HESI RN EXIT EXAM VERSION 2
COMPREHENSIVE REVIEW 2026
QUESTIONS AND ANSWERS
WITH RATIONALES/GRADED
A+/2026 UPDATE/100% CORRECT
/INSTANT DOWNLOAD
SECTION 1: PRIORITIZATION, DELEGATION, & LEADERSHIP
(Questions 1-10)
1. A nurse receives shift report on four clients. Which client should the nurse assess
first?
A) A post-operative day 2 client reporting pain of 5/10 on a 0-10 scale
B) A client with a new ileostomy who has output of 150 mL in 4 hours
C) A client with new-onset confusion and an oxygen saturation of 88% on room
air
D) A client with pneumonia requesting pain medication for a headache
Correct Answer: C
Rationale: Assessment and care are prioritized using the ABCs (Airway, Breathing,
Circulation). An oxygen saturation of 88% indicates severe hypoxemia, a life-
threatening breathing problem. New-onset confusion can be a sign of hypoxia and
requires immediate intervention.
2. A charge nurse is making assignments for a new graduate nurse who has just
completed orientation on the labor and delivery unit. Which client is most
appropriate to assign to this new nurse?
,A) A primigravida who is 8 cm dilated after 14 hours of labor
B) A multiparous client who is dilated 5 cm and 50% effaced
C) A client being induced for a fetal demise at 20 weeks' gestation
D) A client scheduled for a repeat cesarean birth at 38 weeks' gestation
Correct Answer: B
Rationale: The new nurse should be assigned the least complicated client. The client
who is a multipara (has given birth before) and is progressing normally at 5 cm is the
most stable. The other options involve actual or potential complications that require
a more experienced nurse.
3. A registered nurse (RN) is delegating tasks to an unlicensed assistive personnel
(UAP). Which task is most appropriate to delegate?
A) Assessing a client's post-operative pain level
B) Ambulating a client who is post-operative day 1 following an appendectomy
C) Administering a tube feeding to a client with a gastrostomy tube
D) Teaching a client how to administer their own insulin
Correct Answer: B
Rationale: Ambulating a stable client is a routine task that falls within the scope of
practice for a UAP. Delegation follows the "Five Rights": right task, right
circumstance, right person, right directions/communication, and right supervision.
Assessment, teaching, and medication administration (tube feeding) are not
appropriate for a UAP.
4. Who is ultimately responsible for establishing systems to monitor and verify
competency requirements related to delegation within a healthcare organization?
A) Nurse Manager
B) Chief Nursing Officer (CNO)
C) Staff Development Coordinator
D) Human Resources Department
Correct Answer: B
Rationale: Chief Nursing Officers (CNOs) have the administrative responsibility to
establish, monitor, and enforce systems to verify the competency of all nursing staff
related to delegation and safe practice.
5. A client with severe depression tells the nurse, "I don't know why you bother with
me. I am never going to get well." What is the most therapeutic response?
A) "You need to stop thinking negative thoughts. They get in the way of your
recovery."
B) "You are no bother to me or to the staff. We want you to get well."
C) "I have known many clients with depression who have felt better after
several weeks of treatment."
, D) "You are feeling very pessimistic, but that is part of your illness. It should go
away."
Correct Answer: C
Rationale: Stating that others have recovered gives the client hope without offering
false reassurance or arguing with the client's beliefs. It is a therapeutic technique that
instills hope and normalizes the recovery process.
6. The nurse is preparing to apply wrist restraints to a client as ordered. Which
observation by the nurse indicates that the nursing assistant is using the restraints
safely and correctly? (Select all that apply)
A) The restraints are applied tightly to prevent the client from slipping out.
B) The restraints are being released every 2 hours.
C) A safety knot has been used to secure the restraints.
D) The restraints are tied to the siderail of the bed.
E) The call light has been placed within reach of the client.
Correct Answer: B, C, E
Rationale: Restraints must be released every 2 hours to inspect skin and provide
range of motion. A quick-release safety knot is essential for emergency removal. The
call light must always be within reach. Restraints should be tied to the bed frame, not
the siderail, to prevent injury if the siderail is lowered. They should never be applied
tightly as this can impair circulation.
7. A nurse is caring for a client with Clostridioides difficile. Which type of precautions
should the nurse implement?
A) Airborne precautions
B) Contact precautions
C) Droplet precautions
D) Protective environment
Correct Answer: B
Rationale: Contact precautions are implemented for infections that are spread by
direct or indirect contact with the patient or the patient's environment. C. diff is
transmitted via spores that are easily spread on hands and surfaces.
8. A client who is post-operative day 1 after an appendectomy has a prescription for
morphine sulfate 4 mg IV every 4 hours for pain. The client's respiratory rate is 8
breaths/minute. Which medication should the nurse prepare to administer?
A) Flumazenil (Romazicon)
B) Naloxone (Narcan)
C) Protamine sulfate
D) Acetylcysteine (Mucomyst)
COMPREHENSIVE REVIEW 2026
QUESTIONS AND ANSWERS
WITH RATIONALES/GRADED
A+/2026 UPDATE/100% CORRECT
/INSTANT DOWNLOAD
SECTION 1: PRIORITIZATION, DELEGATION, & LEADERSHIP
(Questions 1-10)
1. A nurse receives shift report on four clients. Which client should the nurse assess
first?
A) A post-operative day 2 client reporting pain of 5/10 on a 0-10 scale
B) A client with a new ileostomy who has output of 150 mL in 4 hours
C) A client with new-onset confusion and an oxygen saturation of 88% on room
air
D) A client with pneumonia requesting pain medication for a headache
Correct Answer: C
Rationale: Assessment and care are prioritized using the ABCs (Airway, Breathing,
Circulation). An oxygen saturation of 88% indicates severe hypoxemia, a life-
threatening breathing problem. New-onset confusion can be a sign of hypoxia and
requires immediate intervention.
2. A charge nurse is making assignments for a new graduate nurse who has just
completed orientation on the labor and delivery unit. Which client is most
appropriate to assign to this new nurse?
,A) A primigravida who is 8 cm dilated after 14 hours of labor
B) A multiparous client who is dilated 5 cm and 50% effaced
C) A client being induced for a fetal demise at 20 weeks' gestation
D) A client scheduled for a repeat cesarean birth at 38 weeks' gestation
Correct Answer: B
Rationale: The new nurse should be assigned the least complicated client. The client
who is a multipara (has given birth before) and is progressing normally at 5 cm is the
most stable. The other options involve actual or potential complications that require
a more experienced nurse.
3. A registered nurse (RN) is delegating tasks to an unlicensed assistive personnel
(UAP). Which task is most appropriate to delegate?
A) Assessing a client's post-operative pain level
B) Ambulating a client who is post-operative day 1 following an appendectomy
C) Administering a tube feeding to a client with a gastrostomy tube
D) Teaching a client how to administer their own insulin
Correct Answer: B
Rationale: Ambulating a stable client is a routine task that falls within the scope of
practice for a UAP. Delegation follows the "Five Rights": right task, right
circumstance, right person, right directions/communication, and right supervision.
Assessment, teaching, and medication administration (tube feeding) are not
appropriate for a UAP.
4. Who is ultimately responsible for establishing systems to monitor and verify
competency requirements related to delegation within a healthcare organization?
A) Nurse Manager
B) Chief Nursing Officer (CNO)
C) Staff Development Coordinator
D) Human Resources Department
Correct Answer: B
Rationale: Chief Nursing Officers (CNOs) have the administrative responsibility to
establish, monitor, and enforce systems to verify the competency of all nursing staff
related to delegation and safe practice.
5. A client with severe depression tells the nurse, "I don't know why you bother with
me. I am never going to get well." What is the most therapeutic response?
A) "You need to stop thinking negative thoughts. They get in the way of your
recovery."
B) "You are no bother to me or to the staff. We want you to get well."
C) "I have known many clients with depression who have felt better after
several weeks of treatment."
, D) "You are feeling very pessimistic, but that is part of your illness. It should go
away."
Correct Answer: C
Rationale: Stating that others have recovered gives the client hope without offering
false reassurance or arguing with the client's beliefs. It is a therapeutic technique that
instills hope and normalizes the recovery process.
6. The nurse is preparing to apply wrist restraints to a client as ordered. Which
observation by the nurse indicates that the nursing assistant is using the restraints
safely and correctly? (Select all that apply)
A) The restraints are applied tightly to prevent the client from slipping out.
B) The restraints are being released every 2 hours.
C) A safety knot has been used to secure the restraints.
D) The restraints are tied to the siderail of the bed.
E) The call light has been placed within reach of the client.
Correct Answer: B, C, E
Rationale: Restraints must be released every 2 hours to inspect skin and provide
range of motion. A quick-release safety knot is essential for emergency removal. The
call light must always be within reach. Restraints should be tied to the bed frame, not
the siderail, to prevent injury if the siderail is lowered. They should never be applied
tightly as this can impair circulation.
7. A nurse is caring for a client with Clostridioides difficile. Which type of precautions
should the nurse implement?
A) Airborne precautions
B) Contact precautions
C) Droplet precautions
D) Protective environment
Correct Answer: B
Rationale: Contact precautions are implemented for infections that are spread by
direct or indirect contact with the patient or the patient's environment. C. diff is
transmitted via spores that are easily spread on hands and surfaces.
8. A client who is post-operative day 1 after an appendectomy has a prescription for
morphine sulfate 4 mg IV every 4 hours for pain. The client's respiratory rate is 8
breaths/minute. Which medication should the nurse prepare to administer?
A) Flumazenil (Romazicon)
B) Naloxone (Narcan)
C) Protamine sulfate
D) Acetylcysteine (Mucomyst)
