HESI RN EXIT NGN V7 QUESTIONS
WITH ANSWERS AND EXPLANATIONS
1. During a shift, a client has repeated coughing with meals despite basic nursing interventions. Which
action best reflects collaborative care?
A. Continue the same diet without further assessment.
B. Request evaluation by the appropriate swallowing specialist while maintaining aspiration precautions.
C. Tell the client to eat alone to reduce embarrassment.
D. Remove all nutrition permanently without a plan.
Correct Answer: B. Request evaluation by the appropriate swallowing specialist while maintaining aspiration
precautions.
Explanation: Persistent swallowing difficulty warrants interdisciplinary evaluation, commonly by
speech-language pathology, while the nurse maintains immediate safety measures.
2. During a vaginal examination, gentle fetal scalp stimulation produces an acceleration. What does this
generally suggest?
A. Severe fetal acidemia is certain.
B. The fetal autonomic response is reassuring at that moment.
C. The fetus has shoulder dystocia.
D. The mother has postpartum hemorrhage.
Correct Answer: B. The fetal autonomic response is reassuring at that moment.
Explanation: An acceleration with stimulation is generally reassuring and makes significant acidemia less likely
at that time.
3. A dehydrated older adult with rising creatinine reports taking high-dose ibuprofen daily for back pain.
Which medication history is most relevant to the acute kidney injury?
A. A daily multivitamin at standard dose.
B. Frequent NSAID use during volume depletion.
C. Artificial tears.
D. Topical moisturizer.
Correct Answer: B. Frequent NSAID use during volume depletion.
Explanation: NSAIDs can reduce renal prostaglandin-mediated afferent arteriolar dilation and worsen kidney
perfusion, especially during volume depletion.
4. A postoperative client is restless, has shallow respirations, and is difficult to arouse after receiving an
opioid. Which problem should the nurse address first?
A. Risk for constipation.
B. Disturbed sleep pattern.
C. Need for discharge teaching.
D. Possible respiratory depression.
Correct Answer: D. Possible respiratory depression.
Explanation: Shallow respirations and decreased arousal after an opioid suggest respiratory depression. Airway
and breathing concerns take priority over nonurgent needs.
5. During a shift, a client with extensive terminal ileal Crohn disease is at increased risk for deficiency of
which nutrient?
A. Vitamin C only because it is absorbed exclusively in the ileum.
B. Sodium only with no other nutrient effects.
C. Vitamin K only because it is absorbed only in the stomach.
D. Vitamin B12.
Correct Answer: D. Vitamin B12.
Explanation: Vitamin B12 is absorbed in the terminal ileum after binding intrinsic factor. Ileal inflammation or
resection can impair absorption.
6. If a restraint is required and ordered, how should it be secured according to common safety practice?
A. With a quick-release knot attached to the bed frame according to policy, not to a movable side rail.
B. With a permanent knot tied to a side rail.
C. Around the client's neck for stability.
D. To IV tubing so the restraint moves with the line.
,Correct Answer: A. With a quick-release knot attached to the bed frame according to policy, not to a movable
side rail.
Explanation: Quick-release attachment to a fixed bed-frame location supports rapid removal and reduces injury
risk. Facility policy governs specific restraint application.
7. During a shift, a client wants morning hygiene before breakfast because that routine is important at
home. What is the best nursing response if there is no safety conflict?
A. Incorporate the preference into the care schedule when feasible.
B. Tell the client hospital routines always override preferences.
C. Refuse because all clients must bathe at the same time.
D. Document the preference as noncompliance.
Correct Answer: A. Incorporate the preference into the care schedule when feasible.
Explanation: Respecting reasonable preferences supports dignity, autonomy, and individualized care without
compromising safety or essential treatment.
8. Which set of findings is most consistent with preeclampsia with severe features? Maternal assessment
Finding Result Blood pressure 166/112 mm Hg Platelets 82,000/mm3 Symptoms RUQ pain, headache
A. Blood pressure 118/72 mm Hg with mild nausea.
B. Blood pressure 132/78 mm Hg with trace dependent edema.
C. Blood pressure 126/80 mm Hg with urinary frequency.
D. Blood pressure 166/112 mm Hg with right upper quadrant pain and platelets 82,000/mm3.
Correct Answer: D. Blood pressure 166/112 mm Hg with right upper quadrant pain and platelets 82,000/mm3.
Explanation: Severe-range blood pressure plus thrombocytopenia and right upper quadrant pain indicates
significant maternal organ involvement and requires urgent management.
9. A premature infant with a hemodynamically significant PDA is being medically treated. Which
assessment is important during therapy?
A. Ignore urine output.
B. Stop all cardiorespiratory monitoring.
C. Give unrestricted additional nephrotoxic drugs.
D. Monitor renal function, perfusion, bleeding risk, and response according to the medication used.
Correct Answer: D. Monitor renal function, perfusion, bleeding risk, and response according to the medication
used.
Explanation: Pharmacologic PDA closure can affect renal perfusion and bleeding risk; response and adverse
effects require close monitoring.
10. A competent client asks how to document future healthcare wishes in case they cannot speak for
themselves. Which resource is appropriate?
A. A blank incident report.
B. A medication administration record.
C. A dietary preference sheet only.
D. Information about advance directives and healthcare decision-makers according to state law.
Correct Answer: D. Information about advance directives and healthcare decision-makers according to state law.
Explanation: Advance directives allow individuals to express healthcare preferences and, depending on the
document, designate a surrogate decision-maker.
11. Which new finding is most consistent with orthostatic intolerance? Position change assessment Position
BP Pulse Symptoms Supine 132/76 78/min None Standing 3 min 104/64 98/min Light-headed
A. The blood pressure is unchanged and the client feels well.
B. The pulse decreases slightly after resting.
C. The client becomes light-headed on standing and the blood pressure falls substantially from the supine value.
D. The temperature rises after drinking a warm beverage.
Correct Answer: C. The client becomes light-headed on standing and the blood pressure falls substantially from
the supine value.
Explanation: Symptoms with a significant postural blood-pressure drop suggest orthostatic hypotension or
intolerance and increase fall risk.
12. For Intramuscular medication technique, which complication should the nurse monitor most urgently?
A. Crushing an extended-release dosage form can cause dose dumping and toxicity.
B. Lipohypertrophy can make insulin absorption less predictable.
, C. Incorrect landmarking can injure nerves or blood vessels and may deliver medication into fat.
D. Unresolved discrepancies can signal diversion, documentation error, or an unrecognized
medication-administration problem.
Correct Answer: C. Incorrect landmarking can injure nerves or blood vessels and may deliver medication into
fat.
Explanation: This complication is an important risk associated with Intramuscular medication technique. IM
administration requires selecting a safe site and needle length based on age, muscle mass, medication volume, and
product recommendations.
13. Which concept is necessary to establish professional negligence?
A. The nurse disliked the client.
B. A duty existed, the duty was breached, harm occurred, and the breach caused the harm.
C. The client had any complication at all.
D. The nurse worked an overtime shift.
Correct Answer: B. A duty existed, the duty was breached, harm occurred, and the breach caused the harm.
Explanation: Negligence requires duty, breach, causation, and damages. An adverse outcome alone does not
prove negligence.
14. A hospitalized child with transfusion-dependent thalassemia receives regular red-cell transfusions.
Which long-term complication requires monitoring?
A. Vitamin C deficiency from transfusion.
B. Iron overload.
C. Permanent dehydration.
D. Hypothermia from red cells.
Correct Answer: B. Iron overload.
Explanation: Repeated transfusions can cause iron accumulation, often requiring monitoring and chelation
therapy.
15. Which history increases a toddler’s risk for lead exposure? Environmental history Factor Finding
Home built 1948 Renovation Active sanding/paint removal Child behavior Frequent hand-to-mouth
A. Drinking water from a stainless-steel cup.
B. Sleeping with a cotton blanket.
C. Living in an older home undergoing renovation with peeling paint.
D. Eating iron-fortified cereal.
Correct Answer: C. Living in an older home undergoing renovation with peeling paint.
Explanation: Lead-based paint and renovation dust in older housing are classic exposure risks. Young children
are especially vulnerable because of hand-to-mouth behavior.
16. Assistive personnel reports that a stable client's blood pressure is now 82/48 mm Hg. What should the
RN do? Delegated vital signs Prior BP New BP 126/74 mm Hg 82/48 mm Hg
A. Ask the assistive personnel to decide the treatment.
B. Ignore the result because the RN did not obtain it.
C. Document it as normal.
D. Assess the client promptly and validate the abnormal finding.
Correct Answer: D. Assess the client promptly and validate the abnormal finding.
Explanation: Abnormal delegated data require RN assessment and clinical judgment. The RN evaluates the
client and determines next actions.
17. During a contraction stress test, recurrent late decelerations occur with contractions. How should this
result be interpreted?
A. A reactive nonstress test.
B. A normal newborn transition pattern.
C. An abnormal or positive result suggesting possible uteroplacental insufficiency.
D. Evidence of shoulder dystocia.
Correct Answer: C. An abnormal or positive result suggesting possible uteroplacental insufficiency.
Explanation: Late decelerations provoked by contractions suggest the fetus may not tolerate reduced placental
perfusion well.
18. During a shift, a client on airborne precautions for pulmonary tuberculosis must leave the room for an
essential diagnostic test. What should the nurse do?
WITH ANSWERS AND EXPLANATIONS
1. During a shift, a client has repeated coughing with meals despite basic nursing interventions. Which
action best reflects collaborative care?
A. Continue the same diet without further assessment.
B. Request evaluation by the appropriate swallowing specialist while maintaining aspiration precautions.
C. Tell the client to eat alone to reduce embarrassment.
D. Remove all nutrition permanently without a plan.
Correct Answer: B. Request evaluation by the appropriate swallowing specialist while maintaining aspiration
precautions.
Explanation: Persistent swallowing difficulty warrants interdisciplinary evaluation, commonly by
speech-language pathology, while the nurse maintains immediate safety measures.
2. During a vaginal examination, gentle fetal scalp stimulation produces an acceleration. What does this
generally suggest?
A. Severe fetal acidemia is certain.
B. The fetal autonomic response is reassuring at that moment.
C. The fetus has shoulder dystocia.
D. The mother has postpartum hemorrhage.
Correct Answer: B. The fetal autonomic response is reassuring at that moment.
Explanation: An acceleration with stimulation is generally reassuring and makes significant acidemia less likely
at that time.
3. A dehydrated older adult with rising creatinine reports taking high-dose ibuprofen daily for back pain.
Which medication history is most relevant to the acute kidney injury?
A. A daily multivitamin at standard dose.
B. Frequent NSAID use during volume depletion.
C. Artificial tears.
D. Topical moisturizer.
Correct Answer: B. Frequent NSAID use during volume depletion.
Explanation: NSAIDs can reduce renal prostaglandin-mediated afferent arteriolar dilation and worsen kidney
perfusion, especially during volume depletion.
4. A postoperative client is restless, has shallow respirations, and is difficult to arouse after receiving an
opioid. Which problem should the nurse address first?
A. Risk for constipation.
B. Disturbed sleep pattern.
C. Need for discharge teaching.
D. Possible respiratory depression.
Correct Answer: D. Possible respiratory depression.
Explanation: Shallow respirations and decreased arousal after an opioid suggest respiratory depression. Airway
and breathing concerns take priority over nonurgent needs.
5. During a shift, a client with extensive terminal ileal Crohn disease is at increased risk for deficiency of
which nutrient?
A. Vitamin C only because it is absorbed exclusively in the ileum.
B. Sodium only with no other nutrient effects.
C. Vitamin K only because it is absorbed only in the stomach.
D. Vitamin B12.
Correct Answer: D. Vitamin B12.
Explanation: Vitamin B12 is absorbed in the terminal ileum after binding intrinsic factor. Ileal inflammation or
resection can impair absorption.
6. If a restraint is required and ordered, how should it be secured according to common safety practice?
A. With a quick-release knot attached to the bed frame according to policy, not to a movable side rail.
B. With a permanent knot tied to a side rail.
C. Around the client's neck for stability.
D. To IV tubing so the restraint moves with the line.
,Correct Answer: A. With a quick-release knot attached to the bed frame according to policy, not to a movable
side rail.
Explanation: Quick-release attachment to a fixed bed-frame location supports rapid removal and reduces injury
risk. Facility policy governs specific restraint application.
7. During a shift, a client wants morning hygiene before breakfast because that routine is important at
home. What is the best nursing response if there is no safety conflict?
A. Incorporate the preference into the care schedule when feasible.
B. Tell the client hospital routines always override preferences.
C. Refuse because all clients must bathe at the same time.
D. Document the preference as noncompliance.
Correct Answer: A. Incorporate the preference into the care schedule when feasible.
Explanation: Respecting reasonable preferences supports dignity, autonomy, and individualized care without
compromising safety or essential treatment.
8. Which set of findings is most consistent with preeclampsia with severe features? Maternal assessment
Finding Result Blood pressure 166/112 mm Hg Platelets 82,000/mm3 Symptoms RUQ pain, headache
A. Blood pressure 118/72 mm Hg with mild nausea.
B. Blood pressure 132/78 mm Hg with trace dependent edema.
C. Blood pressure 126/80 mm Hg with urinary frequency.
D. Blood pressure 166/112 mm Hg with right upper quadrant pain and platelets 82,000/mm3.
Correct Answer: D. Blood pressure 166/112 mm Hg with right upper quadrant pain and platelets 82,000/mm3.
Explanation: Severe-range blood pressure plus thrombocytopenia and right upper quadrant pain indicates
significant maternal organ involvement and requires urgent management.
9. A premature infant with a hemodynamically significant PDA is being medically treated. Which
assessment is important during therapy?
A. Ignore urine output.
B. Stop all cardiorespiratory monitoring.
C. Give unrestricted additional nephrotoxic drugs.
D. Monitor renal function, perfusion, bleeding risk, and response according to the medication used.
Correct Answer: D. Monitor renal function, perfusion, bleeding risk, and response according to the medication
used.
Explanation: Pharmacologic PDA closure can affect renal perfusion and bleeding risk; response and adverse
effects require close monitoring.
10. A competent client asks how to document future healthcare wishes in case they cannot speak for
themselves. Which resource is appropriate?
A. A blank incident report.
B. A medication administration record.
C. A dietary preference sheet only.
D. Information about advance directives and healthcare decision-makers according to state law.
Correct Answer: D. Information about advance directives and healthcare decision-makers according to state law.
Explanation: Advance directives allow individuals to express healthcare preferences and, depending on the
document, designate a surrogate decision-maker.
11. Which new finding is most consistent with orthostatic intolerance? Position change assessment Position
BP Pulse Symptoms Supine 132/76 78/min None Standing 3 min 104/64 98/min Light-headed
A. The blood pressure is unchanged and the client feels well.
B. The pulse decreases slightly after resting.
C. The client becomes light-headed on standing and the blood pressure falls substantially from the supine value.
D. The temperature rises after drinking a warm beverage.
Correct Answer: C. The client becomes light-headed on standing and the blood pressure falls substantially from
the supine value.
Explanation: Symptoms with a significant postural blood-pressure drop suggest orthostatic hypotension or
intolerance and increase fall risk.
12. For Intramuscular medication technique, which complication should the nurse monitor most urgently?
A. Crushing an extended-release dosage form can cause dose dumping and toxicity.
B. Lipohypertrophy can make insulin absorption less predictable.
, C. Incorrect landmarking can injure nerves or blood vessels and may deliver medication into fat.
D. Unresolved discrepancies can signal diversion, documentation error, or an unrecognized
medication-administration problem.
Correct Answer: C. Incorrect landmarking can injure nerves or blood vessels and may deliver medication into
fat.
Explanation: This complication is an important risk associated with Intramuscular medication technique. IM
administration requires selecting a safe site and needle length based on age, muscle mass, medication volume, and
product recommendations.
13. Which concept is necessary to establish professional negligence?
A. The nurse disliked the client.
B. A duty existed, the duty was breached, harm occurred, and the breach caused the harm.
C. The client had any complication at all.
D. The nurse worked an overtime shift.
Correct Answer: B. A duty existed, the duty was breached, harm occurred, and the breach caused the harm.
Explanation: Negligence requires duty, breach, causation, and damages. An adverse outcome alone does not
prove negligence.
14. A hospitalized child with transfusion-dependent thalassemia receives regular red-cell transfusions.
Which long-term complication requires monitoring?
A. Vitamin C deficiency from transfusion.
B. Iron overload.
C. Permanent dehydration.
D. Hypothermia from red cells.
Correct Answer: B. Iron overload.
Explanation: Repeated transfusions can cause iron accumulation, often requiring monitoring and chelation
therapy.
15. Which history increases a toddler’s risk for lead exposure? Environmental history Factor Finding
Home built 1948 Renovation Active sanding/paint removal Child behavior Frequent hand-to-mouth
A. Drinking water from a stainless-steel cup.
B. Sleeping with a cotton blanket.
C. Living in an older home undergoing renovation with peeling paint.
D. Eating iron-fortified cereal.
Correct Answer: C. Living in an older home undergoing renovation with peeling paint.
Explanation: Lead-based paint and renovation dust in older housing are classic exposure risks. Young children
are especially vulnerable because of hand-to-mouth behavior.
16. Assistive personnel reports that a stable client's blood pressure is now 82/48 mm Hg. What should the
RN do? Delegated vital signs Prior BP New BP 126/74 mm Hg 82/48 mm Hg
A. Ask the assistive personnel to decide the treatment.
B. Ignore the result because the RN did not obtain it.
C. Document it as normal.
D. Assess the client promptly and validate the abnormal finding.
Correct Answer: D. Assess the client promptly and validate the abnormal finding.
Explanation: Abnormal delegated data require RN assessment and clinical judgment. The RN evaluates the
client and determines next actions.
17. During a contraction stress test, recurrent late decelerations occur with contractions. How should this
result be interpreted?
A. A reactive nonstress test.
B. A normal newborn transition pattern.
C. An abnormal or positive result suggesting possible uteroplacental insufficiency.
D. Evidence of shoulder dystocia.
Correct Answer: C. An abnormal or positive result suggesting possible uteroplacental insufficiency.
Explanation: Late decelerations provoked by contractions suggest the fetus may not tolerate reduced placental
perfusion well.
18. During a shift, a client on airborne precautions for pulmonary tuberculosis must leave the room for an
essential diagnostic test. What should the nurse do?
