2026 RN HESI EXIT EXAM V6
2026 RN HESI Exit Exam V6 — Complete 200-
Question Next Generation NCLEX (NGN) Style
Practice Examination with Verified, Rationalized
Answers and Detailed Clinical Judgment Case
Studies for Comprehensive Registered Nurse
Certification Preparation Graded A+
================================================================================
2026 RN HESI EXIT EXAM V6
COMPLETE 200-QUESTION NEXT GENERATION NCLEX (NGN) STYLE
PRACTICE EXAMINATION WITH VERIFIED
RATIONALIZED ANSWERS AND CLINICAL JUDGMENT
CASE STUDIES FOR COMPREHENSIVE
REGISTERED NURSE CERTIFICATION PREPARATION
================================================================================
EXAM TITLE: 2026 RN HESI Exit Exam V6 — Complete 200-Question Next
Generation NCLEX (NGN) Style Practice Examination with
Verified Rationalized Answers and Clinical Judgment
Case Studies for Comprehensive Registered Nurse
Certification Preparation
DOCUMENT TYPE: Comprehensive Practice Examination / Study Guide
TOTAL QUESTIONS: 200
QUESTION FORMAT: Multiple-Choice, Select-All-That-Apply, True/False,
Case Study, and Scenario-Based NGN Questions
pg. 1
, 2026 RN HESI EXIT EXAM V6
ANSWER FORMAT: Color-Coded with Verified Answers and Detailed Rationales
BLUE = Question
RED = Answer
PURPLE = Rationale
TARGET AUDIENCE: Registered Nurse (RN) Students and Candidates Preparing
for the HESI Exit Exam and NCLEX-RN Licensure
CONTENT AREAS: 1. Medical-Surgical Nursing (Questions 1–50)
2. Maternal-Newborn Nursing (Questions 51–80)
3. Pediatric Nursing (Questions 81–110)
4. Pharmacology (Questions 111–140)
5. Leadership, Delegation & Prioritization (141–150)
6. Community Health and Safety (151–170)
7. NGN Case Studies & Clinical Judgment (171–200)
VERSION: 2026 Edition — V6
LANGUAGE: English
PURPOSE: Exam Preparation, Knowledge Assessment, Clinical
Judgment Development, and Certification Readiness
================================================================================
EXAMINATION BEGINS
================================================================================
pg. 2
, 2026 RN HESI EXIT EXAM V6
2026 RN HESI Exit Exam V6 — Comprehensive Practice Examination
Next Generation NCLEX (NGN) Style with Verified Rationalized Answers
SECTION 1: MEDICAL-SURGICAL NURSING (Questions 1-50)
QUESTION 1:
A client is admitted with low T3 and T4 levels and an elevated TSH level. On initial assessment, the
nurse would anticipate which finding?
A. Heat intolerance
B. Diarrhea
C. Lethargy
D. Skin eruptions
ANSWER:
C. Lethargy
RATIONALE:
Low T3/T4 with elevated TSH suggests primary hypothyroidism. Hallmarks of hypothyroidism include
fatigue, lethargy, cold intolerance, and weight gain. Heat intolerance and diarrhea align more with
hyperthyroidism, not hypothyroidism. Skin eruptions are not typically associated with thyroid
dysfunction. The elevated TSH indicates the pituitary is attempting to stimulate the thyroid, which is
not producing adequate hormone—confirming primary hypothyroidism.
QUESTION 2:
The nurse is providing instructions for a client with pneumonia. Which teaching is most important?
A. "Take at least 2 weeks off from work."
B. "You will need another chest x-ray in 6 weeks."
C. "Take your temperature every day."
D. "Complete all of the antibiotic even if your symptoms decrease."
ANSWER:
D. "Complete all of the antibiotic even if your symptoms decrease."
RATIONALE:
Finishing the full antibiotic course ensures eradication of the pathogen and prevents resistance.
Stopping antibiotics prematurely can lead to relapse and development of antibiotic-resistant
organisms. While follow-up x-rays and temperature monitoring are important, completing the
prescribed antibiotic regimen is the priority teaching point for pneumonia management.
pg. 3
, 2026 RN HESI EXIT EXAM V6
QUESTION 3:
While caring for a toddler with croup, which initial sign of croup requires the nurse's immediate
attention?
A. Respiratory rate of 42
B. Lethargy for the past hour
C. Apical pulse of 54
D. Coughing up copious secretions
ANSWER:
A. Respiratory rate of 42
RATIONALE:
In croup, a significantly elevated respiratory rate may signal increased respiratory distress. While
lethargy and bradycardia are also concerning, tachypnea is often an early hallmark of worsening
airway compromise. A respiratory rate of 42 in a toddler exceeds normal parameters (typically 20-30
for toddlers) and indicates respiratory distress requiring immediate intervention.
QUESTION 4:
A client 2 hours after a total hip arthroplasty reports sudden shortness of breath and chest pain.
Vital signs: HR 122, RR 28, BP 100/70, SpO₂ 88% on 2L nasal cannula. Which action should the nurse
take first?
A. Recheck the SpO₂ in 15 minutes
B. Administer PRN morphine for pain
C. Apply oxygen at 4L via non-rebreather and notify the provider
D. Encourage deep breathing and coughing
ANSWER:
C. Apply oxygen at 4L via non-rebreather and notify the provider
RATIONALE:
This client is demonstrating signs of a pulmonary embolism (PE), a life-threatening complication
following hip arthroplasty. Sudden shortness of breath, chest pain, tachycardia, tachypnea, and
hypoxemia are classic signs. The priority is immediate oxygenation with high-flow oxygen and
provider notification. Rechecking SpO₂ delays treatment. Morphine may mask symptoms. Deep
breathing exercises are insufficient for this emergency.
QUESTION 5:
A client with chronic kidney disease (CKD) has a potassium level of 6.9 mEq/L. Which ECG finding
should the nurse anticipate?
A. Appearance of U waves
B. ST segment elevation
C. Prolonged PR interval
D. Peaked T waves
pg. 4
2026 RN HESI Exit Exam V6 — Complete 200-
Question Next Generation NCLEX (NGN) Style
Practice Examination with Verified, Rationalized
Answers and Detailed Clinical Judgment Case
Studies for Comprehensive Registered Nurse
Certification Preparation Graded A+
================================================================================
2026 RN HESI EXIT EXAM V6
COMPLETE 200-QUESTION NEXT GENERATION NCLEX (NGN) STYLE
PRACTICE EXAMINATION WITH VERIFIED
RATIONALIZED ANSWERS AND CLINICAL JUDGMENT
CASE STUDIES FOR COMPREHENSIVE
REGISTERED NURSE CERTIFICATION PREPARATION
================================================================================
EXAM TITLE: 2026 RN HESI Exit Exam V6 — Complete 200-Question Next
Generation NCLEX (NGN) Style Practice Examination with
Verified Rationalized Answers and Clinical Judgment
Case Studies for Comprehensive Registered Nurse
Certification Preparation
DOCUMENT TYPE: Comprehensive Practice Examination / Study Guide
TOTAL QUESTIONS: 200
QUESTION FORMAT: Multiple-Choice, Select-All-That-Apply, True/False,
Case Study, and Scenario-Based NGN Questions
pg. 1
, 2026 RN HESI EXIT EXAM V6
ANSWER FORMAT: Color-Coded with Verified Answers and Detailed Rationales
BLUE = Question
RED = Answer
PURPLE = Rationale
TARGET AUDIENCE: Registered Nurse (RN) Students and Candidates Preparing
for the HESI Exit Exam and NCLEX-RN Licensure
CONTENT AREAS: 1. Medical-Surgical Nursing (Questions 1–50)
2. Maternal-Newborn Nursing (Questions 51–80)
3. Pediatric Nursing (Questions 81–110)
4. Pharmacology (Questions 111–140)
5. Leadership, Delegation & Prioritization (141–150)
6. Community Health and Safety (151–170)
7. NGN Case Studies & Clinical Judgment (171–200)
VERSION: 2026 Edition — V6
LANGUAGE: English
PURPOSE: Exam Preparation, Knowledge Assessment, Clinical
Judgment Development, and Certification Readiness
================================================================================
EXAMINATION BEGINS
================================================================================
pg. 2
, 2026 RN HESI EXIT EXAM V6
2026 RN HESI Exit Exam V6 — Comprehensive Practice Examination
Next Generation NCLEX (NGN) Style with Verified Rationalized Answers
SECTION 1: MEDICAL-SURGICAL NURSING (Questions 1-50)
QUESTION 1:
A client is admitted with low T3 and T4 levels and an elevated TSH level. On initial assessment, the
nurse would anticipate which finding?
A. Heat intolerance
B. Diarrhea
C. Lethargy
D. Skin eruptions
ANSWER:
C. Lethargy
RATIONALE:
Low T3/T4 with elevated TSH suggests primary hypothyroidism. Hallmarks of hypothyroidism include
fatigue, lethargy, cold intolerance, and weight gain. Heat intolerance and diarrhea align more with
hyperthyroidism, not hypothyroidism. Skin eruptions are not typically associated with thyroid
dysfunction. The elevated TSH indicates the pituitary is attempting to stimulate the thyroid, which is
not producing adequate hormone—confirming primary hypothyroidism.
QUESTION 2:
The nurse is providing instructions for a client with pneumonia. Which teaching is most important?
A. "Take at least 2 weeks off from work."
B. "You will need another chest x-ray in 6 weeks."
C. "Take your temperature every day."
D. "Complete all of the antibiotic even if your symptoms decrease."
ANSWER:
D. "Complete all of the antibiotic even if your symptoms decrease."
RATIONALE:
Finishing the full antibiotic course ensures eradication of the pathogen and prevents resistance.
Stopping antibiotics prematurely can lead to relapse and development of antibiotic-resistant
organisms. While follow-up x-rays and temperature monitoring are important, completing the
prescribed antibiotic regimen is the priority teaching point for pneumonia management.
pg. 3
, 2026 RN HESI EXIT EXAM V6
QUESTION 3:
While caring for a toddler with croup, which initial sign of croup requires the nurse's immediate
attention?
A. Respiratory rate of 42
B. Lethargy for the past hour
C. Apical pulse of 54
D. Coughing up copious secretions
ANSWER:
A. Respiratory rate of 42
RATIONALE:
In croup, a significantly elevated respiratory rate may signal increased respiratory distress. While
lethargy and bradycardia are also concerning, tachypnea is often an early hallmark of worsening
airway compromise. A respiratory rate of 42 in a toddler exceeds normal parameters (typically 20-30
for toddlers) and indicates respiratory distress requiring immediate intervention.
QUESTION 4:
A client 2 hours after a total hip arthroplasty reports sudden shortness of breath and chest pain.
Vital signs: HR 122, RR 28, BP 100/70, SpO₂ 88% on 2L nasal cannula. Which action should the nurse
take first?
A. Recheck the SpO₂ in 15 minutes
B. Administer PRN morphine for pain
C. Apply oxygen at 4L via non-rebreather and notify the provider
D. Encourage deep breathing and coughing
ANSWER:
C. Apply oxygen at 4L via non-rebreather and notify the provider
RATIONALE:
This client is demonstrating signs of a pulmonary embolism (PE), a life-threatening complication
following hip arthroplasty. Sudden shortness of breath, chest pain, tachycardia, tachypnea, and
hypoxemia are classic signs. The priority is immediate oxygenation with high-flow oxygen and
provider notification. Rechecking SpO₂ delays treatment. Morphine may mask symptoms. Deep
breathing exercises are insufficient for this emergency.
QUESTION 5:
A client with chronic kidney disease (CKD) has a potassium level of 6.9 mEq/L. Which ECG finding
should the nurse anticipate?
A. Appearance of U waves
B. ST segment elevation
C. Prolonged PR interval
D. Peaked T waves
pg. 4
