HESI Exit Exam Practice – Version 2 | 260
Questions with Rationales | NCLEX Predictor |
Updated for 2026 Guaranteed Pass
TABLE OF CONTENTS
1. Safe & Effective Care Environment – Management of Care (Questions 1–40)
2. Safe & Effective Care Environment – Safety & Infection Control (Questions 41–70)
3. Health Promotion & Maintenance (Questions 71–100)
4. Psychosocial Integrity (Questions 101–130)
5. Basic Care & Comfort (Questions 131–160)
6. Pharmacological & Parenteral Therapies (Questions 161–200)
7. Reduction of Risk Potential (Questions 201–230)
8. Physiological Adaptation (Questions 231–260)
SAFE & EFFECTIVE CARE ENVIRONMENT – MANAGEMENT OF
CARE (Questions 1–40)
Question 1 A nurse is caring for a client who has a prescription for a physical restraint. Which of the
following actions should the nurse take?
A. Apply the restraint for up to 4 hours before reassessing B. Obtain a new restraint order every 24
hours C. Tie the restraint to the side rail of the bed D. Remove the restraint every 2 hours for range of
motion
Correct Answer: B Rationale: Restraint orders must be renewed every 24 hours (or per facility
policy, often every 4-8 hours). Restraints should be removed every 2 hours for ROM (D). Never tie to
side rails (C).
Question 2 (Select all that apply) A charge nurse is delegating tasks on a medical-surgical unit.
Which tasks can be delegated to an LPN? (Select all that apply)
,A. Administer a tube feeding to a stable client B. Perform an initial admission assessment C. Change
a sterile dressing on a postoperative day 3 wound D. Develop a plan of care for a client with
pneumonia E. Monitor for side effects of a new antihypertensive medication
Correct Answers: A, C Rationale: LPNs can administer tube feedings (A) and change sterile
dressings on stable wounds (C). Initial assessment (B) and care plan development (D) are RN
responsibilities. Monitoring for side effects (E) requires RN-level evaluation.
Question 3 A nurse is caring for a client who refuses a prescribed blood transfusion due to religious
beliefs. The client's family requests that the nurse give the blood anyway. What should the nurse do?
A. Administer the blood transfusion as the family requests B. Contact the facility's ethics
committee C. Respect the client's refusal and document it D. Ask the provider to override the client's
decision
Correct Answer: C Rationale: A competent adult client has the right to refuse treatment. The nurse
must respect the refusal and document it. Ethics committee (B) may be consulted if competency is in
question.
Question 4 A nurse is preparing to discharge a client who speaks a limited amount of English. Which
action is most appropriate?
A. Give written instructions in English only B. Use a certified medical interpreter for discharge
teaching C. Ask the client's 10-year-old child to translate D. Speak loudly and slowly in English
Correct Answer: B Rationale: A certified medical interpreter is required by federal law for
meaningful communication. Family members (C) are not reliable for medical information.
Question 5 (Select all that apply) A nurse is reviewing informed consent with a group of new
graduates. Which statements by a new graduate indicate understanding? (Select all that apply)
A. "The nurse is responsible for obtaining written informed consent." B. "A client can withdraw
consent at any time before the procedure." C. "Consent is valid if the client is under the influence of
pain medication." D. "Family members can sign consent if the client is nervous." E. "The provider is
responsible for explaining the procedure and risks."
Correct Answers: B, E Rationale: The client can withdraw consent at any time (B). The provider
(not the nurse) is responsible for obtaining consent (E). Pain medication (C) invalidates consent.
Question 6 A nurse is caring for a client who is being discharged but refuses to leave because they
feel unsafe at home. What should the nurse do first?
,A. Call security to escort the client out B. Notify the provider and social worker C. Tell the client they
have no choice D. Arrange for temporary shelter
Correct Answer: B Rationale: The nurse must first notify the provider and social worker to assess
safety concerns and legal options. Security (A) is not appropriate.
Question 7 A nurse is preparing to transfer a client from the ICU to a medical-surgical unit. Which
information must be included in the handoff report?
A. The client's full medical history since birth B. The name of the client's primary care provider C.
Current medications and recent vital signs D. The client's preferred meal choices
Correct Answer: C Rationale: Handoff reports must include actionable, current clinical data:
medications, recent vital signs, pending labs, and safety concerns.
Question 8 (Select all that apply) A charge nurse is reviewing HIPAA compliance. Which actions
violate HIPAA? (Select all that apply)
A. Discussing a client's condition in a public elevator B. Faxing records to another facility with a
cover sheet C. Leaving a client's printed lab results on a shared desk D. Sharing login information
with a colleague E. Providing handoff report at the client's bedside
Correct Answers: A, C, D Rationale: Elevator discussion (A), leaving results visible (C), and
sharing logins (D) violate HIPAA. Faxing with cover sheet (B) and bedside handoff (E) are
acceptable.
Question 9 A nurse is caring for a client who has a do-not-resuscitate (DNR) order. The client's
family demands that the nurse "do everything" if the client stops breathing. What should the nurse do
first?
A. Begin CPR immediately B. Notify the provider to speak with the family C. Tell the family the
DNR is legally binding D. Call a code blue
Correct Answer: B Rationale: The nurse should first notify the provider to review the DNR order
with the family. The nurse does not independently override a DNR (A, D).
Question 10 A nurse is caring for a client who is confused and trying to pull out their IV line. What is
the least restrictive intervention first?
A. Apply wrist restraints B. Use a bed alarm and reorient the client C. Request a sedative from the
provider D. Place all four side rails up
Correct Answer: B Rationale: The least restrictive intervention is a bed alarm and reorientation.
Restraints (A) and sedation (C) are last resorts.
, Question 11 (Select all that apply) A nurse is reviewing advance directives with a client. Which
statements are correct? (Select all that apply)
A. A living will specifies treatment preferences B. A durable power of attorney for healthcare appoints
a decision-maker C. Advance directives are only for elderly clients D. Clients can change advance
directives at any time E. Nurses must provide information about advance directives on admission
Correct Answers: A, B, D, E Rationale: Advance directives are for any adult, not just elderly (C).
Clients can change them anytime (D). Facilities must provide information on admission (E).
Question 12 A nurse is caring for a client who has a new diagnosis of terminal cancer. The client
says, "I don't want any further treatment. Please just keep me comfortable." What should the nurse do
first?
A. Notify the provider of the client's request B. Discuss palliative care options with the client C. Ask
the client if they would like to speak with a chaplain D. Document the client's statement in the
medical record
Correct Answer: A Rationale: The nurse's first action should be to notify the provider because the
client is requesting a change in treatment goals.
Question 13 A nurse is caring for a client who is scheduled for surgery but has not signed the consent
form. The client says, "I don't understand what the surgeon explained." What should the nurse do?
A. Explain the procedure in simple terms B. Have the client sign and explain later C. Notify the
surgeon to clarify the information D. Ask a family member to explain
Correct Answer: C Rationale: Only the surgeon (or provider performing the procedure) can clarify
informed consent. The nurse should notify the surgeon.
Question 14 (Select all that apply) A nurse is delegating tasks to an AP. Which tasks are appropriate?
(Select all that apply)
A. Obtain a clean catch urine specimen B. Reinsert a dislodged nasogastric tube C. Perform a bedside
blood glucose check if trained D. Ambulate a client who has a history of falls E. Assess the client's
pain level
Correct Answers: A, C, D Rationale: APs can obtain urine specimens (A), perform glucose checks
if trained (C), and ambulate stable clients (D). Reinserting NG tube (B) and pain assessment (E) are
not AP scope.
Questions with Rationales | NCLEX Predictor |
Updated for 2026 Guaranteed Pass
TABLE OF CONTENTS
1. Safe & Effective Care Environment – Management of Care (Questions 1–40)
2. Safe & Effective Care Environment – Safety & Infection Control (Questions 41–70)
3. Health Promotion & Maintenance (Questions 71–100)
4. Psychosocial Integrity (Questions 101–130)
5. Basic Care & Comfort (Questions 131–160)
6. Pharmacological & Parenteral Therapies (Questions 161–200)
7. Reduction of Risk Potential (Questions 201–230)
8. Physiological Adaptation (Questions 231–260)
SAFE & EFFECTIVE CARE ENVIRONMENT – MANAGEMENT OF
CARE (Questions 1–40)
Question 1 A nurse is caring for a client who has a prescription for a physical restraint. Which of the
following actions should the nurse take?
A. Apply the restraint for up to 4 hours before reassessing B. Obtain a new restraint order every 24
hours C. Tie the restraint to the side rail of the bed D. Remove the restraint every 2 hours for range of
motion
Correct Answer: B Rationale: Restraint orders must be renewed every 24 hours (or per facility
policy, often every 4-8 hours). Restraints should be removed every 2 hours for ROM (D). Never tie to
side rails (C).
Question 2 (Select all that apply) A charge nurse is delegating tasks on a medical-surgical unit.
Which tasks can be delegated to an LPN? (Select all that apply)
,A. Administer a tube feeding to a stable client B. Perform an initial admission assessment C. Change
a sterile dressing on a postoperative day 3 wound D. Develop a plan of care for a client with
pneumonia E. Monitor for side effects of a new antihypertensive medication
Correct Answers: A, C Rationale: LPNs can administer tube feedings (A) and change sterile
dressings on stable wounds (C). Initial assessment (B) and care plan development (D) are RN
responsibilities. Monitoring for side effects (E) requires RN-level evaluation.
Question 3 A nurse is caring for a client who refuses a prescribed blood transfusion due to religious
beliefs. The client's family requests that the nurse give the blood anyway. What should the nurse do?
A. Administer the blood transfusion as the family requests B. Contact the facility's ethics
committee C. Respect the client's refusal and document it D. Ask the provider to override the client's
decision
Correct Answer: C Rationale: A competent adult client has the right to refuse treatment. The nurse
must respect the refusal and document it. Ethics committee (B) may be consulted if competency is in
question.
Question 4 A nurse is preparing to discharge a client who speaks a limited amount of English. Which
action is most appropriate?
A. Give written instructions in English only B. Use a certified medical interpreter for discharge
teaching C. Ask the client's 10-year-old child to translate D. Speak loudly and slowly in English
Correct Answer: B Rationale: A certified medical interpreter is required by federal law for
meaningful communication. Family members (C) are not reliable for medical information.
Question 5 (Select all that apply) A nurse is reviewing informed consent with a group of new
graduates. Which statements by a new graduate indicate understanding? (Select all that apply)
A. "The nurse is responsible for obtaining written informed consent." B. "A client can withdraw
consent at any time before the procedure." C. "Consent is valid if the client is under the influence of
pain medication." D. "Family members can sign consent if the client is nervous." E. "The provider is
responsible for explaining the procedure and risks."
Correct Answers: B, E Rationale: The client can withdraw consent at any time (B). The provider
(not the nurse) is responsible for obtaining consent (E). Pain medication (C) invalidates consent.
Question 6 A nurse is caring for a client who is being discharged but refuses to leave because they
feel unsafe at home. What should the nurse do first?
,A. Call security to escort the client out B. Notify the provider and social worker C. Tell the client they
have no choice D. Arrange for temporary shelter
Correct Answer: B Rationale: The nurse must first notify the provider and social worker to assess
safety concerns and legal options. Security (A) is not appropriate.
Question 7 A nurse is preparing to transfer a client from the ICU to a medical-surgical unit. Which
information must be included in the handoff report?
A. The client's full medical history since birth B. The name of the client's primary care provider C.
Current medications and recent vital signs D. The client's preferred meal choices
Correct Answer: C Rationale: Handoff reports must include actionable, current clinical data:
medications, recent vital signs, pending labs, and safety concerns.
Question 8 (Select all that apply) A charge nurse is reviewing HIPAA compliance. Which actions
violate HIPAA? (Select all that apply)
A. Discussing a client's condition in a public elevator B. Faxing records to another facility with a
cover sheet C. Leaving a client's printed lab results on a shared desk D. Sharing login information
with a colleague E. Providing handoff report at the client's bedside
Correct Answers: A, C, D Rationale: Elevator discussion (A), leaving results visible (C), and
sharing logins (D) violate HIPAA. Faxing with cover sheet (B) and bedside handoff (E) are
acceptable.
Question 9 A nurse is caring for a client who has a do-not-resuscitate (DNR) order. The client's
family demands that the nurse "do everything" if the client stops breathing. What should the nurse do
first?
A. Begin CPR immediately B. Notify the provider to speak with the family C. Tell the family the
DNR is legally binding D. Call a code blue
Correct Answer: B Rationale: The nurse should first notify the provider to review the DNR order
with the family. The nurse does not independently override a DNR (A, D).
Question 10 A nurse is caring for a client who is confused and trying to pull out their IV line. What is
the least restrictive intervention first?
A. Apply wrist restraints B. Use a bed alarm and reorient the client C. Request a sedative from the
provider D. Place all four side rails up
Correct Answer: B Rationale: The least restrictive intervention is a bed alarm and reorientation.
Restraints (A) and sedation (C) are last resorts.
, Question 11 (Select all that apply) A nurse is reviewing advance directives with a client. Which
statements are correct? (Select all that apply)
A. A living will specifies treatment preferences B. A durable power of attorney for healthcare appoints
a decision-maker C. Advance directives are only for elderly clients D. Clients can change advance
directives at any time E. Nurses must provide information about advance directives on admission
Correct Answers: A, B, D, E Rationale: Advance directives are for any adult, not just elderly (C).
Clients can change them anytime (D). Facilities must provide information on admission (E).
Question 12 A nurse is caring for a client who has a new diagnosis of terminal cancer. The client
says, "I don't want any further treatment. Please just keep me comfortable." What should the nurse do
first?
A. Notify the provider of the client's request B. Discuss palliative care options with the client C. Ask
the client if they would like to speak with a chaplain D. Document the client's statement in the
medical record
Correct Answer: A Rationale: The nurse's first action should be to notify the provider because the
client is requesting a change in treatment goals.
Question 13 A nurse is caring for a client who is scheduled for surgery but has not signed the consent
form. The client says, "I don't understand what the surgeon explained." What should the nurse do?
A. Explain the procedure in simple terms B. Have the client sign and explain later C. Notify the
surgeon to clarify the information D. Ask a family member to explain
Correct Answer: C Rationale: Only the surgeon (or provider performing the procedure) can clarify
informed consent. The nurse should notify the surgeon.
Question 14 (Select all that apply) A nurse is delegating tasks to an AP. Which tasks are appropriate?
(Select all that apply)
A. Obtain a clean catch urine specimen B. Reinsert a dislodged nasogastric tube C. Perform a bedside
blood glucose check if trained D. Ambulate a client who has a history of falls E. Assess the client's
pain level
Correct Answers: A, C, D Rationale: APs can obtain urine specimens (A), perform glucose checks
if trained (C), and ambulate stable clients (D). Reinserting NG tube (B) and pain assessment (E) are
not AP scope.
