HESI RN Exit Exam 2026 – Next Generation
NCLEX (NGN) Case Studies Included:Practice
Questions with Verified Answers and Detailed
Rationales | Herz ing University College of
Nursing
This Photo by Unknown Author is licensed under CC BY-NC
1. A charge nurse is making assignments for one practical nurse (PN) and three
registered nurses (RNs) caring for neurologically compromised clients. Which
client should be assigned to the PN?
A) Client with subdural hematoma whose blood pressure changed from 150/80 to
170/60
B) Client with viral meningitis whose temperature changed from 101°F to 102°F
C) Client with DKA whose GCS score changed from 10 to 7
D) Client with myxedema whose blood pressure changed from 80/50 to 70/40
Correct ,,,answer,,,,: B
Rationale: The PN should be assigned the client with the most stable, predictable
condition. The viral meningitis client with a mild temperature elevation is stable and
,can be managed by a PN. The other options represent acute changes requiring RN
assessment and intervention.
2. A nurse is preparing to delegate tasks to an unlicensed assistive personnel
(UAP). Which task is appropriate to delegate?
A) Assessing a client's pain level
B) Administering oral medications
C) Ambulating a stable client
D) Evaluating the effectiveness of pain medication
Correct ,,,answer,,,,: C
Rationale: Delegation follows the "Five Rights": right task, right circumstance, right
person, right direction/communication, and right supervision. UAP can ambulate
stable clients, assist with ADLs, and obtain vital signs on stable clients.
Assessment, medication administration, and evaluation are the responsibility of the
licensed nurse.
3. The nurse is caring for four clients. Which client should be seen first?
A) Client with temperature of 100.8°F and productive cough
B) Client with O₂ saturation of 85% on room air
C) Client requesting pain medication rated 7/10
D) Client with blood glucose of 180 mg/dL
Correct ,,,answer,,,,: B
,Rationale: Hypoxemia (O₂ sat 85%) is life-threatening and must be addressed
immediately. Prioritization follows the ABCs (Airway, Breathing, Circulation). Pain,
fever, and elevated glucose can be addressed after oxygenation is stabilized.
4. A nurse receives a telephone order from a provider for pain medication. What
is the priority action?
A) Implement the order immediately
B) Write the order in the chart and sign "TO"
C) Read the order back to the provider for verification
D) Ask another nurse to listen to the order
Correct ,,,answer,,,,: C
Rationale: The "read back" process is a critical safety measure ensuring accurate
communication of verbal and telephone orders. After writing the order, the nurse
must read it back to the provider to confirm accuracy before implementation.
5. A client is on fall precautions. Which intervention has the highest priority?
A) Keep the bed in the lowest position
B) Place non-slip socks on the client
C) Remove clutter from the room
D) Keep the call light within reach
Correct ,,,answer,,,,: A
, Rationale: While all options reduce fall risk, the lowest bed position most directly
prevents injury if the client falls or attempts to get out of bed unsafely. This is the
most protective intervention.
6. The charge nurse is planning the shift for an RN and a PN. Which client
should be assigned to the RN?
A) 75-year-old with renal calculi requiring urine straining
B) 64-year-old who had a total hip replacement yesterday
C) 30-year-old depressed client who admits to suicidal ideation
D) Adolescent with multiple contusions from a fall 2 days ago
Correct ,,,answer,,,,: C
Rationale: A client with active suicidal ideation requires the RN's assessment
skills, critical thinking, and immediate intervention. This is a complex psychosocial
need requiring RN-level expertise.
7. A client with a platelet count of 20,000/mm³ is post-operative day 2. Which
intervention should the nurse implement?
A) Use an electric razor for shaving
B) Administer IM pain medication
C) Apply warm compresses to IV sites
D) Encourage the client to floss teeth daily
Correct ,,,answer,,,,: A
NCLEX (NGN) Case Studies Included:Practice
Questions with Verified Answers and Detailed
Rationales | Herz ing University College of
Nursing
This Photo by Unknown Author is licensed under CC BY-NC
1. A charge nurse is making assignments for one practical nurse (PN) and three
registered nurses (RNs) caring for neurologically compromised clients. Which
client should be assigned to the PN?
A) Client with subdural hematoma whose blood pressure changed from 150/80 to
170/60
B) Client with viral meningitis whose temperature changed from 101°F to 102°F
C) Client with DKA whose GCS score changed from 10 to 7
D) Client with myxedema whose blood pressure changed from 80/50 to 70/40
Correct ,,,answer,,,,: B
Rationale: The PN should be assigned the client with the most stable, predictable
condition. The viral meningitis client with a mild temperature elevation is stable and
,can be managed by a PN. The other options represent acute changes requiring RN
assessment and intervention.
2. A nurse is preparing to delegate tasks to an unlicensed assistive personnel
(UAP). Which task is appropriate to delegate?
A) Assessing a client's pain level
B) Administering oral medications
C) Ambulating a stable client
D) Evaluating the effectiveness of pain medication
Correct ,,,answer,,,,: C
Rationale: Delegation follows the "Five Rights": right task, right circumstance, right
person, right direction/communication, and right supervision. UAP can ambulate
stable clients, assist with ADLs, and obtain vital signs on stable clients.
Assessment, medication administration, and evaluation are the responsibility of the
licensed nurse.
3. The nurse is caring for four clients. Which client should be seen first?
A) Client with temperature of 100.8°F and productive cough
B) Client with O₂ saturation of 85% on room air
C) Client requesting pain medication rated 7/10
D) Client with blood glucose of 180 mg/dL
Correct ,,,answer,,,,: B
,Rationale: Hypoxemia (O₂ sat 85%) is life-threatening and must be addressed
immediately. Prioritization follows the ABCs (Airway, Breathing, Circulation). Pain,
fever, and elevated glucose can be addressed after oxygenation is stabilized.
4. A nurse receives a telephone order from a provider for pain medication. What
is the priority action?
A) Implement the order immediately
B) Write the order in the chart and sign "TO"
C) Read the order back to the provider for verification
D) Ask another nurse to listen to the order
Correct ,,,answer,,,,: C
Rationale: The "read back" process is a critical safety measure ensuring accurate
communication of verbal and telephone orders. After writing the order, the nurse
must read it back to the provider to confirm accuracy before implementation.
5. A client is on fall precautions. Which intervention has the highest priority?
A) Keep the bed in the lowest position
B) Place non-slip socks on the client
C) Remove clutter from the room
D) Keep the call light within reach
Correct ,,,answer,,,,: A
, Rationale: While all options reduce fall risk, the lowest bed position most directly
prevents injury if the client falls or attempts to get out of bed unsafely. This is the
most protective intervention.
6. The charge nurse is planning the shift for an RN and a PN. Which client
should be assigned to the RN?
A) 75-year-old with renal calculi requiring urine straining
B) 64-year-old who had a total hip replacement yesterday
C) 30-year-old depressed client who admits to suicidal ideation
D) Adolescent with multiple contusions from a fall 2 days ago
Correct ,,,answer,,,,: C
Rationale: A client with active suicidal ideation requires the RN's assessment
skills, critical thinking, and immediate intervention. This is a complex psychosocial
need requiring RN-level expertise.
7. A client with a platelet count of 20,000/mm³ is post-operative day 2. Which
intervention should the nurse implement?
A) Use an electric razor for shaving
B) Administer IM pain medication
C) Apply warm compresses to IV sites
D) Encourage the client to floss teeth daily
Correct ,,,answer,,,,: A
