HESI EXIT
V1 EXAM
NCLEX (NGN), Case-based Scenarios,
Actual Qs & Ans to Pass the Exam
THIS.HESI.EXIT.CONSISTS.OF
160.Questions.and.Answers.
Multiple-choice.Style
Select.All.That.Apply.(SATA),.ordering,.fill-in-the-
blank.for.dosage
including.Next.Generation.NCLEX.(NGN).items.
Case-based.Scenarios.
Expert.Rationales.consistent.with.HESI−Elsevier/Evolve.stan
dards.
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QUESTION.1
A.homeless.client.presents.at.a.community.psychiatric.clinic.for.a.scheduled.medication.ad
ministration..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.dose.can.be.verified...
C..Explain.the.dosage.change.is.probably.correct...
D..Instruct.the.client.to.take.the.medication.now.and.verify.later.
Answer:.B..
Expert-
Verified.Explanation:.If.there.is.any.discrepancy.between.the.client’s.report.and.the.prescri
ption,.always.verify.with.the.healthcare.provider.or.medication.record.before.administering
..This.ensures.client.safety.and.avoids.possible.dosing.errors.
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QUESTION.2
You.are.the.charge.nurse.making.assignments.for.one.Practical.Nurse.(PN).and.three.RNs
.on.a.neuro.unit..Which.client.change.in.status.is.best.to.assign.to.the.PN?
A..A.subdural.hematoma.client.whose.BP.changed.from.150/80.to.170/60...
B..A.viral.meningitis.client.whose.temperature.changed.from.101.5°F.to.102°F...
C..A.diabetic.ketoacidosis.client.whose.GCS.changed.from.10.to.7...
D..A.myxedema.client.whose.BP.changed.from.80/50.to.70/40.
,Answer:.B..
Expert-
Verified.Explanation:.A.PN.can.monitor.a.slight.temperature.increase.in.viral.meningitis..T
he.more.critical.changes.(large.BP.shifts,.significant.drop.in.GCS.from.10.to.7).require.an.R
N’s.advanced.assessment.and.potential.immediate.intervention.
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QUESTION.3
A.pneumonia.client.shows.initial.signs.of.septic.shock.and.multi-
organ.failure..A.sepsis.protocol.is.prescribed..Which.intervention.is.most.important.to.inclu
de?
A..Maintain.strict.intake.and.output...
B..Keep.the.head.of.bed.at.45°...
C..Assess.warmth.of.extremities...
D..Monitor.blood.glucose.level.
Answer:.A..
Expert-
Verified.Explanation:.Strict.I&O.measurement.is.vital.to.gauge.fluid.balance,.renal.perfusio
n,.and.response.to.fluid.resuscitation,.which.are.central.to.sepsis.management.
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QUESTION.4
An.adolescent.admitted.after.writing.a.suicide.note.leaves.a.treatment.team.meeting.in.tea
rs.and.retreats.to.the.room..Which.nursing.intervention.is.best?
A..Let.the.client.rest.quietly...
B..Explore.the.client’s.goals.and.desires.for.treatment...
, C..Ask.the.treatment.team.about.the.client’s.mood...
D..Go.to.the.client’s.room.and.ask.what.happened.
Answer:.D..
Expert-
Verified.Explanation:.Promptly.offering.support.and.exploring.the.client’s.distress.fosters.tr
ust.and.provides.immediate.therapeutic.intervention.for.a.suicidal.adolescent.
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QUESTION.5.(NGN-Style:.Originally.“Select.3.Goals,”.now.multiple.choice)
A.client.with.respiratory.issues:.RR.28,.SpO₂.90%.on.3.L.NC,.thick.sputum,.mild.fever..Whi
ch.of.the.following.goals.is.most.realistic.and.important.in.the.acute.plan.of.care?
A..Achieve.a.2-point.drop.in.pain.rating.within.24.hours...
B..Remain.free.from.skin.breakdown...
C..Maintain.oxygen.saturation.≥94%.with.appropriate.O₂.therapy...
D..Quit.smoking.immediately.before.discharge.
Answer:.C..
Expert-
Verified.Explanation:.For.acute.respiratory.compromise,.stabilizing.oxygen.saturation.is.a.t
op.priority..Other.goals.(pain.relief,.smoking.cessation,.skin.care).are.important.but.not.the.
most.urgent.in.the.short.term.
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QUESTION.6.(NGN-Style:.Oxygen.Administration)
A.new.graduate.nurse.is.teaching.about.simple.face.mask.use.at.8.L/min..Which.teaching.i
ndicates.proper.understanding?
A..“It’s.okay.to.remove.the.mask.1–2.minutes.per.hour.”..
V1 EXAM
NCLEX (NGN), Case-based Scenarios,
Actual Qs & Ans to Pass the Exam
THIS.HESI.EXIT.CONSISTS.OF
160.Questions.and.Answers.
Multiple-choice.Style
Select.All.That.Apply.(SATA),.ordering,.fill-in-the-
blank.for.dosage
including.Next.Generation.NCLEX.(NGN).items.
Case-based.Scenarios.
Expert.Rationales.consistent.with.HESI−Elsevier/Evolve.stan
dards.
,───────────────────────────────────────────────────────
─
QUESTION.1
A.homeless.client.presents.at.a.community.psychiatric.clinic.for.a.scheduled.medication.ad
ministration..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.dose.can.be.verified...
C..Explain.the.dosage.change.is.probably.correct...
D..Instruct.the.client.to.take.the.medication.now.and.verify.later.
Answer:.B..
Expert-
Verified.Explanation:.If.there.is.any.discrepancy.between.the.client’s.report.and.the.prescri
ption,.always.verify.with.the.healthcare.provider.or.medication.record.before.administering
..This.ensures.client.safety.and.avoids.possible.dosing.errors.
───────────────────────────────────────────────────────
─
QUESTION.2
You.are.the.charge.nurse.making.assignments.for.one.Practical.Nurse.(PN).and.three.RNs
.on.a.neuro.unit..Which.client.change.in.status.is.best.to.assign.to.the.PN?
A..A.subdural.hematoma.client.whose.BP.changed.from.150/80.to.170/60...
B..A.viral.meningitis.client.whose.temperature.changed.from.101.5°F.to.102°F...
C..A.diabetic.ketoacidosis.client.whose.GCS.changed.from.10.to.7...
D..A.myxedema.client.whose.BP.changed.from.80/50.to.70/40.
,Answer:.B..
Expert-
Verified.Explanation:.A.PN.can.monitor.a.slight.temperature.increase.in.viral.meningitis..T
he.more.critical.changes.(large.BP.shifts,.significant.drop.in.GCS.from.10.to.7).require.an.R
N’s.advanced.assessment.and.potential.immediate.intervention.
───────────────────────────────────────────────────────
─
QUESTION.3
A.pneumonia.client.shows.initial.signs.of.septic.shock.and.multi-
organ.failure..A.sepsis.protocol.is.prescribed..Which.intervention.is.most.important.to.inclu
de?
A..Maintain.strict.intake.and.output...
B..Keep.the.head.of.bed.at.45°...
C..Assess.warmth.of.extremities...
D..Monitor.blood.glucose.level.
Answer:.A..
Expert-
Verified.Explanation:.Strict.I&O.measurement.is.vital.to.gauge.fluid.balance,.renal.perfusio
n,.and.response.to.fluid.resuscitation,.which.are.central.to.sepsis.management.
───────────────────────────────────────────────────────
─
QUESTION.4
An.adolescent.admitted.after.writing.a.suicide.note.leaves.a.treatment.team.meeting.in.tea
rs.and.retreats.to.the.room..Which.nursing.intervention.is.best?
A..Let.the.client.rest.quietly...
B..Explore.the.client’s.goals.and.desires.for.treatment...
, C..Ask.the.treatment.team.about.the.client’s.mood...
D..Go.to.the.client’s.room.and.ask.what.happened.
Answer:.D..
Expert-
Verified.Explanation:.Promptly.offering.support.and.exploring.the.client’s.distress.fosters.tr
ust.and.provides.immediate.therapeutic.intervention.for.a.suicidal.adolescent.
───────────────────────────────────────────────────────
─
QUESTION.5.(NGN-Style:.Originally.“Select.3.Goals,”.now.multiple.choice)
A.client.with.respiratory.issues:.RR.28,.SpO₂.90%.on.3.L.NC,.thick.sputum,.mild.fever..Whi
ch.of.the.following.goals.is.most.realistic.and.important.in.the.acute.plan.of.care?
A..Achieve.a.2-point.drop.in.pain.rating.within.24.hours...
B..Remain.free.from.skin.breakdown...
C..Maintain.oxygen.saturation.≥94%.with.appropriate.O₂.therapy...
D..Quit.smoking.immediately.before.discharge.
Answer:.C..
Expert-
Verified.Explanation:.For.acute.respiratory.compromise,.stabilizing.oxygen.saturation.is.a.t
op.priority..Other.goals.(pain.relief,.smoking.cessation,.skin.care).are.important.but.not.the.
most.urgent.in.the.short.term.
───────────────────────────────────────────────────────
─
QUESTION.6.(NGN-Style:.Oxygen.Administration)
A.new.graduate.nurse.is.teaching.about.simple.face.mask.use.at.8.L/min..Which.teaching.i
ndicates.proper.understanding?
A..“It’s.okay.to.remove.the.mask.1–2.minutes.per.hour.”..
