HESI Exam – RN Exit V-2

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Sample questions from HESI Exam – RN Exit V-2

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.During morning rounds on a surgical unit, a 72-year-old client's condition changes. Refer to the client's chart. Which action should the RN take first?

   • A.Encourage oral fluids.
   • B.Reassess after the next scheduled antibiotic dose.
   • C.Administer the prescribed PRN opioid.
   • D.Activate the rapid response team.

   Rationale: The decline in BP from 118/70 to 84/48 mm Hg, rising HR, fever, oliguria, and new confusion indicate shock requiring immediate escalation. An opioid could worsen hypotension, and oral fluids are inadequate and unsafe with altered mentation. Waiting for another antibiotic dose delays resuscitation; prioritize acute perfusion threats.

2. 2.At change of shift on a medical unit, the RN works with an experienced LPN/VN and assistive personnel. Which assignment is most appropriate for the LPN/VN, consistent with facility policy?

   • A.Evaluate the initial response of a 28-year-old receiving a first blood transfusion.
   • B.Develop the care plan for a 79-year-old with new delirium.
   • C.Reinforce established inhaler teaching for a stable 45-year-old with COPD.
   • D.Perform the admission assessment of a 61-year-old with chest pain.

   Rationale: Reinforcing an established teaching plan for a stable client is generally appropriate for an LPN/VN. Initial assessment of chest pain and care planning for new delirium require RN assessment and judgment. Evaluating the initial response to a first transfusion also requires the RN; delegate predictable care within applicable scope and policy.

3. 3.On a rehabilitation unit, a 68-year-old recovering from hip replacement is stable and has an established mobility plan. Which tasks may the RN delegate to trained assistive personnel? Select all that apply.

   • A.Teach hip precautions before the first transfer.
   • B.Obtain scheduled vital signs and report values outside specified parameters.
   • C.Determine whether new calf pain indicates a complication.
   • D.Assist with ambulation using the prescribed walker.
   • E.Measure and document oral intake.

   Rationale: Assisting with established ambulation, measuring intake, and collecting scheduled vital signs are routine tasks that trained assistive personnel can perform. Interpreting new calf pain requires nursing assessment, and initial hip-precaution teaching requires a licensed nurse. Delegation includes clear reporting instructions and RN follow-up.

4. 4.Before surgery in an ambulatory center, a 46-year-old scheduled for hernia repair says, 'I signed the form, but I still do not understand the risks.' No sedative has been given. What should the RN do?

   • A.Pause preparation and notify the surgeon to clarify the procedure and risks.
   • B.Ask the spouse to confirm the client's consent.
   • C.Proceed because a signed consent form is present.
   • D.Explain all surgical risks and obtain a new signature.

   Answer and rationale are in the full material.

5. 5.In the emergency department, a 34-year-old with appendicitis refuses surgery because of concerns about missing work. The client is alert, understands the risk of rupture, and has stable vital signs. Which response is appropriate?

   • A.Explain that emergency admission removes the right to refuse.
   • B.Respect the refusal, notify the provider, and document the discussion.
   • C.Request a family member's permission to proceed.
   • D.Administer a sedative before discussing surgery again.

   Answer and rationale are in the full material.