2026
HESI RN Exit Exam 2026 Complete Test
Bank with Priority Nursing Concepts and
NCLEX Alignment
The nurse is caring for a postoperative client who suddenly becomes confused and restless.
Which action should the nurse take first?
A.
Apply soft wrist restraints
B.
Check the client’s oxygen saturation
C.
Notify the health care provider
D.
Administer prescribed pain medication
Correct Answer: B
Rationale: Sudden confusion and restlessness are early signs of hypoxia. The nurse should first
assess oxygenation. Restraints, medications, and provider notification may be needed later but
are not the initial priority.
A client with heart failure is prescribed furosemide. Which laboratory value is most important
for the nurse to monitor?
A.
Serum sodium
B.
Blood urea nitrogen
C.
Serum potassium
D.
Hemoglobin level
Correct Answer: C
Rationale: Furosemide is a loop diuretic that can cause potassium loss, leading to dysrhythmias.
Potassium levels require close monitoring.
,2026
The nurse is teaching a client how to use crutches. Which observation indicates correct use of
crutches?
A.
The client bears weight on the axillae
B.
The crutches are placed 12 inches in front of the feet
C.
The elbows are slightly flexed when holding the hand grips
D.
The crutches are adjusted to the height of the shoulders
Correct Answer: C
Rationale: Proper crutch use includes slight elbow flexion (about 20–30 degrees). Weight should
be borne on the hands, not the axillae. Crutches are positioned about 6 inches from the feet and
adjusted to 2–3 finger widths below the axilla.
The nurse is preparing to administer medications through a gastrostomy tube. Which action is
most appropriate?
A.
Mix medications together to reduce flushing
B.
Crush all medications and administer at once
C.
Flush the tube with water between each medication
D.
Administer medications with enteral feeding
Correct Answer: C
Rationale: Flushing between medications prevents clogging and ensures full delivery of each
drug. Medications should not be mixed together or given with continuous feeding unless
prescribed.
The nurse is caring for a client with a chest tube connected to a water-seal drainage system.
Which finding requires immediate intervention?
A.
Tidaling in the water-seal chamber
B.
Continuous bubbling in the water-seal chamber
C.
Drainage of 50 mL in one hour
D.
Dressing reinforced with gauze
,2026
Correct Answer: B
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak and requires
immediate assessment. Tidaling is expected, and the other findings are not urgent.
The nurse is teaching a client about measures to prevent osteoporosis. Which instruction should
be included?
A.
Limit weight-bearing exercise
B.
Increase intake of calcium and vitamin D
C.
Avoid sunlight exposure
D.
Decrease protein intake
Correct Answer: B
Rationale: Adequate calcium and vitamin D intake helps maintain bone density. Weight-bearing
exercise and sunlight exposure are beneficial, not harmful.
The nurse observes a client ambulating with a walker. Which action by the client indicates a
need for further teaching?
A.
Advancing the walker before stepping
B.
Leaning heavily on the walker
C.
Using the arms to support body weight
D.
Taking small steps forward
Correct Answer: B
Rationale: Leaning heavily on a walker can cause instability and falls. Walkers are used for
balance and light support, not full body weight.
A client with pneumonia is prescribed incentive spirometry. Which instruction is most
appropriate?
A.
Use the device once per shift
B.
Exhale forcefully into the mouthpiece
, 2026
C.
Inhale slowly and deeply through the device
D.
Use the spirometer while lying flat
Correct Answer: C
Rationale: Incentive spirometry requires slow, deep inhalation to expand the lungs. Frequent use
is needed, and the client should be in an upright position.
The nurse is caring for a client receiving IV therapy. Which finding suggests infiltration?
A.
Warmth and redness at the site
B.
Pain along the vein
C.
Swelling and coolness at the site
D.
Blood return when aspirating
Correct Answer: C
Rationale: Infiltration causes swelling, coolness, and discomfort due to fluid leaking into
surrounding tissue. Redness and warmth suggest phlebitis.
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD). Which
finding requires immediate intervention?
A.
Barrel-shaped chest
B.
Respiratory rate of 28 breaths per minute
C.
Use of pursed-lip breathing
D.
Oxygen saturation of 88% on room air
Correct Answer: B
Rationale: A respiratory rate of 28 indicates acute respiratory distress and requires prompt
intervention. The other findings are expected in clients with COPD.
The nurse is preparing to administer a medication to a client with dysphagia. Which action is
most appropriate?
A.
Crush the medication and mix with water
HESI RN Exit Exam 2026 Complete Test
Bank with Priority Nursing Concepts and
NCLEX Alignment
The nurse is caring for a postoperative client who suddenly becomes confused and restless.
Which action should the nurse take first?
A.
Apply soft wrist restraints
B.
Check the client’s oxygen saturation
C.
Notify the health care provider
D.
Administer prescribed pain medication
Correct Answer: B
Rationale: Sudden confusion and restlessness are early signs of hypoxia. The nurse should first
assess oxygenation. Restraints, medications, and provider notification may be needed later but
are not the initial priority.
A client with heart failure is prescribed furosemide. Which laboratory value is most important
for the nurse to monitor?
A.
Serum sodium
B.
Blood urea nitrogen
C.
Serum potassium
D.
Hemoglobin level
Correct Answer: C
Rationale: Furosemide is a loop diuretic that can cause potassium loss, leading to dysrhythmias.
Potassium levels require close monitoring.
,2026
The nurse is teaching a client how to use crutches. Which observation indicates correct use of
crutches?
A.
The client bears weight on the axillae
B.
The crutches are placed 12 inches in front of the feet
C.
The elbows are slightly flexed when holding the hand grips
D.
The crutches are adjusted to the height of the shoulders
Correct Answer: C
Rationale: Proper crutch use includes slight elbow flexion (about 20–30 degrees). Weight should
be borne on the hands, not the axillae. Crutches are positioned about 6 inches from the feet and
adjusted to 2–3 finger widths below the axilla.
The nurse is preparing to administer medications through a gastrostomy tube. Which action is
most appropriate?
A.
Mix medications together to reduce flushing
B.
Crush all medications and administer at once
C.
Flush the tube with water between each medication
D.
Administer medications with enteral feeding
Correct Answer: C
Rationale: Flushing between medications prevents clogging and ensures full delivery of each
drug. Medications should not be mixed together or given with continuous feeding unless
prescribed.
The nurse is caring for a client with a chest tube connected to a water-seal drainage system.
Which finding requires immediate intervention?
A.
Tidaling in the water-seal chamber
B.
Continuous bubbling in the water-seal chamber
C.
Drainage of 50 mL in one hour
D.
Dressing reinforced with gauze
,2026
Correct Answer: B
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak and requires
immediate assessment. Tidaling is expected, and the other findings are not urgent.
The nurse is teaching a client about measures to prevent osteoporosis. Which instruction should
be included?
A.
Limit weight-bearing exercise
B.
Increase intake of calcium and vitamin D
C.
Avoid sunlight exposure
D.
Decrease protein intake
Correct Answer: B
Rationale: Adequate calcium and vitamin D intake helps maintain bone density. Weight-bearing
exercise and sunlight exposure are beneficial, not harmful.
The nurse observes a client ambulating with a walker. Which action by the client indicates a
need for further teaching?
A.
Advancing the walker before stepping
B.
Leaning heavily on the walker
C.
Using the arms to support body weight
D.
Taking small steps forward
Correct Answer: B
Rationale: Leaning heavily on a walker can cause instability and falls. Walkers are used for
balance and light support, not full body weight.
A client with pneumonia is prescribed incentive spirometry. Which instruction is most
appropriate?
A.
Use the device once per shift
B.
Exhale forcefully into the mouthpiece
, 2026
C.
Inhale slowly and deeply through the device
D.
Use the spirometer while lying flat
Correct Answer: C
Rationale: Incentive spirometry requires slow, deep inhalation to expand the lungs. Frequent use
is needed, and the client should be in an upright position.
The nurse is caring for a client receiving IV therapy. Which finding suggests infiltration?
A.
Warmth and redness at the site
B.
Pain along the vein
C.
Swelling and coolness at the site
D.
Blood return when aspirating
Correct Answer: C
Rationale: Infiltration causes swelling, coolness, and discomfort due to fluid leaking into
surrounding tissue. Redness and warmth suggest phlebitis.
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD). Which
finding requires immediate intervention?
A.
Barrel-shaped chest
B.
Respiratory rate of 28 breaths per minute
C.
Use of pursed-lip breathing
D.
Oxygen saturation of 88% on room air
Correct Answer: B
Rationale: A respiratory rate of 28 indicates acute respiratory distress and requires prompt
intervention. The other findings are expected in clients with COPD.
The nurse is preparing to administer a medication to a client with dysphagia. Which action is
most appropriate?
A.
Crush the medication and mix with water
