HESI 2026 RN Exit Exam - Original NCLEX-Style Practice
HESI 2026 RN Exit Exam
Original NCLEX-Style Practice Questions with Rationales
Important: This is a newly written practice set. It uses common RN exit exam content areas for study practice and does not
reproduce the uploaded exam questions.
Format How to use
160 multiple-choice questions Answer first without viewing rationales.
Answers and rationales included Review the rationale and why the other options are weaker.
Diagrams included in Questions 1 and 2 Mark missed topics for focused revision.
Page 1
,HESI 2026 RN Exit Exam - Original NCLEX-Style Practice
Question 1 of 160 | Respiratory - COPD
A client with COPD is dyspneic and using accessory muscles. Which position should the nurse place the client in first?
A. Tripod position with arms supported
B. Flat supine with one pillow
C. Left lateral position
D. Trendelenburg position
Correct Answer: A
Rationale: Leaning forward with arm support improves diaphragmatic movement and can reduce work of breathing.
Key terms explained: Priority, safety, ABCs, and client teaching are common NCLEX decision-making cues.
Why the others are not correct: Incorrect options are less urgent, unsafe, outside the nurse role, or do not address the main problem.
Page 2
,HESI 2026 RN Exit Exam - Original NCLEX-Style Practice
Question 2 of 160 | Cardiac - Conduction system
In the diagram, which numbered structure represents the atrioventricular node?
A. 1
B. 2
C. 3
D. 4
Correct Answer: B
Rationale: The AV node delays the impulse before it travels through the bundle of His and Purkinje fibers.
Key terms explained: Priority, safety, ABCs, and client teaching are common NCLEX decision-making cues.
Why the others are not correct: Incorrect options are less urgent, unsafe, outside the nurse role, or do not address the main problem.
Page 3
, HESI 2026 RN Exit Exam - Original NCLEX-Style Practice
Question 3 of 160 | Neurologic - Meningitis
A child admitted with bacterial meningitis becomes increasingly irritable and vomits. Which finding is most concerning?
A. Bulging fontanel or increasing head size
B. Poor appetite after antibiotics
C. Mild photophobia
D. Low-grade fever
Correct Answer: A
Rationale: Bulging fontanel or increasing head circumference suggests increased intracranial pressure and requires rapid action.
Key terms explained: Priority, safety, ABCs, and client teaching are common NCLEX decision-making cues.
Why the others are not correct: Incorrect options are less urgent, unsafe, outside the nurse role, or do not address the main problem.
Question 4 of 160 | GI - Pancreatitis
A client with acute pancreatitis has severe epigastric pain. Which order should the nurse question?
A. Morphine IV as prescribed
B. Clear liquid diet immediately
C. Aggressive IV fluids
D. Serum lipase monitoring
Correct Answer: B
Rationale: During acute pancreatitis, oral intake is often withheld initially to reduce pancreatic stimulation.
Key terms explained: Priority, safety, ABCs, and client teaching are common NCLEX decision-making cues.
Why the others are not correct: Incorrect options are less urgent, unsafe, outside the nurse role, or do not address the main problem.
Question 5 of 160 | Hematology - Sickle cell disease
A child with sickle cell disease is being discharged. Which instruction is most important?
A. Seek care for fever or signs of infection
B. Limit all fluid intake
C. Avoid all immunizations
D. Use heat only during pain episodes
Correct Answer: A
Rationale: Infection can trigger crisis and become life-threatening in sickle cell disease.
Key terms explained: Priority, safety, ABCs, and client teaching are common NCLEX decision-making cues.
Why the others are not correct: Incorrect options are less urgent, unsafe, outside the nurse role, or do not address the main problem.
Question 6 of 160 | Assessment - Vascular sounds
Where should the nurse place the stethoscope to assess for a carotid bruit?
A. Over the upper abdomen
B. At the base of the neck beside the trachea
C. At the midaxillary line
D. Over the femoral pulse only
Correct Answer: B
Rationale: Carotid bruits are assessed gently over the carotid artery at the side of the neck.
Key terms explained: Priority, safety, ABCs, and client teaching are common NCLEX decision-making cues.
Why the others are not correct: Incorrect options are less urgent, unsafe, outside the nurse role, or do not address the main problem.
Page 4
HESI 2026 RN Exit Exam
Original NCLEX-Style Practice Questions with Rationales
Important: This is a newly written practice set. It uses common RN exit exam content areas for study practice and does not
reproduce the uploaded exam questions.
Format How to use
160 multiple-choice questions Answer first without viewing rationales.
Answers and rationales included Review the rationale and why the other options are weaker.
Diagrams included in Questions 1 and 2 Mark missed topics for focused revision.
Page 1
,HESI 2026 RN Exit Exam - Original NCLEX-Style Practice
Question 1 of 160 | Respiratory - COPD
A client with COPD is dyspneic and using accessory muscles. Which position should the nurse place the client in first?
A. Tripod position with arms supported
B. Flat supine with one pillow
C. Left lateral position
D. Trendelenburg position
Correct Answer: A
Rationale: Leaning forward with arm support improves diaphragmatic movement and can reduce work of breathing.
Key terms explained: Priority, safety, ABCs, and client teaching are common NCLEX decision-making cues.
Why the others are not correct: Incorrect options are less urgent, unsafe, outside the nurse role, or do not address the main problem.
Page 2
,HESI 2026 RN Exit Exam - Original NCLEX-Style Practice
Question 2 of 160 | Cardiac - Conduction system
In the diagram, which numbered structure represents the atrioventricular node?
A. 1
B. 2
C. 3
D. 4
Correct Answer: B
Rationale: The AV node delays the impulse before it travels through the bundle of His and Purkinje fibers.
Key terms explained: Priority, safety, ABCs, and client teaching are common NCLEX decision-making cues.
Why the others are not correct: Incorrect options are less urgent, unsafe, outside the nurse role, or do not address the main problem.
Page 3
, HESI 2026 RN Exit Exam - Original NCLEX-Style Practice
Question 3 of 160 | Neurologic - Meningitis
A child admitted with bacterial meningitis becomes increasingly irritable and vomits. Which finding is most concerning?
A. Bulging fontanel or increasing head size
B. Poor appetite after antibiotics
C. Mild photophobia
D. Low-grade fever
Correct Answer: A
Rationale: Bulging fontanel or increasing head circumference suggests increased intracranial pressure and requires rapid action.
Key terms explained: Priority, safety, ABCs, and client teaching are common NCLEX decision-making cues.
Why the others are not correct: Incorrect options are less urgent, unsafe, outside the nurse role, or do not address the main problem.
Question 4 of 160 | GI - Pancreatitis
A client with acute pancreatitis has severe epigastric pain. Which order should the nurse question?
A. Morphine IV as prescribed
B. Clear liquid diet immediately
C. Aggressive IV fluids
D. Serum lipase monitoring
Correct Answer: B
Rationale: During acute pancreatitis, oral intake is often withheld initially to reduce pancreatic stimulation.
Key terms explained: Priority, safety, ABCs, and client teaching are common NCLEX decision-making cues.
Why the others are not correct: Incorrect options are less urgent, unsafe, outside the nurse role, or do not address the main problem.
Question 5 of 160 | Hematology - Sickle cell disease
A child with sickle cell disease is being discharged. Which instruction is most important?
A. Seek care for fever or signs of infection
B. Limit all fluid intake
C. Avoid all immunizations
D. Use heat only during pain episodes
Correct Answer: A
Rationale: Infection can trigger crisis and become life-threatening in sickle cell disease.
Key terms explained: Priority, safety, ABCs, and client teaching are common NCLEX decision-making cues.
Why the others are not correct: Incorrect options are less urgent, unsafe, outside the nurse role, or do not address the main problem.
Question 6 of 160 | Assessment - Vascular sounds
Where should the nurse place the stethoscope to assess for a carotid bruit?
A. Over the upper abdomen
B. At the base of the neck beside the trachea
C. At the midaxillary line
D. Over the femoral pulse only
Correct Answer: B
Rationale: Carotid bruits are assessed gently over the carotid artery at the side of the neck.
Key terms explained: Priority, safety, ABCs, and client teaching are common NCLEX decision-making cues.
Why the others are not correct: Incorrect options are less urgent, unsafe, outside the nurse role, or do not address the main problem.
Page 4
