1
HESI Exit Exam NCLEX Readiness | 10-
Topic Review with Practice Questions &
Answers
Table of Contents
Subtopic 1: Clinical Decision-Making and Prioritization....................................2
Subtopic 2: Pharmacology and Safe Medication Administration....................10
Subtopic 3: Maternal and Newborn Nursing...................................................19
Subtopic 4: Medical-Surgical Nursing – Complex Adult Health Conditions.....27
Subtopic 5: Mental Health and Crisis Intervention.........................................36
Subtopic 6: Maternity and Newborn Nursing.................................................45
Subtopic 7: Pediatric Nursing and Growth & Development............................53
Subtopic 8: Pharmacology and Medication Administration............................62
Subtopic 9: Pediatric and Maternal-Newborn Nursing....................................70
Subtopic 10: Advanced Nursing Concepts and Leadership/Management......78
, 2
Subtopic 1: Clinical Decision-Making and
Prioritization
Question 1
A nurse is assigned four patients. Which patient should the nurse assess
first?
A. A 62-year-old with COPD who has a pulse oximeter reading of 91%
B. A 50-year-old complaining of moderate incisional pain rated 6/10
C. A 74-year-old with a new onset of confusion and restlessness
D. A 36-year-old diabetic with blood glucose of 180 mg/dL
Correct Answer: C. A 74-year-old with a new onset of confusion and
restlessness
Rationale: Sudden confusion in an elderly patient could indicate hypoxia,
infection, or neurological event (e.g., stroke), making this the most critical
situation requiring immediate attention.
Question 2
The nurse receives morning report. Which task is appropriate to delegate to
the unlicensed assistive personnel (UAP)?
A. Assessing a patient’s pain level
B. Assisting a stable patient with a bed bath
C. Teaching a patient how to use a walker
D. Administering oral medications
Correct Answer: B. Assisting a stable patient with a bed bath
Rationale: UAPs can assist with non-invasive, routine tasks such as hygiene
care. Assessment, teaching, and medication administration are within the
nurse’s scope.
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Question 3
A patient admitted with pneumonia is hypotensive and febrile. What is the
nurse’s priority action?
A. Administer IV fluids as prescribed
B. Notify the family about the patient’s status
C. Call the respiratory therapist
D. Monitor intake and output
Correct Answer: A. Administer IV fluids as prescribed
Rationale: Fluid resuscitation addresses hypotension and is a critical
intervention in sepsis or severe infection.
Question 4
A post-op patient’s BP drops from 122/84 to 90/60 and HR increases to 120
bpm. What should the nurse do first?
A. Reassess in 15 minutes
B. Administer pain medication
C. Assess surgical site for bleeding
D. Elevate the head of the bed
Correct Answer: C. Assess surgical site for bleeding
Rationale: A sudden BP drop and tachycardia suggest hypovolemia, possibly
from hemorrhage. Immediate assessment of the surgical site is warranted.
Question 5
Which patient condition is most urgent?
A. A patient with facial drooping and slurred speech
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B. A patient with a chronic cough and dyspnea
C. A patient with abdominal pain rating 5/10
D. A patient with mild nausea after chemotherapy
Correct Answer: A. A patient with facial drooping and slurred speech
Rationale: These are signs of a possible stroke (FAST symptoms) and require
immediate intervention to prevent permanent damage.
Question 6
A nurse hears a UAP tell a patient with dysphagia, “Just drink water fast to
clear your throat.” What should the nurse do?
A. Intervene immediately and educate the UAP
B. Let it go; the patient is stable
C. Notify the charge nurse
D. Report to the nursing supervisor
Correct Answer: A. Intervene immediately and educate the UAP
Rationale: The UAP is giving incorrect and potentially harmful advice to a
patient with swallowing difficulty, risking aspiration.
Question 7
Which of the following tasks can be delegated to a licensed practical nurse
(LPN)?
A. Initial assessment of a post-op patient
B. Monitoring wound drainage on a stable patient
C. Teaching a diabetic patient how to administer insulin
D. Administering IV chemotherapy
HESI Exit Exam NCLEX Readiness | 10-
Topic Review with Practice Questions &
Answers
Table of Contents
Subtopic 1: Clinical Decision-Making and Prioritization....................................2
Subtopic 2: Pharmacology and Safe Medication Administration....................10
Subtopic 3: Maternal and Newborn Nursing...................................................19
Subtopic 4: Medical-Surgical Nursing – Complex Adult Health Conditions.....27
Subtopic 5: Mental Health and Crisis Intervention.........................................36
Subtopic 6: Maternity and Newborn Nursing.................................................45
Subtopic 7: Pediatric Nursing and Growth & Development............................53
Subtopic 8: Pharmacology and Medication Administration............................62
Subtopic 9: Pediatric and Maternal-Newborn Nursing....................................70
Subtopic 10: Advanced Nursing Concepts and Leadership/Management......78
, 2
Subtopic 1: Clinical Decision-Making and
Prioritization
Question 1
A nurse is assigned four patients. Which patient should the nurse assess
first?
A. A 62-year-old with COPD who has a pulse oximeter reading of 91%
B. A 50-year-old complaining of moderate incisional pain rated 6/10
C. A 74-year-old with a new onset of confusion and restlessness
D. A 36-year-old diabetic with blood glucose of 180 mg/dL
Correct Answer: C. A 74-year-old with a new onset of confusion and
restlessness
Rationale: Sudden confusion in an elderly patient could indicate hypoxia,
infection, or neurological event (e.g., stroke), making this the most critical
situation requiring immediate attention.
Question 2
The nurse receives morning report. Which task is appropriate to delegate to
the unlicensed assistive personnel (UAP)?
A. Assessing a patient’s pain level
B. Assisting a stable patient with a bed bath
C. Teaching a patient how to use a walker
D. Administering oral medications
Correct Answer: B. Assisting a stable patient with a bed bath
Rationale: UAPs can assist with non-invasive, routine tasks such as hygiene
care. Assessment, teaching, and medication administration are within the
nurse’s scope.
, 3
Question 3
A patient admitted with pneumonia is hypotensive and febrile. What is the
nurse’s priority action?
A. Administer IV fluids as prescribed
B. Notify the family about the patient’s status
C. Call the respiratory therapist
D. Monitor intake and output
Correct Answer: A. Administer IV fluids as prescribed
Rationale: Fluid resuscitation addresses hypotension and is a critical
intervention in sepsis or severe infection.
Question 4
A post-op patient’s BP drops from 122/84 to 90/60 and HR increases to 120
bpm. What should the nurse do first?
A. Reassess in 15 minutes
B. Administer pain medication
C. Assess surgical site for bleeding
D. Elevate the head of the bed
Correct Answer: C. Assess surgical site for bleeding
Rationale: A sudden BP drop and tachycardia suggest hypovolemia, possibly
from hemorrhage. Immediate assessment of the surgical site is warranted.
Question 5
Which patient condition is most urgent?
A. A patient with facial drooping and slurred speech
, 4
B. A patient with a chronic cough and dyspnea
C. A patient with abdominal pain rating 5/10
D. A patient with mild nausea after chemotherapy
Correct Answer: A. A patient with facial drooping and slurred speech
Rationale: These are signs of a possible stroke (FAST symptoms) and require
immediate intervention to prevent permanent damage.
Question 6
A nurse hears a UAP tell a patient with dysphagia, “Just drink water fast to
clear your throat.” What should the nurse do?
A. Intervene immediately and educate the UAP
B. Let it go; the patient is stable
C. Notify the charge nurse
D. Report to the nursing supervisor
Correct Answer: A. Intervene immediately and educate the UAP
Rationale: The UAP is giving incorrect and potentially harmful advice to a
patient with swallowing difficulty, risking aspiration.
Question 7
Which of the following tasks can be delegated to a licensed practical nurse
(LPN)?
A. Initial assessment of a post-op patient
B. Monitoring wound drainage on a stable patient
C. Teaching a diabetic patient how to administer insulin
D. Administering IV chemotherapy
