HESI 799 RN Exit Exam Comprehensive
Practice Test Bank: 180 High-Yield, Realistic
Practice Questions with Detailed Rationales, Bold
Correct Answers, and In-Depth Explanations for
Thorough NCLEX-RN Preparation (2026
Updated Edition)
This comprehensive practice resource contains 180 high-quality, long-scenario questions specifically
designed to mirror the style and difficulty of the HESI 799 RN Exit Exam. Each question features a
detailed clinical vignette, four realistic options with the correct answer marked in bold, and an in-depth
rationale that explains the nursing concepts, prioritization strategies (ABCs, Maslow’s), safety,
delegation, and pathophysiology to strengthen critical thinking and prepare students for both the HESI
Exit Exam and the NCLEX-RN
Question 1
A 52-year-old male client is being discharged after treatment
for a duodenal ulcer. During discharge teaching, he tells the
,nurse, “I plan to drink plenty of dairy products like milk and
cream every day to help coat and protect my ulcer from acid.”
The client also mentions he will continue drinking regular
coffee and eat large meals when he feels hungry. What is the
best follow-up action by the nurse?
A. Remind the client that it is also important to switch to
decaffeinated coffee and tea while eating frequent small meals.
B. Suggest that the client also plan to eat frequent small meals
to reduce discomfort and praise him for his understanding. C.
Review with the client the need to avoid foods that are rich in
milk and cream because they can stimulate increased gastric
acid secretion. D. Encourage the client to use antacids with
every meal and continue his current plan since dairy is soothing
initially.
Rationale: Diets high in milk and cream actually stimulate
gastric acid production over time, which can worsen peptic
ulcer disease rather than protect the mucosa. The nurse must
correct this common misconception gently but firmly. Options
A and B contain partially correct advice (decaf and small meals
are helpful), but they do not directly address the client’s
incorrect plan about dairy. Option D reinforces a harmful idea.
This question tests patient education and knowledge of peptic
ulcer pathophysiology.
Question 2
The nurse on a medical-surgical unit observes an unlicensed
assistive personnel (UAP) positioning a newly admitted 28-year-
,old client who has a seizure disorder. The client is lying supine,
and the UAP is placing several soft pillows along both side rails
for protection. What action should the nurse implement first?
A. Ensure that the UAP has placed the pillows effectively and
document the safety measure. B. Instruct the UAP to remove
the pillows and instead pad the side rails with soft blankets
while keeping the client in a side-lying position if possible. C.
Instruct the UAP that loose pillows should not be used along
the side rails because they can cause suffocation if the client
has a seizure, and demonstrate proper seizure precautions. D.
Thank the UAP for the initiative and ask them to add more
pillows for extra cushioning.
Rationale: During a seizure, the priority is airway management
and injury prevention. Loose pillows can shift and obstruct the
airway or cause aspiration. Proper seizure precautions include
padding side rails with blankets or pads (not loose items) and
positioning the client on their side when possible to maintain a
patent airway. The nurse must intervene immediately for safety
and educate the UAP, as delegation includes follow-up. This
tests safety, delegation, and supervision principles.
Question 3
An adult client exhibiting the manic phase of bipolar disorder is
admitted to the psychiatric unit. The client has lost 10 pounds
in the last two weeks, has not bathed in a week, and states,
“I’m trying to start a new business and I’m too busy to eat or
, sleep.” The client is oriented to time, place, and person but not
to situation. Which nursing problem has the greatest priority?
A. Hygiene self-care deficit related to hyperactivity. B.
Imbalanced nutrition: less than body requirements related to
lack of interest in eating. C. Disturbed sleep pattern related to
manic excitement. D. Self-neglect related to grandiosity and
poor insight.
Rationale: Using Maslow’s hierarchy and ABCs, physiological
needs (nutrition) take priority over hygiene or sleep. Severe
weight loss and inadequate intake can quickly lead to
dehydration, electrolyte imbalance, and physical deterioration
in mania. While all are concerns, nutrition is the most
immediate threat to life and stability. This is a classic HESI-style
prioritization question in mental health.
Question 4
A male client with hypertension received new antihypertensive
prescriptions at his last clinic visit. He returns two weeks later,
and his blood pressure remains elevated at 168/94 mmHg. The
client reports he has been taking the medications as prescribed
but admits to occasional headaches and dizziness. What is the
most important assessment for the nurse to complete at this
time?
A. Auscultate the client’s bowel sounds for any changes. B.
Observe for edema around the ankles and sacral area. C.
Measure the client’s apical pulse for one full minute and
Practice Test Bank: 180 High-Yield, Realistic
Practice Questions with Detailed Rationales, Bold
Correct Answers, and In-Depth Explanations for
Thorough NCLEX-RN Preparation (2026
Updated Edition)
This comprehensive practice resource contains 180 high-quality, long-scenario questions specifically
designed to mirror the style and difficulty of the HESI 799 RN Exit Exam. Each question features a
detailed clinical vignette, four realistic options with the correct answer marked in bold, and an in-depth
rationale that explains the nursing concepts, prioritization strategies (ABCs, Maslow’s), safety,
delegation, and pathophysiology to strengthen critical thinking and prepare students for both the HESI
Exit Exam and the NCLEX-RN
Question 1
A 52-year-old male client is being discharged after treatment
for a duodenal ulcer. During discharge teaching, he tells the
,nurse, “I plan to drink plenty of dairy products like milk and
cream every day to help coat and protect my ulcer from acid.”
The client also mentions he will continue drinking regular
coffee and eat large meals when he feels hungry. What is the
best follow-up action by the nurse?
A. Remind the client that it is also important to switch to
decaffeinated coffee and tea while eating frequent small meals.
B. Suggest that the client also plan to eat frequent small meals
to reduce discomfort and praise him for his understanding. C.
Review with the client the need to avoid foods that are rich in
milk and cream because they can stimulate increased gastric
acid secretion. D. Encourage the client to use antacids with
every meal and continue his current plan since dairy is soothing
initially.
Rationale: Diets high in milk and cream actually stimulate
gastric acid production over time, which can worsen peptic
ulcer disease rather than protect the mucosa. The nurse must
correct this common misconception gently but firmly. Options
A and B contain partially correct advice (decaf and small meals
are helpful), but they do not directly address the client’s
incorrect plan about dairy. Option D reinforces a harmful idea.
This question tests patient education and knowledge of peptic
ulcer pathophysiology.
Question 2
The nurse on a medical-surgical unit observes an unlicensed
assistive personnel (UAP) positioning a newly admitted 28-year-
,old client who has a seizure disorder. The client is lying supine,
and the UAP is placing several soft pillows along both side rails
for protection. What action should the nurse implement first?
A. Ensure that the UAP has placed the pillows effectively and
document the safety measure. B. Instruct the UAP to remove
the pillows and instead pad the side rails with soft blankets
while keeping the client in a side-lying position if possible. C.
Instruct the UAP that loose pillows should not be used along
the side rails because they can cause suffocation if the client
has a seizure, and demonstrate proper seizure precautions. D.
Thank the UAP for the initiative and ask them to add more
pillows for extra cushioning.
Rationale: During a seizure, the priority is airway management
and injury prevention. Loose pillows can shift and obstruct the
airway or cause aspiration. Proper seizure precautions include
padding side rails with blankets or pads (not loose items) and
positioning the client on their side when possible to maintain a
patent airway. The nurse must intervene immediately for safety
and educate the UAP, as delegation includes follow-up. This
tests safety, delegation, and supervision principles.
Question 3
An adult client exhibiting the manic phase of bipolar disorder is
admitted to the psychiatric unit. The client has lost 10 pounds
in the last two weeks, has not bathed in a week, and states,
“I’m trying to start a new business and I’m too busy to eat or
, sleep.” The client is oriented to time, place, and person but not
to situation. Which nursing problem has the greatest priority?
A. Hygiene self-care deficit related to hyperactivity. B.
Imbalanced nutrition: less than body requirements related to
lack of interest in eating. C. Disturbed sleep pattern related to
manic excitement. D. Self-neglect related to grandiosity and
poor insight.
Rationale: Using Maslow’s hierarchy and ABCs, physiological
needs (nutrition) take priority over hygiene or sleep. Severe
weight loss and inadequate intake can quickly lead to
dehydration, electrolyte imbalance, and physical deterioration
in mania. While all are concerns, nutrition is the most
immediate threat to life and stability. This is a classic HESI-style
prioritization question in mental health.
Question 4
A male client with hypertension received new antihypertensive
prescriptions at his last clinic visit. He returns two weeks later,
and his blood pressure remains elevated at 168/94 mmHg. The
client reports he has been taking the medications as prescribed
but admits to occasional headaches and dizziness. What is the
most important assessment for the nurse to complete at this
time?
A. Auscultate the client’s bowel sounds for any changes. B.
Observe for edema around the ankles and sacral area. C.
Measure the client’s apical pulse for one full minute and
