HESI PN Exit V2 Exam Practical Nursing
Comprehensive Exit Examination ACTUAL
EXAM 2026/2027 | Practice Test | 150
Questions | Answers and Rationales |
NCLEX-PN Aligned | Verified Q&A | Pass
Guaranteed - A+ Graded
SAFE AND EFFECTIVE CARE ENVIRONMENT – COORDINATED CARE (23 Questions)
Q1: The charge nurse is making client assignments for the medical-surgical unit. Which client
should be assigned to the most experienced LPN?
A. A 45-year-old with diabetes requiring insulin administration and dietary teaching
B. A 72-year-old 2 days post-hip replacement requiring pain management and ambulation
assistance
C. A 60-year-old with new-onset atrial fibrillation on continuous cardiac monitoring and IV
amiodarone [CORRECT]
D. A 55-year-old with pneumonia receiving IV antibiotics every 8 hours and oxygen at 2 L/min
Correct Answer: C
Rationale: The client with new-onset atrial fibrillation on cardiac monitoring and IV amiodarone is
unstable and requires advanced assessment skills, continuous monitoring, and knowledge of
antiarrhythmic medications. This client should be assigned to the most experienced LPN (or RN
depending on facility policy and state scope of practice). Options A, B, and D are stable clients with
predictable outcomes who could be assigned to less experienced LPNs or UAPs under supervision.
HESI Note: When making assignments, consider client acuity, stability, and predictability of
outcomes. Unstable clients require experienced nurses.
Q2: A nurse is caring for a client who has a living will stating DNR status. The client's family
requests that the nurse perform CPR when the client stops breathing. What is the nurse's best
action?
A. Follow the family's request to maintain family relationships
,B. Respect the client's living will and do not initiate CPR [CORRECT]
C. Call the physician for clarification
D. Transfer care to another nurse
Correct Answer: B
Rationale: A living will is a legally binding advance directive that expresses the client's wishes
regarding end-of-life care. The nurse must honor the client's autonomy and legal right to refuse
resuscitation. Family wishes cannot override a valid living will. The nurse should provide emotional
support to the family while maintaining ethical and legal obligations to the client.
HESI Note: Advance directives are legally binding documents that take precedence over family
wishes when the client cannot speak for themselves.
Q3: The nurse is delegating tasks to a UAP (Unlicensed Assistive Personnel). Which task is
appropriate to delegate?
A. Assessing a postoperative client's incision
B. Measuring and recording intake and output for a stable client [CORRECT]
C. Administering oral medications to a client with dysphagia
D. Teaching a client about wound care
Correct Answer: B
Rationale: The five rights of delegation include right task, right circumstance, right person, right
direction/communication, and right supervision. Measuring and recording I&O is an appropriate
task for UAP as it is routine, predictable, and does not require nursing judgment. Assessment (A),
medication administration (C), and patient education (D) are within the scope of licensed nursing
practice only.
HESI Note: Remember the "Five Rights of Delegation" - UAPs can perform routine, predictable
tasks for stable clients.
Q4: A client with chest pain is being transferred from the ED to the cardiac unit. Which
communication tool should the nurse use to ensure continuity of care?
A. SOAP documentation
B. SBAR report [CORRECT]
C. Chart audit
D. Nursing care plan
Correct Answer: B
Rationale: SBAR (Situation, Background, Assessment, Recommendation) is the standardized
communication tool used for handoff reports to ensure critical information is transferred accurately
and completely. It reduces communication errors during transfer of care between units or shifts.
HESI Note: SBAR is the gold standard for handoff communication and should be used for all
transfers and shift reports.
,Q5: A nurse witnesses a colleague documenting care that was not provided. What is the nurse's
legal responsibility?
A. Ignore it since the colleague is experienced
B. Report the incident to the nurse manager [CORRECT]
C. Confront the colleague in front of other staff
D. Document the care themselves to cover the error
Correct Answer: B
Rationale: Falsification of medical records constitutes fraud and malpractice. Nurses have an
ethical and legal obligation to report unsafe practices, unprofessional conduct, and fraudulent
documentation. Most facilities have policies for reporting through the chain of command.
HESI Note: Mandatory reporting applies to unsafe practice, abuse, and fraudulent documentation.
Follow chain of command and facility policy.
Q6: A client refuses a blood transfusion based on religious beliefs. The physician insists the client
will die without it. What is the nurse's priority action?
A. Administer the transfusion to save the client's life
B. Respect the client's right to refuse treatment [CORRECT]
C. Obtain a court order to override the refusal
D. Convince the family to override the client's decision
Correct Answer: B
Rationale: Clients have the legal right to refuse treatment, even life-saving treatment, based on
religious beliefs or personal values (autonomy). The nurse must respect this right, ensure informed
refusal is documented, and provide supportive care. A court order (C) would only be pursued in
specific circumstances involving minors or incapacitated persons without advance directives.
HESI Note: Right to refuse treatment is a fundamental client right. Document informed refusal
thoroughly.
Q7: Which action demonstrates the ethical principle of beneficence?
A. Telling a client the truth about their poor prognosis
B. Acting in the client's best interest to promote good [CORRECT]
C. Treating all clients fairly regardless of ability to pay
D. Keeping promises made to clients
Correct Answer: B
Rationale: Beneficence means "doing good" and acting in the client's best interest. Veracity (A) is
truth-telling. Justice (C) is fairness. Fidelity (D) is keeping promises.
HESI Note: Remember the ethical principles: Autonomy (self-determination), Beneficence (do
good), Non-maleficence (do no harm), Justice (fairness), Fidelity (loyalty), Veracity (truth).
Q8: A nurse receives a phone call from a worried neighbor asking about a mutual friend's hospital
status. The nurse recently cared for this friend. What is the appropriate response?
, A. Share limited information since they are mutual friends
B. Explain that HIPAA prohibits sharing any information without authorization [CORRECT]
C. Tell the neighbor to call the physician instead
D. Confirm the friend is hospitalized but give no details
Correct Answer: B
Rationale: HIPAA regulations strictly prohibit healthcare providers from disclosing protected health
information (PHI) without written authorization from the client. This applies even to friends, family, or
other healthcare providers not involved in care.
HESI Note: Never confirm or deny a person's presence in the facility unless the client has
authorized disclosure.
Q9: The nurse is supervising a UAP who appears sleepy and admits to taking an antihistamine
before work. What is the priority action?
A. Allow the UAP to continue working with closer supervision
B. Remove the UAP from direct client care immediately [CORRECT]
C. Send the UAP home without pay
D. Document the incident after the shift
Correct Answer: B
Rationale: Impaired healthcare workers pose a safety risk to clients. The nurse must immediately
remove the UAP from client care, ensure client safety, and follow facility policy regarding fitness for
duty and substance use. Documentation and management follow-up should occur but safety is
immediate.
HESI Note: Patient safety is the priority. Impaired workers cannot provide safe care.
Q10: A client with a terminal illness asks the nurse, "Am I dying?" The physician has not discussed
the prognosis with the client. What is the best response?
A. "Yes, you are terminally ill and will die soon."
B. "What has your doctor told you about your condition?" [CORRECT]
C. "Don't worry, you are getting better every day."
D. Change the subject to avoid the question
Correct Answer: B
Rationale: This response assesses the client's current understanding and allows the nurse to
determine what information the physician has shared. Nurses should not provide prognostic
information that contradicts the physician or provides information the physician has not yet shared.
This response is therapeutic and facilitates communication.
HESI Note: Never lie to clients, but also avoid providing information that should come from the
physician or that exceeds what the physician has shared.
Q11: A facility is experiencing a staffing shortage during a flu epidemic. Which action demonstrates
appropriate resource management?
Comprehensive Exit Examination ACTUAL
EXAM 2026/2027 | Practice Test | 150
Questions | Answers and Rationales |
NCLEX-PN Aligned | Verified Q&A | Pass
Guaranteed - A+ Graded
SAFE AND EFFECTIVE CARE ENVIRONMENT – COORDINATED CARE (23 Questions)
Q1: The charge nurse is making client assignments for the medical-surgical unit. Which client
should be assigned to the most experienced LPN?
A. A 45-year-old with diabetes requiring insulin administration and dietary teaching
B. A 72-year-old 2 days post-hip replacement requiring pain management and ambulation
assistance
C. A 60-year-old with new-onset atrial fibrillation on continuous cardiac monitoring and IV
amiodarone [CORRECT]
D. A 55-year-old with pneumonia receiving IV antibiotics every 8 hours and oxygen at 2 L/min
Correct Answer: C
Rationale: The client with new-onset atrial fibrillation on cardiac monitoring and IV amiodarone is
unstable and requires advanced assessment skills, continuous monitoring, and knowledge of
antiarrhythmic medications. This client should be assigned to the most experienced LPN (or RN
depending on facility policy and state scope of practice). Options A, B, and D are stable clients with
predictable outcomes who could be assigned to less experienced LPNs or UAPs under supervision.
HESI Note: When making assignments, consider client acuity, stability, and predictability of
outcomes. Unstable clients require experienced nurses.
Q2: A nurse is caring for a client who has a living will stating DNR status. The client's family
requests that the nurse perform CPR when the client stops breathing. What is the nurse's best
action?
A. Follow the family's request to maintain family relationships
,B. Respect the client's living will and do not initiate CPR [CORRECT]
C. Call the physician for clarification
D. Transfer care to another nurse
Correct Answer: B
Rationale: A living will is a legally binding advance directive that expresses the client's wishes
regarding end-of-life care. The nurse must honor the client's autonomy and legal right to refuse
resuscitation. Family wishes cannot override a valid living will. The nurse should provide emotional
support to the family while maintaining ethical and legal obligations to the client.
HESI Note: Advance directives are legally binding documents that take precedence over family
wishes when the client cannot speak for themselves.
Q3: The nurse is delegating tasks to a UAP (Unlicensed Assistive Personnel). Which task is
appropriate to delegate?
A. Assessing a postoperative client's incision
B. Measuring and recording intake and output for a stable client [CORRECT]
C. Administering oral medications to a client with dysphagia
D. Teaching a client about wound care
Correct Answer: B
Rationale: The five rights of delegation include right task, right circumstance, right person, right
direction/communication, and right supervision. Measuring and recording I&O is an appropriate
task for UAP as it is routine, predictable, and does not require nursing judgment. Assessment (A),
medication administration (C), and patient education (D) are within the scope of licensed nursing
practice only.
HESI Note: Remember the "Five Rights of Delegation" - UAPs can perform routine, predictable
tasks for stable clients.
Q4: A client with chest pain is being transferred from the ED to the cardiac unit. Which
communication tool should the nurse use to ensure continuity of care?
A. SOAP documentation
B. SBAR report [CORRECT]
C. Chart audit
D. Nursing care plan
Correct Answer: B
Rationale: SBAR (Situation, Background, Assessment, Recommendation) is the standardized
communication tool used for handoff reports to ensure critical information is transferred accurately
and completely. It reduces communication errors during transfer of care between units or shifts.
HESI Note: SBAR is the gold standard for handoff communication and should be used for all
transfers and shift reports.
,Q5: A nurse witnesses a colleague documenting care that was not provided. What is the nurse's
legal responsibility?
A. Ignore it since the colleague is experienced
B. Report the incident to the nurse manager [CORRECT]
C. Confront the colleague in front of other staff
D. Document the care themselves to cover the error
Correct Answer: B
Rationale: Falsification of medical records constitutes fraud and malpractice. Nurses have an
ethical and legal obligation to report unsafe practices, unprofessional conduct, and fraudulent
documentation. Most facilities have policies for reporting through the chain of command.
HESI Note: Mandatory reporting applies to unsafe practice, abuse, and fraudulent documentation.
Follow chain of command and facility policy.
Q6: A client refuses a blood transfusion based on religious beliefs. The physician insists the client
will die without it. What is the nurse's priority action?
A. Administer the transfusion to save the client's life
B. Respect the client's right to refuse treatment [CORRECT]
C. Obtain a court order to override the refusal
D. Convince the family to override the client's decision
Correct Answer: B
Rationale: Clients have the legal right to refuse treatment, even life-saving treatment, based on
religious beliefs or personal values (autonomy). The nurse must respect this right, ensure informed
refusal is documented, and provide supportive care. A court order (C) would only be pursued in
specific circumstances involving minors or incapacitated persons without advance directives.
HESI Note: Right to refuse treatment is a fundamental client right. Document informed refusal
thoroughly.
Q7: Which action demonstrates the ethical principle of beneficence?
A. Telling a client the truth about their poor prognosis
B. Acting in the client's best interest to promote good [CORRECT]
C. Treating all clients fairly regardless of ability to pay
D. Keeping promises made to clients
Correct Answer: B
Rationale: Beneficence means "doing good" and acting in the client's best interest. Veracity (A) is
truth-telling. Justice (C) is fairness. Fidelity (D) is keeping promises.
HESI Note: Remember the ethical principles: Autonomy (self-determination), Beneficence (do
good), Non-maleficence (do no harm), Justice (fairness), Fidelity (loyalty), Veracity (truth).
Q8: A nurse receives a phone call from a worried neighbor asking about a mutual friend's hospital
status. The nurse recently cared for this friend. What is the appropriate response?
, A. Share limited information since they are mutual friends
B. Explain that HIPAA prohibits sharing any information without authorization [CORRECT]
C. Tell the neighbor to call the physician instead
D. Confirm the friend is hospitalized but give no details
Correct Answer: B
Rationale: HIPAA regulations strictly prohibit healthcare providers from disclosing protected health
information (PHI) without written authorization from the client. This applies even to friends, family, or
other healthcare providers not involved in care.
HESI Note: Never confirm or deny a person's presence in the facility unless the client has
authorized disclosure.
Q9: The nurse is supervising a UAP who appears sleepy and admits to taking an antihistamine
before work. What is the priority action?
A. Allow the UAP to continue working with closer supervision
B. Remove the UAP from direct client care immediately [CORRECT]
C. Send the UAP home without pay
D. Document the incident after the shift
Correct Answer: B
Rationale: Impaired healthcare workers pose a safety risk to clients. The nurse must immediately
remove the UAP from client care, ensure client safety, and follow facility policy regarding fitness for
duty and substance use. Documentation and management follow-up should occur but safety is
immediate.
HESI Note: Patient safety is the priority. Impaired workers cannot provide safe care.
Q10: A client with a terminal illness asks the nurse, "Am I dying?" The physician has not discussed
the prognosis with the client. What is the best response?
A. "Yes, you are terminally ill and will die soon."
B. "What has your doctor told you about your condition?" [CORRECT]
C. "Don't worry, you are getting better every day."
D. Change the subject to avoid the question
Correct Answer: B
Rationale: This response assesses the client's current understanding and allows the nurse to
determine what information the physician has shared. Nurses should not provide prognostic
information that contradicts the physician or provides information the physician has not yet shared.
This response is therapeutic and facilitates communication.
HESI Note: Never lie to clients, but also avoid providing information that should come from the
physician or that exceeds what the physician has shared.
Q11: A facility is experiencing a staffing shortage during a flu epidemic. Which action demonstrates
appropriate resource management?
