HESI RN Exit Exam 2026 | NGN-Style Questions
& Verified Answers | Complete NCLEX-RN®
Predictor Exam | Evolve Testing
Q001: A 68-year-old client with COPD is receiving oxygen via nasal cannula at 2 L/min.
The client becomes increasingly lethargic and his ABG shows pH 7.32, PaCO2 68
mmHg, PaO2 58 mmHg, HCO3 34 mEq/L. Which action should the nurse take first?
Options:
A. Increase O2 to 4 L/min
B. Obtain a stat chest X-ray
C. Decrease O2 to 1 L/min and notify provider - CORRECT
D. Begin high-flow humidified O2
(Correct Answer: C)
Q002: A client on a medical unit has a serum potassium of 2.8 mEq/L. Which
intervention is most appropriate for the nurse to implement initially?
Options:
A. Start IV potassium chloride 40 mEq over 1 hour
B. Place on cardiac monitor and obtain provider order - CORRECT
C. Encourage bananas at next meal
D. Administer oral potassium 20 mEq once
Q003: A 28-year-old postpartum client reports sudden onset of chest pain and
shortness of breath. Vital signs: BP 90/60, HR 110, RR 28, O2 sat 89%. Which action
should the nurse take first?
Options:
A. Administer morphine
B. Apply high-flow O2 and call rapid response - CORRECT
C. Encourage incentive spirometry
D. Obtain pain rating
,Q004: A client with heart failure is prescribed digoxin 0.25 mg PO daily. The nurse notes
a new-onset bradycardia of 52 bpm. Which action is most appropriate?
Options:
A. Give digoxin now
B. Hold digoxin and check morning K+ level
C. Hold digoxin and notify provider - CORRECT
D. Administer atropine
Q005: A client with DM type 1 is admitted with DKA. The nurse notes K+ 3.0 mEq/L on
admission. Insulin infusion is started. Which priority intervention should the nurse
implement?
Options:
A. Administer IV potassium - CORRECT
B. Start sodium bicarbonate
C. Restrict fluids
D. Give calcium gluconate
Q006: A client with a chest tube becomes dyspneic and the chest tube bubbling
suddenly stops. Chest assessment reveals absent breath sounds on the affected side.
Which action should the nurse take first?
Options:
A. Milk the chest tube
B. Clamp the chest tube
C. Call provider and prepare for needle decompression - CORRECT
D. Increase wall suction
Q007: A client with a serum Na+ of 128 mEq/L is confused and lethargic. Which nursing
intervention is most appropriate?
Options:
A. Restrict fluids to 1 L/day - CORRECT
B. Administer 3% saline IV push
C. Encourage PO fluids
D. Administer diuretics
,Q008: A client with liver cirrhosis develops increasing ascites and a serum albumin of
2.0 g/dL. Which dietary modification should the nurse recommend?
Options:
A. Low-sodium diet with moderate protein - CORRECT
B. High-sodium diet
C. Low-protein diet
D. Fluid restriction only
Q009: A client with a pulmonary embolism is started on heparin infusion. Which lab
value should the nurse monitor to assess therapeutic effect?
Options:
A. PT/INR
B. aPTT - CORRECT
C. Platelet count
D. D-dimer
Q010: A client with acute pancreatitis reports severe abdominal pain. Which intervention
should the nurse implement first?
Options:
A. Administer morphine IV as ordered - CORRECT
B. Encourage PO fluids
C. Apply heat to abdomen
D. Ambulate patient
Q011: A client with a C6 spinal cord injury develops bradycardia and hypotension.
Which condition should the nurse suspect?
Options:
A. Autonomic dysreflexia
B. Neurogenic shock - CORRECT
C. Septic shock
D. Pulmonary embolism
Q012: A client with glomerulonephritis has a 24-hour urine protein of 4.5 g and serum
albumin of 2.1 g/dL. Which nursing diagnosis is most appropriate?
, Options:
A. Risk for infection
B. Excess fluid volume
C. Imbalanced nutrition: less than body requirements - CORRECT
D. Impaired gas exchange
Q013: A client with bipolar disorder is receiving lithium and reports nausea, tremors,
and diarrhea. Lithium level is 2.0 mEq/L. Which action should the nurse take first?
Options:
A. Encourage PO fluids
B. Hold lithium and notify provider - CORRECT
C. Administer antiemetic
D. Check sodium level
Q014: A client with a traumatic brain injury has a sudden onset of bradycardia and
hypertension. Which emergency condition should the nurse suspect?
Options:
A. Seizure
B. Increased intracranial pressure - CORRECT
C. Hypovolemia
D. Pulmonary embolism
Q015: A client with DM type 2 is scheduled for an MRI with contrast. The client takes
metformin. Which instruction should the nurse provide?
Options:
A. Continue metformin as usual
B. Hold metformin 48 hours post-MRI - CORRECT
C. Switch to insulin
D. Increase fluid intake only
Q016: A client with Crohn’s disease is receiving infliximab. Which lab should be
monitored prior to each infusion?
Options:
A. Hemoglobin A1C
& Verified Answers | Complete NCLEX-RN®
Predictor Exam | Evolve Testing
Q001: A 68-year-old client with COPD is receiving oxygen via nasal cannula at 2 L/min.
The client becomes increasingly lethargic and his ABG shows pH 7.32, PaCO2 68
mmHg, PaO2 58 mmHg, HCO3 34 mEq/L. Which action should the nurse take first?
Options:
A. Increase O2 to 4 L/min
B. Obtain a stat chest X-ray
C. Decrease O2 to 1 L/min and notify provider - CORRECT
D. Begin high-flow humidified O2
(Correct Answer: C)
Q002: A client on a medical unit has a serum potassium of 2.8 mEq/L. Which
intervention is most appropriate for the nurse to implement initially?
Options:
A. Start IV potassium chloride 40 mEq over 1 hour
B. Place on cardiac monitor and obtain provider order - CORRECT
C. Encourage bananas at next meal
D. Administer oral potassium 20 mEq once
Q003: A 28-year-old postpartum client reports sudden onset of chest pain and
shortness of breath. Vital signs: BP 90/60, HR 110, RR 28, O2 sat 89%. Which action
should the nurse take first?
Options:
A. Administer morphine
B. Apply high-flow O2 and call rapid response - CORRECT
C. Encourage incentive spirometry
D. Obtain pain rating
,Q004: A client with heart failure is prescribed digoxin 0.25 mg PO daily. The nurse notes
a new-onset bradycardia of 52 bpm. Which action is most appropriate?
Options:
A. Give digoxin now
B. Hold digoxin and check morning K+ level
C. Hold digoxin and notify provider - CORRECT
D. Administer atropine
Q005: A client with DM type 1 is admitted with DKA. The nurse notes K+ 3.0 mEq/L on
admission. Insulin infusion is started. Which priority intervention should the nurse
implement?
Options:
A. Administer IV potassium - CORRECT
B. Start sodium bicarbonate
C. Restrict fluids
D. Give calcium gluconate
Q006: A client with a chest tube becomes dyspneic and the chest tube bubbling
suddenly stops. Chest assessment reveals absent breath sounds on the affected side.
Which action should the nurse take first?
Options:
A. Milk the chest tube
B. Clamp the chest tube
C. Call provider and prepare for needle decompression - CORRECT
D. Increase wall suction
Q007: A client with a serum Na+ of 128 mEq/L is confused and lethargic. Which nursing
intervention is most appropriate?
Options:
A. Restrict fluids to 1 L/day - CORRECT
B. Administer 3% saline IV push
C. Encourage PO fluids
D. Administer diuretics
,Q008: A client with liver cirrhosis develops increasing ascites and a serum albumin of
2.0 g/dL. Which dietary modification should the nurse recommend?
Options:
A. Low-sodium diet with moderate protein - CORRECT
B. High-sodium diet
C. Low-protein diet
D. Fluid restriction only
Q009: A client with a pulmonary embolism is started on heparin infusion. Which lab
value should the nurse monitor to assess therapeutic effect?
Options:
A. PT/INR
B. aPTT - CORRECT
C. Platelet count
D. D-dimer
Q010: A client with acute pancreatitis reports severe abdominal pain. Which intervention
should the nurse implement first?
Options:
A. Administer morphine IV as ordered - CORRECT
B. Encourage PO fluids
C. Apply heat to abdomen
D. Ambulate patient
Q011: A client with a C6 spinal cord injury develops bradycardia and hypotension.
Which condition should the nurse suspect?
Options:
A. Autonomic dysreflexia
B. Neurogenic shock - CORRECT
C. Septic shock
D. Pulmonary embolism
Q012: A client with glomerulonephritis has a 24-hour urine protein of 4.5 g and serum
albumin of 2.1 g/dL. Which nursing diagnosis is most appropriate?
, Options:
A. Risk for infection
B. Excess fluid volume
C. Imbalanced nutrition: less than body requirements - CORRECT
D. Impaired gas exchange
Q013: A client with bipolar disorder is receiving lithium and reports nausea, tremors,
and diarrhea. Lithium level is 2.0 mEq/L. Which action should the nurse take first?
Options:
A. Encourage PO fluids
B. Hold lithium and notify provider - CORRECT
C. Administer antiemetic
D. Check sodium level
Q014: A client with a traumatic brain injury has a sudden onset of bradycardia and
hypertension. Which emergency condition should the nurse suspect?
Options:
A. Seizure
B. Increased intracranial pressure - CORRECT
C. Hypovolemia
D. Pulmonary embolism
Q015: A client with DM type 2 is scheduled for an MRI with contrast. The client takes
metformin. Which instruction should the nurse provide?
Options:
A. Continue metformin as usual
B. Hold metformin 48 hours post-MRI - CORRECT
C. Switch to insulin
D. Increase fluid intake only
Q016: A client with Crohn’s disease is receiving infliximab. Which lab should be
monitored prior to each infusion?
Options:
A. Hemoglobin A1C
