HESI RN Exit Exam 2026: Actual Test
Questions & Verified Answers Herzing
University Edition
300 Questions with Correct Answers &
Detailed Rationales
Next Generation NCLEX (NGN) Style
Included
About This Exam Guide
This comprehensive practice examination is specifically designed
for Herzing University nursing students preparing for the NSG 233
/ NSG233: Medical-Surgical Nursing II HESI Exit Exam. Updated
for the 2026/2027 academic year, this resource contains expertly
verified practice questions and detailed rationales to help you
master core concepts and achieve a top score .
The exam is organized into 8 major content domains with 300
questions, each including the correct answer and a detailed
rationale to reinforce understanding of key nursing concepts tested
on the HESI Exit Exam.
Domain 1: Safe and Effective Care Environment (Management of
Care, Safety, Infection Control) (Questions 1-40)
,1. A nurse is caring for a client on fall precautions. Which
intervention has the highest priority?
A. Keep the bed in the lowest position
B. Place non-slip socks on the client
C. Remove clutter from the room
D. Keep the call light within reach
Answer: A. Keep the bed in the lowest position
Rationale: While all options reduce fall risk, the lowest bed
position most directly prevents injury if the client does fall or
attempts to get out of bed unsafely. This intervention
addresses both fall prevention and injury mitigation .
2. A nurse receives a client from PACU who is drowsy but
arousable. What is the first action?
A. Monitor vital signs
B. Assess airway patency
C. Check IV site
D. Review intake and output
Answer: B. Assess airway patency
Rationale: Airway is always the priority in post-anesthesia
care (ABCs). Monitoring vital signs follows after airway is
confirmed. The ABC framework guides all post-operative
assessments .
3. A nurse prepares to administer digoxin. The apical pulse is 56
bpm. What should the nurse do?
,A. Administer the dose
B. Hold the medication and notify the provider
C. Document the pulse and reassess in 30 minutes
D. Give half the dose
Answer: B. Hold the medication and notify the provider
Rationale: Digoxin can cause bradycardia. The safe hold
parameter is HR below 60 bpm in adults. Administering the
medication could worsen bradycardia and lead to heart block
or cardiac arrest .
4. A confused elderly client keeps trying to pull out their IV. What
is the best nursing intervention?
A. Apply wrist restraints
B. Cover the IV site with a protective sleeve
C. Remove the IV
D. Ask family to stay with the client
Answer: B. Cover the IV site with a protective sleeve
Rationale: The least restrictive option that still protects the
client should always be chosen before restraints. Protective
sleeves prevent access to the IV while maintaining client
dignity and mobility .
5. The nurse finds a fire in a client's room. Which action should the
nurse take first?
A. Pull the fire alarm
B. Attempt to extinguish the fire
, C. Rescue the client from the room
D. Close the door
Answer: C. Rescue the client from the room
Rationale: Follow RACE (Rescue, Alarm, Contain, Extinguish).
Safety of the client comes first. The nurse should remove the
client from immediate danger before activating alarms or
attempting extinguishment .
6. The nurse is caring for four clients. Which client should be seen
first?
A. Client with a temperature of 100.8°F and productive cough
B. Client with O₂ saturation of 85% on room air
C. Client requesting pain medication rated 7/10
D. Client with blood glucose of 180 mg/dL
Answer: B. Client with O₂ saturation of 85% on room air
*Rationale: Hypoxemia is life-threatening and must be
addressed before pain or fever. Prioritization uses ABCs
(Airway, Breathing, Circulation). An O₂ saturation of 85%
indicates severe hypoxemia requiring immediate
intervention .*
7. A nurse prepares to insert an indwelling urinary catheter. Which
step is correct for maintaining sterile technique?
A. Place the sterile kit on the client's bed
B. Clean the perineal area with povidone-iodine
C. Keep the sterile gloves above waist level
D. Apply lubricant to the catheter tip after insertion
Questions & Verified Answers Herzing
University Edition
300 Questions with Correct Answers &
Detailed Rationales
Next Generation NCLEX (NGN) Style
Included
About This Exam Guide
This comprehensive practice examination is specifically designed
for Herzing University nursing students preparing for the NSG 233
/ NSG233: Medical-Surgical Nursing II HESI Exit Exam. Updated
for the 2026/2027 academic year, this resource contains expertly
verified practice questions and detailed rationales to help you
master core concepts and achieve a top score .
The exam is organized into 8 major content domains with 300
questions, each including the correct answer and a detailed
rationale to reinforce understanding of key nursing concepts tested
on the HESI Exit Exam.
Domain 1: Safe and Effective Care Environment (Management of
Care, Safety, Infection Control) (Questions 1-40)
,1. A nurse is caring for a client on fall precautions. Which
intervention has the highest priority?
A. Keep the bed in the lowest position
B. Place non-slip socks on the client
C. Remove clutter from the room
D. Keep the call light within reach
Answer: A. Keep the bed in the lowest position
Rationale: While all options reduce fall risk, the lowest bed
position most directly prevents injury if the client does fall or
attempts to get out of bed unsafely. This intervention
addresses both fall prevention and injury mitigation .
2. A nurse receives a client from PACU who is drowsy but
arousable. What is the first action?
A. Monitor vital signs
B. Assess airway patency
C. Check IV site
D. Review intake and output
Answer: B. Assess airway patency
Rationale: Airway is always the priority in post-anesthesia
care (ABCs). Monitoring vital signs follows after airway is
confirmed. The ABC framework guides all post-operative
assessments .
3. A nurse prepares to administer digoxin. The apical pulse is 56
bpm. What should the nurse do?
,A. Administer the dose
B. Hold the medication and notify the provider
C. Document the pulse and reassess in 30 minutes
D. Give half the dose
Answer: B. Hold the medication and notify the provider
Rationale: Digoxin can cause bradycardia. The safe hold
parameter is HR below 60 bpm in adults. Administering the
medication could worsen bradycardia and lead to heart block
or cardiac arrest .
4. A confused elderly client keeps trying to pull out their IV. What
is the best nursing intervention?
A. Apply wrist restraints
B. Cover the IV site with a protective sleeve
C. Remove the IV
D. Ask family to stay with the client
Answer: B. Cover the IV site with a protective sleeve
Rationale: The least restrictive option that still protects the
client should always be chosen before restraints. Protective
sleeves prevent access to the IV while maintaining client
dignity and mobility .
5. The nurse finds a fire in a client's room. Which action should the
nurse take first?
A. Pull the fire alarm
B. Attempt to extinguish the fire
, C. Rescue the client from the room
D. Close the door
Answer: C. Rescue the client from the room
Rationale: Follow RACE (Rescue, Alarm, Contain, Extinguish).
Safety of the client comes first. The nurse should remove the
client from immediate danger before activating alarms or
attempting extinguishment .
6. The nurse is caring for four clients. Which client should be seen
first?
A. Client with a temperature of 100.8°F and productive cough
B. Client with O₂ saturation of 85% on room air
C. Client requesting pain medication rated 7/10
D. Client with blood glucose of 180 mg/dL
Answer: B. Client with O₂ saturation of 85% on room air
*Rationale: Hypoxemia is life-threatening and must be
addressed before pain or fever. Prioritization uses ABCs
(Airway, Breathing, Circulation). An O₂ saturation of 85%
indicates severe hypoxemia requiring immediate
intervention .*
7. A nurse prepares to insert an indwelling urinary catheter. Which
step is correct for maintaining sterile technique?
A. Place the sterile kit on the client's bed
B. Clean the perineal area with povidone-iodine
C. Keep the sterile gloves above waist level
D. Apply lubricant to the catheter tip after insertion
