2026
HESI RN Exit Exam 2026 Mastery Guide
for Clinical Judgment, Safety, and Patient
Care
The nurse is caring for a postoperative client who reports pain rated 8/10. The prescribed
medication is morphine IV PRN every 4 hours. Which action should the nurse take first?
A.
Document the client’s pain rating
B.
Assess the client’s respiratory rate
C.
Administer the prescribed morphine
D.
Reposition the client for comfort
Correct Answer: B
Rationale: Morphine can depress respirations, so assessing the respiratory rate is essential before
administration. Documentation and repositioning are appropriate but not the priority.
Administering the medication without assessment could place the client at risk.
The nurse is assisting with discharge planning for a client with limited mobility who lives alone.
Which referral is most appropriate?
A.
Home health nursing services
B.
Spiritual care services
C.
Dietary consultation
D.
Case management follow-up in 6 months
Correct Answer: A
Rationale: Home health nursing can assist with ongoing care needs, safety, and medication
management. Spiritual care and dietary services may be helpful but do not address mobility and
safety. Waiting 6 months delays needed support.
The nurse observes a client becoming increasingly anxious while awaiting surgery. Which
intervention is most therapeutic?
,2026
A.
Explain that anxiety is normal before surgery
B.
Provide factual information about the procedure
C.
Tell the client to focus on positive thoughts
D.
Administer antianxiety medication immediately
Correct Answer: B
Rationale: Providing clear, factual information reduces fear of the unknown and promotes
coping. Minimizing feelings or giving generic reassurance is less effective. Medication is not the
first intervention without further assessment.
The nurse is caring for a client with a new colostomy. Which statement by the client indicates
effective learning?
A.
“I will clean around the stoma using soap and water.”
B.
“I should expect bleeding from the stoma every day.”
C.
“I must restrict fluids to prevent leakage.”
D.
“I should change the appliance only when it leaks.”
Correct Answer: A
Rationale: Cleaning the stoma with soap and water is appropriate care. Bleeding is not expected.
Fluids should not be restricted. Appliances should be changed routinely, not only when leaking.
The nurse is caring for a client with pneumonia. Which assessment finding best indicates that
treatment is effective?
A.
Decreased cough frequency
B.
Increased appetite
C.
Oxygen saturation of 95% on room air
D.
Clear lung sounds in all fields
Correct Answer: C
Rationale: Improved oxygen saturation demonstrates better gas exchange and treatment
,2026
effectiveness. Lung sounds may remain abnormal during recovery. Appetite and cough
improvement are positive but less direct indicators.
The nurse is preparing to administer an intramuscular injection to an adult client. Which site is
preferred?
A.
Ventrogluteal
B.
Deltoid
C.
Dorsogluteal
D.
Abdominal
Correct Answer: A
Rationale: The ventrogluteal site is the safest IM site for adults due to fewer nerves and blood
vessels. The dorsogluteal site carries a risk of sciatic nerve injury. The deltoid is limited by
muscle mass. The abdomen is used for subcutaneous injections.
The nurse notes that a client’s IV site is red, warm, and painful. What is the most appropriate
nursing action?
A.
Slow the IV infusion rate
B.
Apply a warm compress
C.
Discontinue the IV and restart at another site
D.
Document the finding and continue monitoring
Correct Answer: C
Rationale: These findings indicate phlebitis. The IV must be discontinued to prevent
complications. Slowing the rate or applying warmth does not resolve the cause. Monitoring alone
is insufficient.
The nurse is caring for a confused client at risk for falls. Which intervention is most effective in
preventing injury?
A.
Apply physical restraints
B.
, 2026
Keep the bed in the lowest position
C.
Administer sedatives as prescribed
D.
Place the client near the nurses’ station
Correct Answer: B
Rationale: Keeping the bed low reduces the risk of injury if the client attempts to get up.
Restraints and sedatives increase fall risk. Placing the client near the nurses’ station is helpful but
less effective than environmental safety measures.
The nurse is teaching a client about hypertension management. Which statement indicates
understanding?
A.
“I should stop taking medication when my blood pressure is normal.”
B.
“I will avoid checking my blood pressure at home.”
C.
“I will reduce my sodium intake.”
D.
“I can smoke as long as I exercise.”
Correct Answer: C
Rationale: Reducing sodium intake helps control blood pressure. Antihypertensive medications
are taken continuously. Home monitoring is encouraged. Smoking increases cardiovascular risk.
The nurse is caring for a client who suddenly becomes short of breath. Which action should the
nurse take first?
A.
Notify the healthcare provider
B.
Check the oxygen saturation
C.
Raise the head of the bed
D.
Obtain a chest x-ray
Correct Answer: C
Rationale: Elevating the head of the bed improves lung expansion and breathing immediately.
Further assessment and notification follow after stabilizing the client.
HESI RN Exit Exam 2026 Mastery Guide
for Clinical Judgment, Safety, and Patient
Care
The nurse is caring for a postoperative client who reports pain rated 8/10. The prescribed
medication is morphine IV PRN every 4 hours. Which action should the nurse take first?
A.
Document the client’s pain rating
B.
Assess the client’s respiratory rate
C.
Administer the prescribed morphine
D.
Reposition the client for comfort
Correct Answer: B
Rationale: Morphine can depress respirations, so assessing the respiratory rate is essential before
administration. Documentation and repositioning are appropriate but not the priority.
Administering the medication without assessment could place the client at risk.
The nurse is assisting with discharge planning for a client with limited mobility who lives alone.
Which referral is most appropriate?
A.
Home health nursing services
B.
Spiritual care services
C.
Dietary consultation
D.
Case management follow-up in 6 months
Correct Answer: A
Rationale: Home health nursing can assist with ongoing care needs, safety, and medication
management. Spiritual care and dietary services may be helpful but do not address mobility and
safety. Waiting 6 months delays needed support.
The nurse observes a client becoming increasingly anxious while awaiting surgery. Which
intervention is most therapeutic?
,2026
A.
Explain that anxiety is normal before surgery
B.
Provide factual information about the procedure
C.
Tell the client to focus on positive thoughts
D.
Administer antianxiety medication immediately
Correct Answer: B
Rationale: Providing clear, factual information reduces fear of the unknown and promotes
coping. Minimizing feelings or giving generic reassurance is less effective. Medication is not the
first intervention without further assessment.
The nurse is caring for a client with a new colostomy. Which statement by the client indicates
effective learning?
A.
“I will clean around the stoma using soap and water.”
B.
“I should expect bleeding from the stoma every day.”
C.
“I must restrict fluids to prevent leakage.”
D.
“I should change the appliance only when it leaks.”
Correct Answer: A
Rationale: Cleaning the stoma with soap and water is appropriate care. Bleeding is not expected.
Fluids should not be restricted. Appliances should be changed routinely, not only when leaking.
The nurse is caring for a client with pneumonia. Which assessment finding best indicates that
treatment is effective?
A.
Decreased cough frequency
B.
Increased appetite
C.
Oxygen saturation of 95% on room air
D.
Clear lung sounds in all fields
Correct Answer: C
Rationale: Improved oxygen saturation demonstrates better gas exchange and treatment
,2026
effectiveness. Lung sounds may remain abnormal during recovery. Appetite and cough
improvement are positive but less direct indicators.
The nurse is preparing to administer an intramuscular injection to an adult client. Which site is
preferred?
A.
Ventrogluteal
B.
Deltoid
C.
Dorsogluteal
D.
Abdominal
Correct Answer: A
Rationale: The ventrogluteal site is the safest IM site for adults due to fewer nerves and blood
vessels. The dorsogluteal site carries a risk of sciatic nerve injury. The deltoid is limited by
muscle mass. The abdomen is used for subcutaneous injections.
The nurse notes that a client’s IV site is red, warm, and painful. What is the most appropriate
nursing action?
A.
Slow the IV infusion rate
B.
Apply a warm compress
C.
Discontinue the IV and restart at another site
D.
Document the finding and continue monitoring
Correct Answer: C
Rationale: These findings indicate phlebitis. The IV must be discontinued to prevent
complications. Slowing the rate or applying warmth does not resolve the cause. Monitoring alone
is insufficient.
The nurse is caring for a confused client at risk for falls. Which intervention is most effective in
preventing injury?
A.
Apply physical restraints
B.
, 2026
Keep the bed in the lowest position
C.
Administer sedatives as prescribed
D.
Place the client near the nurses’ station
Correct Answer: B
Rationale: Keeping the bed low reduces the risk of injury if the client attempts to get up.
Restraints and sedatives increase fall risk. Placing the client near the nurses’ station is helpful but
less effective than environmental safety measures.
The nurse is teaching a client about hypertension management. Which statement indicates
understanding?
A.
“I should stop taking medication when my blood pressure is normal.”
B.
“I will avoid checking my blood pressure at home.”
C.
“I will reduce my sodium intake.”
D.
“I can smoke as long as I exercise.”
Correct Answer: C
Rationale: Reducing sodium intake helps control blood pressure. Antihypertensive medications
are taken continuously. Home monitoring is encouraged. Smoking increases cardiovascular risk.
The nurse is caring for a client who suddenly becomes short of breath. Which action should the
nurse take first?
A.
Notify the healthcare provider
B.
Check the oxygen saturation
C.
Raise the head of the bed
D.
Obtain a chest x-ray
Correct Answer: C
Rationale: Elevating the head of the bed improves lung expansion and breathing immediately.
Further assessment and notification follow after stabilizing the client.
