HESI Exit RN Exam 2026/2027 – Actual Practice
Questions Comprehensive Practice Exam with Correct
Answers and Detailed Explanations | INSTANT PDF
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SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1-30)
Q1. A nurse is preparing to delegate tasks to an unlicensed assistive
personnel (UAP). Which task is appropriate for the nurse to delegate?
A) Assessing a client's pain level
B) Administering oral medications
C) Ambulating a stable client
D) Evaluating the effectiveness of pain medication
Correct Answer: C. Ambulating a stable client
Delegation follows the "Five Rights": right task, right circumstance, right person,
right direction/communication, and right supervision. UAP can ambulate stable
clients, assist with activities of daily living, and obtain vital signs on stable
clients. Assessment, medication administration, and evaluation are the
responsibility of the licensed nurse .
Q2. A nurse receives a telephone order from a provider for a client's pain
medication. What is the nurse's priority action?
,A) Implement the order immediately
B) Write the order in the chart and sign "TO"
C) Read the order back to the provider for verification
D) Ask another nurse to listen to the order
Correct Answer: C. Read the order back to the provider for verification
The "read back" process is a critical safety measure that ensures accurate
communication of verbal and telephone orders. After writing the order, the nurse
should read it back to the provider verbatim to confirm accuracy. This is a Joint
Commission safety standard .
Q3. A nurse is caring for a client who is post-operative day 2 and has a
platelet count of 20,000/mm³. Which intervention should the nurse
implement?
A) Use an electric razor for shaving
B) Administer IM pain medication
C) Apply warm compresses to IV sites
D) Encourage the client to floss teeth daily
Correct Answer: A. Use an electric razor for shaving
With severe thrombocytopenia (platelets <50,000), bleeding precautions should
be implemented: electric razor (not straight razor), soft toothbrush (no flossing),
,no IM injections, and avoid rectal temperatures. These measures reduce the risk
of bleeding complications .
Q4. A nurse is preparing to administer a blood transfusion to a client.
Which IV solution is compatible with blood products?
A) Lactated Ringer's solution
B) 5% Dextrose in water
C) 0.9% Normal saline
D) 0.45% Normal saline
Correct Answer: C. 0.9% Normal saline
Only 0.9% normal saline is compatible with blood products. Dextrose solutions
can cause hemolysis (red blood cell destruction), and lactated Ringer's contains
calcium that can cause clotting in the tubing .
Q5. A nurse is caring for a client who has a new prescription for wrist
restraints. Which action is most important?
A) Document the reason for restraint use
B) Tie the restraints to the bed frame (not side rail)
C) Remove restraints every 4 hours for range of motion
D) Obtain a PRN order for restraints
Correct Answer: B. Tie the restraints to the bed frame (not side rail)
, Restraints should be tied to the movable part of the bed frame to prevent injury if
the side rail is lowered. Restraints should never be tied to the side rail.
Restraints require a provider's order, must be removed every 2 hours for ROM,
and require documentation of the reason for use .
Q6. A nurse is caring for a client receiving heparin therapy. Which lab
value should be monitored?
A) INR
B) PT
C) aPTT
D) Platelet count only
Correct Answer: C. aPTT
Activated partial thromboplastin time (aPTT) monitors the effectiveness of
heparin therapy. The therapeutic goal is 1.5 to 2.5 times the normal control
value (approximately 60-80 seconds). This indicates adequate anticoagulation
without excessive bleeding risk .
Q7. A nurse is caring for a client who has a new diagnosis of
Clostridioides difficile. Which infection control precautions should the
nurse implement?
Questions Comprehensive Practice Exam with Correct
Answers and Detailed Explanations | INSTANT PDF
DOWNLOAD
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1-30)
Q1. A nurse is preparing to delegate tasks to an unlicensed assistive
personnel (UAP). Which task is appropriate for the nurse to delegate?
A) Assessing a client's pain level
B) Administering oral medications
C) Ambulating a stable client
D) Evaluating the effectiveness of pain medication
Correct Answer: C. Ambulating a stable client
Delegation follows the "Five Rights": right task, right circumstance, right person,
right direction/communication, and right supervision. UAP can ambulate stable
clients, assist with activities of daily living, and obtain vital signs on stable
clients. Assessment, medication administration, and evaluation are the
responsibility of the licensed nurse .
Q2. A nurse receives a telephone order from a provider for a client's pain
medication. What is the nurse's priority action?
,A) Implement the order immediately
B) Write the order in the chart and sign "TO"
C) Read the order back to the provider for verification
D) Ask another nurse to listen to the order
Correct Answer: C. Read the order back to the provider for verification
The "read back" process is a critical safety measure that ensures accurate
communication of verbal and telephone orders. After writing the order, the nurse
should read it back to the provider verbatim to confirm accuracy. This is a Joint
Commission safety standard .
Q3. A nurse is caring for a client who is post-operative day 2 and has a
platelet count of 20,000/mm³. Which intervention should the nurse
implement?
A) Use an electric razor for shaving
B) Administer IM pain medication
C) Apply warm compresses to IV sites
D) Encourage the client to floss teeth daily
Correct Answer: A. Use an electric razor for shaving
With severe thrombocytopenia (platelets <50,000), bleeding precautions should
be implemented: electric razor (not straight razor), soft toothbrush (no flossing),
,no IM injections, and avoid rectal temperatures. These measures reduce the risk
of bleeding complications .
Q4. A nurse is preparing to administer a blood transfusion to a client.
Which IV solution is compatible with blood products?
A) Lactated Ringer's solution
B) 5% Dextrose in water
C) 0.9% Normal saline
D) 0.45% Normal saline
Correct Answer: C. 0.9% Normal saline
Only 0.9% normal saline is compatible with blood products. Dextrose solutions
can cause hemolysis (red blood cell destruction), and lactated Ringer's contains
calcium that can cause clotting in the tubing .
Q5. A nurse is caring for a client who has a new prescription for wrist
restraints. Which action is most important?
A) Document the reason for restraint use
B) Tie the restraints to the bed frame (not side rail)
C) Remove restraints every 4 hours for range of motion
D) Obtain a PRN order for restraints
Correct Answer: B. Tie the restraints to the bed frame (not side rail)
, Restraints should be tied to the movable part of the bed frame to prevent injury if
the side rail is lowered. Restraints should never be tied to the side rail.
Restraints require a provider's order, must be removed every 2 hours for ROM,
and require documentation of the reason for use .
Q6. A nurse is caring for a client receiving heparin therapy. Which lab
value should be monitored?
A) INR
B) PT
C) aPTT
D) Platelet count only
Correct Answer: C. aPTT
Activated partial thromboplastin time (aPTT) monitors the effectiveness of
heparin therapy. The therapeutic goal is 1.5 to 2.5 times the normal control
value (approximately 60-80 seconds). This indicates adequate anticoagulation
without excessive bleeding risk .
Q7. A nurse is caring for a client who has a new diagnosis of
Clostridioides difficile. Which infection control precautions should the
nurse implement?
