2026 HESI Rn Exit Exam Retake V1 with NGN
Questions and Verified Rationalized Answers,
100% Guarantee Pass
Q001:
Type: NGN – Extended Multiple Response
Scenario Context: Ms. Howard, 26 y/o, 38 wks pregnant, arrives at triage with severe
headache, visual “sparkles,” BP 162/104, HR 92, RR 20, protein/creatinine ratio 0.4.
Provider orders magnesium sulfate 6 g load, 2 g/hr maintenance.
Question: Which assessments are priority before starting the bolus? (Select ALL.)
Options:
A. Deep-tendon reflexes
B. Respiratory rate
C. Urine output in last 2 h
D. Fetal heart rate pattern
,E. Serum magnesium level
F. Patellar reflex present
(Correct: A, B, C, D, F)
Rationale:
● Answer: A, B, C, D, F
● Why (2026 Rationalization): NCSBN CJ-Model Step 1 (recognize cues): reflexes,
RR, U/O predict toxicity; FHR detects placental hypoperfusion.
● Errors: E not required before loading; baseline drawn after start.
Q002:
Type: Stand-Alone
Scenario Context: (Continuing) Magnesium running 30 min; patellar reflex absent.
Question: Immediate action?
Options:
A. Stop infusion & give calcium gluconate 1 g IV
B. Reduce rate to 1 g/hr
C. Check deep-tendon reflexes q15min
,D. Increase IVF to 150 mL/hr
(Correct: A)
Rationale:
● Answer: A
● Why (2026 Rationalization): Reflex absence signals impending toxicity; calcium
reverses neuromuscular blockade per ACOG 2026.
● Errors: B continues toxicity; C/D delays antidote.
Q003:
Type: NGN – Matrix
Scenario Context: Mr. Riley, 58 y/o, COPD, admitted for pneumonia, receiving bi-level
NIV. ABG on admission: pH 7.32, PaCO₂ 58, PaO₂ 56, HCO₃ 30.
Question: Match ABG change to clinical significance after 1 h NIV.
Matrix:
1. pH 7.38
2. PaCO₂ 48
3. PaO₂ 70
4. Resp rate 24 from 32
A. Improved ventilation
B. Improved oxygenation
C. Decreased work of breathing
D. Corrected respiratory acidosis
Options:
, A. 1-D, 2-A, 3-B, 4-C
B. 1-A, 2-D, 3-C, 4-B
C. 1-D, 2-B, 3-A, 4-C
D. 1-C, 2-A, 3-B, 4-D
(Correct: A)
Rationale:
● Answer: A
● Why (2026 Rationalization): NCSBN CJ Step 2 (analyze): pH normalization
reflects acidosis correction; PaCO₂ drop = ventilation; PaO₂ rise = oxygenation;
RR fall = work reduction.
● Errors: B mixes oxygenation/ventilation labels.
Q004:
Type: NGN – Bowtie
Scenario Context: Ms. Gupta, 24 y/o, T1DM, insulin pump, glucose 38 mg/dL,
conscious, diaphoretic.
Left cues (3): Choose 3
Middle (Correct action): Choose 1
Right complications (2): Choose 2
Left options:
A. Shaking tremors
B. HR 92
Questions and Verified Rationalized Answers,
100% Guarantee Pass
Q001:
Type: NGN – Extended Multiple Response
Scenario Context: Ms. Howard, 26 y/o, 38 wks pregnant, arrives at triage with severe
headache, visual “sparkles,” BP 162/104, HR 92, RR 20, protein/creatinine ratio 0.4.
Provider orders magnesium sulfate 6 g load, 2 g/hr maintenance.
Question: Which assessments are priority before starting the bolus? (Select ALL.)
Options:
A. Deep-tendon reflexes
B. Respiratory rate
C. Urine output in last 2 h
D. Fetal heart rate pattern
,E. Serum magnesium level
F. Patellar reflex present
(Correct: A, B, C, D, F)
Rationale:
● Answer: A, B, C, D, F
● Why (2026 Rationalization): NCSBN CJ-Model Step 1 (recognize cues): reflexes,
RR, U/O predict toxicity; FHR detects placental hypoperfusion.
● Errors: E not required before loading; baseline drawn after start.
Q002:
Type: Stand-Alone
Scenario Context: (Continuing) Magnesium running 30 min; patellar reflex absent.
Question: Immediate action?
Options:
A. Stop infusion & give calcium gluconate 1 g IV
B. Reduce rate to 1 g/hr
C. Check deep-tendon reflexes q15min
,D. Increase IVF to 150 mL/hr
(Correct: A)
Rationale:
● Answer: A
● Why (2026 Rationalization): Reflex absence signals impending toxicity; calcium
reverses neuromuscular blockade per ACOG 2026.
● Errors: B continues toxicity; C/D delays antidote.
Q003:
Type: NGN – Matrix
Scenario Context: Mr. Riley, 58 y/o, COPD, admitted for pneumonia, receiving bi-level
NIV. ABG on admission: pH 7.32, PaCO₂ 58, PaO₂ 56, HCO₃ 30.
Question: Match ABG change to clinical significance after 1 h NIV.
Matrix:
1. pH 7.38
2. PaCO₂ 48
3. PaO₂ 70
4. Resp rate 24 from 32
A. Improved ventilation
B. Improved oxygenation
C. Decreased work of breathing
D. Corrected respiratory acidosis
Options:
, A. 1-D, 2-A, 3-B, 4-C
B. 1-A, 2-D, 3-C, 4-B
C. 1-D, 2-B, 3-A, 4-C
D. 1-C, 2-A, 3-B, 4-D
(Correct: A)
Rationale:
● Answer: A
● Why (2026 Rationalization): NCSBN CJ Step 2 (analyze): pH normalization
reflects acidosis correction; PaCO₂ drop = ventilation; PaO₂ rise = oxygenation;
RR fall = work reduction.
● Errors: B mixes oxygenation/ventilation labels.
Q004:
Type: NGN – Bowtie
Scenario Context: Ms. Gupta, 24 y/o, T1DM, insulin pump, glucose 38 mg/dL,
conscious, diaphoretic.
Left cues (3): Choose 3
Middle (Correct action): Choose 1
Right complications (2): Choose 2
Left options:
A. Shaking tremors
B. HR 92
