HESI RN EXIT COMPREHENSIVE EXAM 2026/2027 QUESTIONS
AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Fundamentals of Nursing and Patient Safety
Medical-Surgical Nursing and Chronic Illness
Pharmacology and Medication Administration
Maternal-Newborn and Pediatric Nursing
Mental Health and Psychiatric Nursing
Leadership, Delegation, and Prioritization
Infection Control and Emergency Response
Laboratory Interpretation and Clinical Decision-Making
Introduction
This comprehensive exit assessment evaluates the nursing
knowledge, clinical judgment, and safety competencies required for
entry-level professional practice. It covers foundational theory,
applied medical-surgical care, pharmacology, maternal-newborn
and pediatric nursing, mental health, leadership, and emergency
response. Questions are multiple-choice and scenario-based,
emphasizing prioritization, delegation, ethical decision-making, and
real-world application. The examination is designed to reflect
NCLEX-RN readiness expectations and to strengthen clinical
reasoning for safe, effective nursing practice.
SECTION ONE: QUESTIONS 1-180
1. A nurse is caring for a client with a new colostomy. Which
finding should be reported immediately?
,A. Pink, moist stoma
B. 🟢 Dusky, cyanotic stoma
C. Small amount of bleeding at the stoma
D. Output of liquid stool
🔴 RATIONALE: A dusky or cyanotic stoma indicates decreased
perfusion and possible necrosis, requiring immediate notification
of the provider.
2. A client is prescribed digoxin. Which assessment finding
indicates possible toxicity?
A. Heart rate 88 beats/min
B. 🟢 Nausea and visual disturbances
C. Blood pressure 120/78 mm Hg
D. Respiratory rate 18 breaths/min
🔴 RATIONALE: Digoxin toxicity commonly causes nausea,
vomiting, anorexia, and visual changes such as yellow-green
halos.
3. A nurse is prioritizing care for four clients. Which client should
be assessed first?
A. Client requesting pain medication after surgery
B. 🟢 Client with new onset shortness of breath and crackles
C. Client due for routine dressing change
D. Client asking about discharge instructions
🔴 RATIONALE: New shortness of breath and crackles suggest
fluid overload or heart failure exacerbation, which is the highest
priority.
4. A client with diabetes is found unresponsive with a blood
glucose of 40 mg/dL. What is the nurse's first action?
,A. Administer insulin as prescribed
B. 🟢 Administer glucagon or IV dextrose per protocol
C. Start an IV infusion of normal saline
D. Recheck blood glucose in 1 hour
🔴 RATIONALE: Hypoglycemia with unresponsiveness requires
immediate glucose administration to prevent brain injury.
5. A nurse is teaching a client about warfarin. Which statement
indicates understanding?
A. "I should increase my vitamin K intake."
B. 🟢 "I will use a soft toothbrush and report unusual bleeding."
C. "I can take aspirin for headaches without asking."
D. "I will stop taking it when my leg swelling improves."
🔴 RATIONALE: Warfarin increases bleeding risk; clients should
report bleeding and avoid aspirin unless prescribed.
6. A client is in the acute phase after a myocardial infarction.
Which activity is most appropriate?
A. Ambulate in the hallway three times daily
B. 🟢 Use a bedside commode with assistance
C. Perform isometric exercises
D. Climb stairs to assess tolerance
🔴 RATIONALE: In the acute phase, activity is limited to reduce
cardiac workload; a bedside commode with assistance is
appropriate.
7. A nurse is preparing to administer heparin subcutaneously.
Which action is correct?
A. Massage the injection site after injection
B. 🟢 Insert the needle at a 90-degree angle and do not aspirate
, C. Use a 21-gauge needle
D. Administer into the deltoid muscle
🔴 RATIONALE: Heparin is given subcutaneously at a 90-degree
angle, without aspiration or massage, to reduce bleeding and
bruising.
8. A client with COPD has an oxygen saturation of 88%. Which
oxygen delivery is safest?
A. High-flow 100% nonrebreather mask
B. 🟢 Low-flow oxygen titrated to 88% to 92%
C. Oxygen at 10 L/min via face mask
D. No oxygen unless saturation is below 80%
🔴 RATIONALE: Clients with COPD may rely on hypoxic drive;
oxygen is titrated to 88% to 92% to avoid respiratory depression.
9. A nurse is assessing a client with dehydration. Which finding is
expected?
A. Bounding pulse
B. 🟢 Poor skin turgor and dry mucous membranes
C. Hypertension
D. Crackles in the lungs
🔴 RATIONALE: Dehydration causes poor skin turgor, dry mucous
membranes, tachycardia, and hypotension.
10. A client is receiving a blood transfusion and develops fever,
chills, and flank pain. What is the nurse's first action?
A. Slow the transfusion rate
B. 🟢 Stop the transfusion and maintain IV access with normal
saline
AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Fundamentals of Nursing and Patient Safety
Medical-Surgical Nursing and Chronic Illness
Pharmacology and Medication Administration
Maternal-Newborn and Pediatric Nursing
Mental Health and Psychiatric Nursing
Leadership, Delegation, and Prioritization
Infection Control and Emergency Response
Laboratory Interpretation and Clinical Decision-Making
Introduction
This comprehensive exit assessment evaluates the nursing
knowledge, clinical judgment, and safety competencies required for
entry-level professional practice. It covers foundational theory,
applied medical-surgical care, pharmacology, maternal-newborn
and pediatric nursing, mental health, leadership, and emergency
response. Questions are multiple-choice and scenario-based,
emphasizing prioritization, delegation, ethical decision-making, and
real-world application. The examination is designed to reflect
NCLEX-RN readiness expectations and to strengthen clinical
reasoning for safe, effective nursing practice.
SECTION ONE: QUESTIONS 1-180
1. A nurse is caring for a client with a new colostomy. Which
finding should be reported immediately?
,A. Pink, moist stoma
B. 🟢 Dusky, cyanotic stoma
C. Small amount of bleeding at the stoma
D. Output of liquid stool
🔴 RATIONALE: A dusky or cyanotic stoma indicates decreased
perfusion and possible necrosis, requiring immediate notification
of the provider.
2. A client is prescribed digoxin. Which assessment finding
indicates possible toxicity?
A. Heart rate 88 beats/min
B. 🟢 Nausea and visual disturbances
C. Blood pressure 120/78 mm Hg
D. Respiratory rate 18 breaths/min
🔴 RATIONALE: Digoxin toxicity commonly causes nausea,
vomiting, anorexia, and visual changes such as yellow-green
halos.
3. A nurse is prioritizing care for four clients. Which client should
be assessed first?
A. Client requesting pain medication after surgery
B. 🟢 Client with new onset shortness of breath and crackles
C. Client due for routine dressing change
D. Client asking about discharge instructions
🔴 RATIONALE: New shortness of breath and crackles suggest
fluid overload or heart failure exacerbation, which is the highest
priority.
4. A client with diabetes is found unresponsive with a blood
glucose of 40 mg/dL. What is the nurse's first action?
,A. Administer insulin as prescribed
B. 🟢 Administer glucagon or IV dextrose per protocol
C. Start an IV infusion of normal saline
D. Recheck blood glucose in 1 hour
🔴 RATIONALE: Hypoglycemia with unresponsiveness requires
immediate glucose administration to prevent brain injury.
5. A nurse is teaching a client about warfarin. Which statement
indicates understanding?
A. "I should increase my vitamin K intake."
B. 🟢 "I will use a soft toothbrush and report unusual bleeding."
C. "I can take aspirin for headaches without asking."
D. "I will stop taking it when my leg swelling improves."
🔴 RATIONALE: Warfarin increases bleeding risk; clients should
report bleeding and avoid aspirin unless prescribed.
6. A client is in the acute phase after a myocardial infarction.
Which activity is most appropriate?
A. Ambulate in the hallway three times daily
B. 🟢 Use a bedside commode with assistance
C. Perform isometric exercises
D. Climb stairs to assess tolerance
🔴 RATIONALE: In the acute phase, activity is limited to reduce
cardiac workload; a bedside commode with assistance is
appropriate.
7. A nurse is preparing to administer heparin subcutaneously.
Which action is correct?
A. Massage the injection site after injection
B. 🟢 Insert the needle at a 90-degree angle and do not aspirate
, C. Use a 21-gauge needle
D. Administer into the deltoid muscle
🔴 RATIONALE: Heparin is given subcutaneously at a 90-degree
angle, without aspiration or massage, to reduce bleeding and
bruising.
8. A client with COPD has an oxygen saturation of 88%. Which
oxygen delivery is safest?
A. High-flow 100% nonrebreather mask
B. 🟢 Low-flow oxygen titrated to 88% to 92%
C. Oxygen at 10 L/min via face mask
D. No oxygen unless saturation is below 80%
🔴 RATIONALE: Clients with COPD may rely on hypoxic drive;
oxygen is titrated to 88% to 92% to avoid respiratory depression.
9. A nurse is assessing a client with dehydration. Which finding is
expected?
A. Bounding pulse
B. 🟢 Poor skin turgor and dry mucous membranes
C. Hypertension
D. Crackles in the lungs
🔴 RATIONALE: Dehydration causes poor skin turgor, dry mucous
membranes, tachycardia, and hypotension.
10. A client is receiving a blood transfusion and develops fever,
chills, and flank pain. What is the nurse's first action?
A. Slow the transfusion rate
B. 🟢 Stop the transfusion and maintain IV access with normal
saline
