HESI PN EXIT NGN – COMPLETE PRACTICE EXAM
(QUESTIONS 1–200)
QUESTIONS 1–50
1. A client with heart failure is prescribed furosemide. Which laboratory value
requires the nurse to notify the healthcare provider?
A) Sodium 138 mEq/L
B) Potassium 3.1 mEq/L
C) Calcium 9.2 mg/dL
D) Magnesium 2.0 mEq/L
Answer: B (Furosemide causes potassium wasting; hypokalemia < 3.5 requires
notification.)
2. A client with diabetes mellitus type 2 has a blood glucose of 58 mg/dL and is
confused. Which action should the nurse take FIRST?
A) Administer 50% dextrose IV push
B) Give 15 g of oral glucose gel
C) Check blood glucose again
D) Call the healthcare provider
Answer: A (The client is confused/unable to swallow safely, so IV dextrose is indicated.)
3. NGN Bow-Tie Question: A client is admitted with acute pancreatitis. Place the
following interventions in the correct order of priority.
1. Administer IV fluids
, 2. Insert NG tube
3. Assess pain level
4. Obtain serum amylase/lipase
Answers:
• First: Assess pain level
• Second: Obtain serum amylase/lipase
• Third: Administer IV fluids
• Fourth: Insert NG tube
(Airway/Breathing/Circulation and ABCs guide priority.)
4. Which finding in a newborn is MOST indicative of respiratory distress syndrome
(RDS)?
A) Grunting respirations
B) Heart rate of 140 bpm
C) Acrocyanosis
D) Periodic breathing
Answer: A (Grunting is an early sign of RDS; it indicates the infant is trying to maintain
positive end-expiratory pressure.)
5. A client with major depressive disorder is started on phenelzine. Which food
should the nurse instruct the client to AVOID?
A) Broccoli
B) Aged cheese
C) Apples
D) Rice
Answer: B (Phenelzine is an MAOI; aged cheeses contain tyramine, which can cause
hypertensive crisis.)
6. A client is 2 days post-mastectomy. Which statement by the client indicates a
need for further teaching?
A) "I will perform range-of-motion exercises daily."
,B) "I will avoid lifting anything over 5 pounds with that arm."
C) "I can have blood drawn from my left arm now."
D) "I should check my incision site daily for redness."
Answer: C (Blood draws and BP readings should be done on the non-surgical side to
prevent lymphedema.)
7. NGN Matrix Question: A client with pneumonia has the following assessment
findings. Indicate which findings require immediate nursing action.
Finding Action Required (Yes/No)
Temperature 102.4°F (39.1°C) Yes
Oxygen saturation 88% on room air Yes
Productive cough with green sputum Yes
Heart rate 82 bpm No
Respiratory rate 18/min No
8. A client receiving digoxin has a potassium level of 2.8 mEq/L. The nurse should
monitor for which complication?
A) Digoxin toxicity
B) Hyperkalemia
C) Bradycardia
D) Hypertension
Answer: A (Hypokalemia increases the risk of digoxin toxicity.)
, 9. A client with a history of seizures is prescribed phenytoin. Which finding
indicates a therapeutic serum level?
A) 5 mcg/mL
B) 10 mcg/mL
C) 20 mcg/mL
D) 30 mcg/mL
Answer: B (Therapeutic phenytoin level is 10–20 mcg/mL.)
10. A client on warfarin has an INR of 5.5. The nurse should anticipate which
action?
A) Administer vitamin K
B) Increase the warfarin dose
C) Draw a PT/INR in 1 week
D) No action needed
Answer: A (INR > 5.0 requires vitamin K and holding the warfarin per protocol.)
11. A postpartum client reports a heavy gush of blood and a firm, displaced uterus
to the right. The nurse should suspect:
A) Uterine atony
B) Retained placental fragments
C) Bladder distention
D) Uterine inversion
Answer: C (A distended bladder displaces the uterus and can cause heavy bleeding;
have the client void first.)
12. NGN Drag-and-Drop: A client with COPD is ordered oxygen at 2 L/min via nasal
cannula. Place the steps for applying the nasal cannula in correct order.
• Assess oxygen saturation
• Attach cannula to oxygen source
• Adjust flow rate to prescribed setting
• Place prongs in client's nostrils
(QUESTIONS 1–200)
QUESTIONS 1–50
1. A client with heart failure is prescribed furosemide. Which laboratory value
requires the nurse to notify the healthcare provider?
A) Sodium 138 mEq/L
B) Potassium 3.1 mEq/L
C) Calcium 9.2 mg/dL
D) Magnesium 2.0 mEq/L
Answer: B (Furosemide causes potassium wasting; hypokalemia < 3.5 requires
notification.)
2. A client with diabetes mellitus type 2 has a blood glucose of 58 mg/dL and is
confused. Which action should the nurse take FIRST?
A) Administer 50% dextrose IV push
B) Give 15 g of oral glucose gel
C) Check blood glucose again
D) Call the healthcare provider
Answer: A (The client is confused/unable to swallow safely, so IV dextrose is indicated.)
3. NGN Bow-Tie Question: A client is admitted with acute pancreatitis. Place the
following interventions in the correct order of priority.
1. Administer IV fluids
, 2. Insert NG tube
3. Assess pain level
4. Obtain serum amylase/lipase
Answers:
• First: Assess pain level
• Second: Obtain serum amylase/lipase
• Third: Administer IV fluids
• Fourth: Insert NG tube
(Airway/Breathing/Circulation and ABCs guide priority.)
4. Which finding in a newborn is MOST indicative of respiratory distress syndrome
(RDS)?
A) Grunting respirations
B) Heart rate of 140 bpm
C) Acrocyanosis
D) Periodic breathing
Answer: A (Grunting is an early sign of RDS; it indicates the infant is trying to maintain
positive end-expiratory pressure.)
5. A client with major depressive disorder is started on phenelzine. Which food
should the nurse instruct the client to AVOID?
A) Broccoli
B) Aged cheese
C) Apples
D) Rice
Answer: B (Phenelzine is an MAOI; aged cheeses contain tyramine, which can cause
hypertensive crisis.)
6. A client is 2 days post-mastectomy. Which statement by the client indicates a
need for further teaching?
A) "I will perform range-of-motion exercises daily."
,B) "I will avoid lifting anything over 5 pounds with that arm."
C) "I can have blood drawn from my left arm now."
D) "I should check my incision site daily for redness."
Answer: C (Blood draws and BP readings should be done on the non-surgical side to
prevent lymphedema.)
7. NGN Matrix Question: A client with pneumonia has the following assessment
findings. Indicate which findings require immediate nursing action.
Finding Action Required (Yes/No)
Temperature 102.4°F (39.1°C) Yes
Oxygen saturation 88% on room air Yes
Productive cough with green sputum Yes
Heart rate 82 bpm No
Respiratory rate 18/min No
8. A client receiving digoxin has a potassium level of 2.8 mEq/L. The nurse should
monitor for which complication?
A) Digoxin toxicity
B) Hyperkalemia
C) Bradycardia
D) Hypertension
Answer: A (Hypokalemia increases the risk of digoxin toxicity.)
, 9. A client with a history of seizures is prescribed phenytoin. Which finding
indicates a therapeutic serum level?
A) 5 mcg/mL
B) 10 mcg/mL
C) 20 mcg/mL
D) 30 mcg/mL
Answer: B (Therapeutic phenytoin level is 10–20 mcg/mL.)
10. A client on warfarin has an INR of 5.5. The nurse should anticipate which
action?
A) Administer vitamin K
B) Increase the warfarin dose
C) Draw a PT/INR in 1 week
D) No action needed
Answer: A (INR > 5.0 requires vitamin K and holding the warfarin per protocol.)
11. A postpartum client reports a heavy gush of blood and a firm, displaced uterus
to the right. The nurse should suspect:
A) Uterine atony
B) Retained placental fragments
C) Bladder distention
D) Uterine inversion
Answer: C (A distended bladder displaces the uterus and can cause heavy bleeding;
have the client void first.)
12. NGN Drag-and-Drop: A client with COPD is ordered oxygen at 2 L/min via nasal
cannula. Place the steps for applying the nasal cannula in correct order.
• Assess oxygen saturation
• Attach cannula to oxygen source
• Adjust flow rate to prescribed setting
• Place prongs in client's nostrils
