NGN HESI LEADERSHIP AND MANAGEMENT
EXAM FINAL PAPER 2026 TEST PAPER
QUESTIONS AND SOLUTIONS GRADED A+
◉ The nurse is reviewing the diagnostic tests prescribed for a client
with a positive skin test. Which subjective findings reported by the
client supports the diagnosis of tuberculosis?
A. Barking cough and vomiting
B. Mucopurulent cough and night sweats
C. Dry cough and chest tightness
D. Chronic cough and fatty stools Answer: B. Mucopurulent cough
and night sweats
◉ In assessing a client with type 1 diabetes mellitus, the nurse notes
that the client's respirations have changed from 16 breaths/min
with a normal depth to 32 breaths/min and deep, and the client
become lethargic. Which assessment data should the nurse obtain
next?
A. Temperature
B. Breath sounds
C. Blood glucose
D. White blood cell count Answer: C. Blood glucose
,◉ A nurse receives report on a client who is four hours post-total
abdominal hysterectomy. The previous nurse reports that it was
necessary to change the client's perineal pad hourly and that it is
again saturated. The previous nurse also reports that the client's
urinary output has decreased. Which action should the nurse
implement first?
A. Evaluate the skin turgor
B. Assess for weakness or dizziness
C. Change the perineal pad
D. Measure the urinary output Answer: B. Assess for weakness or
dizziness
◉ The father of a 4-year-old has been battling metastatic lung
cancer for the past 2 years. After discussing the remaining options
with his healthcare provider, the client requests that all treatment
stop and that no heroic measures be taken to save his life. When the
client is transferred to the palliative care unit, which action is most
important for the nurse working on the palliative care unit to take in
facilitating continuity of care?
A. Reassure the client that his child will be allowed to visit
B. Provide the client written information about end-of-life care
C. Obtain a detailed report from the nurse transferring the client
D. Mark the chart with client's request for no heroic measures
Answer: C. Obtain a detailed report from the nurse transferring the
client
,◉ While assessing a client who is admitted with heart failure and
pulmonary edema, the nurse identifies dependent peripheral edema,
an irregular heart rate, and a persistent cough that produces pink
blood-tinged sputum. After initiating continuous telemetry and
positioning the client, which intervention should the nurse
implement?
A. Obtain sputum sample
B. Document degree of edema
C. Initiate hourly urine output measurement
D. Administer intravenous diuretics Answer: A. Obtain sputum
sample
◉ A client who is admitted for primary hypothyroidism has early
signs of myxedema coma. In assessing the client, in which sequence
should the nurse complete these actions? (descending order)
Answer: 1. Observe breathing patterns
2. Assess blood pressure
3. Measure body temperature
4. Palpate for pedal edema
◉ A client with type 2 diabetes mellitus arrives to the clinic
reporting episodes of weakness and palpitations. Which finding
should the nurse identify may indicate an emerging situation?
A. Potassium 3.5 mEq/L
, B. Fingertips feel numb
C. Sodium 135 mEq/L
D. Cervical spine stiffness Answer: B. Fingertips feel numb
◉ An older client is brought to the ED with a sudden onset of
confusion that occurred after experiencing a fall at home. The
client's daughter, who has power of attorney, has brought the client's
prescriptions. Which information should the nurse provide first
when reporting to the healthcare provider using SBAR
communication?
A. currently prescribed medications
B. Client's healthcare power of attorney
C. Increasing confusion of the client
D. Fall at home as reason for admission Answer: C. Increasing
confusion of the client
◉ The nurse identifies an electrolyte imbalance, a weight gain of
4.4lbs (2kg) in 24 hours and an elevated central venous pressure for
a client with full thickness burns. Which intervention should the
nurse implement?
A. Auscultate for irregular heart rate
B. Review arterial blood gases results
C. Measure ankle circumference
EXAM FINAL PAPER 2026 TEST PAPER
QUESTIONS AND SOLUTIONS GRADED A+
◉ The nurse is reviewing the diagnostic tests prescribed for a client
with a positive skin test. Which subjective findings reported by the
client supports the diagnosis of tuberculosis?
A. Barking cough and vomiting
B. Mucopurulent cough and night sweats
C. Dry cough and chest tightness
D. Chronic cough and fatty stools Answer: B. Mucopurulent cough
and night sweats
◉ In assessing a client with type 1 diabetes mellitus, the nurse notes
that the client's respirations have changed from 16 breaths/min
with a normal depth to 32 breaths/min and deep, and the client
become lethargic. Which assessment data should the nurse obtain
next?
A. Temperature
B. Breath sounds
C. Blood glucose
D. White blood cell count Answer: C. Blood glucose
,◉ A nurse receives report on a client who is four hours post-total
abdominal hysterectomy. The previous nurse reports that it was
necessary to change the client's perineal pad hourly and that it is
again saturated. The previous nurse also reports that the client's
urinary output has decreased. Which action should the nurse
implement first?
A. Evaluate the skin turgor
B. Assess for weakness or dizziness
C. Change the perineal pad
D. Measure the urinary output Answer: B. Assess for weakness or
dizziness
◉ The father of a 4-year-old has been battling metastatic lung
cancer for the past 2 years. After discussing the remaining options
with his healthcare provider, the client requests that all treatment
stop and that no heroic measures be taken to save his life. When the
client is transferred to the palliative care unit, which action is most
important for the nurse working on the palliative care unit to take in
facilitating continuity of care?
A. Reassure the client that his child will be allowed to visit
B. Provide the client written information about end-of-life care
C. Obtain a detailed report from the nurse transferring the client
D. Mark the chart with client's request for no heroic measures
Answer: C. Obtain a detailed report from the nurse transferring the
client
,◉ While assessing a client who is admitted with heart failure and
pulmonary edema, the nurse identifies dependent peripheral edema,
an irregular heart rate, and a persistent cough that produces pink
blood-tinged sputum. After initiating continuous telemetry and
positioning the client, which intervention should the nurse
implement?
A. Obtain sputum sample
B. Document degree of edema
C. Initiate hourly urine output measurement
D. Administer intravenous diuretics Answer: A. Obtain sputum
sample
◉ A client who is admitted for primary hypothyroidism has early
signs of myxedema coma. In assessing the client, in which sequence
should the nurse complete these actions? (descending order)
Answer: 1. Observe breathing patterns
2. Assess blood pressure
3. Measure body temperature
4. Palpate for pedal edema
◉ A client with type 2 diabetes mellitus arrives to the clinic
reporting episodes of weakness and palpitations. Which finding
should the nurse identify may indicate an emerging situation?
A. Potassium 3.5 mEq/L
, B. Fingertips feel numb
C. Sodium 135 mEq/L
D. Cervical spine stiffness Answer: B. Fingertips feel numb
◉ An older client is brought to the ED with a sudden onset of
confusion that occurred after experiencing a fall at home. The
client's daughter, who has power of attorney, has brought the client's
prescriptions. Which information should the nurse provide first
when reporting to the healthcare provider using SBAR
communication?
A. currently prescribed medications
B. Client's healthcare power of attorney
C. Increasing confusion of the client
D. Fall at home as reason for admission Answer: C. Increasing
confusion of the client
◉ The nurse identifies an electrolyte imbalance, a weight gain of
4.4lbs (2kg) in 24 hours and an elevated central venous pressure for
a client with full thickness burns. Which intervention should the
nurse implement?
A. Auscultate for irregular heart rate
B. Review arterial blood gases results
C. Measure ankle circumference
