HESI RN EXIT EXAM
ACTUAL EXAM 2026
COMPREHENSIVE STUDY GUIDE
SECTION 1: PEDIATRICS
QUESTION 1
4-month-old baby choking. Steps? (Select all)
ANSWER
Note any obstruction or absence of breathing
Deliver five backslaps between shoulder blades
Place infant over nurse's arm
RATIONALE / EXPLANATION
Infant choking: 5 back slaps then 5 chest thrusts. Chest thrusts between nipples with two fingers.
NO blind finger sweeps (may push object deeper). Compress chest once is for CPR, not choking.
QUESTION 2
1-year-old vital signs. Which to report? Temp 97.5°F, Pulse 80, RR 26, BP 90/53
ANSWER
Pulse: 80 beats/min
RATIONALE / EXPLANATION
Normal 1-year-old pulse: 90-130 bpm. 80 is below normal range. Other vitals within normal limits
for age.
QUESTION 3
Bathing uncircumcised boy older than 3 years. Action?
ANSWER
Retract the foreskin gently to cleanse the penis
RATIONALE / EXPLANATION
Page 1 of 37
,Foreskin (prepuce) should be gently retracted to clean areas harboring bacteria. Child's cognitive
level may not allow effective self-care instruction. Daily perineal care needed regardless of age.
QUESTION 4
7-year-old often awake until midnight, hard to awaken for school. Assessment data?
ANSWER
Description of the family's home environment
RATIONALE / EXPLANATION
Assess home environment for factors not conducive to bedtime rituals. Sleep apnea causes
daytime fatigue, not resistance to sleep. Can't determine REM sleep clinically.
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, SECTION 2: FUNDAMENTALS & SKILLS
QUESTION 5
Which fluid for blood transfusion?
ANSWER
Normal saline
RATIONALE / EXPLANATION
Normal saline is the ONLY solution compatible with blood. Not D5W, not LR, not D5LR.
QUESTION 6
Assisting client from bed to chair. Best procedure?
ANSWER
With feet spread apart and knees aligned with client's knees, stand and pivot
client into chair
RATIONALE / EXPLANATION
Wide base of support, knees aligned to stabilize. Chair at 45° angle to bed, back toward head of
bed. NEVER lift under axillae (nerve damage). Client arms on chair arms, not around nurse's
neck.
QUESTION 7
I&O calculation: 1200 mL water, 4 oz gelatin, 8 oz OJ, 355 mL soda, 1 cup soup. Total?
ANSWER
2155 mL
RATIONALE / EXPLANATION
1200 + 120 (4 oz) + 240 (8 oz) + 355 + 240 (1 cup) = 2155 mL
QUESTION 8
UAP taking BP in lower extremity. What requires intervention?
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, ANSWER
The UAP auscultates the popliteal pulse with the cuff on the lower leg
RATIONALE / EXPLANATION
For lower extremity BP: cuff on THIGH, auscultate popliteal pulse. Not cuff on lower leg. Prone
position is correct. Systolic is normally 10-40 mm Hg higher than brachial.
QUESTION 9
Best site for IV catheter documentation?
ANSWER
Right cephalic vein
RATIONALE / EXPLANATION
Cephalic vein is large and superficial. Document anatomic name. Basilic vein used for IV, not
brachial (too deep). Dorsal wrist veins fragile and painful. 'Right upper extremity' not specific
enough.
QUESTION 10
Counting respiratory rate. First count: 6 breaths with 3 coughs in 30 sec. Second count: 8
breaths in 30 sec. Document?
ANSWER
16 breaths/min
RATIONALE / EXPLANATION
Use second count (not interrupted by coughing). 8 breaths × 2 = 16/min.
QUESTION 11
Preparing bolus tube feeding. Steps to include? (Select all)
ANSWER
Aspirate stomach contents
Assess bowel sounds
Warm feeding to room temperature
Assess pH of stomach contents
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ACTUAL EXAM 2026
COMPREHENSIVE STUDY GUIDE
SECTION 1: PEDIATRICS
QUESTION 1
4-month-old baby choking. Steps? (Select all)
ANSWER
Note any obstruction or absence of breathing
Deliver five backslaps between shoulder blades
Place infant over nurse's arm
RATIONALE / EXPLANATION
Infant choking: 5 back slaps then 5 chest thrusts. Chest thrusts between nipples with two fingers.
NO blind finger sweeps (may push object deeper). Compress chest once is for CPR, not choking.
QUESTION 2
1-year-old vital signs. Which to report? Temp 97.5°F, Pulse 80, RR 26, BP 90/53
ANSWER
Pulse: 80 beats/min
RATIONALE / EXPLANATION
Normal 1-year-old pulse: 90-130 bpm. 80 is below normal range. Other vitals within normal limits
for age.
QUESTION 3
Bathing uncircumcised boy older than 3 years. Action?
ANSWER
Retract the foreskin gently to cleanse the penis
RATIONALE / EXPLANATION
Page 1 of 37
,Foreskin (prepuce) should be gently retracted to clean areas harboring bacteria. Child's cognitive
level may not allow effective self-care instruction. Daily perineal care needed regardless of age.
QUESTION 4
7-year-old often awake until midnight, hard to awaken for school. Assessment data?
ANSWER
Description of the family's home environment
RATIONALE / EXPLANATION
Assess home environment for factors not conducive to bedtime rituals. Sleep apnea causes
daytime fatigue, not resistance to sleep. Can't determine REM sleep clinically.
Page 2 of 37
, SECTION 2: FUNDAMENTALS & SKILLS
QUESTION 5
Which fluid for blood transfusion?
ANSWER
Normal saline
RATIONALE / EXPLANATION
Normal saline is the ONLY solution compatible with blood. Not D5W, not LR, not D5LR.
QUESTION 6
Assisting client from bed to chair. Best procedure?
ANSWER
With feet spread apart and knees aligned with client's knees, stand and pivot
client into chair
RATIONALE / EXPLANATION
Wide base of support, knees aligned to stabilize. Chair at 45° angle to bed, back toward head of
bed. NEVER lift under axillae (nerve damage). Client arms on chair arms, not around nurse's
neck.
QUESTION 7
I&O calculation: 1200 mL water, 4 oz gelatin, 8 oz OJ, 355 mL soda, 1 cup soup. Total?
ANSWER
2155 mL
RATIONALE / EXPLANATION
1200 + 120 (4 oz) + 240 (8 oz) + 355 + 240 (1 cup) = 2155 mL
QUESTION 8
UAP taking BP in lower extremity. What requires intervention?
Page 3 of 37
, ANSWER
The UAP auscultates the popliteal pulse with the cuff on the lower leg
RATIONALE / EXPLANATION
For lower extremity BP: cuff on THIGH, auscultate popliteal pulse. Not cuff on lower leg. Prone
position is correct. Systolic is normally 10-40 mm Hg higher than brachial.
QUESTION 9
Best site for IV catheter documentation?
ANSWER
Right cephalic vein
RATIONALE / EXPLANATION
Cephalic vein is large and superficial. Document anatomic name. Basilic vein used for IV, not
brachial (too deep). Dorsal wrist veins fragile and painful. 'Right upper extremity' not specific
enough.
QUESTION 10
Counting respiratory rate. First count: 6 breaths with 3 coughs in 30 sec. Second count: 8
breaths in 30 sec. Document?
ANSWER
16 breaths/min
RATIONALE / EXPLANATION
Use second count (not interrupted by coughing). 8 breaths × 2 = 16/min.
QUESTION 11
Preparing bolus tube feeding. Steps to include? (Select all)
ANSWER
Aspirate stomach contents
Assess bowel sounds
Warm feeding to room temperature
Assess pH of stomach contents
Page 4 of 37
