2026
HESI RN Exit Exam 2026 Full-Length
Practice Tests, Rationales, and Test-
Taking Strategies
The nurse teaches the use of a gait belt to a caregiver whose spouse has right-sided weakness and
needs assistance with ambulation. The caregiver performs a return demonstration of the skill.
Which observation indicates that the caregiver has learned how to use the belt?
A. Standing on the spouse's strong side, the caregiver is ready to hold the gait belt if any
evidence of weakness is observed.
B. Standing on the spouse's weak side, the caregiver provides security by holding the gait belt
from the back.
C. Standing behind the spouse, the caregiver provides balance by holding both sides of the gait
belt.
D. Standing slightly in front and to the right of the spouse, the caregiver guides the client
forward by gently pulling on the gait belt.
Correct Answer: B. Standing on the spouse's weak side, the caregiver provides security by
holding the gait belt from the back.
Rationale: The spouse is most likely to lean toward the weak side and needs extra support on that
side and from the back to prevent falling. The other options provide less stability and increase
fall risk.
The nurse is working with one LPN and two aides on a 20-bed unit. Which tasks are appropriate
to delegate? (Select all that apply.)
A. Feeding an elderly and confused client to the aide
B. Toileting the client for the first time after surgery to the LPN
C. Placing bathroom supplies in the room of a new admission to the LPN
D. Reinforcing discharge teaching instructions to the LPN
E. Administering a PO pain medication to the LPN
F. Performing a routine dressing change 5 days after surgery to the LPN
Correct Answer: A, D, E, F
Rationale: The RN follows the five rights of delegation. Aides perform routine care; LPNs may
administer medications, reinforce teaching, and perform dressing changes. Initial toileting after
surgery requires RN assessment, and placing supplies is appropriate for an aide.
,2026
The nurse is concerned a client may develop a nosocomial infection. Which nursing action is
best when providing care for an incontinent client?
A. Maintain standard precautions
B. Initiate contact isolation measures
C. Insert an indwelling urinary catheter
D. Instruct the client to use adult diapers
Correct Answer: A. Maintain standard precautions
Rationale: Hand hygiene and standard precautions are the most effective methods to reduce
infection risk. Catheterization increases infection risk, and isolation is unnecessary without
infection.
An employee walks into an occupational health clinic stating they were struck by lightning. The
client is alert but feels faint. Which assessment should the nurse perform first?
A. Pulse characteristics
B. Open airway
C. Entrance and exit wounds
D. Cervical spine injury
Correct Answer: A. Pulse characteristics
Rationale: Lightning can cause cardiac dysrhythmias or cardiac arrest. Circulation assessment is
the priority. The client is speaking, indicating a patent airway.
An older adult calls daily to review insulin injection steps despite demonstrating proper
technique previously. What is the nurse’s best response?
A. “I know you are capable of giving yourself the insulin.”
B. “Giving yourself injections seems to make you nervous.”
C. “When I watched you give yourself the injection, you did it correctly.”
D. “Tell me what you want me to do to help you give the injection.”
Correct Answer: C. When I watched you give yourself the injection, you did it correctly.
Rationale: Positive reinforcement strengthens confidence and independence without encouraging
dependency or anxiety.
The nurse prepares to change the bed of a nonresponsive client receiving continuous tube
feedings. What action must be taken first?
A. Stop the feeding for 15 minutes
B. Place extra linens to absorb leakage
C. Ask another nurse for assistance
D. Ask the spouse to leave the room
,2026
Correct Answer: A. Stop the feeding for 15 minutes
Rationale: Lowering the head of the bed increases aspiration risk. Stopping the feeding reduces
gastric volume and aspiration risk.
At a teen health event, which statements would prompt the nurse to provide safety education?
(Select all that apply.)
A. “My boyfriend never comes when he is inside me.”
B. “I hang out with friends after football games.”
C. “I work until 10 pm at a fast-food restaurant.”
D. “I never wear a seatbelt.”
E. “We play beach volleyball often.”
Correct Answer: A, D
Rationale: Pregnancy can occur without intravaginal ejaculation, and seatbelt nonuse
significantly increases mortality risk. The other behaviors are age-appropriate.
Rolling contaminated gloves inside-out affects which link in the chain of infection?
A. Mode of transmission
B. Portal of entry
C. Reservoir
D. Portal of exit
Correct Answer: A. Mode of transmission
Rationale: Proper glove removal prevents organism spread between individuals.
An elderly client is diagnosed with metastatic cancer. The adult child requests withholding the
diagnosis. What guides the nurse’s response?
A. The family can consent due to the client’s age
B. The child may waive consent
C. Therapeutic privilege applies
D. Withholding consent may result in negligence
Correct Answer: D. Withholding consent may result in negligence
Rationale: Performing procedures without informed consent may constitute assault and battery.
Stable mental status requires client involvement.
A nurse experiences a needle stick while recapping a sterile needle. What action should be taken
next?
, 2026
A. Complete an incident report
B. Select another sterile needle
C. Disinfect the needle
D. Notify the supervisor
Correct Answer: B. Select another sterile needle
Rationale: A needle stick renders the needle contaminated. Since no exposure occurred, reporting
is unnecessary.
An 89-year-old client describes a strict daily routine after hip fracture admission. What is the
nurse’s best response?
A. “We will try our best to work around your schedule.”
B. “Your therapy is scheduled for 1500.”
C. “You will need to get your own supper.”
D. “Could you move your prayer time to midday?”
Correct Answer: D. Could you move your prayer time to midday?
Rationale: Maintaining circadian rhythm is essential for older adults. Prayer time offers
flexibility without disrupting sleep or therapy schedules.
The nurse is caring for a client with a newly inserted nasogastric (NG) tube. Which action is the
priority to verify correct placement before administering feedings?
A.
Auscultate air over the epigastrium
B.
Check the pH of aspirated gastric contents
C.
Observe the client for coughing or choking
D.
Measure the length of the external tube
Correct Answer: B
Rationale: Checking the pH of aspirated gastric contents is the most reliable bedside method to
verify NG tube placement. Auscultation is unreliable, coughing is nonspecific, and tube length
alone does not confirm placement.
The nurse is preparing to administer digoxin to an adult client. Which assessment finding
requires the nurse to withhold the medication and notify the provider?
A.
Blood pressure of 110/70 mm Hg
B.
Apical pulse of 52 beats per minute
HESI RN Exit Exam 2026 Full-Length
Practice Tests, Rationales, and Test-
Taking Strategies
The nurse teaches the use of a gait belt to a caregiver whose spouse has right-sided weakness and
needs assistance with ambulation. The caregiver performs a return demonstration of the skill.
Which observation indicates that the caregiver has learned how to use the belt?
A. Standing on the spouse's strong side, the caregiver is ready to hold the gait belt if any
evidence of weakness is observed.
B. Standing on the spouse's weak side, the caregiver provides security by holding the gait belt
from the back.
C. Standing behind the spouse, the caregiver provides balance by holding both sides of the gait
belt.
D. Standing slightly in front and to the right of the spouse, the caregiver guides the client
forward by gently pulling on the gait belt.
Correct Answer: B. Standing on the spouse's weak side, the caregiver provides security by
holding the gait belt from the back.
Rationale: The spouse is most likely to lean toward the weak side and needs extra support on that
side and from the back to prevent falling. The other options provide less stability and increase
fall risk.
The nurse is working with one LPN and two aides on a 20-bed unit. Which tasks are appropriate
to delegate? (Select all that apply.)
A. Feeding an elderly and confused client to the aide
B. Toileting the client for the first time after surgery to the LPN
C. Placing bathroom supplies in the room of a new admission to the LPN
D. Reinforcing discharge teaching instructions to the LPN
E. Administering a PO pain medication to the LPN
F. Performing a routine dressing change 5 days after surgery to the LPN
Correct Answer: A, D, E, F
Rationale: The RN follows the five rights of delegation. Aides perform routine care; LPNs may
administer medications, reinforce teaching, and perform dressing changes. Initial toileting after
surgery requires RN assessment, and placing supplies is appropriate for an aide.
,2026
The nurse is concerned a client may develop a nosocomial infection. Which nursing action is
best when providing care for an incontinent client?
A. Maintain standard precautions
B. Initiate contact isolation measures
C. Insert an indwelling urinary catheter
D. Instruct the client to use adult diapers
Correct Answer: A. Maintain standard precautions
Rationale: Hand hygiene and standard precautions are the most effective methods to reduce
infection risk. Catheterization increases infection risk, and isolation is unnecessary without
infection.
An employee walks into an occupational health clinic stating they were struck by lightning. The
client is alert but feels faint. Which assessment should the nurse perform first?
A. Pulse characteristics
B. Open airway
C. Entrance and exit wounds
D. Cervical spine injury
Correct Answer: A. Pulse characteristics
Rationale: Lightning can cause cardiac dysrhythmias or cardiac arrest. Circulation assessment is
the priority. The client is speaking, indicating a patent airway.
An older adult calls daily to review insulin injection steps despite demonstrating proper
technique previously. What is the nurse’s best response?
A. “I know you are capable of giving yourself the insulin.”
B. “Giving yourself injections seems to make you nervous.”
C. “When I watched you give yourself the injection, you did it correctly.”
D. “Tell me what you want me to do to help you give the injection.”
Correct Answer: C. When I watched you give yourself the injection, you did it correctly.
Rationale: Positive reinforcement strengthens confidence and independence without encouraging
dependency or anxiety.
The nurse prepares to change the bed of a nonresponsive client receiving continuous tube
feedings. What action must be taken first?
A. Stop the feeding for 15 minutes
B. Place extra linens to absorb leakage
C. Ask another nurse for assistance
D. Ask the spouse to leave the room
,2026
Correct Answer: A. Stop the feeding for 15 minutes
Rationale: Lowering the head of the bed increases aspiration risk. Stopping the feeding reduces
gastric volume and aspiration risk.
At a teen health event, which statements would prompt the nurse to provide safety education?
(Select all that apply.)
A. “My boyfriend never comes when he is inside me.”
B. “I hang out with friends after football games.”
C. “I work until 10 pm at a fast-food restaurant.”
D. “I never wear a seatbelt.”
E. “We play beach volleyball often.”
Correct Answer: A, D
Rationale: Pregnancy can occur without intravaginal ejaculation, and seatbelt nonuse
significantly increases mortality risk. The other behaviors are age-appropriate.
Rolling contaminated gloves inside-out affects which link in the chain of infection?
A. Mode of transmission
B. Portal of entry
C. Reservoir
D. Portal of exit
Correct Answer: A. Mode of transmission
Rationale: Proper glove removal prevents organism spread between individuals.
An elderly client is diagnosed with metastatic cancer. The adult child requests withholding the
diagnosis. What guides the nurse’s response?
A. The family can consent due to the client’s age
B. The child may waive consent
C. Therapeutic privilege applies
D. Withholding consent may result in negligence
Correct Answer: D. Withholding consent may result in negligence
Rationale: Performing procedures without informed consent may constitute assault and battery.
Stable mental status requires client involvement.
A nurse experiences a needle stick while recapping a sterile needle. What action should be taken
next?
, 2026
A. Complete an incident report
B. Select another sterile needle
C. Disinfect the needle
D. Notify the supervisor
Correct Answer: B. Select another sterile needle
Rationale: A needle stick renders the needle contaminated. Since no exposure occurred, reporting
is unnecessary.
An 89-year-old client describes a strict daily routine after hip fracture admission. What is the
nurse’s best response?
A. “We will try our best to work around your schedule.”
B. “Your therapy is scheduled for 1500.”
C. “You will need to get your own supper.”
D. “Could you move your prayer time to midday?”
Correct Answer: D. Could you move your prayer time to midday?
Rationale: Maintaining circadian rhythm is essential for older adults. Prayer time offers
flexibility without disrupting sleep or therapy schedules.
The nurse is caring for a client with a newly inserted nasogastric (NG) tube. Which action is the
priority to verify correct placement before administering feedings?
A.
Auscultate air over the epigastrium
B.
Check the pH of aspirated gastric contents
C.
Observe the client for coughing or choking
D.
Measure the length of the external tube
Correct Answer: B
Rationale: Checking the pH of aspirated gastric contents is the most reliable bedside method to
verify NG tube placement. Auscultation is unreliable, coughing is nonspecific, and tube length
alone does not confirm placement.
The nurse is preparing to administer digoxin to an adult client. Which assessment finding
requires the nurse to withhold the medication and notify the provider?
A.
Blood pressure of 110/70 mm Hg
B.
Apical pulse of 52 beats per minute
