PASS 2026 HESI RN EXIT EXAM, NGN
NURSING QUESTIONS | 2026 HESI NURSING
EXIT EXAM QUESTIONS WITH RATIONALES
140 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
PASS 2026 HESI RN EXIT EXAM, NGN NURSING QUESTIONS | 2026 HESI NURSING EXIT EXAM
QUESTIONS WITH RATIONALES. It contains 140 carefully selected questions that reflect the most current exam
content and testing strategies. Each question is accompanied by a correct answer and a detailed rationale that
explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 140 Questions
Foundations - Application - PASS 2026 HESI RN EXIT NGN Nursing 2026 HESI Nursing EXIT WITH
Rationales Nursing HESI RN EXIT / NEXT Generation Nclex Undergraduate YEAR 4 / Pre-licensure BSN
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Management OF CARE 1-24 Finding, Indicates, Prescribed, Failure, Heart
Safety AND Infection Control 25-48 Intervention, Prescribed, Finding, Indicates, Reviews
Health Promotion AND 49-72 Appropriate, Pressure, Likely, Intervention, Receiving
Maintenance
Psychosocial Integrity 73-96 Finding, Immediate, Medication, Intervention, Acute
Basic CARE AND Comfort 97-120 Finding, Intervention, Appropriate, Indicates, Immediate
Pharmacological Therapies 121-140 Finding, Laboratory, Receiving, Indicates, Prescribed
TOTAL 140 All questions include answers and detailed rationales
,Section A - Management OF CARE
Q1.
A patient with heart failure is receiving digoxin and furosemide. The nurse notes a serum
potassium level of 3.0 mEq/L and a digoxin level of 1.8 ng/mL. Which electrocardiogram
(ECG) change is most indicative of digoxin toxicity in this setting?
A. Peaked T waves B. Prolonged PR interval
C. ST-segment depression with 'scooping' D. Ventricular bigeminy
Correct: D - Ventricular bigeminy
Rationale:Hypokalemia potentiates digoxin toxicity, and ventricular dysrhythmias such as
bigeminy are classic signs of digoxin toxicity. ST-segment 'scooping' is a digoxin effect but not
toxicity; peaked T waves suggest hyperkalemia; prolonged PR is a digoxin effect, not
necessarily toxicity.
Why the other answers are wrong:
A. Peaked T waves are associated with hyperkalemia, not digoxin toxicity.
B. Prolonged PR interval is a common digoxin effect but not the most indicative of toxicity.
C. ST-segment scooping is a therapeutic effect of digoxin, not a sign of toxicity.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th ed., Ch. 34, 47.
Q2.
A patient with sepsis is prescribed norepinephrine and hydrocortisone. Which finding
indicates that the prescribed therapies are achieving the desired physiological effect?
A. Mean arterial pressure (MAP) of 70 mm B. Serum lactate decreasing from 4 mmol/L
Hg and blood glucose of 150 mg/dL to 2 mmol/L and urine output of 0.7 mL/kg/hr
C. Central venous pressure (CVP) of 12 mm D. PaO2 of 90 mm Hg and oxygen
Hg and heart rate of 110 beats/min saturation of 95% on room air
Correct: B - Serum lactate decreasing from 4 mmol/L to 2 mmol/L and urine output of 0.7
mL/kg/hr
Rationale:In sepsis, the goal is to restore tissue perfusion; decreasing lactate and adequate
urine output indicate improved perfusion. Norepinephrine increases MAP, and hydrocortisone
may help hemodynamic stability; however, the desired effect is end-organ perfusion, not just
blood pressure. Hyperglycemia is a side effect of steroids, not a therapeutic goal.
Why the other answers are wrong:
A. MAP 70 mm Hg may be adequate but blood glucose of 150 mg/dL is a side effect of
steroids, not a therapeutic goal.
C. CVP of 12 mm Hg and tachycardia may indicate fluid overload or persistent stress, not
Page 3
, Section A - Management OF CARE
necessarily therapeutic success.
D. PaO2 and oxygen saturation reflect oxygenation, not the direct effect of these vasoactive and steroid therapies.
Reference: Urden, L.D., et al. (2026). Critical Care Nursing, 10th ed., Ch. 19.
Q3.
The nurse is assessing a postpartum patient who had a vaginal delivery 6 hours ago.
Which assessment finding indicates a potential complication that requires immediate
intervention?
A. Fundus at the level of the umbilicus, B. Perineal pad saturated with lochia rubra
midline, and firm in 30 minutes
C. Temperature of 99.8°F (37.7°C), pulse 88 D. Afterpains that intensify during
beats/min, respirations 16/min breastfeeding
Correct: B - Perineal pad saturated with lochia rubra in 30 minutes
Rationale:A saturated perineal pad in 30 minutes suggests excessive bleeding, potentially
indicating uterine atony or retained products, requiring immediate intervention. The other
findings are normal postpartum: fundus at umbilicus, low-grade temperature, and afterpains
are expected.
Why the other answers are wrong:
A. Fundus at the umbilicus, midline, and firm is a normal finding after delivery.
C. A temperature of 99.8°F and pulse of 88 are within normal limits in the early postpartum
period.
D. Afterpains are common and may intensify with breastfeeding due to oxytocin release.
Reference: Perry, S.E., et al. (2026). Maternal Child Nursing Care, 7th ed., Ch. 23.
Q4.
A patient with type 2 diabetes is prescribed metformin and liraglutide. The patient reports
persistent nausea and vomiting. Which laboratory value is most important for the nurse to
review?
A. Hemoglobin A1c B. Serum creatinine
C. Serum sodium D. Blood urea nitrogen (BUN)
Correct: B - Serum creatinine
Rationale:Persistent vomiting can lead to dehydration and acute kidney injury, which is a risk
factor for metformin-associated lactic acidosis. Serum creatinine is the most important value
to assess renal function before continuing metformin. Liraglutide also can cause nausea, but
the critical concern is renal status.
Why the other answers are wrong:
A. Hemoglobin A1c reflects long-term glucose control, not acute complications.
Page 4
NURSING QUESTIONS | 2026 HESI NURSING
EXIT EXAM QUESTIONS WITH RATIONALES
140 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
PASS 2026 HESI RN EXIT EXAM, NGN NURSING QUESTIONS | 2026 HESI NURSING EXIT EXAM
QUESTIONS WITH RATIONALES. It contains 140 carefully selected questions that reflect the most current exam
content and testing strategies. Each question is accompanied by a correct answer and a detailed rationale that
explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 140 Questions
Foundations - Application - PASS 2026 HESI RN EXIT NGN Nursing 2026 HESI Nursing EXIT WITH
Rationales Nursing HESI RN EXIT / NEXT Generation Nclex Undergraduate YEAR 4 / Pre-licensure BSN
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Management OF CARE 1-24 Finding, Indicates, Prescribed, Failure, Heart
Safety AND Infection Control 25-48 Intervention, Prescribed, Finding, Indicates, Reviews
Health Promotion AND 49-72 Appropriate, Pressure, Likely, Intervention, Receiving
Maintenance
Psychosocial Integrity 73-96 Finding, Immediate, Medication, Intervention, Acute
Basic CARE AND Comfort 97-120 Finding, Intervention, Appropriate, Indicates, Immediate
Pharmacological Therapies 121-140 Finding, Laboratory, Receiving, Indicates, Prescribed
TOTAL 140 All questions include answers and detailed rationales
,Section A - Management OF CARE
Q1.
A patient with heart failure is receiving digoxin and furosemide. The nurse notes a serum
potassium level of 3.0 mEq/L and a digoxin level of 1.8 ng/mL. Which electrocardiogram
(ECG) change is most indicative of digoxin toxicity in this setting?
A. Peaked T waves B. Prolonged PR interval
C. ST-segment depression with 'scooping' D. Ventricular bigeminy
Correct: D - Ventricular bigeminy
Rationale:Hypokalemia potentiates digoxin toxicity, and ventricular dysrhythmias such as
bigeminy are classic signs of digoxin toxicity. ST-segment 'scooping' is a digoxin effect but not
toxicity; peaked T waves suggest hyperkalemia; prolonged PR is a digoxin effect, not
necessarily toxicity.
Why the other answers are wrong:
A. Peaked T waves are associated with hyperkalemia, not digoxin toxicity.
B. Prolonged PR interval is a common digoxin effect but not the most indicative of toxicity.
C. ST-segment scooping is a therapeutic effect of digoxin, not a sign of toxicity.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th ed., Ch. 34, 47.
Q2.
A patient with sepsis is prescribed norepinephrine and hydrocortisone. Which finding
indicates that the prescribed therapies are achieving the desired physiological effect?
A. Mean arterial pressure (MAP) of 70 mm B. Serum lactate decreasing from 4 mmol/L
Hg and blood glucose of 150 mg/dL to 2 mmol/L and urine output of 0.7 mL/kg/hr
C. Central venous pressure (CVP) of 12 mm D. PaO2 of 90 mm Hg and oxygen
Hg and heart rate of 110 beats/min saturation of 95% on room air
Correct: B - Serum lactate decreasing from 4 mmol/L to 2 mmol/L and urine output of 0.7
mL/kg/hr
Rationale:In sepsis, the goal is to restore tissue perfusion; decreasing lactate and adequate
urine output indicate improved perfusion. Norepinephrine increases MAP, and hydrocortisone
may help hemodynamic stability; however, the desired effect is end-organ perfusion, not just
blood pressure. Hyperglycemia is a side effect of steroids, not a therapeutic goal.
Why the other answers are wrong:
A. MAP 70 mm Hg may be adequate but blood glucose of 150 mg/dL is a side effect of
steroids, not a therapeutic goal.
C. CVP of 12 mm Hg and tachycardia may indicate fluid overload or persistent stress, not
Page 3
, Section A - Management OF CARE
necessarily therapeutic success.
D. PaO2 and oxygen saturation reflect oxygenation, not the direct effect of these vasoactive and steroid therapies.
Reference: Urden, L.D., et al. (2026). Critical Care Nursing, 10th ed., Ch. 19.
Q3.
The nurse is assessing a postpartum patient who had a vaginal delivery 6 hours ago.
Which assessment finding indicates a potential complication that requires immediate
intervention?
A. Fundus at the level of the umbilicus, B. Perineal pad saturated with lochia rubra
midline, and firm in 30 minutes
C. Temperature of 99.8°F (37.7°C), pulse 88 D. Afterpains that intensify during
beats/min, respirations 16/min breastfeeding
Correct: B - Perineal pad saturated with lochia rubra in 30 minutes
Rationale:A saturated perineal pad in 30 minutes suggests excessive bleeding, potentially
indicating uterine atony or retained products, requiring immediate intervention. The other
findings are normal postpartum: fundus at umbilicus, low-grade temperature, and afterpains
are expected.
Why the other answers are wrong:
A. Fundus at the umbilicus, midline, and firm is a normal finding after delivery.
C. A temperature of 99.8°F and pulse of 88 are within normal limits in the early postpartum
period.
D. Afterpains are common and may intensify with breastfeeding due to oxytocin release.
Reference: Perry, S.E., et al. (2026). Maternal Child Nursing Care, 7th ed., Ch. 23.
Q4.
A patient with type 2 diabetes is prescribed metformin and liraglutide. The patient reports
persistent nausea and vomiting. Which laboratory value is most important for the nurse to
review?
A. Hemoglobin A1c B. Serum creatinine
C. Serum sodium D. Blood urea nitrogen (BUN)
Correct: B - Serum creatinine
Rationale:Persistent vomiting can lead to dehydration and acute kidney injury, which is a risk
factor for metformin-associated lactic acidosis. Serum creatinine is the most important value
to assess renal function before continuing metformin. Liraglutide also can cause nausea, but
the critical concern is renal status.
Why the other answers are wrong:
A. Hemoglobin A1c reflects long-term glucose control, not acute complications.
Page 4
