HESI RN EXIT EXAM NGN NURSING | LATEST
2026 EXAM QUESTIONS & VERIFIED
ANSWERS (100% ACCURATE SOLUTIONS |
INSTANT PDF DOWNLOAD)
HESI RN EXIT EXAM NGN NURSING | LATEST 2026 EXAM QUESTIONS & VERIFIED
ANSWERS
DOCUMENT OVERVIEW:
• This resource contains high-yield HESI RN EXIT NGN practice questions with
detailed EXPERT RATIONALE to reinforce critical thinking and clinical decision-
making skills needed for success on the actual exam.
• Study these questions by reviewing each scenario, selecting your answer, and
then reading the detailed EXPERT RATIONALE to understand not just what is
correct, but why—building the clinical judgment necessary for nursing practice.
QUESTION 1
A 45-year-old client with hypertension is prescribed lisinopril, an ACE
inhibitor. Which nursing assessment finding would indicate an adverse
reaction to this medication?
A) Increased blood pressure readings
B) Persistent dry cough
C) Decreased blood glucose levels
D) Increased appetite and weight gain
E) Elevated cholesterol levels
✓ CORRECT ANSWER: B) Persistent dry cough
EXPERT RATIONALE: A persistent dry cough is a well-known adverse effect of
ACE inhibitors like lisinopril, occurring in 10-20% of patients. This occurs
because ACE inhibitors block the breakdown of bradykinin, which
accumulates in the lungs and triggers coughing. While increased blood
,pressure would indicate the medication is not working, a dry cough
specifically indicates an adverse reaction. The nurse should report this finding
to the healthcare provider, who may switch the client to an angiotensin II
receptor blocker (ARB) instead. Decreased blood glucose, increased appetite,
and elevated cholesterol are not typical adverse effects of ACE inhibitors.
QUESTION 2
A 28-year-old primigravida client at 32 weeks gestation presents to the clinic
reporting severe headache, visual disturbances, and right upper quadrant
pain. Her blood pressure is 165/110 mmHg. What is the nurse's priority
intervention?
A) Administer acetaminophen for the headache
B) Schedule a routine follow-up appointment in 2 weeks
C) Notify the healthcare provider immediately and prepare for possible admission
D) Encourage the client to rest at home and monitor blood pressure
E) Initiate a 24-hour urine collection for protein
✓ CORRECT ANSWER: C) Notify the healthcare provider immediately and
prepare for possible admission
EXPERT RATIONALE: These clinical findings are classic signs of severe
preeclampsia or HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low
Platelets), which constitute a medical emergency. The combination of
hypertension (165/110), severe headache, visual disturbances, and right upper
quadrant pain indicates end-organ involvement and risk of eclampsia or
placental abruption. The priority is to notify the provider immediately and
prepare for hospital admission where the client can be monitored for seizures
and managed with medications like magnesium sulfate and
antihypertensives. Simply managing pain at home or scheduling a routine
appointment delays critical intervention and places both mother and fetus at
risk.
,QUESTION 3
A client receiving IV heparin for deep vein thrombosis asks the nurse why
they cannot take aspirin while on heparin. Which response by the nurse is
most accurate?
A) "Aspirin and heparin have no significant interaction; you can take them together
safely."
B) "Aspirin increases the anticoagulant effect of heparin, increasing bleeding risk."
C) "Aspirin decreases the effectiveness of heparin, making treatment ineffective."
D) "Aspirin causes heparin to accumulate in your liver and become toxic."
E) "Aspirin interferes with heparin metabolism in the kidneys."
✓ CORRECT ANSWER: B) Aspirin increases the anticoagulant effect of heparin,
increasing bleeding risk
EXPERT RATIONALE: Aspirin and heparin both inhibit platelet function and
coagulation through different mechanisms. When combined, they have a
synergistic effect that significantly increases bleeding risk. While aspirin is
sometimes given concurrently with heparin in specific clinical situations (like
acute coronary syndrome) under careful monitoring, the general teaching is
to avoid NSAIDs including aspirin while on heparin unless specifically
prescribed. The nurse should educate the client to inform all healthcare
providers about heparin use before taking any additional medications.
Heparin does not accumulate in the liver from aspirin interaction, and the
interaction is not primarily about effectiveness loss or kidney metabolism
interference.
QUESTION 4
A 72-year-old client with COPD is admitted with acute exacerbation. ABG
results show: pH 7.30, PaCO2 65 mmHg, HCO3 28 mEq/L, PaO2 55 mmHg.
Which acid-base disturbance is this client experiencing?
, A) Metabolic acidosis with respiratory compensation
B) Respiratory acidosis with metabolic compensation
C) Respiratory alkalosis with metabolic compensation
D) Metabolic alkalosis with respiratory compensation
E) Mixed acidosis (respiratory and metabolic)
✓ CORRECT ANSWER: B) Respiratory acidosis with metabolic compensation
EXPERT RATIONALE: Analysis of this ABG shows: pH is low (7.30, normal 7.35-
7.45) indicating acidemia; PaCO2 is elevated (65, normal 35-45) indicating
respiratory component; HCO3 is slightly elevated (28, normal 22-26) indicating
metabolic compensation attempting to normalize pH. In respiratory acidosis,
the kidneys compensate by retaining bicarbonate (increasing HCO3), which is
evident here. The primary problem is elevated CO2 from COPD preventing
adequate ventilation (respiratory acidosis), and the body is trying to
compensate metabolically by retaining HCO3. The PaO2 of 55 is also
dangerously low, indicating severe hypoxemia requiring oxygen therapy and
possibly mechanical ventilation support.
QUESTION 5
A client is prescribed metformin for type 2 diabetes. When teaching the client
about this medication, which statement by the client indicates understanding
of proper use?
A) "I should take metformin on an empty stomach for best absorption."
B) "I should hold the metformin if I'm having diarrhea."
C) "I need to have my kidney function monitored regularly while taking this
medication."
D) "I can stop taking metformin once my blood sugar is controlled."
E) "I should avoid all fruits and vegetables while taking metformin."
2026 EXAM QUESTIONS & VERIFIED
ANSWERS (100% ACCURATE SOLUTIONS |
INSTANT PDF DOWNLOAD)
HESI RN EXIT EXAM NGN NURSING | LATEST 2026 EXAM QUESTIONS & VERIFIED
ANSWERS
DOCUMENT OVERVIEW:
• This resource contains high-yield HESI RN EXIT NGN practice questions with
detailed EXPERT RATIONALE to reinforce critical thinking and clinical decision-
making skills needed for success on the actual exam.
• Study these questions by reviewing each scenario, selecting your answer, and
then reading the detailed EXPERT RATIONALE to understand not just what is
correct, but why—building the clinical judgment necessary for nursing practice.
QUESTION 1
A 45-year-old client with hypertension is prescribed lisinopril, an ACE
inhibitor. Which nursing assessment finding would indicate an adverse
reaction to this medication?
A) Increased blood pressure readings
B) Persistent dry cough
C) Decreased blood glucose levels
D) Increased appetite and weight gain
E) Elevated cholesterol levels
✓ CORRECT ANSWER: B) Persistent dry cough
EXPERT RATIONALE: A persistent dry cough is a well-known adverse effect of
ACE inhibitors like lisinopril, occurring in 10-20% of patients. This occurs
because ACE inhibitors block the breakdown of bradykinin, which
accumulates in the lungs and triggers coughing. While increased blood
,pressure would indicate the medication is not working, a dry cough
specifically indicates an adverse reaction. The nurse should report this finding
to the healthcare provider, who may switch the client to an angiotensin II
receptor blocker (ARB) instead. Decreased blood glucose, increased appetite,
and elevated cholesterol are not typical adverse effects of ACE inhibitors.
QUESTION 2
A 28-year-old primigravida client at 32 weeks gestation presents to the clinic
reporting severe headache, visual disturbances, and right upper quadrant
pain. Her blood pressure is 165/110 mmHg. What is the nurse's priority
intervention?
A) Administer acetaminophen for the headache
B) Schedule a routine follow-up appointment in 2 weeks
C) Notify the healthcare provider immediately and prepare for possible admission
D) Encourage the client to rest at home and monitor blood pressure
E) Initiate a 24-hour urine collection for protein
✓ CORRECT ANSWER: C) Notify the healthcare provider immediately and
prepare for possible admission
EXPERT RATIONALE: These clinical findings are classic signs of severe
preeclampsia or HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low
Platelets), which constitute a medical emergency. The combination of
hypertension (165/110), severe headache, visual disturbances, and right upper
quadrant pain indicates end-organ involvement and risk of eclampsia or
placental abruption. The priority is to notify the provider immediately and
prepare for hospital admission where the client can be monitored for seizures
and managed with medications like magnesium sulfate and
antihypertensives. Simply managing pain at home or scheduling a routine
appointment delays critical intervention and places both mother and fetus at
risk.
,QUESTION 3
A client receiving IV heparin for deep vein thrombosis asks the nurse why
they cannot take aspirin while on heparin. Which response by the nurse is
most accurate?
A) "Aspirin and heparin have no significant interaction; you can take them together
safely."
B) "Aspirin increases the anticoagulant effect of heparin, increasing bleeding risk."
C) "Aspirin decreases the effectiveness of heparin, making treatment ineffective."
D) "Aspirin causes heparin to accumulate in your liver and become toxic."
E) "Aspirin interferes with heparin metabolism in the kidneys."
✓ CORRECT ANSWER: B) Aspirin increases the anticoagulant effect of heparin,
increasing bleeding risk
EXPERT RATIONALE: Aspirin and heparin both inhibit platelet function and
coagulation through different mechanisms. When combined, they have a
synergistic effect that significantly increases bleeding risk. While aspirin is
sometimes given concurrently with heparin in specific clinical situations (like
acute coronary syndrome) under careful monitoring, the general teaching is
to avoid NSAIDs including aspirin while on heparin unless specifically
prescribed. The nurse should educate the client to inform all healthcare
providers about heparin use before taking any additional medications.
Heparin does not accumulate in the liver from aspirin interaction, and the
interaction is not primarily about effectiveness loss or kidney metabolism
interference.
QUESTION 4
A 72-year-old client with COPD is admitted with acute exacerbation. ABG
results show: pH 7.30, PaCO2 65 mmHg, HCO3 28 mEq/L, PaO2 55 mmHg.
Which acid-base disturbance is this client experiencing?
, A) Metabolic acidosis with respiratory compensation
B) Respiratory acidosis with metabolic compensation
C) Respiratory alkalosis with metabolic compensation
D) Metabolic alkalosis with respiratory compensation
E) Mixed acidosis (respiratory and metabolic)
✓ CORRECT ANSWER: B) Respiratory acidosis with metabolic compensation
EXPERT RATIONALE: Analysis of this ABG shows: pH is low (7.30, normal 7.35-
7.45) indicating acidemia; PaCO2 is elevated (65, normal 35-45) indicating
respiratory component; HCO3 is slightly elevated (28, normal 22-26) indicating
metabolic compensation attempting to normalize pH. In respiratory acidosis,
the kidneys compensate by retaining bicarbonate (increasing HCO3), which is
evident here. The primary problem is elevated CO2 from COPD preventing
adequate ventilation (respiratory acidosis), and the body is trying to
compensate metabolically by retaining HCO3. The PaO2 of 55 is also
dangerously low, indicating severe hypoxemia requiring oxygen therapy and
possibly mechanical ventilation support.
QUESTION 5
A client is prescribed metformin for type 2 diabetes. When teaching the client
about this medication, which statement by the client indicates understanding
of proper use?
A) "I should take metformin on an empty stomach for best absorption."
B) "I should hold the metformin if I'm having diarrhea."
C) "I need to have my kidney function monitored regularly while taking this
medication."
D) "I can stop taking metformin once my blood sugar is controlled."
E) "I should avoid all fruits and vegetables while taking metformin."
