NGN HESI RN
RN EXIT REVIEW
NGN HESI RN Exit
Review
160 Original Study Questions with Answers and Rationales
| 2026/2027
Independent educational review; not official HESI/Elsevier content, not leaked test items, and not
a guarantee of passing.
160 160 2026/2027
QUESTIONS ORIGINAL ITEMS EDITION
TOPICS COVERED
Management of care Psychosocial integrity
Safety and infection control Pharmacology and IV therapy
Maternal-newborn and pediatrics Physiological adaptation
COVER PAGE - 1
NGN HESI RN Exit Review - 2026/2027 | Passing Score: 75% | Page 1 of 67
,NGN HESI RN Exit Review
160 Original Study Questions with Answers and Rationales | 2026/2027
Independent educational review; not official HESI/Elsevier content, not leaked test items, and not a guarantee of passing.
Section Questions High-yield focus
Management of Care and Safety/Infection Control
Q1-Q38 prioritization, delegation, isolation precautions, informed consent
Health Promotion and Maintenance Q39-Q56 maternal-newborn care, pediatric milestones, screening and immunization, prenata
Psychosocial Integrity Q57-Q72 therapeutic communication, crisis intervention, suicide safety, substance withdrawa
Basic Care and Comfort Q73-Q90 nutrition, mobility, skin integrity, elimination
Pharmacological and Parenteral Therapies Q91-Q118 medication safety, IV therapy, high-alert medications, adverse effects
Reduction of Risk Potential and Physiological Adaptation
Q119-Q160 clinical judgment, acute deterioration, oxygenation, perfusion
NGN HESI RN Exit Review - 2026/2027 | Passing Score: 75% | Page 2 of 67
, SECTION 1 | Management of Care and Safety/Infection Control | Q1-Q38 | NGN HESI RN Exit Review
2026/2027
Q1 Question 1 of 160
A 78-year-old client admitted with pneumonia is restless, has SpO2 88% on 2 L/min nasal cannula,
and is pulling at the tubing. Four clients need care at the same time, and the nurse is deciding
who to assess first.
A. Assess the client with pneumonia and low oxygen saturation first.
B. Assist a stable postoperative client who requests help choosing lunch.
C. Return a routine phone call from a family member asking about visiting hours.
D. Change linens for a client who is sleeping after pain medication.
Correct Answer: A
Rationale:
Airway and oxygenation take priority because hypoxemia can quickly progress to respiratory failure. Comfort and routine
communication can be delayed or delegated after the unstable client is assessed.
Q2 Question 2 of 160
A charge nurse is assigning tasks on a medical-surgical unit with one RN, one LPN, and one
experienced unlicensed assistive personnel. A stable client needs assistance ambulating after
breakfast and has no new symptoms.
A. Assign the unlicensed assistive personnel to teach the client how to use a walker independently.
B. Delegate ambulation assistance to the experienced unlicensed assistive personnel with fall precautions.
C. Assign the LPN to complete the initial nursing assessment before ambulation.
D. Keep the task for the RN because ambulation can never be delegated.
Correct Answer: B
Rationale:
Routine ambulation for a stable client is appropriate to delegate when directions and safety precautions are clear.
Teaching and initial assessment remain RN responsibilities.
NGN HESI RN Exit Review - 2026/2027 | Passing Score: 75% | Page 3 of 67
, Q3 Question 3 of 160
A nurse receives a telephone order for a new medication while caring for a client with severe pain.
The provider is in the operating room and cannot enter the order immediately.
A. Administer the medication without read-back because the client is in pain.
B. Ask another nurse to guess the dose based on similar prescriptions.
C. Read back the complete order, document per policy, and enter it according to facility procedure.
D. Delay all analgesia until the provider can write the order in person.
Correct Answer: C
Rationale:
Telephone orders require read-back verification to reduce medication errors. Pain should be treated promptly, but safety
steps cannot be skipped.
Q4 Question 4 of 160
A client with tuberculosis is admitted to a negative-pressure room. A new nurse prepares to enter
the room to administer oral medications.
A. Wear a simple surgical mask only because oral medications are not invasive.
B. Use gloves only because tuberculosis spreads mainly by contact with surfaces.
C. Place the client on protective isolation to prevent exposure from staff.
D. Wear a fit-tested N95 respirator before entering the room.
Correct Answer: D
Rationale:
Active pulmonary tuberculosis requires airborne precautions with a fit-tested respirator. Surgical masks and contact
precautions alone do not protect staff from airborne droplet nuclei.
Q5 Question 5 of 160
A client with profuse watery diarrhea is positive for Clostridioides difficile. The nurse observes a
staff member leaving the room after using alcohol-based hand rub only.
A. Instruct the staff member to wash hands with soap and water after caring for this client.
B. Reassure the staff member because alcohol hand rub is preferred for all organisms.
C. Remove the contact precaution sign because hand hygiene was performed.
D. Ask housekeeping to clean only if the client leaves the room.
Correct Answer: A
Rationale:
C. difficile spores require soap-and-water hand hygiene and sporicidal cleaning. Alcohol-based rub is useful for many
organisms but is not sufficient after C. difficile exposure.
NGN HESI RN Exit Review - 2026/2027 | Passing Score: 75% | Page 4 of 67
RN EXIT REVIEW
NGN HESI RN Exit
Review
160 Original Study Questions with Answers and Rationales
| 2026/2027
Independent educational review; not official HESI/Elsevier content, not leaked test items, and not
a guarantee of passing.
160 160 2026/2027
QUESTIONS ORIGINAL ITEMS EDITION
TOPICS COVERED
Management of care Psychosocial integrity
Safety and infection control Pharmacology and IV therapy
Maternal-newborn and pediatrics Physiological adaptation
COVER PAGE - 1
NGN HESI RN Exit Review - 2026/2027 | Passing Score: 75% | Page 1 of 67
,NGN HESI RN Exit Review
160 Original Study Questions with Answers and Rationales | 2026/2027
Independent educational review; not official HESI/Elsevier content, not leaked test items, and not a guarantee of passing.
Section Questions High-yield focus
Management of Care and Safety/Infection Control
Q1-Q38 prioritization, delegation, isolation precautions, informed consent
Health Promotion and Maintenance Q39-Q56 maternal-newborn care, pediatric milestones, screening and immunization, prenata
Psychosocial Integrity Q57-Q72 therapeutic communication, crisis intervention, suicide safety, substance withdrawa
Basic Care and Comfort Q73-Q90 nutrition, mobility, skin integrity, elimination
Pharmacological and Parenteral Therapies Q91-Q118 medication safety, IV therapy, high-alert medications, adverse effects
Reduction of Risk Potential and Physiological Adaptation
Q119-Q160 clinical judgment, acute deterioration, oxygenation, perfusion
NGN HESI RN Exit Review - 2026/2027 | Passing Score: 75% | Page 2 of 67
, SECTION 1 | Management of Care and Safety/Infection Control | Q1-Q38 | NGN HESI RN Exit Review
2026/2027
Q1 Question 1 of 160
A 78-year-old client admitted with pneumonia is restless, has SpO2 88% on 2 L/min nasal cannula,
and is pulling at the tubing. Four clients need care at the same time, and the nurse is deciding
who to assess first.
A. Assess the client with pneumonia and low oxygen saturation first.
B. Assist a stable postoperative client who requests help choosing lunch.
C. Return a routine phone call from a family member asking about visiting hours.
D. Change linens for a client who is sleeping after pain medication.
Correct Answer: A
Rationale:
Airway and oxygenation take priority because hypoxemia can quickly progress to respiratory failure. Comfort and routine
communication can be delayed or delegated after the unstable client is assessed.
Q2 Question 2 of 160
A charge nurse is assigning tasks on a medical-surgical unit with one RN, one LPN, and one
experienced unlicensed assistive personnel. A stable client needs assistance ambulating after
breakfast and has no new symptoms.
A. Assign the unlicensed assistive personnel to teach the client how to use a walker independently.
B. Delegate ambulation assistance to the experienced unlicensed assistive personnel with fall precautions.
C. Assign the LPN to complete the initial nursing assessment before ambulation.
D. Keep the task for the RN because ambulation can never be delegated.
Correct Answer: B
Rationale:
Routine ambulation for a stable client is appropriate to delegate when directions and safety precautions are clear.
Teaching and initial assessment remain RN responsibilities.
NGN HESI RN Exit Review - 2026/2027 | Passing Score: 75% | Page 3 of 67
, Q3 Question 3 of 160
A nurse receives a telephone order for a new medication while caring for a client with severe pain.
The provider is in the operating room and cannot enter the order immediately.
A. Administer the medication without read-back because the client is in pain.
B. Ask another nurse to guess the dose based on similar prescriptions.
C. Read back the complete order, document per policy, and enter it according to facility procedure.
D. Delay all analgesia until the provider can write the order in person.
Correct Answer: C
Rationale:
Telephone orders require read-back verification to reduce medication errors. Pain should be treated promptly, but safety
steps cannot be skipped.
Q4 Question 4 of 160
A client with tuberculosis is admitted to a negative-pressure room. A new nurse prepares to enter
the room to administer oral medications.
A. Wear a simple surgical mask only because oral medications are not invasive.
B. Use gloves only because tuberculosis spreads mainly by contact with surfaces.
C. Place the client on protective isolation to prevent exposure from staff.
D. Wear a fit-tested N95 respirator before entering the room.
Correct Answer: D
Rationale:
Active pulmonary tuberculosis requires airborne precautions with a fit-tested respirator. Surgical masks and contact
precautions alone do not protect staff from airborne droplet nuclei.
Q5 Question 5 of 160
A client with profuse watery diarrhea is positive for Clostridioides difficile. The nurse observes a
staff member leaving the room after using alcohol-based hand rub only.
A. Instruct the staff member to wash hands with soap and water after caring for this client.
B. Reassure the staff member because alcohol hand rub is preferred for all organisms.
C. Remove the contact precaution sign because hand hygiene was performed.
D. Ask housekeeping to clean only if the client leaves the room.
Correct Answer: A
Rationale:
C. difficile spores require soap-and-water hand hygiene and sporicidal cleaning. Alcohol-based rub is useful for many
organisms but is not sufficient after C. difficile exposure.
NGN HESI RN Exit Review - 2026/2027 | Passing Score: 75% | Page 4 of 67
