Virtual RN HESI Exit Exam 2026/2027 with NGN – Version 3
150 New Verified Questions, Correct Answers, and Explanations
Section 1: Management of Care / Delegation / Ethics (1–15)
Question 1
A charge nurse is making assignments for a medical-surgical unit. Which client should be assigned to
the most experienced RN?
A) Client with a newly inserted chest tube
B) Client with diabetes needing insulin administration
C) Client with a urinary tract infection on oral antibiotics
D) Client with a chronic pressure injury requiring dressing change
Correct Answer: A) Newly inserted chest tube
Explanation: Unstable or newly placed devices require experienced RN assessment. Stable clients can be
assigned to less experienced staff.
Question 2
A nurse observes a colleague documenting care that was not provided. What should the nurse do
first?
A) Confront the colleague privately
B) Report to the nurse manager
C) Ignore it as a one-time event
D) Document the observation in the colleague's file
Correct Answer: B) Report to the nurse manager
Explanation: Falsifying documentation is unethical and illegal. Immediate reporting is required.
Confrontation may escalate.
Question 3
A client with a DNR order is admitted from a nursing home. The family demands full code status. What
should the nurse do?
A) Change the code status to full code
B) Respect the DNR and clarify with the provider
C) Call ethics committee before admission
D) Ask the family to leave the hospital
,Correct Answer: B) Respect the DNR and clarify with provider
Explanation: Valid DNR orders follow the client across settings. Family cannot override without client's
change of wish.
Question 4
A nurse is caring for four clients. Which should the nurse see first?
A) Client with COPD and O2 saturation 90% on 2L
B) Client with chest pain rated 4/10
C) Client with a new onset of confusion and fever
D) Client requesting pain medication for headache
Correct Answer: C) New onset confusion and fever
Explanation: Confusion + fever suggests possible sepsis or meningitis. Needs immediate assessment.
Question 5
A nurse is preparing to discharge a client who does not speak English. What is the best method for
providing discharge instructions?
A) Give written instructions in English
B) Use a family member as interpreter
C) Use a certified medical interpreter via phone or in person
D) Use a translation app on a personal device
Correct Answer: C) Certified medical interpreter
Explanation: Certified interpreters ensure accuracy and confidentiality. Family members may omit or
alter information.
Question 6
A nurse makes a medication error and the client experiences no harm. What is the nurse's priority
action?
A) Complete an incident report and notify the provider
B) Document the error in the client's chart only
C) Tell no one to avoid discipline
D) Blame the pharmacy for incorrect labeling
Correct Answer: A) Incident report and notify provider
Explanation: All errors require reporting for quality improvement. Provider must be aware for client
monitoring.
,Question 7
A charge nurse is assigning a new graduate RN. Which client is most appropriate?
A) Client on a ventilator with multiple IV drips
B) Client with unstable angina on telemetry
C) Client post-appendectomy day 2, stable
D) Client with active seizures every 2 hours
Correct Answer: C) Post-appendectomy day 2, stable
Explanation: New grads should receive stable, predictable assignments. High-acuity clients need
experienced RNs.
Question 8
A nurse overhears two colleagues discussing a client's mental health diagnosis in the elevator. What
should the nurse do?
A) Join the conversation
B) Report the incident to the privacy officer
C) Ignore because it's a public space
D) Ask them to speak louder
Correct Answer: B) Report to privacy officer
Explanation: Discussing confidential information in public violates HIPAA. Report through proper
channels.
Question 9
A client with end-stage renal disease refuses dialysis. The family insists on treatment. What should the
nurse do?
A) Respect the client's refusal and document
B) Administer dialysis as the family requests
C) Call ethics committee immediately
D) Delay decision until client is sedated
Correct Answer: A) Respect client's refusal and document
Explanation: Competent adults have the right to refuse treatment. Advocate for client autonomy.
Question 10
A nurse receives report on four clients. Which should be assessed first?
A) Client with a fever of 101°F and cough
B) Client post-op day 1 with pain 6/10
C) Client with a tracheostomy who has thick secretions and noisy breathing
D) Client requesting a sleeping pill at 9 AM
, Correct Answer: C) Tracheostomy with thick secretions and noisy breathing
Explanation: Noisy breathing indicates potential airway obstruction. ABCs take priority.
Question 11
A nurse is mentoring a student who administered the wrong dose of insulin. The client's blood glucose
is now 45 mg/dL. What should the mentor do first?
A) Report the student to the instructor
B) Administer IV dextrose or oral glucose
C) Complete an incident report
D) Blame the student
Correct Answer: B) Administer IV dextrose or oral glucose
Explanation: Client safety is priority. Treat hypoglycemia first, then report and document.
Question 12
A client with a living will becomes unconscious. The family demands aggressive chemotherapy that the
client previously refused. What should the nurse do?
A) Honor the living will and provide comfort care
B) Start chemotherapy as family requests
C) Wait for a court order
D) Call security to remove the family
Correct Answer: A) Honor the living will
Explanation: Living wills are legal documents. Advocate for client's wishes.
Question 13
A nurse is preparing to float to a psychiatric unit. The nurse has no mental health experience. What
should the nurse do?
A) Refuse to float
B) Accept and request a brief orientation and stable patients
C) Call in sick
D) Take the assignment without comment
Correct Answer: B) Accept and request orientation
Explanation: Floating is expected. Request training and appropriate assignment.
Question 14
A nurse sees a colleague taking a client's narcotic pain medication for personal use. What is the
priority action?
150 New Verified Questions, Correct Answers, and Explanations
Section 1: Management of Care / Delegation / Ethics (1–15)
Question 1
A charge nurse is making assignments for a medical-surgical unit. Which client should be assigned to
the most experienced RN?
A) Client with a newly inserted chest tube
B) Client with diabetes needing insulin administration
C) Client with a urinary tract infection on oral antibiotics
D) Client with a chronic pressure injury requiring dressing change
Correct Answer: A) Newly inserted chest tube
Explanation: Unstable or newly placed devices require experienced RN assessment. Stable clients can be
assigned to less experienced staff.
Question 2
A nurse observes a colleague documenting care that was not provided. What should the nurse do
first?
A) Confront the colleague privately
B) Report to the nurse manager
C) Ignore it as a one-time event
D) Document the observation in the colleague's file
Correct Answer: B) Report to the nurse manager
Explanation: Falsifying documentation is unethical and illegal. Immediate reporting is required.
Confrontation may escalate.
Question 3
A client with a DNR order is admitted from a nursing home. The family demands full code status. What
should the nurse do?
A) Change the code status to full code
B) Respect the DNR and clarify with the provider
C) Call ethics committee before admission
D) Ask the family to leave the hospital
,Correct Answer: B) Respect the DNR and clarify with provider
Explanation: Valid DNR orders follow the client across settings. Family cannot override without client's
change of wish.
Question 4
A nurse is caring for four clients. Which should the nurse see first?
A) Client with COPD and O2 saturation 90% on 2L
B) Client with chest pain rated 4/10
C) Client with a new onset of confusion and fever
D) Client requesting pain medication for headache
Correct Answer: C) New onset confusion and fever
Explanation: Confusion + fever suggests possible sepsis or meningitis. Needs immediate assessment.
Question 5
A nurse is preparing to discharge a client who does not speak English. What is the best method for
providing discharge instructions?
A) Give written instructions in English
B) Use a family member as interpreter
C) Use a certified medical interpreter via phone or in person
D) Use a translation app on a personal device
Correct Answer: C) Certified medical interpreter
Explanation: Certified interpreters ensure accuracy and confidentiality. Family members may omit or
alter information.
Question 6
A nurse makes a medication error and the client experiences no harm. What is the nurse's priority
action?
A) Complete an incident report and notify the provider
B) Document the error in the client's chart only
C) Tell no one to avoid discipline
D) Blame the pharmacy for incorrect labeling
Correct Answer: A) Incident report and notify provider
Explanation: All errors require reporting for quality improvement. Provider must be aware for client
monitoring.
,Question 7
A charge nurse is assigning a new graduate RN. Which client is most appropriate?
A) Client on a ventilator with multiple IV drips
B) Client with unstable angina on telemetry
C) Client post-appendectomy day 2, stable
D) Client with active seizures every 2 hours
Correct Answer: C) Post-appendectomy day 2, stable
Explanation: New grads should receive stable, predictable assignments. High-acuity clients need
experienced RNs.
Question 8
A nurse overhears two colleagues discussing a client's mental health diagnosis in the elevator. What
should the nurse do?
A) Join the conversation
B) Report the incident to the privacy officer
C) Ignore because it's a public space
D) Ask them to speak louder
Correct Answer: B) Report to privacy officer
Explanation: Discussing confidential information in public violates HIPAA. Report through proper
channels.
Question 9
A client with end-stage renal disease refuses dialysis. The family insists on treatment. What should the
nurse do?
A) Respect the client's refusal and document
B) Administer dialysis as the family requests
C) Call ethics committee immediately
D) Delay decision until client is sedated
Correct Answer: A) Respect client's refusal and document
Explanation: Competent adults have the right to refuse treatment. Advocate for client autonomy.
Question 10
A nurse receives report on four clients. Which should be assessed first?
A) Client with a fever of 101°F and cough
B) Client post-op day 1 with pain 6/10
C) Client with a tracheostomy who has thick secretions and noisy breathing
D) Client requesting a sleeping pill at 9 AM
, Correct Answer: C) Tracheostomy with thick secretions and noisy breathing
Explanation: Noisy breathing indicates potential airway obstruction. ABCs take priority.
Question 11
A nurse is mentoring a student who administered the wrong dose of insulin. The client's blood glucose
is now 45 mg/dL. What should the mentor do first?
A) Report the student to the instructor
B) Administer IV dextrose or oral glucose
C) Complete an incident report
D) Blame the student
Correct Answer: B) Administer IV dextrose or oral glucose
Explanation: Client safety is priority. Treat hypoglycemia first, then report and document.
Question 12
A client with a living will becomes unconscious. The family demands aggressive chemotherapy that the
client previously refused. What should the nurse do?
A) Honor the living will and provide comfort care
B) Start chemotherapy as family requests
C) Wait for a court order
D) Call security to remove the family
Correct Answer: A) Honor the living will
Explanation: Living wills are legal documents. Advocate for client's wishes.
Question 13
A nurse is preparing to float to a psychiatric unit. The nurse has no mental health experience. What
should the nurse do?
A) Refuse to float
B) Accept and request a brief orientation and stable patients
C) Call in sick
D) Take the assignment without comment
Correct Answer: B) Accept and request orientation
Explanation: Floating is expected. Request training and appropriate assignment.
Question 14
A nurse sees a colleague taking a client's narcotic pain medication for personal use. What is the
priority action?
