1 | Page
HESI EXIT RN EXAM 2026-2027
COMPREHENSIVE STUDY GUIDE & QUESTION
BANK VERIFIED ANSWERS WITH DETAILED
RATIONALES | NEXT GENERATION NCLEX
(NGN) ALIGNED
: SAFE & EFFECTIVE CARE ENVIRONMENT (20 Questions)
---
**1. A nurse is preparing to delegate tasks to an unlicensed assistive
personnel (UAP). Which task is appropriate for the nurse to delegate?**
- A) Assessing a client's pain level
- B) Administering oral medications
- C) Ambulating a stable client
- D) Evaluating the effectiveness of pain medication
** Correct Answer: C – Ambulating a stable client**
,2 | Page
**Rationale:** Delegation follows the "Five Rights": right task, right
circumstance, right person, right direction/communication, and right
supervision. UAP can ambulate stable clients, assist with activities of
daily living, and obtain vital signs on stable clients. Assessment,
medication administration, and evaluation are the responsibility of the
licensed nurse.
---
**2. A nurse receives a telephone order from a provider for a client's
pain medication. What is the nurse's priority action?**
- A) Implement the order immediately
- B) Write the order in the chart and sign "TO"
- C) Read the order back to the provider for verification
- D) Ask another nurse to listen to the order
** Correct Answer: C – Read the order back to the provider for
verification**
**Rationale:** The "read back" process is a critical safety measure that
ensures accurate communication of verbal and telephone orders. After
,3 | Page
writing the order, the nurse must read it back verbatim to the provider to
verify accuracy. This aligns with National Patient Safety Goals.
---
**3. A client with a do-not-resuscitate (DNR) order experiences cardiac
arrest. What should the nurse do first?**
- A) Begin chest compressions
- B) Call a code blue
- C) Verify the DNR order in the chart
- D) Notify the family
** Correct Answer: C – Verify the DNR order**
**Rationale:** Before withholding resuscitation, the nurse must verify
that a valid DNR order is present in the medical record. If the order is
not clearly documented, the nurse should initiate CPR while clarifying
the code status with the provider.
---
, 4 | Page
**4. A nurse is caring for a client who is post-operative day 2 and has a
platelet count of 20,000/mm³. Which intervention should the nurse
implement?**
- A) Use an electric razor for shaving
- B) Administer IM pain medication
- C) Apply warm compresses to IV sites
- D) Encourage the client to floss teeth daily
** Correct Answer: A – Use an electric razor for shaving**
**Rationale:** With severe thrombocytopenia (platelets <50,000),
bleeding precautions should be implemented: electric razor (not straight
razor), soft toothbrush (no flossing), no IM injections, and avoid rectal
temperatures.
---
**5. A nurse is preparing to administer a blood transfusion to a client.
Which IV solution is compatible with blood products?**
- A) Lactated Ringer's solution
HESI EXIT RN EXAM 2026-2027
COMPREHENSIVE STUDY GUIDE & QUESTION
BANK VERIFIED ANSWERS WITH DETAILED
RATIONALES | NEXT GENERATION NCLEX
(NGN) ALIGNED
: SAFE & EFFECTIVE CARE ENVIRONMENT (20 Questions)
---
**1. A nurse is preparing to delegate tasks to an unlicensed assistive
personnel (UAP). Which task is appropriate for the nurse to delegate?**
- A) Assessing a client's pain level
- B) Administering oral medications
- C) Ambulating a stable client
- D) Evaluating the effectiveness of pain medication
** Correct Answer: C – Ambulating a stable client**
,2 | Page
**Rationale:** Delegation follows the "Five Rights": right task, right
circumstance, right person, right direction/communication, and right
supervision. UAP can ambulate stable clients, assist with activities of
daily living, and obtain vital signs on stable clients. Assessment,
medication administration, and evaluation are the responsibility of the
licensed nurse.
---
**2. A nurse receives a telephone order from a provider for a client's
pain medication. What is the nurse's priority action?**
- A) Implement the order immediately
- B) Write the order in the chart and sign "TO"
- C) Read the order back to the provider for verification
- D) Ask another nurse to listen to the order
** Correct Answer: C – Read the order back to the provider for
verification**
**Rationale:** The "read back" process is a critical safety measure that
ensures accurate communication of verbal and telephone orders. After
,3 | Page
writing the order, the nurse must read it back verbatim to the provider to
verify accuracy. This aligns with National Patient Safety Goals.
---
**3. A client with a do-not-resuscitate (DNR) order experiences cardiac
arrest. What should the nurse do first?**
- A) Begin chest compressions
- B) Call a code blue
- C) Verify the DNR order in the chart
- D) Notify the family
** Correct Answer: C – Verify the DNR order**
**Rationale:** Before withholding resuscitation, the nurse must verify
that a valid DNR order is present in the medical record. If the order is
not clearly documented, the nurse should initiate CPR while clarifying
the code status with the provider.
---
, 4 | Page
**4. A nurse is caring for a client who is post-operative day 2 and has a
platelet count of 20,000/mm³. Which intervention should the nurse
implement?**
- A) Use an electric razor for shaving
- B) Administer IM pain medication
- C) Apply warm compresses to IV sites
- D) Encourage the client to floss teeth daily
** Correct Answer: A – Use an electric razor for shaving**
**Rationale:** With severe thrombocytopenia (platelets <50,000),
bleeding precautions should be implemented: electric razor (not straight
razor), soft toothbrush (no flossing), no IM injections, and avoid rectal
temperatures.
---
**5. A nurse is preparing to administer a blood transfusion to a client.
Which IV solution is compatible with blood products?**
- A) Lactated Ringer's solution
