Actual Online RN HESI Exit Exam 2026/2027 NGN Version with 150 Questions and Answers –
Multiple Choice, Select All That Apply, Correct Answers, and Detailed Rationales to Help You Excel
on Your First Attempt
COMPLETE HESI RN EXIT EXAM 2026/2027 – 150 QUESTIONS
WITH ANSWERS & RATIONALES
QUESTIONS 1–10: MEDICATION ADMINISTRATION & SAFETY
Question 1
The nurse is wearing personal protective equipment (PPE) while caring for a patient on contact
precautions. When exiting the room, which PPE should be removed first?
A) Gown
B) Mask
C) Gloves
D) Goggles
Correct Answer: C) Gloves
Rationale: Gloves are considered the most contaminated piece of PPE and should be removed first to
prevent spreading microorganisms to other PPE or the environment. The correct sequence is: gloves →
goggles/face shield → gown → mask.
Question 2
A client receiving haloperidol (Haldol) for schizophrenia complains of jaw tightness and a stiff neck.
Which intervention should the nurse implement first?
A) Give a PRN dose of diphenhydramine (Benadryl)
B) Assess for other types of sensory hallucinations
C) Massage the client's neck until muscles relax
D) Obtain a 12-lead electrocardiogram
Correct Answer: A) Give a PRN dose of diphenhydramine (Benadryl)
Rationale: Jaw tightness and stiff neck are signs of acute dystonia, an extrapyramidal symptom (EPS)
caused by antipsychotic medications. This can be reversed with anticholinergic medications like
,diphenhydramine.
Question 3
When preparing to administer a prescribed medication to a homeless client at a community psychiatric
clinic, the client tells the nurse that the usual dosage taken is different from the dose the nurse is
giving. Which action should the nurse take?
A) Inform the client that he may refuse the medication and document this
B) Withhold the medication until the dosage can be confirmed
C) Explain to the client that the dosage has been changed
D) Tell the client to take the medication and verify the dosage later
Correct Answer: B) Withhold the medication until the dosage can be confirmed
Rationale: If there is any discrepancy between the client's report and the prescribed dose, the nurse
must verify the correct dosage with the healthcare provider or medication record before administering
to ensure client safety and prevent medication errors.
Question 4
A client receives a prescription for dalteparin 200 units per kilogram subcutaneously once daily. The
client weighs 154 pounds. The medication is available in a 25,000 units per milliliter vial. How many
milliliters should the nurse administer? (Round to the nearest tenth)
A) 0.4 mL
B) 0.6 mL
C) 0.8 mL
D) 1.0 mL
Correct Answer: B) 0.6 mL
Rationale: Convert weight: 154 lbs ÷ 2.2 = 70 kg. Calculate dose: 70 kg × 200 units/kg = 14,000 units.
Calculate volume: 14,000 units ÷ 25,000 units/mL = 0.56 mL. Round to nearest tenth = 0.6 mL.
Question 5
The nurse should withhold which medication if the client's serum potassium level is 6.2 mEq/L?
A) Furosemide
B) Spironolactone
C) Metoprolol
, D) Lisinopril
Correct Answer: B) Spironolactone
Rationale: Spironolactone is a potassium-sparing diuretic. With a potassium level of 6.2 mEq/L (normal
3.5–5.0), the client is already hyperkalemic, and administering spironolactone could cause life-
threatening cardiac dysrhythmias.
Question 6
The healthcare provider prescribes acarbose, an alpha-glucosidase inhibitor, for a client with type 2
diabetes. Which information provides the best indicator of the drug's effectiveness?
A) Body mass index between 20 and 24
B) Blood pressure readings less than 120/80
C) Self-reported glucose levels within target range
D) Hemoglobin A1c level below 7%
Correct Answer: D) Hemoglobin A1c level below 7%
Rationale: Hemoglobin A1c reflects average blood glucose over the past 2–3 months and is the gold
standard for evaluating long-term glycemic control. A level below 7% indicates effective diabetes
management.
Question 7
A client on mechanical ventilation is receiving ranitidine (Zantac). What is the primary purpose of this
treatment?
A) Prevent sedation
B) Reduce gastric acid to prevent stress ulcers
C) Stimulate gastric emptying
D) Increase appetite
Correct Answer: B) Reduce gastric acid to prevent stress ulcers
Rationale: Patients on mechanical ventilation are at high risk for stress ulcers and gastrointestinal
bleeding. H2 antagonists like ranitidine reduce gastric acid secretion to prevent stress-related mucosal
damage.
Question 8
Which intervention is most important for a client receiving lispro (Humalog) insulin?
, A) Check blood glucose levels every six hours
B) Provide meals at the same time that insulin is given
C) Assess for hypoglycemia between meals
D) Keep oral glucose solution at the bedside
Correct Answer: B) Provide meals at the same time that insulin is given
Rationale: Lispro is a rapid-acting insulin that begins working within 15 minutes. The client's meal
must be available immediately to prevent hypoglycemia. This is the priority intervention.
Question 9
A client with bipolar disorder has slightly slurred speech and an unsteady gait. Which assessment
finding is most important to report to the healthcare provider?
A) Weight loss of 10 pounds in the past month
B) Six hours of sleep in the past three days
C) Blood alcohol level of 0.09%
D) Serum lithium level of 1.6 mEq/L
Correct Answer: D) Serum lithium level of 1.6 mEq/L
Rationale: The therapeutic lithium range is 0.6–1.2 mEq/L. A level of 1.6 suggests possible toxicity,
which correlates with neurologic symptoms (slurred speech, ataxia). This requires immediate reporting.
Question 10
A client is prescribed digoxin 0.25 mg daily. Which finding indicates digoxin toxicity?
A) Blood pressure 140/90 mm Hg
B) Heart rate of 62 beats per minute
C) Yellow-tinged vision
D) Weight gain of 2 pounds in 24 hours
Correct Answer: C) Yellow-tinged vision (xanthopsia)
Rationale: Classic signs of digoxin toxicity include yellow-tinged or blurred vision, nausea, vomiting,
and bradycardia. Vision changes are a specific and early indicator of toxicity.
QUESTIONS 11–20: PRIORITIZATION & DELEGATION
Multiple Choice, Select All That Apply, Correct Answers, and Detailed Rationales to Help You Excel
on Your First Attempt
COMPLETE HESI RN EXIT EXAM 2026/2027 – 150 QUESTIONS
WITH ANSWERS & RATIONALES
QUESTIONS 1–10: MEDICATION ADMINISTRATION & SAFETY
Question 1
The nurse is wearing personal protective equipment (PPE) while caring for a patient on contact
precautions. When exiting the room, which PPE should be removed first?
A) Gown
B) Mask
C) Gloves
D) Goggles
Correct Answer: C) Gloves
Rationale: Gloves are considered the most contaminated piece of PPE and should be removed first to
prevent spreading microorganisms to other PPE or the environment. The correct sequence is: gloves →
goggles/face shield → gown → mask.
Question 2
A client receiving haloperidol (Haldol) for schizophrenia complains of jaw tightness and a stiff neck.
Which intervention should the nurse implement first?
A) Give a PRN dose of diphenhydramine (Benadryl)
B) Assess for other types of sensory hallucinations
C) Massage the client's neck until muscles relax
D) Obtain a 12-lead electrocardiogram
Correct Answer: A) Give a PRN dose of diphenhydramine (Benadryl)
Rationale: Jaw tightness and stiff neck are signs of acute dystonia, an extrapyramidal symptom (EPS)
caused by antipsychotic medications. This can be reversed with anticholinergic medications like
,diphenhydramine.
Question 3
When preparing to administer a prescribed medication to a homeless client at a community psychiatric
clinic, the client tells the nurse that the usual dosage taken is different from the dose the nurse is
giving. Which action should the nurse take?
A) Inform the client that he may refuse the medication and document this
B) Withhold the medication until the dosage can be confirmed
C) Explain to the client that the dosage has been changed
D) Tell the client to take the medication and verify the dosage later
Correct Answer: B) Withhold the medication until the dosage can be confirmed
Rationale: If there is any discrepancy between the client's report and the prescribed dose, the nurse
must verify the correct dosage with the healthcare provider or medication record before administering
to ensure client safety and prevent medication errors.
Question 4
A client receives a prescription for dalteparin 200 units per kilogram subcutaneously once daily. The
client weighs 154 pounds. The medication is available in a 25,000 units per milliliter vial. How many
milliliters should the nurse administer? (Round to the nearest tenth)
A) 0.4 mL
B) 0.6 mL
C) 0.8 mL
D) 1.0 mL
Correct Answer: B) 0.6 mL
Rationale: Convert weight: 154 lbs ÷ 2.2 = 70 kg. Calculate dose: 70 kg × 200 units/kg = 14,000 units.
Calculate volume: 14,000 units ÷ 25,000 units/mL = 0.56 mL. Round to nearest tenth = 0.6 mL.
Question 5
The nurse should withhold which medication if the client's serum potassium level is 6.2 mEq/L?
A) Furosemide
B) Spironolactone
C) Metoprolol
, D) Lisinopril
Correct Answer: B) Spironolactone
Rationale: Spironolactone is a potassium-sparing diuretic. With a potassium level of 6.2 mEq/L (normal
3.5–5.0), the client is already hyperkalemic, and administering spironolactone could cause life-
threatening cardiac dysrhythmias.
Question 6
The healthcare provider prescribes acarbose, an alpha-glucosidase inhibitor, for a client with type 2
diabetes. Which information provides the best indicator of the drug's effectiveness?
A) Body mass index between 20 and 24
B) Blood pressure readings less than 120/80
C) Self-reported glucose levels within target range
D) Hemoglobin A1c level below 7%
Correct Answer: D) Hemoglobin A1c level below 7%
Rationale: Hemoglobin A1c reflects average blood glucose over the past 2–3 months and is the gold
standard for evaluating long-term glycemic control. A level below 7% indicates effective diabetes
management.
Question 7
A client on mechanical ventilation is receiving ranitidine (Zantac). What is the primary purpose of this
treatment?
A) Prevent sedation
B) Reduce gastric acid to prevent stress ulcers
C) Stimulate gastric emptying
D) Increase appetite
Correct Answer: B) Reduce gastric acid to prevent stress ulcers
Rationale: Patients on mechanical ventilation are at high risk for stress ulcers and gastrointestinal
bleeding. H2 antagonists like ranitidine reduce gastric acid secretion to prevent stress-related mucosal
damage.
Question 8
Which intervention is most important for a client receiving lispro (Humalog) insulin?
, A) Check blood glucose levels every six hours
B) Provide meals at the same time that insulin is given
C) Assess for hypoglycemia between meals
D) Keep oral glucose solution at the bedside
Correct Answer: B) Provide meals at the same time that insulin is given
Rationale: Lispro is a rapid-acting insulin that begins working within 15 minutes. The client's meal
must be available immediately to prevent hypoglycemia. This is the priority intervention.
Question 9
A client with bipolar disorder has slightly slurred speech and an unsteady gait. Which assessment
finding is most important to report to the healthcare provider?
A) Weight loss of 10 pounds in the past month
B) Six hours of sleep in the past three days
C) Blood alcohol level of 0.09%
D) Serum lithium level of 1.6 mEq/L
Correct Answer: D) Serum lithium level of 1.6 mEq/L
Rationale: The therapeutic lithium range is 0.6–1.2 mEq/L. A level of 1.6 suggests possible toxicity,
which correlates with neurologic symptoms (slurred speech, ataxia). This requires immediate reporting.
Question 10
A client is prescribed digoxin 0.25 mg daily. Which finding indicates digoxin toxicity?
A) Blood pressure 140/90 mm Hg
B) Heart rate of 62 beats per minute
C) Yellow-tinged vision
D) Weight gain of 2 pounds in 24 hours
Correct Answer: C) Yellow-tinged vision (xanthopsia)
Rationale: Classic signs of digoxin toxicity include yellow-tinged or blurred vision, nausea, vomiting,
and bradycardia. Vision changes are a specific and early indicator of toxicity.
QUESTIONS 11–20: PRIORITIZATION & DELEGATION
