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 standards.
,1. A 35-year-old client with sickle cell crisis is talking on the telephone but stops as the nurse
enters the room to request something for pain. The nurse should:
A) Administer a placebo
B) Encourage increased fluid intake
C) Administer the prescribed analgesia
D) Recommend relaxation exercises for pain control
Answer: C) Administer the prescribed analgesia
Expert-Verified Explanation: Sickle cell crisis causes severe pain; timely administration of
prescribed analgesia is crucial. Other measures (e.g., fluids, relaxation) are helpful but not
sufficient alone for acute pain.
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2. While caring for a toddler with croup, which initial sign of croup requires the nurse's
immediate attention?
A) Respiratory rate of 42
B) Lethargy for the past hour
C) Apical pulse of 54
D) Coughing up copious secretions
Answer: A) Respiratory rate of 42
Expert-Verified Explanation: An elevated respiratory rate may signal respiratory distress.
Immediate recognition and intervention are key to preventing worsening croup.
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,3. A client is admitted with low T3 and T4 levels and an elevated TSH level. On initial
assessment, the nurse would anticipate which of the following findings?
A) Lethargy
B) Heat intolerance
C) Diarrhea
D) Skin eruptions
Answer: A) Lethargy
Expert-Verified Explanation: Low T3/T4 with high TSH indicates hypothyroidism,
commonly presenting with lethargy, fatigue, and cold intolerance.
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4. In planning care for a 6-month-old infant, what must the nurse provide to assist in the
development of trust?
A) Food
B) Warmth
C) Security
D) Comfort
Answer: C) Security
Expert-Verified Explanation: Consistent and reliable caregiving that provides a sense of
security is vital for establishing trust in infancy.
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, 5. A nurse has just received a medication order which is not legible. Which statement best
reflects assertive communication?
A) "I cannot give this medication as it is written. I have no idea of what you mean."
B) "Would you please clarify what you have written so I am sure I am reading it correctly?"
C) "I am having difficulty reading your handwriting. It would save me time if you would be
more careful."
D) "Please print in the future so I do not have to spend extra time attempting to read your
writing."
Answer: B) "Would you please clarify what you have written so I am sure I am reading it
correctly?"
Expert-Verified Explanation: This response is both professional and assertive, focusing on
patient safety and clarifying the order without blame.
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6. What is the most important consideration when teaching parents how to reduce risks in
the home?
A) Age and knowledge level of the parents
B) Proximity to emergency services
C) Number of children in the home
D) Age of children in the home
Answer: D) Age of children in the home
Expert-Verified Explanation: Safety measures should be customized according to the
developmental stage of the child(ren).