1
RN HESI Exit Exam V1 with
NGN Questions and Verified
Rationalized Answers | 100%
Guaranteed Pass
Section 1: Clinical Judgment (Questions 1–50)
Question 1 (Multiple-Choice):
A nurse is caring for a client with chest pain. Which assessment finding should the nurse
prioritize?
A. Blood pressure of 120/80 mmHg
B. Heart rate of 110 bpm
C. Oxygen saturation of 88%
D. Temperature of 99.2°F
Correct Answer: C. Oxygen saturation of 88%
Rationale: An oxygen saturation of 88% indicates hypoxemia, which is critical in a client with
chest pain and requires immediate intervention to prevent further cardiac compromise.
Question 2 (SATA):
A nurse is assessing a client with suspected heart failure. Which findings should the nurse report
to the provider? (Select all that apply.)
A. Jugular vein distension
B. Crackles in lung bases
C. Heart rate of 72 bpm
D. Peripheral edema
E. Dry mucous membranes
Correct Answers: A. Jugular vein distension, B. Crackles in lung bases, D. Peripheral
edema
Rationale: These findings indicate fluid overload, a hallmark of heart failure. Normal heart rate
and dry mucous membranes are not specific to heart failure.
Question 3 (Multiple-Choice):
A client with diabetes mellitus reports nausea and vomiting. The blood glucose is 450 mg/dL.
What is the nurse’s priority action?
A. Administer insulin as prescribed.
B. Encourage oral fluid intake.
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C. Check the client’s temperature.
D. Monitor urine output.
Correct Answer: A. Administer insulin as prescribed.
Rationale: Hyperglycemia (450 mg/dL) requires urgent insulin administration to lower blood
glucose and prevent diabetic ketoacidosis.
Question 4 (NGN Bow-Tie):
Case Study: A 65-year-old client presents with shortness of breath, chest pain, and cyanosis.
Vital signs: BP 90/60 mmHg, HR 120 bpm, RR 28 breaths/min, SpO2 85%, Temp 98.6°F. The
nurse suspects an acute myocardial infarction (MI). Complete the bow-tie diagram.
Potential Conditions: Acute MI, Pneumothorax, Pulmonary embolism
Actions to Take: Administer oxygen, Obtain 12-lead ECG, Notify provider, Prepare for
thrombolytic therapy
Parameters to Monitor: Oxygen saturation, Cardiac rhythm, Chest pain level, Blood pressure
Correct Answer:
• Condition: Acute MI
• Actions to Take: Administer oxygen, Obtain 12-lead ECG, Notify provider
• Parameters to Monitor: Oxygen saturation, Cardiac rhythm, Chest pain level
Rationale: Acute MI is indicated by chest pain, cyanosis, and vital sign abnormalities.
Administering oxygen, obtaining an ECG, and notifying the provider are priority actions.
Monitoring oxygen saturation, cardiac rhythm, and chest pain assesses treatment
effectiveness.
Question 5 (Multiple-Choice):
A client is receiving heparin for a deep vein thrombosis. Which laboratory value should the nurse
monitor?
A. INR
B. aPTT
C. Platelet count
D. Serum potassium
Correct Answer: B. aPTT
Rationale: Heparin’s anticoagulant effect is monitored using aPTT to ensure therapeutic levels
and prevent bleeding.
Question 6 (SATA):
A nurse is planning care for a client with sepsis. Which interventions should be included? (Select
all that apply.)
A. Administer antibiotics within 1 hour.
B. Obtain blood cultures after antibiotics.
C. Monitor urine output hourly.
D. Administer IV fluids as prescribed.
E. Restrict oral intake.
Correct Answers: A. Administer antibiotics within 1 hour, C. Monitor urine output hourly,
D. Administer IV fluids as prescribed
Rationale: Early antibiotics, fluid resuscitation, and monitoring urine output are critical in
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sepsis management. Blood cultures should be obtained before antibiotics, and oral intake may
not be restricted.
Question 7 (Multiple-Choice):
A client with a new tracheostomy is experiencing respiratory distress. What is the nurse’s first
action?
A. Suction the tracheostomy.
B. Check tracheostomy patency.
C. Administer oxygen via nasal cannula.
D. Notify the respiratory therapist.
Correct Answer: B. Check tracheostomy patency.
Rationale: Ensuring tracheostomy patency is the priority to address respiratory distress, as
obstruction is a common cause.
Question 8 (NGN Matrix):
Case Study: A 50-year-old client with chronic obstructive pulmonary disease (COPD)
exacerbation presents with dyspnea and wheezing. Indicate whether the following interventions
are Appropriate or Inappropriate.
Intervention Appropriate Inappropriate
Administer albuterol nebulizer X
Encourage pursed-lip breathing X
Administer high-flow oxygen at 10 L/min X
Obtain arterial blood gas (ABG) X
Restrict fluid intake X
Rationale: Albuterol, pursed-lip breathing, and ABG are
appropriate for COPD exacerbation. High-flow oxygen risks CO2
retention in COPD, and fluid restriction is not indicated.
Question 9 (Multiple-Choice):
A client with a head injury has a Glasgow Coma Scale (GCS) score of 7. What is the nurse’s
priority?
A. Monitor blood glucose levels.
B. Assess airway and breathing.
C. Administer pain medication.
D. Perform a neurological exam.
Correct Answer: B. Assess airway and breathing.
Rationale: A GCS of 7 indicates severe impairment, and ensuring airway patency and adequate
breathing is critical.
Question 10 (SATA):
A nurse is caring for a client with a new colostomy. Which teaching points should be included?
(Select all that apply.)
A. Empty the pouch when it is one-third full.
B. Change the appliance every 7–10 days.
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C. Avoid gas-forming foods like broccoli.
D. Use soap and water to clean the stoma.
E. Expect bright red blood in the pouch.
Correct Answers: A. Empty the pouch when it is one-third full, B. Change the appliance
every 7–10 days, C. Avoid gas-forming foods like broccoli, D. Use soap and water to clean
the stoma
Rationale: These promote proper colostomy care. Bright red blood indicates potential
complications and should be reported.
Question 11 (Multiple-Choice):
A client with pneumonia has a respiratory rate of 30 breaths/min and SpO2 of 90%. What is the
nurse’s first action?
A. Administer antibiotics.
B. Apply supplemental oxygen.
C. Encourage coughing and deep breathing.
D. Obtain a sputum culture.
Correct Answer: B. Apply supplemental oxygen.
Rationale: Hypoxemia (SpO2 90%) requires immediate oxygen administration to improve
oxygenation.
Question 12 (NGN Case Study):
Case Study: A 70-year-old client with atrial fibrillation is admitted with dizziness and
palpitations. Vital signs: BP 100/60 mmHg, HR 140 bpm (irregular), RR 20 breaths/min, SpO2
94%. The nurse observes a heart rhythm strip showing atrial fibrillation.
Question 12a (Multiple-Choice): What is the nurse’s priority action?
A. Administer digoxin as prescribed.
B. Prepare for synchronized cardioversion.
C. Monitor for signs of stroke.
D. Administer oxygen at 2 L/min.
Correct Answer: B. Prepare for synchronized cardioversion.
Rationale: Uncontrolled atrial fibrillation with hypotension and symptoms may require
cardioversion to restore sinus rhythm.
Question 12b (SATA): Which findings should the nurse monitor? (Select all that apply.)
A. Chest pain
B. Blood pressure
C. Heart rhythm
D. Urine output
E. Temperature
Correct Answers: A. Chest pain, B. Blood pressure, C. Heart rhythm
Rationale: These are critical in atrial fibrillation to assess for complications like ischemia or
hemodynamic instability.
Question 13 (Multiple-Choice):
A client is receiving a blood transfusion and reports itching. What is the nurse’s first action?
A. Slow the transfusion rate.
RN HESI Exit Exam V1 with
NGN Questions and Verified
Rationalized Answers | 100%
Guaranteed Pass
Section 1: Clinical Judgment (Questions 1–50)
Question 1 (Multiple-Choice):
A nurse is caring for a client with chest pain. Which assessment finding should the nurse
prioritize?
A. Blood pressure of 120/80 mmHg
B. Heart rate of 110 bpm
C. Oxygen saturation of 88%
D. Temperature of 99.2°F
Correct Answer: C. Oxygen saturation of 88%
Rationale: An oxygen saturation of 88% indicates hypoxemia, which is critical in a client with
chest pain and requires immediate intervention to prevent further cardiac compromise.
Question 2 (SATA):
A nurse is assessing a client with suspected heart failure. Which findings should the nurse report
to the provider? (Select all that apply.)
A. Jugular vein distension
B. Crackles in lung bases
C. Heart rate of 72 bpm
D. Peripheral edema
E. Dry mucous membranes
Correct Answers: A. Jugular vein distension, B. Crackles in lung bases, D. Peripheral
edema
Rationale: These findings indicate fluid overload, a hallmark of heart failure. Normal heart rate
and dry mucous membranes are not specific to heart failure.
Question 3 (Multiple-Choice):
A client with diabetes mellitus reports nausea and vomiting. The blood glucose is 450 mg/dL.
What is the nurse’s priority action?
A. Administer insulin as prescribed.
B. Encourage oral fluid intake.
, 2
C. Check the client’s temperature.
D. Monitor urine output.
Correct Answer: A. Administer insulin as prescribed.
Rationale: Hyperglycemia (450 mg/dL) requires urgent insulin administration to lower blood
glucose and prevent diabetic ketoacidosis.
Question 4 (NGN Bow-Tie):
Case Study: A 65-year-old client presents with shortness of breath, chest pain, and cyanosis.
Vital signs: BP 90/60 mmHg, HR 120 bpm, RR 28 breaths/min, SpO2 85%, Temp 98.6°F. The
nurse suspects an acute myocardial infarction (MI). Complete the bow-tie diagram.
Potential Conditions: Acute MI, Pneumothorax, Pulmonary embolism
Actions to Take: Administer oxygen, Obtain 12-lead ECG, Notify provider, Prepare for
thrombolytic therapy
Parameters to Monitor: Oxygen saturation, Cardiac rhythm, Chest pain level, Blood pressure
Correct Answer:
• Condition: Acute MI
• Actions to Take: Administer oxygen, Obtain 12-lead ECG, Notify provider
• Parameters to Monitor: Oxygen saturation, Cardiac rhythm, Chest pain level
Rationale: Acute MI is indicated by chest pain, cyanosis, and vital sign abnormalities.
Administering oxygen, obtaining an ECG, and notifying the provider are priority actions.
Monitoring oxygen saturation, cardiac rhythm, and chest pain assesses treatment
effectiveness.
Question 5 (Multiple-Choice):
A client is receiving heparin for a deep vein thrombosis. Which laboratory value should the nurse
monitor?
A. INR
B. aPTT
C. Platelet count
D. Serum potassium
Correct Answer: B. aPTT
Rationale: Heparin’s anticoagulant effect is monitored using aPTT to ensure therapeutic levels
and prevent bleeding.
Question 6 (SATA):
A nurse is planning care for a client with sepsis. Which interventions should be included? (Select
all that apply.)
A. Administer antibiotics within 1 hour.
B. Obtain blood cultures after antibiotics.
C. Monitor urine output hourly.
D. Administer IV fluids as prescribed.
E. Restrict oral intake.
Correct Answers: A. Administer antibiotics within 1 hour, C. Monitor urine output hourly,
D. Administer IV fluids as prescribed
Rationale: Early antibiotics, fluid resuscitation, and monitoring urine output are critical in
, 3
sepsis management. Blood cultures should be obtained before antibiotics, and oral intake may
not be restricted.
Question 7 (Multiple-Choice):
A client with a new tracheostomy is experiencing respiratory distress. What is the nurse’s first
action?
A. Suction the tracheostomy.
B. Check tracheostomy patency.
C. Administer oxygen via nasal cannula.
D. Notify the respiratory therapist.
Correct Answer: B. Check tracheostomy patency.
Rationale: Ensuring tracheostomy patency is the priority to address respiratory distress, as
obstruction is a common cause.
Question 8 (NGN Matrix):
Case Study: A 50-year-old client with chronic obstructive pulmonary disease (COPD)
exacerbation presents with dyspnea and wheezing. Indicate whether the following interventions
are Appropriate or Inappropriate.
Intervention Appropriate Inappropriate
Administer albuterol nebulizer X
Encourage pursed-lip breathing X
Administer high-flow oxygen at 10 L/min X
Obtain arterial blood gas (ABG) X
Restrict fluid intake X
Rationale: Albuterol, pursed-lip breathing, and ABG are
appropriate for COPD exacerbation. High-flow oxygen risks CO2
retention in COPD, and fluid restriction is not indicated.
Question 9 (Multiple-Choice):
A client with a head injury has a Glasgow Coma Scale (GCS) score of 7. What is the nurse’s
priority?
A. Monitor blood glucose levels.
B. Assess airway and breathing.
C. Administer pain medication.
D. Perform a neurological exam.
Correct Answer: B. Assess airway and breathing.
Rationale: A GCS of 7 indicates severe impairment, and ensuring airway patency and adequate
breathing is critical.
Question 10 (SATA):
A nurse is caring for a client with a new colostomy. Which teaching points should be included?
(Select all that apply.)
A. Empty the pouch when it is one-third full.
B. Change the appliance every 7–10 days.
, 4
C. Avoid gas-forming foods like broccoli.
D. Use soap and water to clean the stoma.
E. Expect bright red blood in the pouch.
Correct Answers: A. Empty the pouch when it is one-third full, B. Change the appliance
every 7–10 days, C. Avoid gas-forming foods like broccoli, D. Use soap and water to clean
the stoma
Rationale: These promote proper colostomy care. Bright red blood indicates potential
complications and should be reported.
Question 11 (Multiple-Choice):
A client with pneumonia has a respiratory rate of 30 breaths/min and SpO2 of 90%. What is the
nurse’s first action?
A. Administer antibiotics.
B. Apply supplemental oxygen.
C. Encourage coughing and deep breathing.
D. Obtain a sputum culture.
Correct Answer: B. Apply supplemental oxygen.
Rationale: Hypoxemia (SpO2 90%) requires immediate oxygen administration to improve
oxygenation.
Question 12 (NGN Case Study):
Case Study: A 70-year-old client with atrial fibrillation is admitted with dizziness and
palpitations. Vital signs: BP 100/60 mmHg, HR 140 bpm (irregular), RR 20 breaths/min, SpO2
94%. The nurse observes a heart rhythm strip showing atrial fibrillation.
Question 12a (Multiple-Choice): What is the nurse’s priority action?
A. Administer digoxin as prescribed.
B. Prepare for synchronized cardioversion.
C. Monitor for signs of stroke.
D. Administer oxygen at 2 L/min.
Correct Answer: B. Prepare for synchronized cardioversion.
Rationale: Uncontrolled atrial fibrillation with hypotension and symptoms may require
cardioversion to restore sinus rhythm.
Question 12b (SATA): Which findings should the nurse monitor? (Select all that apply.)
A. Chest pain
B. Blood pressure
C. Heart rhythm
D. Urine output
E. Temperature
Correct Answers: A. Chest pain, B. Blood pressure, C. Heart rhythm
Rationale: These are critical in atrial fibrillation to assess for complications like ischemia or
hemodynamic instability.
Question 13 (Multiple-Choice):
A client is receiving a blood transfusion and reports itching. What is the nurse’s first action?
A. Slow the transfusion rate.
