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HESI RN Exit Exam V3 with NGN ACTUAL
EXAM QUESTIONS AND ANSWERS
2026/2027 | Hybrid Exam | 135 Questions |
Pass Guaranteed - A+ Graded
PART A: TRADITIONAL COMPREHENSIVE QUESTIONS (1-85)
SAFE AND EFFECTIVE CARE ENVIRONMENT
Management of Care (Q1-20)
Q1. The nurse is assigning tasks for the day. Which client is most appropriate to assign to a
licensed practical nurse (LPN)?
A. A client with diabetic ketoacidosis who is on an insulin drip.
B. A client who is 2 hours post-op total knee replacement and needs vital signs and
neurovascular checks. [CORRECT]
C. A client with a new diagnosis of Guillain-Barré syndrome requiring frequent respiratory
assessment.
D. A client with chest pain awaiting transfer to the cardiac catheterization lab.
Correct Answer: B
Rationale: The LPN's scope includes monitoring stable post-operative clients and performing
routine assessments. Clients who are unstable (A - DKA on drip), have a potential for rapid
deterioration (C - GBS with respiratory risk), or are in an emergent situation (D) require the
comprehensive assessment and critical thinking skills of an RN.
Q2. A nurse manager is reviewing incident reports. Which situation requires immediate
intervention to prevent client harm?
A. A nurse documented vital signs 30 minutes after they were taken.
B. A client received a scheduled medication 15 minutes late.
C. A confused client was found attempting to climb over bed rails. [CORRECT]
D. A nurse forgot to sign off on a medication administration record.
Correct Answer: C
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Rationale: Client safety is the priority. A confused client climbing bed rails presents immediate
fall risk and potential for serious injury. While documentation timeliness (A), late medications
(B), and unsigned MARs (D) require follow-up, they do not pose immediate physical danger.
Q3. During a fire drill, a nurse is caring for a client on ventilator support. What is the priority
action?
A. Extinguish the fire if possible.
B. Close all doors and windows in the room.
C. Evacuate the client using a portable oxygen tank and manual resuscitation bag. [CORRECT]
D. Call the fire department.
Correct Answer: C
Rationale: The RACE acronym applies: Rescue/Remove clients in immediate danger first. A
ventilator-dependent client cannot breathe without support; therefore, maintaining oxygenation
during evacuation is critical. Rescue has priority over Alarm, Contain, or Extinguish when client
life is at immediate risk.
Q4. A nurse is caring for four clients. Which task can be delegated to unlicensed assistive
personnel (UAP)?
A. Assessing a post-operative client's incision for signs of infection.
B. Feeding a client who had a stroke and has dysphagia.
C. Obtaining vital signs on a stable client 2 days post-appendectomy. [CORRECT]
D. Teaching a newly diagnosed diabetic client about insulin administration.
Correct Answer: C
Rationale: UAPs can collect data (vital signs) on stable, predictable clients. Assessment (A),
care for clients with swallowing risks (B), and client education (D) require nursing judgment and
must be performed by licensed personnel.
Q5. A client is being discharged with a new colostomy. Which documentation by the nurse best
demonstrates continuity of care?
A. "Client has a new colostomy and is ready for discharge."
B. "Client demonstrated proper colostomy bag emptying technique; tolerating regular diet;
referral to home health for follow-up placed." [CORRECT]
C. "Client will need help at home with colostomy care."
D. "Dr. Smith performed the surgery and ordered discharge today."
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Correct Answer: B
Rationale: Effective discharge documentation includes client education verification, current
status, and follow-up plans. Option B demonstrates the client has learned self-care, is stable diet-
wise, and has support systems arranged, ensuring safe transition to home.
Q6. The charge nurse notices a pattern of increased medication errors on the night shift. What is
the first step in quality improvement?
A. Discipline the nurses involved.
B. Conduct a root cause analysis. [CORRECT]
C. Implement a new medication administration system.
D. Increase staffing levels immediately.
Correct Answer: B
Rationale: Quality improvement follows a systematic process: identify the problem, analyze
root causes, then implement solutions. Root cause analysis determines whether factors include
staffing, system design, knowledge deficits, or environmental distractions before selecting
appropriate interventions.
Q7. A client requires restraints due to confusion and pulling at IV lines. How often must the
nurse assess this client?
A. Every 2 hours.
B. Every 4 hours.
C. Every 1 hour. [CORRECT]
D. Every 8 hours.
Correct Answer: C
Rationale: Restrained clients require assessment at least every hour for circulation, range of
motion, nutrition/hydration needs, elimination, and continued justification for restraints. This
frequent monitoring prevents complications like neurovascular compromise or skin breakdown.
Q8. A nurse is precepting a new graduate. Which action by the new nurse requires immediate
intervention?
A. The new nurse takes 30 minutes to complete an admission assessment.
B. The new nurse asks to observe a central line dressing change before performing one.
C. The new nurse administers insulin without checking the blood glucose first. [CORRECT]
, 4
D. The new nurse documents in the electronic health record using abbreviations approved by the
facility.
Correct Answer: C
Rationale: Administering insulin without verifying blood glucose is a serious safety error that
could cause fatal hypoglycemia or fail to treat hyperglycemia appropriately. This requires
immediate correction. Other options demonstrate appropriate learning behavior or acceptable
practices.
Q9. Which client should the nurse see first after receiving the shift report?
A. A client scheduled for discharge in 2 hours who needs final teaching.
B. A client with pneumonia who is receiving IV antibiotics and has a temp of 38°C.
C. A client 1 hour post-thoracentesis who reports difficulty breathing. [CORRECT]
D. A client with diabetes who needs a routine blood glucose check before lunch.
Correct Answer: C
Rationale: Prioritization follows the ABCs (Airway, Breathing, Circulation). Difficulty
breathing post-thoracentesis suggests potential pneumothorax—a life-threatening emergency
requiring immediate assessment. Other clients are stable or have less acute needs.
Q10. A nurse is caring for a client with tuberculosis. Which precaution is required?
A. Standard precautions only.
B. Contact precautions.
C. Droplet precautions.
D. Airborne precautions. [CORRECT]
Correct Answer: D
Rationale: Tuberculosis is transmitted via airborne droplet nuclei that remain suspended in air.
Airborne precautions (negative pressure room, N95 respirator) are required. Droplet precautions
(surgical mask) are insufficient for TB.
Q11. A client is brought to the ED after a motor vehicle accident. The client is unconscious and
has no identification. What is the nurse's legal obligation?
A. Wait for family to arrive before providing treatment.
B. Provide emergency treatment based on implied consent. [CORRECT]
HESI RN Exit Exam V3 with NGN ACTUAL
EXAM QUESTIONS AND ANSWERS
2026/2027 | Hybrid Exam | 135 Questions |
Pass Guaranteed - A+ Graded
PART A: TRADITIONAL COMPREHENSIVE QUESTIONS (1-85)
SAFE AND EFFECTIVE CARE ENVIRONMENT
Management of Care (Q1-20)
Q1. The nurse is assigning tasks for the day. Which client is most appropriate to assign to a
licensed practical nurse (LPN)?
A. A client with diabetic ketoacidosis who is on an insulin drip.
B. A client who is 2 hours post-op total knee replacement and needs vital signs and
neurovascular checks. [CORRECT]
C. A client with a new diagnosis of Guillain-Barré syndrome requiring frequent respiratory
assessment.
D. A client with chest pain awaiting transfer to the cardiac catheterization lab.
Correct Answer: B
Rationale: The LPN's scope includes monitoring stable post-operative clients and performing
routine assessments. Clients who are unstable (A - DKA on drip), have a potential for rapid
deterioration (C - GBS with respiratory risk), or are in an emergent situation (D) require the
comprehensive assessment and critical thinking skills of an RN.
Q2. A nurse manager is reviewing incident reports. Which situation requires immediate
intervention to prevent client harm?
A. A nurse documented vital signs 30 minutes after they were taken.
B. A client received a scheduled medication 15 minutes late.
C. A confused client was found attempting to climb over bed rails. [CORRECT]
D. A nurse forgot to sign off on a medication administration record.
Correct Answer: C
,2
Rationale: Client safety is the priority. A confused client climbing bed rails presents immediate
fall risk and potential for serious injury. While documentation timeliness (A), late medications
(B), and unsigned MARs (D) require follow-up, they do not pose immediate physical danger.
Q3. During a fire drill, a nurse is caring for a client on ventilator support. What is the priority
action?
A. Extinguish the fire if possible.
B. Close all doors and windows in the room.
C. Evacuate the client using a portable oxygen tank and manual resuscitation bag. [CORRECT]
D. Call the fire department.
Correct Answer: C
Rationale: The RACE acronym applies: Rescue/Remove clients in immediate danger first. A
ventilator-dependent client cannot breathe without support; therefore, maintaining oxygenation
during evacuation is critical. Rescue has priority over Alarm, Contain, or Extinguish when client
life is at immediate risk.
Q4. A nurse is caring for four clients. Which task can be delegated to unlicensed assistive
personnel (UAP)?
A. Assessing a post-operative client's incision for signs of infection.
B. Feeding a client who had a stroke and has dysphagia.
C. Obtaining vital signs on a stable client 2 days post-appendectomy. [CORRECT]
D. Teaching a newly diagnosed diabetic client about insulin administration.
Correct Answer: C
Rationale: UAPs can collect data (vital signs) on stable, predictable clients. Assessment (A),
care for clients with swallowing risks (B), and client education (D) require nursing judgment and
must be performed by licensed personnel.
Q5. A client is being discharged with a new colostomy. Which documentation by the nurse best
demonstrates continuity of care?
A. "Client has a new colostomy and is ready for discharge."
B. "Client demonstrated proper colostomy bag emptying technique; tolerating regular diet;
referral to home health for follow-up placed." [CORRECT]
C. "Client will need help at home with colostomy care."
D. "Dr. Smith performed the surgery and ordered discharge today."
,3
Correct Answer: B
Rationale: Effective discharge documentation includes client education verification, current
status, and follow-up plans. Option B demonstrates the client has learned self-care, is stable diet-
wise, and has support systems arranged, ensuring safe transition to home.
Q6. The charge nurse notices a pattern of increased medication errors on the night shift. What is
the first step in quality improvement?
A. Discipline the nurses involved.
B. Conduct a root cause analysis. [CORRECT]
C. Implement a new medication administration system.
D. Increase staffing levels immediately.
Correct Answer: B
Rationale: Quality improvement follows a systematic process: identify the problem, analyze
root causes, then implement solutions. Root cause analysis determines whether factors include
staffing, system design, knowledge deficits, or environmental distractions before selecting
appropriate interventions.
Q7. A client requires restraints due to confusion and pulling at IV lines. How often must the
nurse assess this client?
A. Every 2 hours.
B. Every 4 hours.
C. Every 1 hour. [CORRECT]
D. Every 8 hours.
Correct Answer: C
Rationale: Restrained clients require assessment at least every hour for circulation, range of
motion, nutrition/hydration needs, elimination, and continued justification for restraints. This
frequent monitoring prevents complications like neurovascular compromise or skin breakdown.
Q8. A nurse is precepting a new graduate. Which action by the new nurse requires immediate
intervention?
A. The new nurse takes 30 minutes to complete an admission assessment.
B. The new nurse asks to observe a central line dressing change before performing one.
C. The new nurse administers insulin without checking the blood glucose first. [CORRECT]
, 4
D. The new nurse documents in the electronic health record using abbreviations approved by the
facility.
Correct Answer: C
Rationale: Administering insulin without verifying blood glucose is a serious safety error that
could cause fatal hypoglycemia or fail to treat hyperglycemia appropriately. This requires
immediate correction. Other options demonstrate appropriate learning behavior or acceptable
practices.
Q9. Which client should the nurse see first after receiving the shift report?
A. A client scheduled for discharge in 2 hours who needs final teaching.
B. A client with pneumonia who is receiving IV antibiotics and has a temp of 38°C.
C. A client 1 hour post-thoracentesis who reports difficulty breathing. [CORRECT]
D. A client with diabetes who needs a routine blood glucose check before lunch.
Correct Answer: C
Rationale: Prioritization follows the ABCs (Airway, Breathing, Circulation). Difficulty
breathing post-thoracentesis suggests potential pneumothorax—a life-threatening emergency
requiring immediate assessment. Other clients are stable or have less acute needs.
Q10. A nurse is caring for a client with tuberculosis. Which precaution is required?
A. Standard precautions only.
B. Contact precautions.
C. Droplet precautions.
D. Airborne precautions. [CORRECT]
Correct Answer: D
Rationale: Tuberculosis is transmitted via airborne droplet nuclei that remain suspended in air.
Airborne precautions (negative pressure room, N95 respirator) are required. Droplet precautions
(surgical mask) are insufficient for TB.
Q11. A client is brought to the ED after a motor vehicle accident. The client is unconscious and
has no identification. What is the nurse's legal obligation?
A. Wait for family to arrive before providing treatment.
B. Provide emergency treatment based on implied consent. [CORRECT]
