touching the catheter tip briefly B)
Maintaining a sterile field above waist C) Wearing street clothes under gown
D) Talking over the field B) Maintaining a sterile field above waist
