RN HESI Exit Exam V1 – Elsevier HESI RN Exit
Exam – 2026/2027 Academic Year –
Comprehensive Nursing Exam with 150
Verified Questions and Answers
SECTION I: PRIORITIZATION & DELEGATION
Question 1
A young adult client with asthma, admitted yesterday, is sitting on the side of the
bed leaning over the bedside table. The client is on 2 L/min of oxygen via nasal
cannula, is wheezing, and using pursed-lip breathing. Which intervention should
the nurse implement FIRST?
A. Increase oxygen to 6 L/min
B. Call for an Ambu resuscitation bag
C. Instruct the client to lie back in bed
D. Administer a nebulizer treatment
Answer: D
Rationale: The client is in respiratory distress (wheezing, pursed-lip breathing). A
nebulizer treatment (e.g., albuterol) helps open the airways quickly. Increasing
oxygen alone does not address bronchospasm. Having the client lie down can
worsen breathing, and an Ambu bag is used if the client is not adequately
ventilating or is in severe distress .
,Question 2
The charge nurse is assigning clients to one LPN and three RNs. Which client status
change is BEST to assign to the LPN?
A. A subdural hematoma whose BP changed from 150/80 to 170/60
B. Viral meningitis whose temperature changed from 101°F to 102°F
C. Diabetic ketoacidosis whose Glasgow Coma Scale changed from 10 to 7
D. Myxedema whose blood pressure changed from 80/50 to 70/40
Answer: B
Rationale: An increasing fever in viral meningitis is concerning but typically lower
risk than the other changes. The LPN can monitor and report back. The other
status changes (especially large BP changes in severe conditions or GCS drop) are
more acute and need an RN's higher-level skills .
Question 3
A client with pneumonia is now showing initial signs of septic shock and potential
multi-organ failure. A sepsis protocol is prescribed. Which intervention is most
important for the nurse to include?
A. Maintain strict intake and output
B. Keep the head of bed at 45°
C. Assess warmth of extremities
D. Monitor blood glucose levels
Answer: A
Rationale: In septic shock, fluid status is critical because of massive vasodilation
and capillary permeability. Strict I&O helps track fluid replacement effectiveness
and perfusion .
Question 4
A homeless client presents at a community psychiatric clinic for a scheduled
,medication administration. When you prepare to give the prescribed dose, the
client says the usual dose taken is different from what you've drawn up. Which
action should the nurse take?
A. Tell the client they can refuse the medication
B. Withhold the medication until the dosage can be confirmed
C. Explain that the dosage has been changed by the provider
D. Tell the client to take the medication and verify the dose at the next meeting
Answer: B
Rationale: If there is any discrepancy between the prescribed and usual dose the
client reports, the safest action is to hold the dose until verification occurs to
prevent adverse events .
Question 5
An adolescent who wrote a suicide note is admitted. On Day 2, after meeting the
treatment team, the adolescent leaves in tears and goes to their room. Which
nursing intervention is BEST?
A. Let the client rest quietly in their room for a while
B. Explore the client's goals and desire for treatment
C. Ask the treatment team about the client's behavior
D. Go to the client's room and ask what happened
Answer: D
Rationale: The nurse should provide a safe space and encourage open
communication. Going to the client's room and inquiring fosters therapeutic
interaction .
Question 6
The healthcare provider prescribes dalteparin 200 units/kg SC daily for a 70 kg
, client (154 lb). The vial is 25,000 units/mL. How many mL should the nurse
administer? (Round to the nearest tenth if needed.)
A. 0.4 mL
B. 0.6 mL
C. 0.7 mL
D. 0.8 mL
Answer: B (0.6 mL)
Rationale: Dose = 200 units/kg × 70 kg = 14,000 units total. Volume = 14,000 ÷
25,000 = 0.56 mL, rounded to 0.6 mL .
Question 7
A client is being discharged with a new prescription for warfarin. Which statement
by the client indicates a need for further teaching?
A. "I will take my medication at the same time each day."
B. "I will report any unusual bleeding or bruising."
C. "I will eat plenty of green leafy vegetables to stay healthy."
D. "I will keep my lab appointments to check my INR."
Answer: C
Rationale: Clients taking warfarin should maintain consistent vitamin K intake.
Green leafy vegetables are high in vitamin K and can interfere with warfarin
therapy .
Question 8
A client is 2 hours post-total hip replacement. The nurse notes the client is
restless, tachycardic, and complaining of sudden sharp chest pain. What is the
priority nursing action?
A. Administer prescribed PRN pain medication
B. Apply oxygen and notify the healthcare provider
Exam – 2026/2027 Academic Year –
Comprehensive Nursing Exam with 150
Verified Questions and Answers
SECTION I: PRIORITIZATION & DELEGATION
Question 1
A young adult client with asthma, admitted yesterday, is sitting on the side of the
bed leaning over the bedside table. The client is on 2 L/min of oxygen via nasal
cannula, is wheezing, and using pursed-lip breathing. Which intervention should
the nurse implement FIRST?
A. Increase oxygen to 6 L/min
B. Call for an Ambu resuscitation bag
C. Instruct the client to lie back in bed
D. Administer a nebulizer treatment
Answer: D
Rationale: The client is in respiratory distress (wheezing, pursed-lip breathing). A
nebulizer treatment (e.g., albuterol) helps open the airways quickly. Increasing
oxygen alone does not address bronchospasm. Having the client lie down can
worsen breathing, and an Ambu bag is used if the client is not adequately
ventilating or is in severe distress .
,Question 2
The charge nurse is assigning clients to one LPN and three RNs. Which client status
change is BEST to assign to the LPN?
A. A subdural hematoma whose BP changed from 150/80 to 170/60
B. Viral meningitis whose temperature changed from 101°F to 102°F
C. Diabetic ketoacidosis whose Glasgow Coma Scale changed from 10 to 7
D. Myxedema whose blood pressure changed from 80/50 to 70/40
Answer: B
Rationale: An increasing fever in viral meningitis is concerning but typically lower
risk than the other changes. The LPN can monitor and report back. The other
status changes (especially large BP changes in severe conditions or GCS drop) are
more acute and need an RN's higher-level skills .
Question 3
A client with pneumonia is now showing initial signs of septic shock and potential
multi-organ failure. A sepsis protocol is prescribed. Which intervention is most
important for the nurse to include?
A. Maintain strict intake and output
B. Keep the head of bed at 45°
C. Assess warmth of extremities
D. Monitor blood glucose levels
Answer: A
Rationale: In septic shock, fluid status is critical because of massive vasodilation
and capillary permeability. Strict I&O helps track fluid replacement effectiveness
and perfusion .
Question 4
A homeless client presents at a community psychiatric clinic for a scheduled
,medication administration. When you prepare to give the prescribed dose, the
client says the usual dose taken is different from what you've drawn up. Which
action should the nurse take?
A. Tell the client they can refuse the medication
B. Withhold the medication until the dosage can be confirmed
C. Explain that the dosage has been changed by the provider
D. Tell the client to take the medication and verify the dose at the next meeting
Answer: B
Rationale: If there is any discrepancy between the prescribed and usual dose the
client reports, the safest action is to hold the dose until verification occurs to
prevent adverse events .
Question 5
An adolescent who wrote a suicide note is admitted. On Day 2, after meeting the
treatment team, the adolescent leaves in tears and goes to their room. Which
nursing intervention is BEST?
A. Let the client rest quietly in their room for a while
B. Explore the client's goals and desire for treatment
C. Ask the treatment team about the client's behavior
D. Go to the client's room and ask what happened
Answer: D
Rationale: The nurse should provide a safe space and encourage open
communication. Going to the client's room and inquiring fosters therapeutic
interaction .
Question 6
The healthcare provider prescribes dalteparin 200 units/kg SC daily for a 70 kg
, client (154 lb). The vial is 25,000 units/mL. How many mL should the nurse
administer? (Round to the nearest tenth if needed.)
A. 0.4 mL
B. 0.6 mL
C. 0.7 mL
D. 0.8 mL
Answer: B (0.6 mL)
Rationale: Dose = 200 units/kg × 70 kg = 14,000 units total. Volume = 14,000 ÷
25,000 = 0.56 mL, rounded to 0.6 mL .
Question 7
A client is being discharged with a new prescription for warfarin. Which statement
by the client indicates a need for further teaching?
A. "I will take my medication at the same time each day."
B. "I will report any unusual bleeding or bruising."
C. "I will eat plenty of green leafy vegetables to stay healthy."
D. "I will keep my lab appointments to check my INR."
Answer: C
Rationale: Clients taking warfarin should maintain consistent vitamin K intake.
Green leafy vegetables are high in vitamin K and can interfere with warfarin
therapy .
Question 8
A client is 2 hours post-total hip replacement. The nurse notes the client is
restless, tachycardic, and complaining of sudden sharp chest pain. What is the
priority nursing action?
A. Administer prescribed PRN pain medication
B. Apply oxygen and notify the healthcare provider
