2025/2026 HESI Exit RN Exam V1-V7 with Next
Generation NCLEX (NGN) by Sandra Upchurch and
Health Education Systems Inc. (Elsevier) - Ultimate
Test Bank with Rationales .
*
*Q1. A 65-year-old patient presents with gradual, painless vision loss
in the left eye over several months. Fundoscopic examination reveals
a cup-to-disc ratio of 0.7 and pallor of the optic disc. What is the
most likely diagnosis?**
A. Glaucoma
B. Optic neuritis
C. Macular degeneration
D. Diabetic retinopathy
**Answer: A. Glaucoma**
*Rationale:* Glaucoma is characterized by progressive optic nerve
damage, often due to increased intraocular pressure. The resulting
optic atrophy leads to characteristic findings of optic disc cupping
(increased cup-to-disc ratio, often >0.5) and disc pallor.
**Q2. A patient presents with acute, severe eye pain, nausea,
vomiting, and halos around lights. The pupil is mid-dilated and non-
reactive. What is the most likely diagnosis?**
A. Conjunctivitis
, B. Acute angle-closure glaucoma
C. Corneal abrasion
D. Uveitis
**Answer: B. Acute angle-closure glaucoma**
*Rationale:* This is an ophthalmologic emergency caused by a
sudden rise in intraocular pressure. The classic presentation includes
severe pain, nausea/vomiting, seeing halos around lights, and a fixed,
mid-dilated pupil.
**Q3. A patient with dizziness undergoes the Dix-Hallpike maneuver.
Nystagmus is elicited after a 5-second latency and fatigues with
repetition. This is most consistent with which condition?**
A. Vestibular neuritis
B. Benign paroxysmal positional vertigo (BPPV)
C. Meniere's disease
D. Central vertigo
**Answer: B. Benign paroxysmal positional vertigo (BPPV)**
*Rationale:* The Dix-Hallpike test is the diagnostic maneuver for
BPPV. A positive test reproduces the patient's vertigo and
nystagmus. The key characteristics of BPPV are a delayed onset of
nystagmus (latency of 5-20 seconds) and fatigability upon repeat
testing.
Generation NCLEX (NGN) by Sandra Upchurch and
Health Education Systems Inc. (Elsevier) - Ultimate
Test Bank with Rationales .
*
*Q1. A 65-year-old patient presents with gradual, painless vision loss
in the left eye over several months. Fundoscopic examination reveals
a cup-to-disc ratio of 0.7 and pallor of the optic disc. What is the
most likely diagnosis?**
A. Glaucoma
B. Optic neuritis
C. Macular degeneration
D. Diabetic retinopathy
**Answer: A. Glaucoma**
*Rationale:* Glaucoma is characterized by progressive optic nerve
damage, often due to increased intraocular pressure. The resulting
optic atrophy leads to characteristic findings of optic disc cupping
(increased cup-to-disc ratio, often >0.5) and disc pallor.
**Q2. A patient presents with acute, severe eye pain, nausea,
vomiting, and halos around lights. The pupil is mid-dilated and non-
reactive. What is the most likely diagnosis?**
A. Conjunctivitis
, B. Acute angle-closure glaucoma
C. Corneal abrasion
D. Uveitis
**Answer: B. Acute angle-closure glaucoma**
*Rationale:* This is an ophthalmologic emergency caused by a
sudden rise in intraocular pressure. The classic presentation includes
severe pain, nausea/vomiting, seeing halos around lights, and a fixed,
mid-dilated pupil.
**Q3. A patient with dizziness undergoes the Dix-Hallpike maneuver.
Nystagmus is elicited after a 5-second latency and fatigues with
repetition. This is most consistent with which condition?**
A. Vestibular neuritis
B. Benign paroxysmal positional vertigo (BPPV)
C. Meniere's disease
D. Central vertigo
**Answer: B. Benign paroxysmal positional vertigo (BPPV)**
*Rationale:* The Dix-Hallpike test is the diagnostic maneuver for
BPPV. A positive test reproduces the patient's vertigo and
nystagmus. The key characteristics of BPPV are a delayed onset of
nystagmus (latency of 5-20 seconds) and fatigability upon repeat
testing.
