Virtual RN HESI Exit Exam 2026/2027 with NGN
150 Verified Questions, Correct Answers, and Explanations
Section 1: Management of Care & Delegation (Questions 1–15)
Question 1
A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is appropriate?
A) Assess a postoperative incision
B) Reinforce teaching on crutch walking
C) Measure a client's oral temperature
D) Evaluate pain level after medication
Correct Answer: C) Measure a client's oral temperature
Explanation: UAPs can perform vital signs on stable clients. Assessment, teaching, and evaluation
require licensed nursing judgment.
Question 2
A charge nurse is making assignments. Which client should be assigned to an RN rather than an
LPN/LVN?
A) Client with a stable ileostomy
B) Client receiving continuous tube feeding
C) Client with unstable angina on a cardiac monitor
D) Client requiring dressing change for a pressure injury
Correct Answer: C) Client with unstable angina on a cardiac monitor
Explanation: Unstable clients requiring ongoing assessment and titration of medications need RN care.
Stable ostomy, tube feeding, and chronic wound care can be delegated to LPNs.
Question 3
A nurse on a busy medical floor has five clients. Which client should the nurse assess first?
A) Client with pneumonia and oxygen saturation 92% on 2L NC
B) Client post-appendectomy reporting pain 5/10
C) Client with diabetes and blood glucose 180 mg/dL
D) Client with CHF reporting sudden weight gain and dyspnea at rest
,Correct Answer: D) Client with CHF reporting sudden weight gain and dyspnea at rest
Explanation: This client shows signs of fluid overload and possible pulmonary edema, which is life-
threatening. ABCs (Airway/Breathing) take priority.
Question 4
A nurse is caring for a client with a DNR order. The client becomes unresponsive and stops breathing.
What should the nurse do?
A) Start CPR immediately
B) Call a code blue
C) Provide comfort care and notify family
D) Administer oxygen via bag-valve-mask
Correct Answer: C) Provide comfort care and notify family
Explanation: A valid DNR order means no resuscitative measures, including CPR, intubation, or
defibrillation. Comfort care includes pain relief and emotional support.
Question 5
A nurse notices a colleague taking a photo of a client's wound on a personal phone. What should the
nurse do first?
A) Report to the nursing supervisor
B) Confront the colleague directly
C) Ignore it to avoid conflict
D) Ask the colleague to delete the photo
Correct Answer: A) Report to the nursing supervisor
Explanation: This is a HIPAA violation. The nurse should report immediately to protect client privacy.
Confrontation may escalate; the supervisor handles the issue appropriately.
Question 6
A client refuses a blood transfusion due to religious beliefs (Jehovah's Witness). The surgeon insists it's
life-saving. What should the nurse do?
A) Administer the blood as ordered
B) Explain the risks of refusal and document
C) Call hospital ethics committee
D) Ask family to persuade the client
Correct Answer: B) Explain risks and document refusal
Explanation: Competent adults have the right to refuse treatment. The nurse must inform, document,
and respect autonomy. Ethics committee may be consulted if capacity is unclear.
,Question 7
A nurse is preparing to discharge a client who speaks only Spanish. What is the best way to provide
discharge instructions?
A) Give written instructions in English
B) Use a family member as interpreter
C) Request a certified medical interpreter
D) Use a translation app on a personal device
Correct Answer: C) Request a certified medical interpreter
Explanation: Certified medical interpreters ensure accuracy, confidentiality, and cultural competence.
Family members may misinterpret medical terms.
Question 8
A nurse commits a medication error by giving the wrong dose. What is the priority action?
A) Document the error in the incident report only
B) Assess the client for adverse effects
C) Tell no one to avoid discipline
D) Blame the pharmacy for labeling error
Correct Answer: B) Assess the client for adverse effects
Explanation: Client safety is priority. Assess first, then notify provider, monitor, and complete an
incident report.
Question 9
A charge nurse is making assignments for a new graduate RN. Which client is most appropriate for the
new grad?
A) Client on a ventilator with multiple drips
B) Client with new-onset chest pain
C) Client 1-day post-appendectomy, stable
D) Client in active seizure precautions
Correct Answer: C) Client 1-day post-appendectomy, stable
Explanation: New grads should be assigned stable, predictable clients. Complex, unstable, or high-
acuity clients need experienced RNs.
Question 10
A nurse is caring for four clients. Which should be seen first?
A) Client post-op day 2, pain 4/10
B) Client with COPD and O2 sat 88% on 2L
C) Client requesting pain med for headache
D) Client with new ostomy needing teaching
, Correct Answer: B) Client with COPD and O2 sat 88% on 2L
Explanation: Hypoxia (O2 sat <90%) is a priority. Assess breathing, increase oxygen, and notify
provider if needed.
Question 11
A nurse overhears two colleagues discussing a client's HIV status in the elevator. What should the
nurse do?
A) Join the conversation
B) Report the incident to the unit manager
C) Ignore it because it's a public space
D) Ask them to lower their voices
Correct Answer: B) Report the incident to the unit manager
Explanation: Discussing confidential health information in public violates HIPAA. The nurse must
report the breach.
Question 12
A client with end-stage cancer asks for palliative care only, no further treatment. Family demands
chemotherapy. What should the nurse do?
A) Follow the family's wishes
B) Respect the client's decision and document
C) Consult ethics committee immediately
D) Delay decision until client is confused
Correct Answer: B) Respect the client's decision and document
Explanation: Client autonomy overrides family wishes when the client is competent. Document
decision and support the client's choice.
Question 13
A nurse receives report on 4 clients. Which should be seen first?
A) Client with UTI and temp 100.2°F
B) Client with hip fracture and pain 8/10
C) Client with chest tube and sudden bubbling in water seal chamber
D) Client with diabetes requesting insulin before breakfast
Correct Answer: C) Chest tube with sudden bubbling in water seal chamber
Explanation: Continuous bubbling indicates an air leak, which can lead to pneumothorax. Assess
immediately. Pain and fever are lower priority.
150 Verified Questions, Correct Answers, and Explanations
Section 1: Management of Care & Delegation (Questions 1–15)
Question 1
A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is appropriate?
A) Assess a postoperative incision
B) Reinforce teaching on crutch walking
C) Measure a client's oral temperature
D) Evaluate pain level after medication
Correct Answer: C) Measure a client's oral temperature
Explanation: UAPs can perform vital signs on stable clients. Assessment, teaching, and evaluation
require licensed nursing judgment.
Question 2
A charge nurse is making assignments. Which client should be assigned to an RN rather than an
LPN/LVN?
A) Client with a stable ileostomy
B) Client receiving continuous tube feeding
C) Client with unstable angina on a cardiac monitor
D) Client requiring dressing change for a pressure injury
Correct Answer: C) Client with unstable angina on a cardiac monitor
Explanation: Unstable clients requiring ongoing assessment and titration of medications need RN care.
Stable ostomy, tube feeding, and chronic wound care can be delegated to LPNs.
Question 3
A nurse on a busy medical floor has five clients. Which client should the nurse assess first?
A) Client with pneumonia and oxygen saturation 92% on 2L NC
B) Client post-appendectomy reporting pain 5/10
C) Client with diabetes and blood glucose 180 mg/dL
D) Client with CHF reporting sudden weight gain and dyspnea at rest
,Correct Answer: D) Client with CHF reporting sudden weight gain and dyspnea at rest
Explanation: This client shows signs of fluid overload and possible pulmonary edema, which is life-
threatening. ABCs (Airway/Breathing) take priority.
Question 4
A nurse is caring for a client with a DNR order. The client becomes unresponsive and stops breathing.
What should the nurse do?
A) Start CPR immediately
B) Call a code blue
C) Provide comfort care and notify family
D) Administer oxygen via bag-valve-mask
Correct Answer: C) Provide comfort care and notify family
Explanation: A valid DNR order means no resuscitative measures, including CPR, intubation, or
defibrillation. Comfort care includes pain relief and emotional support.
Question 5
A nurse notices a colleague taking a photo of a client's wound on a personal phone. What should the
nurse do first?
A) Report to the nursing supervisor
B) Confront the colleague directly
C) Ignore it to avoid conflict
D) Ask the colleague to delete the photo
Correct Answer: A) Report to the nursing supervisor
Explanation: This is a HIPAA violation. The nurse should report immediately to protect client privacy.
Confrontation may escalate; the supervisor handles the issue appropriately.
Question 6
A client refuses a blood transfusion due to religious beliefs (Jehovah's Witness). The surgeon insists it's
life-saving. What should the nurse do?
A) Administer the blood as ordered
B) Explain the risks of refusal and document
C) Call hospital ethics committee
D) Ask family to persuade the client
Correct Answer: B) Explain risks and document refusal
Explanation: Competent adults have the right to refuse treatment. The nurse must inform, document,
and respect autonomy. Ethics committee may be consulted if capacity is unclear.
,Question 7
A nurse is preparing to discharge a client who speaks only Spanish. What is the best way to provide
discharge instructions?
A) Give written instructions in English
B) Use a family member as interpreter
C) Request a certified medical interpreter
D) Use a translation app on a personal device
Correct Answer: C) Request a certified medical interpreter
Explanation: Certified medical interpreters ensure accuracy, confidentiality, and cultural competence.
Family members may misinterpret medical terms.
Question 8
A nurse commits a medication error by giving the wrong dose. What is the priority action?
A) Document the error in the incident report only
B) Assess the client for adverse effects
C) Tell no one to avoid discipline
D) Blame the pharmacy for labeling error
Correct Answer: B) Assess the client for adverse effects
Explanation: Client safety is priority. Assess first, then notify provider, monitor, and complete an
incident report.
Question 9
A charge nurse is making assignments for a new graduate RN. Which client is most appropriate for the
new grad?
A) Client on a ventilator with multiple drips
B) Client with new-onset chest pain
C) Client 1-day post-appendectomy, stable
D) Client in active seizure precautions
Correct Answer: C) Client 1-day post-appendectomy, stable
Explanation: New grads should be assigned stable, predictable clients. Complex, unstable, or high-
acuity clients need experienced RNs.
Question 10
A nurse is caring for four clients. Which should be seen first?
A) Client post-op day 2, pain 4/10
B) Client with COPD and O2 sat 88% on 2L
C) Client requesting pain med for headache
D) Client with new ostomy needing teaching
, Correct Answer: B) Client with COPD and O2 sat 88% on 2L
Explanation: Hypoxia (O2 sat <90%) is a priority. Assess breathing, increase oxygen, and notify
provider if needed.
Question 11
A nurse overhears two colleagues discussing a client's HIV status in the elevator. What should the
nurse do?
A) Join the conversation
B) Report the incident to the unit manager
C) Ignore it because it's a public space
D) Ask them to lower their voices
Correct Answer: B) Report the incident to the unit manager
Explanation: Discussing confidential health information in public violates HIPAA. The nurse must
report the breach.
Question 12
A client with end-stage cancer asks for palliative care only, no further treatment. Family demands
chemotherapy. What should the nurse do?
A) Follow the family's wishes
B) Respect the client's decision and document
C) Consult ethics committee immediately
D) Delay decision until client is confused
Correct Answer: B) Respect the client's decision and document
Explanation: Client autonomy overrides family wishes when the client is competent. Document
decision and support the client's choice.
Question 13
A nurse receives report on 4 clients. Which should be seen first?
A) Client with UTI and temp 100.2°F
B) Client with hip fracture and pain 8/10
C) Client with chest tube and sudden bubbling in water seal chamber
D) Client with diabetes requesting insulin before breakfast
Correct Answer: C) Chest tube with sudden bubbling in water seal chamber
Explanation: Continuous bubbling indicates an air leak, which can lead to pneumothorax. Assess
immediately. Pain and fever are lower priority.
