1
HESI Exit Exam Prep: Prioritization of
Multiple Patient Assignments for
Nurses
Table of Contents
Subtopic 1: Emergent vs. Non-Emergent Prioritization....................................2
Subtopic 2: Time-Sensitive Interventions in Patient Assignments.................10
Subtopic 3: Delegation and Prioritization with Assistive Personnel
(UAP/LPN/RN).................................................................................................18
Subtopic 4: Prioritization in Acute Care and Critical Conditions.....................27
Subtopic 5: Chronic vs. Acute Exacerbation Prioritization..............................35
Subtopic 6: Delegation and Supervision Prioritization...................................44
Subtopic 7: Emergency vs Non-Emergency Prioritization..............................53
Subtopic 8: Prioritizing Diagnostic and Treatment Procedures.......................61
Subtopic 9: Prioritizing Client Education and Discharge Planning..................70
Subtopic 10: Prioritizing Ethical and Legal Responsibilities in Patient
Assignments..................................................................................................79
, 2
Subtopic 1: Emergent vs. Non-Emergent
Prioritization
Question 1
A nurse receives the following report at shift change. Which patient should
the nurse assess first?
A. A 70-year-old with chronic COPD scheduled for discharge today
B. A 56-year-old post-op day 2 complaining of moderate incisional pain
C. A 45-year-old with asthma who is using accessory muscles to breathe
D. A 23-year-old with a broken ankle waiting for X-ray results
Correct Answer: C
Rationale: Respiratory distress is life-threatening and requires immediate
intervention. Use of accessory muscles is a sign of increased work of
breathing and possibly impending respiratory failure.
Question 2
Which of the following patients should the nurse prioritize for care?
A. A client with a stage 1 pressure ulcer
B. A client reporting chest pain rated 8/10 and diaphoresis
C. A client requesting assistance to the restroom
D. A client with stable vital signs waiting for a dressing change
Correct Answer: B
Rationale: Chest pain and diaphoresis are symptoms of a potential
myocardial infarction and must be addressed immediately using the ABC
(Airway, Breathing, Circulation) and urgent needs frameworks.
, 3
Question 3
Which patient should be seen first during morning rounds?
A. A diabetic client with fasting blood glucose of 185 mg/dL
B. A client with a potassium level of 2.9 mEq/L
C. A client waiting to be discharged with normal vitals
D. A client complaining of a mild headache
Correct Answer: B
Rationale: Hypokalemia can lead to life-threatening cardiac arrhythmias and
requires immediate correction.
Question 4
The nurse is caring for four patients. Who is the priority to assess first?
A. A client post-appendectomy requesting pain medication
B. A client with shortness of breath and a respiratory rate of 32
C. A client with a temperature of 100.8°F
D. A client asking for help to ambulate
Correct Answer: B
Rationale: Respiratory compromise takes precedence over pain, fever, or
mobility needs due to the threat to life.
Question 5
Which client condition requires immediate nursing intervention?
A. A client with hypertension reporting a headache
B. A client with a new diagnosis of diabetes asking questions
C. A client with a tracheostomy and copious secretions
, 4
D. A client with stage 2 heart failure receiving scheduled meds
Correct Answer: C
Rationale: Airway patency is critical. Copious tracheal secretions increase the
risk of obstruction and respiratory arrest.
Question 6
Which patient should be assessed first?
A. A client with chronic kidney disease and scheduled dialysis
B. A client with a new onset of confusion and disorientation
C. A client recovering from total hip replacement surgery
D. A client requesting information about discharge planning
Correct Answer: B
Rationale: Sudden confusion could indicate hypoxia, infection, or a
neurological emergency like stroke or delirium.
Question 7
The nurse is caring for four patients. Who is the highest priority?
A. A post-op client with absent breath sounds on the right side
B. A client with a chronic pressure injury needing a dressing change
C. A client with stable COPD on 2L oxygen via nasal cannula
D. A client who needs assistance with feeding
Correct Answer: A
Rationale: Absent breath sounds could indicate a pneumothorax, which is
potentially life-threatening and requires immediate evaluation.
HESI Exit Exam Prep: Prioritization of
Multiple Patient Assignments for
Nurses
Table of Contents
Subtopic 1: Emergent vs. Non-Emergent Prioritization....................................2
Subtopic 2: Time-Sensitive Interventions in Patient Assignments.................10
Subtopic 3: Delegation and Prioritization with Assistive Personnel
(UAP/LPN/RN).................................................................................................18
Subtopic 4: Prioritization in Acute Care and Critical Conditions.....................27
Subtopic 5: Chronic vs. Acute Exacerbation Prioritization..............................35
Subtopic 6: Delegation and Supervision Prioritization...................................44
Subtopic 7: Emergency vs Non-Emergency Prioritization..............................53
Subtopic 8: Prioritizing Diagnostic and Treatment Procedures.......................61
Subtopic 9: Prioritizing Client Education and Discharge Planning..................70
Subtopic 10: Prioritizing Ethical and Legal Responsibilities in Patient
Assignments..................................................................................................79
, 2
Subtopic 1: Emergent vs. Non-Emergent
Prioritization
Question 1
A nurse receives the following report at shift change. Which patient should
the nurse assess first?
A. A 70-year-old with chronic COPD scheduled for discharge today
B. A 56-year-old post-op day 2 complaining of moderate incisional pain
C. A 45-year-old with asthma who is using accessory muscles to breathe
D. A 23-year-old with a broken ankle waiting for X-ray results
Correct Answer: C
Rationale: Respiratory distress is life-threatening and requires immediate
intervention. Use of accessory muscles is a sign of increased work of
breathing and possibly impending respiratory failure.
Question 2
Which of the following patients should the nurse prioritize for care?
A. A client with a stage 1 pressure ulcer
B. A client reporting chest pain rated 8/10 and diaphoresis
C. A client requesting assistance to the restroom
D. A client with stable vital signs waiting for a dressing change
Correct Answer: B
Rationale: Chest pain and diaphoresis are symptoms of a potential
myocardial infarction and must be addressed immediately using the ABC
(Airway, Breathing, Circulation) and urgent needs frameworks.
, 3
Question 3
Which patient should be seen first during morning rounds?
A. A diabetic client with fasting blood glucose of 185 mg/dL
B. A client with a potassium level of 2.9 mEq/L
C. A client waiting to be discharged with normal vitals
D. A client complaining of a mild headache
Correct Answer: B
Rationale: Hypokalemia can lead to life-threatening cardiac arrhythmias and
requires immediate correction.
Question 4
The nurse is caring for four patients. Who is the priority to assess first?
A. A client post-appendectomy requesting pain medication
B. A client with shortness of breath and a respiratory rate of 32
C. A client with a temperature of 100.8°F
D. A client asking for help to ambulate
Correct Answer: B
Rationale: Respiratory compromise takes precedence over pain, fever, or
mobility needs due to the threat to life.
Question 5
Which client condition requires immediate nursing intervention?
A. A client with hypertension reporting a headache
B. A client with a new diagnosis of diabetes asking questions
C. A client with a tracheostomy and copious secretions
, 4
D. A client with stage 2 heart failure receiving scheduled meds
Correct Answer: C
Rationale: Airway patency is critical. Copious tracheal secretions increase the
risk of obstruction and respiratory arrest.
Question 6
Which patient should be assessed first?
A. A client with chronic kidney disease and scheduled dialysis
B. A client with a new onset of confusion and disorientation
C. A client recovering from total hip replacement surgery
D. A client requesting information about discharge planning
Correct Answer: B
Rationale: Sudden confusion could indicate hypoxia, infection, or a
neurological emergency like stroke or delirium.
Question 7
The nurse is caring for four patients. Who is the highest priority?
A. A post-op client with absent breath sounds on the right side
B. A client with a chronic pressure injury needing a dressing change
C. A client with stable COPD on 2L oxygen via nasal cannula
D. A client who needs assistance with feeding
Correct Answer: A
Rationale: Absent breath sounds could indicate a pneumothorax, which is
potentially life-threatening and requires immediate evaluation.
