Virtual RN HESI Exit Exam 2026/2027 with NGN – Version 2
150 New Verified Questions, Correct Answers, and Explanations
Section 1: Management of Care / Delegation / Ethics (1–15)
1. A charge nurse is assigning staff for a shift. Which client should be assigned to an experienced RN
rather than an LPN?
A) Client with a newly inserted chest tube
B) Client with chronic osteomyelitis requiring IV antibiotics
C) Client with a permanent tracheostomy needing routine suctioning
D) Client with a colostomy requiring irrigation
Correct Answer: A) Newly inserted chest tube
Explanation: Unstable or newly placed devices (chest tube within 24 hours) require RN assessment. Stable
tracheostomy and colostomy can be delegated to LPN.
2. A nurse manager observes a staff nurse documenting in the electronic health record (EHR) using
another nurse’s login credentials. What should the manager do first?
A) Terminate the staff nurse immediately
B) Confront the nurse privately and remind of policy
C) Report to the board of nursing
D) Ignore if no harm occurred
Correct Answer: B) Confront privately and remind of policy
Explanation: First address directly. Sharing passwords violates HIPAA and hospital policy. Further action if
repeated.
3. A nurse is preparing to discharge a homeless client with no insurance. Which action demonstrates
advocacy?
A) Discharge with no follow-up
B) Arrange for medications through a patient assistance program
C) Tell the client to go to the ER if needed
D) Ask the client to pay cash for prescriptions
Correct Answer: B) Arrange medication assistance
Explanation: Advocacy includes connecting clients with resources (social work, medication assistance,
shelter referrals).
4. A client with a DNR and do-not-intubate (DNI) order develops severe respiratory distress with
stridor. The family demands intubation. What should the nurse do?
A) Intubate as the family requests
,B) Honor the DNR/DNI and provide comfort care
C) Call ethics committee before acting
D) Ask the family to leave
Correct Answer: B) Honor DNR/DNI
Explanation: Legal advance directives supersede family wishes. Provide comfort, oxygen, morphine for air
hunger.
5. A nurse is floating to a pediatric unit and has not worked with children in 5 years. What is the best
action?
A) Refuse to float
B) Accept assignment and ask for simple, stable patients
C) Call the supervisor and request orientation to pediatric emergencies
D) Take the assignment without comment
Correct Answer: C) Request orientation and stable assignment
Explanation: Accept but request training. Refusing may be insubordination. Patient safety first.
6. A nurse finds a client lying on the floor next to the bed. The client is alert and denies injury. Which
sequence is correct?
A) Help client back to bed, then complete incident report
B) Assess for injury, call for help, assist to bed, notify provider, complete incident report
C) Complete incident report first, then assess
D) Tell the client to get up using the call light
Correct Answer: B) Assess → call for help → assist → notify provider → incident report
Explanation: Assess first. Then follow protocol for fall with no injury.
7. A nurse overhears two physicians discussing a client’s HIV status in the cafeteria. What should the
nurse do?
A) Ignore it
B) Join the conversation to remind them of HIPAA
C) Report the incident to the privacy officer
D) Send an anonymous email
Correct Answer: C) Report to privacy officer
Explanation: HIPAA violation in public area. Report through proper channels.
8. A client with terminal cancer requests no further chemotherapy but the oncologist recommends it.
The nurse should:
A) Support the client’s decision and document refusal
B) Try to convince the client to accept treatment
C) Ask the family to decide
D) Refuse to care for the client
Correct Answer: A) Support client’s decision
Explanation: Autonomy. Document refusal after explaining risks/benefits.
,9. A new graduate RN reports feeling overwhelmed with a 1:6 ratio on a medical unit. The charge
nurse should:
A) Tell the new RN to work faster
B) Reassign one stable client to an LPN
C) Ignore the complaint
D) Report the new RN to the manager
Correct Answer: B) Reassign one stable client to LPN
Explanation: Support new grads. Adjust assignments to safe levels.
10. A client refuses to bathe or allow morning care. The nurse should:
A) Force care with assistance
B) Document refusal and try again later
C) Tell the client it’s hospital policy
D) Call family to convince the client
Correct Answer: B) Document refusal and try later
Explanation: Respect autonomy. Reassess need later. Offer alternatives.
11. A nurse is caring for four clients. Which should be assessed first?
A) Client with diabetes, blood glucose 250, no symptoms
B) Client post-angiogram with oozing at femoral site
C) Client with UTI and temp 100.8°F
D) Client requesting pain med for headache
Correct Answer: B) Oozing at femoral site
Explanation: Bleeding risk post-angiogram. Apply pressure, assess hematoma.
12. A nurse sees a colleague taking a client’s opioid pain medication for themselves. What is the
priority?
A) Confront colleague privately
B) Report to nurse manager immediately
C) Ignore if it’s a one-time event
D) Warn the colleague to stop
Correct Answer: B) Report to nurse manager
Explanation: Drug diversion is illegal and unsafe. Mandatory reporting.
13. A client who speaks only Mandarin Chinese is being discharged. The nurse uses a translation app
on a personal phone. Is this appropriate?
A) Yes, if the app is free
B) No, use a certified medical interpreter
C) Yes, if the client agrees
D) No, use a family member
Correct Answer: B) No, use certified interpreter
Explanation: Apps may not be HIPAA-compliant. Certified interpreter ensures accuracy and
confidentiality.
, 14. A nurse is mentoring a student who administers the wrong medication but no harm occurred. The
nurse should:
A) Ignore it
B) Report to instructor and complete incident report
C) Tell the student to be more careful
D) Blame the pharmacy
Correct Answer: B) Report to instructor and incident report
Explanation: All errors require reporting for quality improvement.
15. A client with a living will becomes unconscious. The family demands a blood transfusion that the
client previously refused. What should the nurse do?
A) Transfuse to avoid conflict
B) Honor the living will and notify provider
C) Call ethics committee
D) Ask the family to leave
Correct Answer: B) Honor the living will
Explanation: Legal document. Advocate for client’s wishes.
Section 2: Safety & Infection Control (16–30)
16. A client with active varicella (chickenpox) requires which type of isolation?
A) Contact
B) Droplet
C) Airborne
D) Protective
Correct Answer: C) Airborne
Explanation: Varicella (chickenpox) and herpes zoster (disseminated) require airborne + contact
precautions.
17. A nurse is preparing to insert a Foley catheter. Which action breaks sterile technique?
A) Opening the kit on a clean bedside table
B) Touching the sterile drape with sterile gloves
C) Placing the catheter tip in sterile lubricant
D) Opening the sterile package away from the body
Correct Answer: A) Opening on a clean table
Explanation: Sterile field must be on a sterile surface or inside the kit’s own sterile wrapper. Clean is not
sterile.
18. A client on a heparin drip has an aPTT of 120 seconds (therapeutic range 60-80). What should the
nurse do first?
A) Stop the heparin drip
B) Notify the provider
150 New Verified Questions, Correct Answers, and Explanations
Section 1: Management of Care / Delegation / Ethics (1–15)
1. A charge nurse is assigning staff for a shift. Which client should be assigned to an experienced RN
rather than an LPN?
A) Client with a newly inserted chest tube
B) Client with chronic osteomyelitis requiring IV antibiotics
C) Client with a permanent tracheostomy needing routine suctioning
D) Client with a colostomy requiring irrigation
Correct Answer: A) Newly inserted chest tube
Explanation: Unstable or newly placed devices (chest tube within 24 hours) require RN assessment. Stable
tracheostomy and colostomy can be delegated to LPN.
2. A nurse manager observes a staff nurse documenting in the electronic health record (EHR) using
another nurse’s login credentials. What should the manager do first?
A) Terminate the staff nurse immediately
B) Confront the nurse privately and remind of policy
C) Report to the board of nursing
D) Ignore if no harm occurred
Correct Answer: B) Confront privately and remind of policy
Explanation: First address directly. Sharing passwords violates HIPAA and hospital policy. Further action if
repeated.
3. A nurse is preparing to discharge a homeless client with no insurance. Which action demonstrates
advocacy?
A) Discharge with no follow-up
B) Arrange for medications through a patient assistance program
C) Tell the client to go to the ER if needed
D) Ask the client to pay cash for prescriptions
Correct Answer: B) Arrange medication assistance
Explanation: Advocacy includes connecting clients with resources (social work, medication assistance,
shelter referrals).
4. A client with a DNR and do-not-intubate (DNI) order develops severe respiratory distress with
stridor. The family demands intubation. What should the nurse do?
A) Intubate as the family requests
,B) Honor the DNR/DNI and provide comfort care
C) Call ethics committee before acting
D) Ask the family to leave
Correct Answer: B) Honor DNR/DNI
Explanation: Legal advance directives supersede family wishes. Provide comfort, oxygen, morphine for air
hunger.
5. A nurse is floating to a pediatric unit and has not worked with children in 5 years. What is the best
action?
A) Refuse to float
B) Accept assignment and ask for simple, stable patients
C) Call the supervisor and request orientation to pediatric emergencies
D) Take the assignment without comment
Correct Answer: C) Request orientation and stable assignment
Explanation: Accept but request training. Refusing may be insubordination. Patient safety first.
6. A nurse finds a client lying on the floor next to the bed. The client is alert and denies injury. Which
sequence is correct?
A) Help client back to bed, then complete incident report
B) Assess for injury, call for help, assist to bed, notify provider, complete incident report
C) Complete incident report first, then assess
D) Tell the client to get up using the call light
Correct Answer: B) Assess → call for help → assist → notify provider → incident report
Explanation: Assess first. Then follow protocol for fall with no injury.
7. A nurse overhears two physicians discussing a client’s HIV status in the cafeteria. What should the
nurse do?
A) Ignore it
B) Join the conversation to remind them of HIPAA
C) Report the incident to the privacy officer
D) Send an anonymous email
Correct Answer: C) Report to privacy officer
Explanation: HIPAA violation in public area. Report through proper channels.
8. A client with terminal cancer requests no further chemotherapy but the oncologist recommends it.
The nurse should:
A) Support the client’s decision and document refusal
B) Try to convince the client to accept treatment
C) Ask the family to decide
D) Refuse to care for the client
Correct Answer: A) Support client’s decision
Explanation: Autonomy. Document refusal after explaining risks/benefits.
,9. A new graduate RN reports feeling overwhelmed with a 1:6 ratio on a medical unit. The charge
nurse should:
A) Tell the new RN to work faster
B) Reassign one stable client to an LPN
C) Ignore the complaint
D) Report the new RN to the manager
Correct Answer: B) Reassign one stable client to LPN
Explanation: Support new grads. Adjust assignments to safe levels.
10. A client refuses to bathe or allow morning care. The nurse should:
A) Force care with assistance
B) Document refusal and try again later
C) Tell the client it’s hospital policy
D) Call family to convince the client
Correct Answer: B) Document refusal and try later
Explanation: Respect autonomy. Reassess need later. Offer alternatives.
11. A nurse is caring for four clients. Which should be assessed first?
A) Client with diabetes, blood glucose 250, no symptoms
B) Client post-angiogram with oozing at femoral site
C) Client with UTI and temp 100.8°F
D) Client requesting pain med for headache
Correct Answer: B) Oozing at femoral site
Explanation: Bleeding risk post-angiogram. Apply pressure, assess hematoma.
12. A nurse sees a colleague taking a client’s opioid pain medication for themselves. What is the
priority?
A) Confront colleague privately
B) Report to nurse manager immediately
C) Ignore if it’s a one-time event
D) Warn the colleague to stop
Correct Answer: B) Report to nurse manager
Explanation: Drug diversion is illegal and unsafe. Mandatory reporting.
13. A client who speaks only Mandarin Chinese is being discharged. The nurse uses a translation app
on a personal phone. Is this appropriate?
A) Yes, if the app is free
B) No, use a certified medical interpreter
C) Yes, if the client agrees
D) No, use a family member
Correct Answer: B) No, use certified interpreter
Explanation: Apps may not be HIPAA-compliant. Certified interpreter ensures accuracy and
confidentiality.
, 14. A nurse is mentoring a student who administers the wrong medication but no harm occurred. The
nurse should:
A) Ignore it
B) Report to instructor and complete incident report
C) Tell the student to be more careful
D) Blame the pharmacy
Correct Answer: B) Report to instructor and incident report
Explanation: All errors require reporting for quality improvement.
15. A client with a living will becomes unconscious. The family demands a blood transfusion that the
client previously refused. What should the nurse do?
A) Transfuse to avoid conflict
B) Honor the living will and notify provider
C) Call ethics committee
D) Ask the family to leave
Correct Answer: B) Honor the living will
Explanation: Legal document. Advocate for client’s wishes.
Section 2: Safety & Infection Control (16–30)
16. A client with active varicella (chickenpox) requires which type of isolation?
A) Contact
B) Droplet
C) Airborne
D) Protective
Correct Answer: C) Airborne
Explanation: Varicella (chickenpox) and herpes zoster (disseminated) require airborne + contact
precautions.
17. A nurse is preparing to insert a Foley catheter. Which action breaks sterile technique?
A) Opening the kit on a clean bedside table
B) Touching the sterile drape with sterile gloves
C) Placing the catheter tip in sterile lubricant
D) Opening the sterile package away from the body
Correct Answer: A) Opening on a clean table
Explanation: Sterile field must be on a sterile surface or inside the kit’s own sterile wrapper. Clean is not
sterile.
18. A client on a heparin drip has an aPTT of 120 seconds (therapeutic range 60-80). What should the
nurse do first?
A) Stop the heparin drip
B) Notify the provider
