1
NGN Nursing HESI Exit Exam Test Bank for RN
Students Actual Exam 2026/2027 – Complete
Exam-Style Questions with Detailed Rationales |
Pass Guaranteed – A+ Graded
[SECTION 1: Safe & Effective Care Environment — Questions 1-30]
Q1: The charge nurse is making assignments for the day shift. Which client should be assigned to
the Licensed Practical Nurse (LPN)?
A. A newly admitted client with acute pancreatitis who is receiving IV morphine.
B. A client with a fresh tracheostomy who requires suctioning.
C. A client who is 2 days post-hemicolectomy requiring wound care and IV antibiotic
administration. [CORRECT]
D. A client experiencing unstable atrial fibrillation who requires diltiazem titration.
Correct Answer: C
Rationale: The LPN scope of practice includes stable clients with predictable outcomes, such as
administering IV antibiotics and performing wound care. The RN should manage unstable clients
(acute pancreatitis with pain management, unstable A-fib with titration) and clients with complex
airway needs like fresh tracheostomies (depending on state rules, often RN preferred for fresh).
Assignments must consider client stability and the educational preparation of the nurse.
Q2: The nurse is caring for a client diagnosed with tuberculosis (TB). Which action by the nurse
indicates a breach in infection control precautions?
A. Wearing an N95 respirator when entering the client’s room.
B. Keeping the door to the client’s room closed.
C. Placing the client in a negative pressure room and opening the door to the hallway.
[CORRECT]
D. Placing the client in airborne precautions.
,2
Correct Answer: C
Rationale: Airborne precautions require negative pressure rooms to prevent infectious droplet
nuclei from escaping into the hallway. Keeping the door open violates the integrity of the
isolation environment, potentially exposing others. N95 respirators and closed doors are standard
requirements for airborne precautions.
Q3: A client is being discharged on warfarin (Coumadin). Which statement by the client indicates
a need for further teaching regarding this medication?
A. "I will have my blood drawn regularly to check my INR level."
B. "I will eat a consistent amount of green leafy vegetables."
C. "If I miss a dose, I can take two pills the next day to make up for it." [CORRECT]
D. "I will use a soft toothbrush and electric razor to prevent bleeding."
Correct Answer: C
Rationale: Warfarin has a narrow therapeutic index; doubling a dose can lead to severe bleeding.
Clients should be instructed never to double up on doses if one is missed; instead, they should
take it as soon as they remember unless it is almost time for the next dose. Consistent INR
monitoring, diet consistency, and bleeding precautions are correct teaching points.
Q4: The nurse is preparing to administer a unit of packed red blood cells (PRBCs). Which action
is most appropriate to prevent an acute hemolytic reaction?
A. Premedicating the client with acetaminophen and diphenhydramine.
B. Verifying the client identification with another RN and checking blood compatibility.
[CORRECT]
C. Running the blood rapidly over 15 minutes.
D. Adding normal saline to the blood bag to thin it out.
Correct Answer: B
Rationale: The most critical step in preventing an acute hemolytic reaction is proper
identification and compatibility checking by two nurses (or per facility policy). This ensures the
right blood is given to the right patient. Premedication prevents febrile non-hemolytic reactions,
,3
and blood should be run slowly initially (not rapidly). Saline is the only solution compatible with
blood; adding anything to the bag is prohibited.
Q5: A client who is on contact precautions for Clostridioides difficile (C. diff) needs to be
transported to the radiology department for a CT scan. Which nursing action is correct?
A. Place the client in a surgical mask.
B. Keep the client’s door open for ventilation.
C. Ensure the client wears a clean gown and performs hand hygiene before leaving the room.
[CORRECT]
D. Do not transport the client until they are no longer infectious.
Correct Answer: C
Rationale: Transporting a client in contact precautions requires minimizing environmental
contamination. The client should wear a clean gown, and if the client can cooperate, perform
hand hygiene. A mask is for droplet/airborne precautions; C. diff is contact (spore-forming).
While clean transport is needed, delaying diagnostic tests is not an option if medically necessary;
transport can occur with proper protocols.
Q6: The RN delegates the task of ambulating a stable postoperative client to an Unlicensed
Assistive Personnel (UAP). Which instruction is most important for the RN to include?
A. "Report if the client's heart rate increases by more than 10 beats per minute."
B. "Stop the ambulation and call me immediately if the client reports dizziness or shortness of
breath." [CORRECT]
C. "Make sure the client walks at least 200 feet today."
D. "Do not allow the client to use the handrail for stability."
Correct Answer: B
Rationale: The RN must delegate the task with appropriate instructions regarding what to report.
Safety is the priority; dizziness or shortness of breath are signs of decompensation requiring
immediate RN assessment. While setting a goal (C) is helpful, it is secondary to safety criteria.
, 4
Using a handrail (D) is encouraged. A slight increase in HR (A) is expected with activity, not
necessarily an emergency.
Q7: During a fire drill, the nurse discovers a fire in the medication room. The nurse should take
which action first?
A. Remove clients from the immediate area.
B. Activate the fire alarm.
C. Close the doors to the medication room. [CORRECT]
D. Call the operator to page a code.
Correct Answer: C
Rationale: The acronym RACE is standard fire safety protocol. The first action is to
Remove/Rescue those in immediate danger (if safe), but the immediate action to stop fire spread
is to Contain the fire (Close doors). However, technically, RACE is often taught as Rescue,
Alarm, Contain, Extinguish. BUT, if you discover a fire, removing patients or closing the door to
contain it depends on proximity. The immediate physical act to stop the spread is closing the
door. Self-correction based on NCLEX standard: If a fire is small and close, close the door. If
people are in danger, rescue first. Since it's a medication room (likely empty of patients),
Containment (Closing the door) is the priority action before Alarm or Extinguish.
Q8: A client admitted with right-sided weakness following a stroke is at risk for falls. Which
intervention is the priority?
A. Place the call light within the client’s reach.
B. Keep the bed in the lowest position.
C. Implement fall precautions and place a fall risk sign on the door. [CORRECT]
D. Encourage the client to ring for assistance before getting out of bed.
Correct Answer: C
Rationale: While A, B, and D are all correct interventions for fall prevention, the question asks
for the priority action which initiates the safety protocol (System-level intervention first).
However, strictly speaking, "Implement fall precautions" is the umbrella. Let's refine: The
NGN Nursing HESI Exit Exam Test Bank for RN
Students Actual Exam 2026/2027 – Complete
Exam-Style Questions with Detailed Rationales |
Pass Guaranteed – A+ Graded
[SECTION 1: Safe & Effective Care Environment — Questions 1-30]
Q1: The charge nurse is making assignments for the day shift. Which client should be assigned to
the Licensed Practical Nurse (LPN)?
A. A newly admitted client with acute pancreatitis who is receiving IV morphine.
B. A client with a fresh tracheostomy who requires suctioning.
C. A client who is 2 days post-hemicolectomy requiring wound care and IV antibiotic
administration. [CORRECT]
D. A client experiencing unstable atrial fibrillation who requires diltiazem titration.
Correct Answer: C
Rationale: The LPN scope of practice includes stable clients with predictable outcomes, such as
administering IV antibiotics and performing wound care. The RN should manage unstable clients
(acute pancreatitis with pain management, unstable A-fib with titration) and clients with complex
airway needs like fresh tracheostomies (depending on state rules, often RN preferred for fresh).
Assignments must consider client stability and the educational preparation of the nurse.
Q2: The nurse is caring for a client diagnosed with tuberculosis (TB). Which action by the nurse
indicates a breach in infection control precautions?
A. Wearing an N95 respirator when entering the client’s room.
B. Keeping the door to the client’s room closed.
C. Placing the client in a negative pressure room and opening the door to the hallway.
[CORRECT]
D. Placing the client in airborne precautions.
,2
Correct Answer: C
Rationale: Airborne precautions require negative pressure rooms to prevent infectious droplet
nuclei from escaping into the hallway. Keeping the door open violates the integrity of the
isolation environment, potentially exposing others. N95 respirators and closed doors are standard
requirements for airborne precautions.
Q3: A client is being discharged on warfarin (Coumadin). Which statement by the client indicates
a need for further teaching regarding this medication?
A. "I will have my blood drawn regularly to check my INR level."
B. "I will eat a consistent amount of green leafy vegetables."
C. "If I miss a dose, I can take two pills the next day to make up for it." [CORRECT]
D. "I will use a soft toothbrush and electric razor to prevent bleeding."
Correct Answer: C
Rationale: Warfarin has a narrow therapeutic index; doubling a dose can lead to severe bleeding.
Clients should be instructed never to double up on doses if one is missed; instead, they should
take it as soon as they remember unless it is almost time for the next dose. Consistent INR
monitoring, diet consistency, and bleeding precautions are correct teaching points.
Q4: The nurse is preparing to administer a unit of packed red blood cells (PRBCs). Which action
is most appropriate to prevent an acute hemolytic reaction?
A. Premedicating the client with acetaminophen and diphenhydramine.
B. Verifying the client identification with another RN and checking blood compatibility.
[CORRECT]
C. Running the blood rapidly over 15 minutes.
D. Adding normal saline to the blood bag to thin it out.
Correct Answer: B
Rationale: The most critical step in preventing an acute hemolytic reaction is proper
identification and compatibility checking by two nurses (or per facility policy). This ensures the
right blood is given to the right patient. Premedication prevents febrile non-hemolytic reactions,
,3
and blood should be run slowly initially (not rapidly). Saline is the only solution compatible with
blood; adding anything to the bag is prohibited.
Q5: A client who is on contact precautions for Clostridioides difficile (C. diff) needs to be
transported to the radiology department for a CT scan. Which nursing action is correct?
A. Place the client in a surgical mask.
B. Keep the client’s door open for ventilation.
C. Ensure the client wears a clean gown and performs hand hygiene before leaving the room.
[CORRECT]
D. Do not transport the client until they are no longer infectious.
Correct Answer: C
Rationale: Transporting a client in contact precautions requires minimizing environmental
contamination. The client should wear a clean gown, and if the client can cooperate, perform
hand hygiene. A mask is for droplet/airborne precautions; C. diff is contact (spore-forming).
While clean transport is needed, delaying diagnostic tests is not an option if medically necessary;
transport can occur with proper protocols.
Q6: The RN delegates the task of ambulating a stable postoperative client to an Unlicensed
Assistive Personnel (UAP). Which instruction is most important for the RN to include?
A. "Report if the client's heart rate increases by more than 10 beats per minute."
B. "Stop the ambulation and call me immediately if the client reports dizziness or shortness of
breath." [CORRECT]
C. "Make sure the client walks at least 200 feet today."
D. "Do not allow the client to use the handrail for stability."
Correct Answer: B
Rationale: The RN must delegate the task with appropriate instructions regarding what to report.
Safety is the priority; dizziness or shortness of breath are signs of decompensation requiring
immediate RN assessment. While setting a goal (C) is helpful, it is secondary to safety criteria.
, 4
Using a handrail (D) is encouraged. A slight increase in HR (A) is expected with activity, not
necessarily an emergency.
Q7: During a fire drill, the nurse discovers a fire in the medication room. The nurse should take
which action first?
A. Remove clients from the immediate area.
B. Activate the fire alarm.
C. Close the doors to the medication room. [CORRECT]
D. Call the operator to page a code.
Correct Answer: C
Rationale: The acronym RACE is standard fire safety protocol. The first action is to
Remove/Rescue those in immediate danger (if safe), but the immediate action to stop fire spread
is to Contain the fire (Close doors). However, technically, RACE is often taught as Rescue,
Alarm, Contain, Extinguish. BUT, if you discover a fire, removing patients or closing the door to
contain it depends on proximity. The immediate physical act to stop the spread is closing the
door. Self-correction based on NCLEX standard: If a fire is small and close, close the door. If
people are in danger, rescue first. Since it's a medication room (likely empty of patients),
Containment (Closing the door) is the priority action before Alarm or Extinguish.
Q8: A client admitted with right-sided weakness following a stroke is at risk for falls. Which
intervention is the priority?
A. Place the call light within the client’s reach.
B. Keep the bed in the lowest position.
C. Implement fall precautions and place a fall risk sign on the door. [CORRECT]
D. Encourage the client to ring for assistance before getting out of bed.
Correct Answer: C
Rationale: While A, B, and D are all correct interventions for fall prevention, the question asks
for the priority action which initiates the safety protocol (System-level intervention first).
However, strictly speaking, "Implement fall precautions" is the umbrella. Let's refine: The
