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HESI Exit Exam 2026/2027: 205 NCLEX-Style Questions with Verified Answers & Rationales – Management of Care, Safety, Pharmacology, Maternal-Newborn, Mental Health, Med-Surg (A+ Guide)

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Pass the HESI Exit Exam on your first attempt with this 2026/2027 comprehensive test bank. Over 205 NCLEX-style questions with detailed rationales, organized by HESI/NCLEX categories. Covers all content areas: Management of Care: Delegation, advocacy, ethics, mass casualty triage, restraints, informed consent Safety & Infection Control: TB, MRSA, C. diff, airborne/droplet/contact precautions, needlestick, PPE Health Promotion: Antepartum (preeclampsia, placenta previa), postpartum (fundus, mastitis), growth & development (milestones, car seats), prevention (cancer screening, vaccines) Psychosocial Integrity: Therapeutic communication, grief stages, suicide assessment, substance withdrawal (CIWA), serotonin syndrome, NMS, crisis intervention Pharmacology: Digoxin toxicity, warfarin (INR), heparin (PTT), enoxaparin, insulin mixing, metformin (contrast), lithium (hyponatremia), vancomycin (red man), clozapine (ANC) Physiological Adaptation: DKA, heart failure, COPD, pancreatitis, autonomic dysreflexia, thyroid storm, SIADH vs DI, ABGs, ECGs (a-fib, peaked T waves) Calculations: IV drip rates, dosages, intake/output Perfect for: HESI RN Exit Exam, NCLEX-RN prep, nursing school final comprehensive exams.

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HESI EXIT EXAM 2026/2027: 205 NCLEX-STYLE
QUESTIONS WITH VERIFIED ANSWERS &
RATIONALES – UNIVERSITY OF NORTHERN
COLORADO (GRADED A+)


Table of Contents
| Section | Title | Number of Questions |
| 1 | Safe and Effective Care Environment – Management of Care | 20 |
| 2 | Safe and Effective Care Environment – Safety & Infection Control |
20 |
| 3 | Health Promotion and Maintenance – Antepartum & Postpartum | 12
|
| 4 | Health Promotion and Maintenance – Growth & Development | 11 |
| 5 | Health Promotion and Maintenance – Prevention & Screening | 12 |
| 6 | Psychosocial Integrity – Mental Health Disorders | 15 |
| 7 | Psychosocial Integrity – Coping & Therapeutic Communication | 15
|
| 8 | Physiological Integrity – Basic Care & Comfort | 25 |
| 9 | Physiological Integrity – Pharmacological & Parenteral Therapies |
30 |
| 10 | Physiological Integrity – Reduction of Risk Potential | 25 |
| 11 | Physiological Integrity – Physiological Adaptation | 20 |
| 12 | Comprehensive/Mixed High-Yield Review | 20 |

,2|Page


## Section 1: Safe and Effective Care Environment – Management of
Care (20 questions)


**1. A charge nurse is assigning staff. Which client should be assigned
to a new graduate RN who is on orientation?**
A. Client with unstable atrial fibrillation on a drip.
B. Client 2 hours post-thyroidectomy with stridor.
C. Client with stable chronic kidney disease receiving daily
hemodialysis.
D. Client with active upper GI bleed and hypotension.


**Answer: C**
**Rationale:** New graduates should care for stable, predictable clients.
Unstable dysrhythmias, post-op airway compromise, and active bleeding
require experienced RN.


**2. A nurse witnesses a colleague administering a wrong dose of
insulin. What is the first action?**
A. Report to the nursing supervisor immediately.
B. Confront the colleague in the med room.
C. Assess the client for hypoglycemia.
D. Document the incident in the colleague’s file.


**Answer: C**

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**Rationale:** Client safety first – assess for harm. Then report through
chain of command.


**3. A client refuses a blood transfusion due to religious beliefs
(Jehovah’s Witness). The provider wants to transfuse anyway. What
should the nurse do?**
A. Transfuse because the provider ordered it.
B. Call the ethics committee and respect the client’s refusal.
C. Ask the family to convince the client.
D. Document refusal but transfuse if client loses consciousness.


**Answer: B**
**Rationale:** Competent adults have the right to refuse treatment,
even if life-saving. Document refusal, notify provider, and involve ethics
if conflict persists.


**4. A nurse receives a telephone order for morphine 4 mg IV push.
What is the correct process?**
A. Administer, then have the provider sign later.
B. Write the order, read it back, and verify with the provider.
C. Ask the provider to fax the order first.
D. Have another nurse listen to the order.


**Answer: B**

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**Rationale:** Telephone orders require “read back” verification. Write,
read back verbatim, then implement.


**5. A client is being discharged but has no insurance and cannot afford
medications. Which action demonstrates advocacy?**
A. Discharge as planned; it’s not the nurse’s problem.
B. Refer the client to a social worker and medication assistance
programs.
C. Give the client samples from the hospital pharmacy.
D. Tell the client to go to the ER for each dose.


**Answer: B**
**Rationale:** Advocacy includes connecting clients to resources
(social work, patient assistance programs).


**6. A nurse delegates vital signs for a stable post-op client to an
unlicensed assistive personnel (UAP). Which finding requires the nurse
to intervene immediately?**
A. BP 110/70.
B. HR 88.
C. RR 26.
D. Temperature 98.6°F.


**Answer: C**

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