1
HESI RN Exit Exam Legacy
V2 – 2024/2025 Complete Test
with Verified Correct
Answers | Graded A+ Prep
Pack
Advanced-Level RN Exit Exam (150 Questions)
Question 1 (MCQ)
A nurse is prioritizing care for four clients in the emergency department. Which client should the
nurse assess first?
A. A client with chest pain and diaphoresis.
B. A client with a laceration on the arm requesting pain medication.
C. A client with a fever of 38.2°C and chills.
D. A client with nausea and vomiting for 2 hours.
Correct Answer: A. A client with chest pain and diaphoresis.
Rationale: Chest pain with diaphoresis suggests a potential myocardial infarction, a life-
threatening condition requiring immediate assessment. Lacerations (B), fever (C), and nausea
(D) are less urgent.
Question 2 (SATA)
Which actions should a nurse take when delegating tasks to a licensed practical nurse (LPN)?
(Select all that apply.)
A. Assign tasks within the LPN’s scope of practice.
B. Provide clear instructions for the task.
C. Delegate the initial client assessment.
D. Monitor the LPN’s performance periodically.
E. Ensure the LPN reports back after task completion.
, 2
Correct Answers: A, B, D, E
Rationale: Delegation requires assigning tasks within scope (A), giving clear instructions (B),
monitoring performance (D), and ensuring follow-up (E). Initial assessments (C) are the RN’s
responsibility.
Question 3 (MCQ)
A client with a history of heart failure reports sudden shortness of breath and weight gain of 3 kg
in 2 days. What is the nurse’s priority action?
A. Administer a diuretic immediately.
B. Assess respiratory status and oxygen saturation.
C. Restrict fluid intake to 500 mL/day.
D. Document the findings and continue monitoring.
Correct Answer: B. Assess respiratory status and oxygen saturation.
Rationale: Sudden shortness of breath and weight gain suggest fluid overload, potentially
causing pulmonary edema. Assessing respiratory status is the priority. Diuretics (A) require an
order, fluid restriction (C) is secondary, and documentation alone (D) delays intervention.
Question 4 (MCQ)
A nurse is preparing to administer heparin 5,000 units subcutaneously. The vial contains 10,000
units/mL. How many mL should the nurse administer?
A. 0.25 mL
B. 0.5 mL
C. 1 mL
D. 2 mL
Correct Answer: B. 0.5 mL
Rationale: To calculate: 5,000 units ÷ 10,000 units/mL = 0.5 mL. Options A, C, and D are
incorrect calculations.
Question 5 (SATA)
Which interventions should a nurse implement for a client receiving total parenteral nutrition
(TPN)? (Select all that apply.)
A. Monitor blood glucose levels regularly.
B. Use a dedicated IV line for TPN.
C. Administer TPN through a peripheral IV.
, 3
D. Change the IV tubing every 24 hours.
E. Assess for signs of infection at the IV site.
Correct Answers: A, B, D, E
Rationale: TPN requires glucose monitoring (A), a dedicated line (B), daily tubing changes (D),
and infection monitoring (E). Peripheral IVs (C) are not suitable for TPN due to high osmolarity.
Question 6 (MCQ)
A charge nurse observes a new graduate nurse using an incorrect technique to insert a urinary
catheter. What is the best leadership action?
A. Reprimand the nurse in front of the team.
B. Provide immediate, private feedback and demonstrate correct technique.
C. Ignore the error to avoid embarrassing the nurse.
D. Report the nurse to the supervisor immediately.
Correct Answer: B. Provide immediate, private feedback and demonstrate correct
technique.
Rationale: Private feedback corrects the error while supporting learning and maintaining
professionalism. Reprimanding publicly (A) is unprofessional, ignoring the error (C) risks
patient safety, and reporting (D) is premature.
Question 7 (MCQ)
A client with a suspected stroke presents with slurred speech and right-sided weakness. What is
the nurse’s priority action?
A. Administer aspirin immediately.
B. Notify the stroke team and prepare for a CT scan.
C. Place the client on a cardiac monitor.
D. Document the neurological findings.
Correct Answer: B. Notify the stroke team and prepare for a CT scan.
Rationale: Stroke symptoms require urgent activation of the stroke team and imaging to
determine treatment. Aspirin (A) is contraindicated until hemorrhage is ruled out, cardiac
monitoring (C) is secondary, and documentation (D) follows urgent action.
Question 8 (SATA)
Which actions ensure patient safety when administering insulin? (Select all that apply.)
A. Verify the insulin type and dose with another nurse.
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B. Check the client’s blood glucose before administration.
C. Administer insulin in the same site repeatedly.
D. Use two client identifiers before administration.
E. Document the administration immediately after giving.
Correct Answers: A, B, D, E
Rationale: Verifying with another nurse (A), checking glucose (B), using identifiers (D), and
documenting (E) ensure safety. Repeated site use (C) risks lipodystrophy.
Question 9 (MCQ)
A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is appropriate
to delegate?
A. Assessing a client’s pain level.
B. Assisting a stable client with ambulation.
C. Administering oral medications.
D. Evaluating a client’s response to therapy.
Correct Answer: B. Assisting a stable client with ambulation.
Rationale: UAPs can assist with ambulation for stable clients. Assessments (A), medication
administration (C), and evaluations (D) are RN responsibilities.
Question 10 (MCQ)
A client with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of 88%.
What is the nurse’s first action?
A. Increase oxygen flow to 6 L/min.
B. Assess respiratory status and breath sounds.
C. Administer a bronchodilator immediately.
D. Place the client in a supine position.
Correct Answer: B. Assess respiratory status and breath sounds.
Rationale: An SpO2 of 88% is common in COPD but requires assessment to determine the
cause. Increasing oxygen (A) or administering bronchodilators (C) requires orders, and supine
positioning (D) may worsen breathing.
Question 11 (SATA)
Which actions should a nurse take to prevent hospital-acquired infections? (Select all that apply.)
A. Perform hand hygiene before and after client contact.
HESI RN Exit Exam Legacy
V2 – 2024/2025 Complete Test
with Verified Correct
Answers | Graded A+ Prep
Pack
Advanced-Level RN Exit Exam (150 Questions)
Question 1 (MCQ)
A nurse is prioritizing care for four clients in the emergency department. Which client should the
nurse assess first?
A. A client with chest pain and diaphoresis.
B. A client with a laceration on the arm requesting pain medication.
C. A client with a fever of 38.2°C and chills.
D. A client with nausea and vomiting for 2 hours.
Correct Answer: A. A client with chest pain and diaphoresis.
Rationale: Chest pain with diaphoresis suggests a potential myocardial infarction, a life-
threatening condition requiring immediate assessment. Lacerations (B), fever (C), and nausea
(D) are less urgent.
Question 2 (SATA)
Which actions should a nurse take when delegating tasks to a licensed practical nurse (LPN)?
(Select all that apply.)
A. Assign tasks within the LPN’s scope of practice.
B. Provide clear instructions for the task.
C. Delegate the initial client assessment.
D. Monitor the LPN’s performance periodically.
E. Ensure the LPN reports back after task completion.
, 2
Correct Answers: A, B, D, E
Rationale: Delegation requires assigning tasks within scope (A), giving clear instructions (B),
monitoring performance (D), and ensuring follow-up (E). Initial assessments (C) are the RN’s
responsibility.
Question 3 (MCQ)
A client with a history of heart failure reports sudden shortness of breath and weight gain of 3 kg
in 2 days. What is the nurse’s priority action?
A. Administer a diuretic immediately.
B. Assess respiratory status and oxygen saturation.
C. Restrict fluid intake to 500 mL/day.
D. Document the findings and continue monitoring.
Correct Answer: B. Assess respiratory status and oxygen saturation.
Rationale: Sudden shortness of breath and weight gain suggest fluid overload, potentially
causing pulmonary edema. Assessing respiratory status is the priority. Diuretics (A) require an
order, fluid restriction (C) is secondary, and documentation alone (D) delays intervention.
Question 4 (MCQ)
A nurse is preparing to administer heparin 5,000 units subcutaneously. The vial contains 10,000
units/mL. How many mL should the nurse administer?
A. 0.25 mL
B. 0.5 mL
C. 1 mL
D. 2 mL
Correct Answer: B. 0.5 mL
Rationale: To calculate: 5,000 units ÷ 10,000 units/mL = 0.5 mL. Options A, C, and D are
incorrect calculations.
Question 5 (SATA)
Which interventions should a nurse implement for a client receiving total parenteral nutrition
(TPN)? (Select all that apply.)
A. Monitor blood glucose levels regularly.
B. Use a dedicated IV line for TPN.
C. Administer TPN through a peripheral IV.
, 3
D. Change the IV tubing every 24 hours.
E. Assess for signs of infection at the IV site.
Correct Answers: A, B, D, E
Rationale: TPN requires glucose monitoring (A), a dedicated line (B), daily tubing changes (D),
and infection monitoring (E). Peripheral IVs (C) are not suitable for TPN due to high osmolarity.
Question 6 (MCQ)
A charge nurse observes a new graduate nurse using an incorrect technique to insert a urinary
catheter. What is the best leadership action?
A. Reprimand the nurse in front of the team.
B. Provide immediate, private feedback and demonstrate correct technique.
C. Ignore the error to avoid embarrassing the nurse.
D. Report the nurse to the supervisor immediately.
Correct Answer: B. Provide immediate, private feedback and demonstrate correct
technique.
Rationale: Private feedback corrects the error while supporting learning and maintaining
professionalism. Reprimanding publicly (A) is unprofessional, ignoring the error (C) risks
patient safety, and reporting (D) is premature.
Question 7 (MCQ)
A client with a suspected stroke presents with slurred speech and right-sided weakness. What is
the nurse’s priority action?
A. Administer aspirin immediately.
B. Notify the stroke team and prepare for a CT scan.
C. Place the client on a cardiac monitor.
D. Document the neurological findings.
Correct Answer: B. Notify the stroke team and prepare for a CT scan.
Rationale: Stroke symptoms require urgent activation of the stroke team and imaging to
determine treatment. Aspirin (A) is contraindicated until hemorrhage is ruled out, cardiac
monitoring (C) is secondary, and documentation (D) follows urgent action.
Question 8 (SATA)
Which actions ensure patient safety when administering insulin? (Select all that apply.)
A. Verify the insulin type and dose with another nurse.
, 4
B. Check the client’s blood glucose before administration.
C. Administer insulin in the same site repeatedly.
D. Use two client identifiers before administration.
E. Document the administration immediately after giving.
Correct Answers: A, B, D, E
Rationale: Verifying with another nurse (A), checking glucose (B), using identifiers (D), and
documenting (E) ensure safety. Repeated site use (C) risks lipodystrophy.
Question 9 (MCQ)
A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is appropriate
to delegate?
A. Assessing a client’s pain level.
B. Assisting a stable client with ambulation.
C. Administering oral medications.
D. Evaluating a client’s response to therapy.
Correct Answer: B. Assisting a stable client with ambulation.
Rationale: UAPs can assist with ambulation for stable clients. Assessments (A), medication
administration (C), and evaluations (D) are RN responsibilities.
Question 10 (MCQ)
A client with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of 88%.
What is the nurse’s first action?
A. Increase oxygen flow to 6 L/min.
B. Assess respiratory status and breath sounds.
C. Administer a bronchodilator immediately.
D. Place the client in a supine position.
Correct Answer: B. Assess respiratory status and breath sounds.
Rationale: An SpO2 of 88% is common in COPD but requires assessment to determine the
cause. Increasing oxygen (A) or administering bronchodilators (C) requires orders, and supine
positioning (D) may worsen breathing.
Question 11 (SATA)
Which actions should a nurse take to prevent hospital-acquired infections? (Select all that apply.)
A. Perform hand hygiene before and after client contact.
