HESI RN EXIT EXAM V4 NGN QUESTIONS
WITH ANSWERS AND EXPLANATIONS
Question 1.
Case scenario: The nurse reviews readiness for discharge after Desmopressin. Which
instruction best supports both prevention and appropriate escalation of care?
A. Follow prescribed fluid guidance and report headache confusion or sudden weight gain.
B. Report difficulty breathing extreme weakness or decreased alertness during therapy.
C. Report new involuntary movements restlessness or rigidity early.
D. Take the medication consistently after coronary stenting unless the cardiology team
changes the plan.
Correct Answer: A. Follow prescribed fluid guidance and report headache
confusion or sudden weight gain.
Explanation: The priority teaching point for Desmopressin is: Follow prescribed fluid
guidance and report headache confusion or sudden weight gain. Medication decisions
require attention to indication, pharmacologic effect, administration safety, adverse
effects, interactions, and appropriate follow-up. The distractor instructions may be useful
in related situations, but they do not target the principal self-management or safety need
described here. Teach-back and follow-up assessment should confirm that the learner can
apply the instruction correctly in the relevant setting.
Question 2.
On an emergency department, the nurse provides education related to Placenta previa.
Which instruction is the priority?
A. Call emergency services immediately for sudden face arm speech or balance changes.
B. Clients with high spinal injuries should know common triggers and carry an emergency
plan.
C. Complete antibiotics and seek care for persistent fever vomiting or worsening flank
pain.
D. Seek urgent evaluation for any late-pregnancy bleeding even when painless.
Correct Answer: D. Seek urgent evaluation for any late-pregnancy bleeding even
when painless.
Explanation: The priority teaching point for Placenta previa is: Seek urgent evaluation for
any late-pregnancy bleeding even when painless. Physiological adaptation priorities
protect airway, breathing, circulation, perfusion, neurologic function, and organ stability
while definitive treatment proceeds. The distractor instructions may be useful in related
situations, but they do not target the principal self-management or safety need described
here. Teach-back and follow-up assessment should confirm that the learner can apply the
instruction correctly in the relevant setting.
,Question 3.
A learner asks how to apply safe care principles related to RACE fire response. Which
guidance is best?
A. Room number is not an acceptable unique identifier.
B. Avoid raw or unsafe foods and fresh items restricted by institutional neutropenic policy.
C. Close doors to contain smoke and follow the facility fire plan.
D. Do not rely on a no-suicide contract as a substitute for assessment and safety
measures.
Correct Answer: C. Close doors to contain smoke and follow the facility fire plan.
Explanation: The priority teaching point for RACE fire response is: Close doors to contain
smoke and follow the facility fire plan. Safety decisions should interrupt exposure or injury
risk while maintaining appropriate precautions and surveillance. The distractor instructions
may be useful in related situations, but they do not target the principal self-management
or safety need described here. Teach-back and follow-up assessment should confirm that
the learner can apply the instruction correctly in the relevant setting.
Question 4.
The nurse is preparing written instructions about Acute pyelonephritis. Which point should
be emphasized?
A. Use pursed-lip breathing energy conservation vaccination and smoking cessation
strategies.
B. Complete antibiotics and seek care for persistent fever vomiting or worsening flank
pain.
C. Seek emergency care for chest pressure not relieved promptly according to the
prescribed plan.
D. Do not ignore brief unilateral weakness speech difficulty or vision loss.
Correct Answer: B. Complete antibiotics and seek care for persistent fever
vomiting or worsening flank pain.
Explanation: The priority teaching point for Acute pyelonephritis is: Complete antibiotics
and seek care for persistent fever vomiting or worsening flank pain. Physiological
adaptation priorities protect airway, breathing, circulation, perfusion, neurologic function,
and organ stability while definitive treatment proceeds. The distractor instructions may be
useful in related situations, but they do not target the principal self-management or safety
need described here. Teach-back and follow-up assessment should confirm that the
learner can apply the instruction correctly in the relevant setting.
,Question 5.
Case scenario: A 31-year-old client is preparing for discharge after care for NSAIDs.
Considering recurrence risk and early warning signs, which instruction is most important?
A. Take with food if advised and avoid combining multiple NSAIDs without direction.
B. Use reliable pregnancy prevention when indicated and attend ordered liver and platelet
monitoring.
C. Therapeutic benefit may take several weeks and medication should not be stopped
abruptly without guidance.
D. Avoid grapefruit products when instructed because they can alter drug exposure.
Correct Answer: A. Take with food if advised and avoid combining multiple
NSAIDs without direction.
Explanation: The priority teaching point for NSAIDs is: Take with food if advised and
avoid combining multiple NSAIDs without direction. Medication decisions require attention
to indication, pharmacologic effect, administration safety, adverse effects, interactions,
and appropriate follow-up. The distractor instructions may be useful in related situations,
but they do not target the principal self-management or safety need described here.
Teach-back and follow-up assessment should confirm that the learner can apply the
instruction correctly in the relevant setting.
Question 6.
On an acute-care medical-surgical unit, the nurse provides education related to BNP trend.
Which instruction is the priority?
A. Splinting the incision can make coughing more effective and less painful.
B. Rapid deep breathing may be a compensatory response and should not be suppressed
without addressing the cause.
C. A downward trend with improving congestion may support treatment response.
D. New unexplained dyspnea after surgery is not an expected recovery finding.
Correct Answer: C. A downward trend with improving congestion may support
treatment response.
Explanation: The priority teaching point for BNP trend is: A downward trend with
improving congestion may support treatment response. Risk-reduction questions depend
on recognizing early complications, abnormal trends, procedure-related hazards, and
when escalation is required. The distractor instructions may be useful in related situations,
but they do not target the principal self-management or safety need described here.
Teach-back and follow-up assessment should confirm that the learner can apply the
instruction correctly in the relevant setting.
, Question 7.
On an intensive-care step-down unit, the nurse provides education related to Fall
prevention. Which instruction is the priority?
A. Use approved water-based products near oxygen equipment.
B. Teach the client to call for help before getting up when assistance is needed.
C. Clients should tell all health-care and dental providers about the allergy.
D. Gloves do not replace hand hygiene.
Correct Answer: B. Teach the client to call for help before getting up when
assistance is needed.
Explanation: The priority teaching point for Fall prevention is: Teach the client to call for
help before getting up when assistance is needed. Safety decisions should interrupt
exposure or injury risk while maintaining appropriate precautions and surveillance. The
distractor instructions may be useful in related situations, but they do not target the
principal self-management or safety need described here. Teach-back and follow-up
assessment should confirm that the learner can apply the instruction correctly in the
relevant setting.
Question 8.
Which teaching point is most appropriate for a client learning about Sleep hygiene?
A. Address poor intake nausea chewing problems or financial barriers that limit nutrition.
B. Encourage privacy upright positioning and running water for nonobstructive difficulty
voiding when appropriate.
C. Report dusky black pale or persistently bleeding stoma tissue.
D. Avoid relying on daytime naps or late stimulants when nighttime insomnia is the goal.
Correct Answer: D. Avoid relying on daytime naps or late stimulants when
nighttime insomnia is the goal.
Explanation: The priority teaching point for Sleep hygiene is: Avoid relying on daytime
naps or late stimulants when nighttime insomnia is the goal. Basic-care interventions
should preserve function, comfort, nutrition, elimination, mobility, skin integrity, and
dignity without adding avoidable risk. The distractor instructions may be useful in related
situations, but they do not target the principal self-management or safety need described
here. Teach-back and follow-up assessment should confirm that the learner can apply the
instruction correctly in the relevant setting.
WITH ANSWERS AND EXPLANATIONS
Question 1.
Case scenario: The nurse reviews readiness for discharge after Desmopressin. Which
instruction best supports both prevention and appropriate escalation of care?
A. Follow prescribed fluid guidance and report headache confusion or sudden weight gain.
B. Report difficulty breathing extreme weakness or decreased alertness during therapy.
C. Report new involuntary movements restlessness or rigidity early.
D. Take the medication consistently after coronary stenting unless the cardiology team
changes the plan.
Correct Answer: A. Follow prescribed fluid guidance and report headache
confusion or sudden weight gain.
Explanation: The priority teaching point for Desmopressin is: Follow prescribed fluid
guidance and report headache confusion or sudden weight gain. Medication decisions
require attention to indication, pharmacologic effect, administration safety, adverse
effects, interactions, and appropriate follow-up. The distractor instructions may be useful
in related situations, but they do not target the principal self-management or safety need
described here. Teach-back and follow-up assessment should confirm that the learner can
apply the instruction correctly in the relevant setting.
Question 2.
On an emergency department, the nurse provides education related to Placenta previa.
Which instruction is the priority?
A. Call emergency services immediately for sudden face arm speech or balance changes.
B. Clients with high spinal injuries should know common triggers and carry an emergency
plan.
C. Complete antibiotics and seek care for persistent fever vomiting or worsening flank
pain.
D. Seek urgent evaluation for any late-pregnancy bleeding even when painless.
Correct Answer: D. Seek urgent evaluation for any late-pregnancy bleeding even
when painless.
Explanation: The priority teaching point for Placenta previa is: Seek urgent evaluation for
any late-pregnancy bleeding even when painless. Physiological adaptation priorities
protect airway, breathing, circulation, perfusion, neurologic function, and organ stability
while definitive treatment proceeds. The distractor instructions may be useful in related
situations, but they do not target the principal self-management or safety need described
here. Teach-back and follow-up assessment should confirm that the learner can apply the
instruction correctly in the relevant setting.
,Question 3.
A learner asks how to apply safe care principles related to RACE fire response. Which
guidance is best?
A. Room number is not an acceptable unique identifier.
B. Avoid raw or unsafe foods and fresh items restricted by institutional neutropenic policy.
C. Close doors to contain smoke and follow the facility fire plan.
D. Do not rely on a no-suicide contract as a substitute for assessment and safety
measures.
Correct Answer: C. Close doors to contain smoke and follow the facility fire plan.
Explanation: The priority teaching point for RACE fire response is: Close doors to contain
smoke and follow the facility fire plan. Safety decisions should interrupt exposure or injury
risk while maintaining appropriate precautions and surveillance. The distractor instructions
may be useful in related situations, but they do not target the principal self-management
or safety need described here. Teach-back and follow-up assessment should confirm that
the learner can apply the instruction correctly in the relevant setting.
Question 4.
The nurse is preparing written instructions about Acute pyelonephritis. Which point should
be emphasized?
A. Use pursed-lip breathing energy conservation vaccination and smoking cessation
strategies.
B. Complete antibiotics and seek care for persistent fever vomiting or worsening flank
pain.
C. Seek emergency care for chest pressure not relieved promptly according to the
prescribed plan.
D. Do not ignore brief unilateral weakness speech difficulty or vision loss.
Correct Answer: B. Complete antibiotics and seek care for persistent fever
vomiting or worsening flank pain.
Explanation: The priority teaching point for Acute pyelonephritis is: Complete antibiotics
and seek care for persistent fever vomiting or worsening flank pain. Physiological
adaptation priorities protect airway, breathing, circulation, perfusion, neurologic function,
and organ stability while definitive treatment proceeds. The distractor instructions may be
useful in related situations, but they do not target the principal self-management or safety
need described here. Teach-back and follow-up assessment should confirm that the
learner can apply the instruction correctly in the relevant setting.
,Question 5.
Case scenario: A 31-year-old client is preparing for discharge after care for NSAIDs.
Considering recurrence risk and early warning signs, which instruction is most important?
A. Take with food if advised and avoid combining multiple NSAIDs without direction.
B. Use reliable pregnancy prevention when indicated and attend ordered liver and platelet
monitoring.
C. Therapeutic benefit may take several weeks and medication should not be stopped
abruptly without guidance.
D. Avoid grapefruit products when instructed because they can alter drug exposure.
Correct Answer: A. Take with food if advised and avoid combining multiple
NSAIDs without direction.
Explanation: The priority teaching point for NSAIDs is: Take with food if advised and
avoid combining multiple NSAIDs without direction. Medication decisions require attention
to indication, pharmacologic effect, administration safety, adverse effects, interactions,
and appropriate follow-up. The distractor instructions may be useful in related situations,
but they do not target the principal self-management or safety need described here.
Teach-back and follow-up assessment should confirm that the learner can apply the
instruction correctly in the relevant setting.
Question 6.
On an acute-care medical-surgical unit, the nurse provides education related to BNP trend.
Which instruction is the priority?
A. Splinting the incision can make coughing more effective and less painful.
B. Rapid deep breathing may be a compensatory response and should not be suppressed
without addressing the cause.
C. A downward trend with improving congestion may support treatment response.
D. New unexplained dyspnea after surgery is not an expected recovery finding.
Correct Answer: C. A downward trend with improving congestion may support
treatment response.
Explanation: The priority teaching point for BNP trend is: A downward trend with
improving congestion may support treatment response. Risk-reduction questions depend
on recognizing early complications, abnormal trends, procedure-related hazards, and
when escalation is required. The distractor instructions may be useful in related situations,
but they do not target the principal self-management or safety need described here.
Teach-back and follow-up assessment should confirm that the learner can apply the
instruction correctly in the relevant setting.
, Question 7.
On an intensive-care step-down unit, the nurse provides education related to Fall
prevention. Which instruction is the priority?
A. Use approved water-based products near oxygen equipment.
B. Teach the client to call for help before getting up when assistance is needed.
C. Clients should tell all health-care and dental providers about the allergy.
D. Gloves do not replace hand hygiene.
Correct Answer: B. Teach the client to call for help before getting up when
assistance is needed.
Explanation: The priority teaching point for Fall prevention is: Teach the client to call for
help before getting up when assistance is needed. Safety decisions should interrupt
exposure or injury risk while maintaining appropriate precautions and surveillance. The
distractor instructions may be useful in related situations, but they do not target the
principal self-management or safety need described here. Teach-back and follow-up
assessment should confirm that the learner can apply the instruction correctly in the
relevant setting.
Question 8.
Which teaching point is most appropriate for a client learning about Sleep hygiene?
A. Address poor intake nausea chewing problems or financial barriers that limit nutrition.
B. Encourage privacy upright positioning and running water for nonobstructive difficulty
voiding when appropriate.
C. Report dusky black pale or persistently bleeding stoma tissue.
D. Avoid relying on daytime naps or late stimulants when nighttime insomnia is the goal.
Correct Answer: D. Avoid relying on daytime naps or late stimulants when
nighttime insomnia is the goal.
Explanation: The priority teaching point for Sleep hygiene is: Avoid relying on daytime
naps or late stimulants when nighttime insomnia is the goal. Basic-care interventions
should preserve function, comfort, nutrition, elimination, mobility, skin integrity, and
dignity without adding avoidable risk. The distractor instructions may be useful in related
situations, but they do not target the principal self-management or safety need described
here. Teach-back and follow-up assessment should confirm that the learner can apply the
instruction correctly in the relevant setting.
