1
HESI Exit Exam 2026/2027 Actual Exam |
Complete Questions, Answers, and Detailed
Rationales for Nursing Students | Pass
Guaranteed - A+ Graded
Safe and Effective Care Environment – Management of Care
Q1: A nurse is caring for a patient who has a living will refusing life-sustaining treatment. The
patient develops respiratory failure and the family demands intubation. Which of the following
actions should the nurse take?
A. Intubate the patient to satisfy family wishes
B. Refuse to care for the patient
C. Advocate for the patient's wishes as documented in the living will [CORRECT]
D. Transfer the patient to another unit
Correct Answer: C
Rationale: The patient's living will is a legal document expressing their autonomous wishes
regarding end-of-life care. The nurse has an ethical and legal duty to advocate for these wishes,
even if the family disagrees. Option A violates patient autonomy. Option B constitutes
abandonment. Option D delays care and is unnecessary if the will is valid.
Q2: A registered nurse (RN) is delegating tasks to a licensed practical nurse (LPN) and an
unlicensed assistive personnel (UAP). Which of the following tasks is appropriate to delegate to
the UAP?
A. Teaching a patient how to use a glucometer
B. Measuring vital signs on a stable post-operative patient [CORRECT]
C. Assessing a patient's incision site for infection
D. Administering oral medications
,2
Correct Answer: B
Rationale: UAPs can perform routine tasks like measuring vital signs on stable patients.
Teaching (Option A) and assessment (Option C) are within the scope of the RN. Medication
administration (Option D) typically requires a license (RN or LPN).
Q3: A nurse witnesses a colleague diverting narcotics for personal use. Which of the following is
the most appropriate initial action?
A. Report the colleague to the State Board of Nursing
B. Confront the colleague in the presence of a supervisor
C. Document the observation and report it to the nurse manager [CORRECT]
D. Ignore the behavior until proof is obtained
Correct Answer: C
Rationale: The chain of command requires reporting unsafe practice. Documenting the
observation objectively and reporting it to the immediate supervisor (nurse manager) allows for
proper investigation. Option A is usually a later step if facility process fails. Option B is
confrontational and potentially unsafe. Option D allows the diversion to continue.
Q4: A patient is admitted with a gunshot wound to the abdomen. The nurse should prioritize
which of the following assessments?
A. Level of consciousness
B. Site of injury
C. Airway patency [CORRECT]
D. Pain level
Correct Answer: C
Rationale: The ABCs (Airway, Breathing, Circulation) guide prioritization in trauma. Airway
patency is the first priority. Once the airway is secured, breathing and circulation (bleeding
control) follow. Pain and level of consciousness are secondary assessments.
,3
Q5: The nurse is caring for four patients. Which patient should the nurse assess first?
A. A patient with diabetes requesting a snack
B. A patient with a new cast reporting "hot spots" and burning pain [CORRECT]
C. A patient waiting for discharge instructions
D. A patient requiring a dressing change on a chronic wound
Correct Answer: B
Rationale: Burning pain and "hot spots" under a cast suggest compartment syndrome or pressure
injury, which requires immediate intervention to prevent permanent neurovascular damage. This
is the highest priority compared to routine needs like snacks, discharge, or dressing changes.
Q6: Which of the following situations requires the nurse to complete an incident report?
A. A patient refuses to take a prescribed medication.
B. A visitor slips and falls in the hallway [CORRECT]
C. A patient requests to speak with a chaplain.
D. A patient's family member brings food from home.
Correct Answer: B
Rationale: Incident reports are required for any unexpected event that causes or has the potential
to cause injury, including visitor falls. Refusal of medication (Option A) is documented in the
chart but is not necessarily an "incident" requiring a separate report unless harm results. Options
C and D are routine occurrences.
Q7: A nurse is assigned to care for a patient with tuberculosis (TB). Which type of isolation
precautions is required?
A. Contact Precautions
B. Droplet Precautions
C. Airborne Precautions [CORRECT]
D. Protective Environment
, 4
Correct Answer: C
Rationale: TB is an airborne disease transmitted by droplet nuclei smaller than 5 microns.
Airborne precautions require a negative pressure room and N95 respirator. Droplet precautions
(B) are for larger droplets (e.g., influenza). Contact precautions (A) are for direct touch
transmission.
Q8: The nurse receives a telephone order from a physician for a medication. Which action must
the nurse take to ensure safety?
A. Administer the medication immediately
B. Write "VO" (verbal order) on the chart and sign it
C. Read the order back to the physician to verify accuracy [CORRECT]
D. Ask another nurse to witness the order
Correct Answer: C
Rationale: The "read-back" or "repeat-back" method is a standard safety practice to verify
telephone and verbal orders. The nurse must ensure the order is understood correctly before
administration and documentation.
Q9: A patient is scheduled for surgery and has a "Do Not Resuscitate" (DNR) order in the chart.
The surgeon requests that the DNR be suspended during the procedure. What is the nurse's
responsibility?
A. Follow the surgeon's request automatically
B. Advise the patient to revoke the DNR permanently
C. Facilitate a discussion between the patient and the surgical team regarding the temporary
suspension [CORRECT]
D. Cancel the surgery
Correct Answer: C
HESI Exit Exam 2026/2027 Actual Exam |
Complete Questions, Answers, and Detailed
Rationales for Nursing Students | Pass
Guaranteed - A+ Graded
Safe and Effective Care Environment – Management of Care
Q1: A nurse is caring for a patient who has a living will refusing life-sustaining treatment. The
patient develops respiratory failure and the family demands intubation. Which of the following
actions should the nurse take?
A. Intubate the patient to satisfy family wishes
B. Refuse to care for the patient
C. Advocate for the patient's wishes as documented in the living will [CORRECT]
D. Transfer the patient to another unit
Correct Answer: C
Rationale: The patient's living will is a legal document expressing their autonomous wishes
regarding end-of-life care. The nurse has an ethical and legal duty to advocate for these wishes,
even if the family disagrees. Option A violates patient autonomy. Option B constitutes
abandonment. Option D delays care and is unnecessary if the will is valid.
Q2: A registered nurse (RN) is delegating tasks to a licensed practical nurse (LPN) and an
unlicensed assistive personnel (UAP). Which of the following tasks is appropriate to delegate to
the UAP?
A. Teaching a patient how to use a glucometer
B. Measuring vital signs on a stable post-operative patient [CORRECT]
C. Assessing a patient's incision site for infection
D. Administering oral medications
,2
Correct Answer: B
Rationale: UAPs can perform routine tasks like measuring vital signs on stable patients.
Teaching (Option A) and assessment (Option C) are within the scope of the RN. Medication
administration (Option D) typically requires a license (RN or LPN).
Q3: A nurse witnesses a colleague diverting narcotics for personal use. Which of the following is
the most appropriate initial action?
A. Report the colleague to the State Board of Nursing
B. Confront the colleague in the presence of a supervisor
C. Document the observation and report it to the nurse manager [CORRECT]
D. Ignore the behavior until proof is obtained
Correct Answer: C
Rationale: The chain of command requires reporting unsafe practice. Documenting the
observation objectively and reporting it to the immediate supervisor (nurse manager) allows for
proper investigation. Option A is usually a later step if facility process fails. Option B is
confrontational and potentially unsafe. Option D allows the diversion to continue.
Q4: A patient is admitted with a gunshot wound to the abdomen. The nurse should prioritize
which of the following assessments?
A. Level of consciousness
B. Site of injury
C. Airway patency [CORRECT]
D. Pain level
Correct Answer: C
Rationale: The ABCs (Airway, Breathing, Circulation) guide prioritization in trauma. Airway
patency is the first priority. Once the airway is secured, breathing and circulation (bleeding
control) follow. Pain and level of consciousness are secondary assessments.
,3
Q5: The nurse is caring for four patients. Which patient should the nurse assess first?
A. A patient with diabetes requesting a snack
B. A patient with a new cast reporting "hot spots" and burning pain [CORRECT]
C. A patient waiting for discharge instructions
D. A patient requiring a dressing change on a chronic wound
Correct Answer: B
Rationale: Burning pain and "hot spots" under a cast suggest compartment syndrome or pressure
injury, which requires immediate intervention to prevent permanent neurovascular damage. This
is the highest priority compared to routine needs like snacks, discharge, or dressing changes.
Q6: Which of the following situations requires the nurse to complete an incident report?
A. A patient refuses to take a prescribed medication.
B. A visitor slips and falls in the hallway [CORRECT]
C. A patient requests to speak with a chaplain.
D. A patient's family member brings food from home.
Correct Answer: B
Rationale: Incident reports are required for any unexpected event that causes or has the potential
to cause injury, including visitor falls. Refusal of medication (Option A) is documented in the
chart but is not necessarily an "incident" requiring a separate report unless harm results. Options
C and D are routine occurrences.
Q7: A nurse is assigned to care for a patient with tuberculosis (TB). Which type of isolation
precautions is required?
A. Contact Precautions
B. Droplet Precautions
C. Airborne Precautions [CORRECT]
D. Protective Environment
, 4
Correct Answer: C
Rationale: TB is an airborne disease transmitted by droplet nuclei smaller than 5 microns.
Airborne precautions require a negative pressure room and N95 respirator. Droplet precautions
(B) are for larger droplets (e.g., influenza). Contact precautions (A) are for direct touch
transmission.
Q8: The nurse receives a telephone order from a physician for a medication. Which action must
the nurse take to ensure safety?
A. Administer the medication immediately
B. Write "VO" (verbal order) on the chart and sign it
C. Read the order back to the physician to verify accuracy [CORRECT]
D. Ask another nurse to witness the order
Correct Answer: C
Rationale: The "read-back" or "repeat-back" method is a standard safety practice to verify
telephone and verbal orders. The nurse must ensure the order is understood correctly before
administration and documentation.
Q9: A patient is scheduled for surgery and has a "Do Not Resuscitate" (DNR) order in the chart.
The surgeon requests that the DNR be suspended during the procedure. What is the nurse's
responsibility?
A. Follow the surgeon's request automatically
B. Advise the patient to revoke the DNR permanently
C. Facilitate a discussion between the patient and the surgical team regarding the temporary
suspension [CORRECT]
D. Cancel the surgery
Correct Answer: C
