RN HESI EXIT EXAM VERSION 2 (V2) Actual
Exam 2026/2027 – Complete Questions and
Answers with Detailed Rationales – Pass
Guaranteed - A+ Graded
Total Questions: 160 | Time: 240 min | Pass: 850 scaled (75%)
TABLE OF CONTENTS
Section 1 | Safe & Effective Care Environment | Q1 – Q25
Section 2 | Health Promotion & Maintenance | Q26 – Q50
Section 3 | Psychosocial Integrity | Q51 – Q70
Section 4 | Basic Care & Comfort | Q71 – Q88
Section 5 | Pharmacological & Parenteral Therapies | Q89 – Q106
Section 6 | Reduction of Risk Potential | Q107 – Q126
Section 7 | Physiological Adaptation | Q127 – Q146
Section 8 | Integrated Nursing Concepts & Prioritization | Q147 – Q160
Instructions: Choose the single best answer. Pass: 850 scaled (75%) in 240 minutes.
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SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT Q1 – Q25
══════════════════════════════════════
Question 1 of 160
A 78-year-old patient with dementia attempts to climb out of bed every 30 minutes
despite a low bed and floor mats. The nurse has tried reorientation, frequent toileting,
and a sitter, but the behavior persists. The next safest intervention is to:
A. Apply bilateral wrist restraints to keep the patient in bed
B. Place the patient in a vest restraint secured to the bed frame
C. Use a bed alarm and engage family at bedside for redirection ✓ CORRECT
D. Move the patient to a room farthest from the nurses' station
,Correct Answer: C
Rationale: Bed alarms with family engagement are less restrictive than physical
restraints and align with CMS guidelines to minimize restraint use in confused patients.
Option B increases risks of strangulation, aspiration, and injury from struggling, and
restraints require a provider's order with timed reassessment. Non-restraint alternatives
should be exhausted and documented before any physical restraint is considered.
Question 2 of 160
During a fire drill on the surgical unit, the nurse smells smoke coming from a storage
closet near oxygen tanks. The nurse's immediate action according to the RACE protocol
is to:
A. Activate the alarm, then contain the fire by closing doors ✓ CORRECT
B. Extinguish the fire with the nearest available fire blanket
C. Evacuate patients horizontally to the next smoke compartment
D. Call engineering first to verify if the smoke is from construction
Correct Answer: A
Rationale: RACE stands for Rescue, Alarm, Contain, and Extinguish or Evacuate;
activating the alarm and containing the fire are the first priorities when smoke is near
oxygen. Option B is dangerous because attempting to extinguish a fire near oxygen
without knowing the extent risks explosion and personal injury. Closing doors limits
oxygen supply to the fire and protects patient areas.
Question 3 of 160
A nurse manager reviews an incident report after a patient received the wrong
antibiotic. The root cause analysis reveals that the pharmacy stocks azithromycin and
aztreonam in identical-size vials next to each other. The most effective system
intervention is to:
,A. Reprimand the nurse who administered the wrong medication
B. Require two nurses to verify all antibiotic administrations
C. Separate the look-alike medications and apply tall-man lettering ✓ CORRECT
D. Eliminate aztreonam from the formulary entirely
Correct Answer: C
Rationale: Look-alike sound-alike medication errors are best prevented at the system
level through physical separation and tall-man lettering to distinguish similar names.
Option A focuses on individual blame rather than fixing the hazardous condition that set
the nurse up for failure. Pharmacy and nursing collaboration on storage solutions
prevents future errors before they reach the bedside.
Question 4 of 160
A home health nurse visits a 68-year-old patient who lives alone and notices extension
cords running under carpets, a space heater near oxygen tubing, and expired fire
extinguishers. The nurse's priority teaching is to address:
A. The need for a medical alert bracelet in case of falls
B. Fire hazards from the space heater and oxygen combination ✓ CORRECT
C. Social isolation and referral to a senior community center
D. Medication adherence and pill organizer use
Correct Answer: B
Rationale: Oxygen accelerates combustion, and a space heater near oxygen tubing
creates an imminent fire hazard that could kill the patient and neighbors. Option C
addresses psychosocial needs but does not take priority over immediate life safety.
Home health nurses must address environmental safety first and document hazards for
the interdisciplinary team.
Question 5 of 160
, A registered nurse is delegating morning care on a busy medical-surgical unit. Which
task is most appropriate to assign to an experienced unlicensed assistive personnel?
A. Assess a new postoperative patient's abdominal incision for dehiscence
B. Evaluate a patient's response to PRN pain medication administered an hour ago
C. Perform standard bed baths on stable patients who are alert and oriented ✓
CORRECT
D. Teach a newly diagnosed diabetic patient how to draw up insulin
Correct Answer: C
Rationale: Bed baths for stable patients have predictable outcomes and fall within the
UAP scope of practice under RN delegation and supervision. Options A and B require
nursing assessment and clinical judgment, which cannot be delegated to unlicensed
staff. Patient education about high-risk medications like insulin requires RN-level
teaching and return demonstration.
Question 6 of 160
A 4-year-old child is brought to the emergency department with a spiral fracture of the
femur. The parent states the child fell off a low chair. The child is withdrawn and
flinches when the nurse approaches. The nurse's legal obligation is to:
A. Confront the parent about the inconsistency between the injury and explanation
B. Obtain a skeletal survey and report suspected abuse to child protective services ✓
CORRECT
C. Document the findings and wait for the physician to decide on reporting
D. Ask the child directly if the parent caused the injury
Correct Answer: B
Rationale: Nurses are mandatory reporters, and a spiral femur fracture inconsistent with
a minor fall in a withdrawn child meets criteria for suspected abuse requiring immediate
reporting. Option C delays protection of the child because waiting for the physician
Exam 2026/2027 – Complete Questions and
Answers with Detailed Rationales – Pass
Guaranteed - A+ Graded
Total Questions: 160 | Time: 240 min | Pass: 850 scaled (75%)
TABLE OF CONTENTS
Section 1 | Safe & Effective Care Environment | Q1 – Q25
Section 2 | Health Promotion & Maintenance | Q26 – Q50
Section 3 | Psychosocial Integrity | Q51 – Q70
Section 4 | Basic Care & Comfort | Q71 – Q88
Section 5 | Pharmacological & Parenteral Therapies | Q89 – Q106
Section 6 | Reduction of Risk Potential | Q107 – Q126
Section 7 | Physiological Adaptation | Q127 – Q146
Section 8 | Integrated Nursing Concepts & Prioritization | Q147 – Q160
Instructions: Choose the single best answer. Pass: 850 scaled (75%) in 240 minutes.
══════════════════════════════════════
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT Q1 – Q25
══════════════════════════════════════
Question 1 of 160
A 78-year-old patient with dementia attempts to climb out of bed every 30 minutes
despite a low bed and floor mats. The nurse has tried reorientation, frequent toileting,
and a sitter, but the behavior persists. The next safest intervention is to:
A. Apply bilateral wrist restraints to keep the patient in bed
B. Place the patient in a vest restraint secured to the bed frame
C. Use a bed alarm and engage family at bedside for redirection ✓ CORRECT
D. Move the patient to a room farthest from the nurses' station
,Correct Answer: C
Rationale: Bed alarms with family engagement are less restrictive than physical
restraints and align with CMS guidelines to minimize restraint use in confused patients.
Option B increases risks of strangulation, aspiration, and injury from struggling, and
restraints require a provider's order with timed reassessment. Non-restraint alternatives
should be exhausted and documented before any physical restraint is considered.
Question 2 of 160
During a fire drill on the surgical unit, the nurse smells smoke coming from a storage
closet near oxygen tanks. The nurse's immediate action according to the RACE protocol
is to:
A. Activate the alarm, then contain the fire by closing doors ✓ CORRECT
B. Extinguish the fire with the nearest available fire blanket
C. Evacuate patients horizontally to the next smoke compartment
D. Call engineering first to verify if the smoke is from construction
Correct Answer: A
Rationale: RACE stands for Rescue, Alarm, Contain, and Extinguish or Evacuate;
activating the alarm and containing the fire are the first priorities when smoke is near
oxygen. Option B is dangerous because attempting to extinguish a fire near oxygen
without knowing the extent risks explosion and personal injury. Closing doors limits
oxygen supply to the fire and protects patient areas.
Question 3 of 160
A nurse manager reviews an incident report after a patient received the wrong
antibiotic. The root cause analysis reveals that the pharmacy stocks azithromycin and
aztreonam in identical-size vials next to each other. The most effective system
intervention is to:
,A. Reprimand the nurse who administered the wrong medication
B. Require two nurses to verify all antibiotic administrations
C. Separate the look-alike medications and apply tall-man lettering ✓ CORRECT
D. Eliminate aztreonam from the formulary entirely
Correct Answer: C
Rationale: Look-alike sound-alike medication errors are best prevented at the system
level through physical separation and tall-man lettering to distinguish similar names.
Option A focuses on individual blame rather than fixing the hazardous condition that set
the nurse up for failure. Pharmacy and nursing collaboration on storage solutions
prevents future errors before they reach the bedside.
Question 4 of 160
A home health nurse visits a 68-year-old patient who lives alone and notices extension
cords running under carpets, a space heater near oxygen tubing, and expired fire
extinguishers. The nurse's priority teaching is to address:
A. The need for a medical alert bracelet in case of falls
B. Fire hazards from the space heater and oxygen combination ✓ CORRECT
C. Social isolation and referral to a senior community center
D. Medication adherence and pill organizer use
Correct Answer: B
Rationale: Oxygen accelerates combustion, and a space heater near oxygen tubing
creates an imminent fire hazard that could kill the patient and neighbors. Option C
addresses psychosocial needs but does not take priority over immediate life safety.
Home health nurses must address environmental safety first and document hazards for
the interdisciplinary team.
Question 5 of 160
, A registered nurse is delegating morning care on a busy medical-surgical unit. Which
task is most appropriate to assign to an experienced unlicensed assistive personnel?
A. Assess a new postoperative patient's abdominal incision for dehiscence
B. Evaluate a patient's response to PRN pain medication administered an hour ago
C. Perform standard bed baths on stable patients who are alert and oriented ✓
CORRECT
D. Teach a newly diagnosed diabetic patient how to draw up insulin
Correct Answer: C
Rationale: Bed baths for stable patients have predictable outcomes and fall within the
UAP scope of practice under RN delegation and supervision. Options A and B require
nursing assessment and clinical judgment, which cannot be delegated to unlicensed
staff. Patient education about high-risk medications like insulin requires RN-level
teaching and return demonstration.
Question 6 of 160
A 4-year-old child is brought to the emergency department with a spiral fracture of the
femur. The parent states the child fell off a low chair. The child is withdrawn and
flinches when the nurse approaches. The nurse's legal obligation is to:
A. Confront the parent about the inconsistency between the injury and explanation
B. Obtain a skeletal survey and report suspected abuse to child protective services ✓
CORRECT
C. Document the findings and wait for the physician to decide on reporting
D. Ask the child directly if the parent caused the injury
Correct Answer: B
Rationale: Nurses are mandatory reporters, and a spiral femur fracture inconsistent with
a minor fall in a withdrawn child meets criteria for suspected abuse requiring immediate
reporting. Option C delays protection of the child because waiting for the physician
