Pass 2026 HESI RN Exit Exam, NGN Nursing
Questions 2026 HESI Nursing Exit Exam Questions
(10 full Version Exams)
2026 HESI RN EXIT EXAM – NGN PRACTICE QUESTIONS
COMPLETE STUDY GUIDE WITH ANSWERS & RATIONALES
UPDATED 2026/2027 | 10 FULL EXAM VERSIONS
SECTION 1: MEDICAL-SURGICAL NURSING
1. A client presents with a raspy voice, cold intolerance, and fatigue. Labs show
elevated TSH and low T3/T4. The client is admitted to telemetry. Which priority
intervention should the nurse implement?
A) Administer the prescribed levothyroxine
B) Note the client's most recent hemoglobin level
C) Offer additional blankets and warm drinks
D) Assess for the presence of non-pitting edema
Answer: A
1
,Rationale: Elevated TSH with low T3/T4 indicates hypothyroidism. Levothyroxine
replaces the missing thyroid hormone, addressing the root cause of symptoms (cold
intolerance, fatigue). Comfort measures are supportive but do not correct the
fundamental hormonal deficiency [citation:4].
2. While changing a postoperative dressing, the nurse notes purulent drainage. The
wound was previously inflamed and tender but without drainage. Which is the
most important action?
A) Determine if the drainage has an unpleasant odor
B) Cleanse the wound with sterile saline solution
C) Monitor the client's WBC count
D) Obtain a wound culture and sensitivity
Answer: D
Rationale: Identifying the causative organism is essential for targeted antibiotic
therapy. Cleansing is important, but obtaining a culture first ensures accurate
results. Monitoring WBC is also key, but the immediate next step is to culture any
new purulent drainage [citation:4].
3. A client is receiving a blood transfusion. Which assessment finding requires
immediate intervention?
A) Temperature increase of 1°F from baseline
B) Heart rate increase of 10 beats per minute
C) Blood pressure decrease of 5 mmHg
D) Mild itching at the IV site
2
,Answer: A
Rationale: A temperature increase of 1°F (0.5°C) or more during a blood
transfusion may indicate a febrile or hemolytic reaction. This requires immediate
stopping of the transfusion and notification of the provider. Frequent vital signs
(every 15 minutes initially, then every 30 minutes) are essential during transfusion
monitoring [citation:6].
4. The nurse is preparing a client who had a below-the-knee amputation (BKA) for
discharge. Which recommendations should the nurse provide? (Select all that
apply)
A) Avoid range of motion exercises
B) Use a residual limb shrinker
C) Apply alcohol to the stump after bathing
D) Inspect skin for redness
E) Wash the stump with soap and water
Answer: B, D, E
Rationale: A shrinker helps shape the limb for prosthetic use. Inspection helps
detect infection or skin breakdown. Gentle washing helps keep skin clean; alcohol
overdries and irritates the skin. Range of motion exercises are encouraged, not
avoided [citation:6].
5. A client with a diagnosis of schizophrenia sits in the day room and fails to
interact with staff or peers. Which intervention is best for the nurse to implement?
A) Give the client a schedule of planned daily activities
B) Engage the client in a game of cards
3
, C) Encourage the client to have lunch off the unit
D) Complete an assessment of social support
Answer: B
Rationale: Engaging the client in a structured, low-demand activity like a card
game provides social interaction without pressure. Structured daily activities are
important, but direct engagement is more effective for withdrawal [citation:5].
SECTION 2: MATERNAL-NEWBORN NURSING
6. A client arrives to labor and delivery with greenish-brown fluid leaking. Which
action should the nurse take first?
A) Start an IV infusion
B) Administer oxygen via facemask
C) Perform a vaginal exam
D) Begin continuous fetal monitoring
Answer: D
Rationale: Greenish-brown fluid indicates meconium staining, which can signal
fetal distress. Immediate fetal heart rate assessment is priority. Once fetal tracings
are evaluated, steps such as amnioinfusion or oxygen administration may follow
[citation:6].
4
Questions 2026 HESI Nursing Exit Exam Questions
(10 full Version Exams)
2026 HESI RN EXIT EXAM – NGN PRACTICE QUESTIONS
COMPLETE STUDY GUIDE WITH ANSWERS & RATIONALES
UPDATED 2026/2027 | 10 FULL EXAM VERSIONS
SECTION 1: MEDICAL-SURGICAL NURSING
1. A client presents with a raspy voice, cold intolerance, and fatigue. Labs show
elevated TSH and low T3/T4. The client is admitted to telemetry. Which priority
intervention should the nurse implement?
A) Administer the prescribed levothyroxine
B) Note the client's most recent hemoglobin level
C) Offer additional blankets and warm drinks
D) Assess for the presence of non-pitting edema
Answer: A
1
,Rationale: Elevated TSH with low T3/T4 indicates hypothyroidism. Levothyroxine
replaces the missing thyroid hormone, addressing the root cause of symptoms (cold
intolerance, fatigue). Comfort measures are supportive but do not correct the
fundamental hormonal deficiency [citation:4].
2. While changing a postoperative dressing, the nurse notes purulent drainage. The
wound was previously inflamed and tender but without drainage. Which is the
most important action?
A) Determine if the drainage has an unpleasant odor
B) Cleanse the wound with sterile saline solution
C) Monitor the client's WBC count
D) Obtain a wound culture and sensitivity
Answer: D
Rationale: Identifying the causative organism is essential for targeted antibiotic
therapy. Cleansing is important, but obtaining a culture first ensures accurate
results. Monitoring WBC is also key, but the immediate next step is to culture any
new purulent drainage [citation:4].
3. A client is receiving a blood transfusion. Which assessment finding requires
immediate intervention?
A) Temperature increase of 1°F from baseline
B) Heart rate increase of 10 beats per minute
C) Blood pressure decrease of 5 mmHg
D) Mild itching at the IV site
2
,Answer: A
Rationale: A temperature increase of 1°F (0.5°C) or more during a blood
transfusion may indicate a febrile or hemolytic reaction. This requires immediate
stopping of the transfusion and notification of the provider. Frequent vital signs
(every 15 minutes initially, then every 30 minutes) are essential during transfusion
monitoring [citation:6].
4. The nurse is preparing a client who had a below-the-knee amputation (BKA) for
discharge. Which recommendations should the nurse provide? (Select all that
apply)
A) Avoid range of motion exercises
B) Use a residual limb shrinker
C) Apply alcohol to the stump after bathing
D) Inspect skin for redness
E) Wash the stump with soap and water
Answer: B, D, E
Rationale: A shrinker helps shape the limb for prosthetic use. Inspection helps
detect infection or skin breakdown. Gentle washing helps keep skin clean; alcohol
overdries and irritates the skin. Range of motion exercises are encouraged, not
avoided [citation:6].
5. A client with a diagnosis of schizophrenia sits in the day room and fails to
interact with staff or peers. Which intervention is best for the nurse to implement?
A) Give the client a schedule of planned daily activities
B) Engage the client in a game of cards
3
, C) Encourage the client to have lunch off the unit
D) Complete an assessment of social support
Answer: B
Rationale: Engaging the client in a structured, low-demand activity like a card
game provides social interaction without pressure. Structured daily activities are
important, but direct engagement is more effective for withdrawal [citation:5].
SECTION 2: MATERNAL-NEWBORN NURSING
6. A client arrives to labor and delivery with greenish-brown fluid leaking. Which
action should the nurse take first?
A) Start an IV infusion
B) Administer oxygen via facemask
C) Perform a vaginal exam
D) Begin continuous fetal monitoring
Answer: D
Rationale: Greenish-brown fluid indicates meconium staining, which can signal
fetal distress. Immediate fetal heart rate assessment is priority. Once fetal tracings
are evaluated, steps such as amnioinfusion or oxygen administration may follow
[citation:6].
4
