2027 HESI RN Exit Exam V8–V10 (3 Full Set
Exams) – NGN Questions, Case Studies &
Verified Answers with Rationales (Pass
Guaranteed)
3 Full-Set NGN-Style Exams • Questions
Case Studies • Clinical Judgment • Answers • Rationales
Contents
Exam V8
Exam V9
Exam V10
EXAM V8
CASE STUDY 1 — SEPSIS
A 72-year-old client is admitted with pneumonia. The client is confused and
restless. Temperature is 39.2°C (102.6°F), heart rate 124/min, respiratory rate
30/min, blood pressure 86/48 mm Hg, and oxygen saturation 89% on room air.
WBC count is 19,000/mm³ and serum lactate is 4.2 mmol/L.
1. Which finding requires the nurse's immediate attention?
A. Temperature of 39.2°C
B. Heart rate of 124/min
C. Blood pressure of 86/48 mm Hg
D. WBC count of 19,000/mm³
Answer: C
Rationale: Severe hypotension indicates inadequate tissue perfusion and
possible septic shock. Airway, breathing, and circulation take priority.
2. Which prescription should the nurse implement first?
A. Obtain a sputum specimen
B. Administer an isotonic IV fluid bolus
,C. Give acetaminophen
D. Encourage oral fluids
Answer: B
Rationale: Rapid isotonic fluid administration is a priority intervention for
sepsis-associated hypotension and impaired perfusion.
3. Which laboratory value is most concerning?
A. Sodium 138 mEq/L
B. Hemoglobin 13.2 g/dL
C. Lactate 4.2 mmol/L
D. Platelets 210,000/mm³
Answer: C
Rationale: Elevated lactate suggests tissue hypoperfusion and is an important
marker of severe sepsis.
4. Which assessment finding best indicates worsening tissue perfusion?
A. Warm skin
B. Urine output of 15 mL/hr
C. Temperature of 38.5°C
D. Respiratory rate of 22/min
Answer: B
Rationale: Urine output below approximately 30 mL/hr in an adult suggests
decreased renal perfusion.
5. Which medication should the nurse anticipate administering promptly after
cultures are obtained?
A. Broad-spectrum IV antibiotics
B. Oral antihypertensive medication
C. Long-acting insulin
D. Potassium supplement
Answer: A
Rationale: Early administration of appropriate broad-spectrum antibiotics is
central to treatment of suspected bacterial sepsis.
6. The client's blood pressure remains 82/46 mm Hg after fluid resuscitation.
Which medication should the nurse anticipate?
,A. Norepinephrine
B. Furosemide
C. Metoprolol
D. Nitroglycerin
Answer: A
Rationale: Norepinephrine is a first-line vasopressor when hypotension
persists despite adequate fluid resuscitation.
7. Which finding indicates improvement?
A. Lactate increases to 5.0 mmol/L
B. Urine output increases to 40 mL/hr
C. Blood pressure decreases to 78/40 mm Hg
D. Mental status becomes more confused
Answer: B
Rationale: Improved urine output indicates better renal perfusion and overall
circulatory status.
8. Which oxygen saturation goal is generally appropriate for this acutely
hypoxemic client?
A. 70%
B. 80%
C. 90% or greater
D. Exactly 100%
Answer: C
Rationale: Maintaining adequate oxygenation is essential; a saturation of at
least about 90% is commonly targeted unless the client's condition requires a
different goal.
9. Which finding should the nurse report immediately after treatment begins?
A. Temperature decreases to 38.1°C
B. Urine output is 35 mL/hr
C. New onset of crackles and severe dyspnea
D. Heart rate decreases to 108/min
Answer: C
Rationale: New crackles and severe dyspnea may indicate pulmonary edema
after fluid administration and require immediate reassessment.
, 10. Which statement best describes the priority nursing goal?
A. Normalize temperature immediately
B. Restore adequate tissue perfusion
C. Increase oral intake
D. Prevent all pain
Answer: B
Rationale: The immediate priority in septic shock is restoration and
maintenance of adequate organ perfusion.
CASE STUDY 2 — ACUTE HEART FAILURE
A 68-year-old client with chronic heart failure reports increasing dyspnea and
orthopnea. The client has bilateral crackles, jugular venous distention, 3+ lower-
extremity edema, respiratory rate 32/min, and oxygen saturation 84%.
11. Which action should the nurse take first?
A. Place the client supine
B. Place the client in high-Fowler position
C. Encourage ambulation
D. Restrict all oxygen
Answer: B
Rationale: Upright positioning decreases venous return and improves lung
expansion, helping relieve pulmonary congestion.
12. Which medication would the nurse anticipate for acute pulmonary
congestion?
A. Furosemide
B. Ferrous sulfate
C. Lactulose
D. Levothyroxine
Answer: A
Rationale: Furosemide promotes diuresis and reduces fluid overload
associated with heart failure.
13. Which assessment best evaluates response to diuretic therapy?
Exams) – NGN Questions, Case Studies &
Verified Answers with Rationales (Pass
Guaranteed)
3 Full-Set NGN-Style Exams • Questions
Case Studies • Clinical Judgment • Answers • Rationales
Contents
Exam V8
Exam V9
Exam V10
EXAM V8
CASE STUDY 1 — SEPSIS
A 72-year-old client is admitted with pneumonia. The client is confused and
restless. Temperature is 39.2°C (102.6°F), heart rate 124/min, respiratory rate
30/min, blood pressure 86/48 mm Hg, and oxygen saturation 89% on room air.
WBC count is 19,000/mm³ and serum lactate is 4.2 mmol/L.
1. Which finding requires the nurse's immediate attention?
A. Temperature of 39.2°C
B. Heart rate of 124/min
C. Blood pressure of 86/48 mm Hg
D. WBC count of 19,000/mm³
Answer: C
Rationale: Severe hypotension indicates inadequate tissue perfusion and
possible septic shock. Airway, breathing, and circulation take priority.
2. Which prescription should the nurse implement first?
A. Obtain a sputum specimen
B. Administer an isotonic IV fluid bolus
,C. Give acetaminophen
D. Encourage oral fluids
Answer: B
Rationale: Rapid isotonic fluid administration is a priority intervention for
sepsis-associated hypotension and impaired perfusion.
3. Which laboratory value is most concerning?
A. Sodium 138 mEq/L
B. Hemoglobin 13.2 g/dL
C. Lactate 4.2 mmol/L
D. Platelets 210,000/mm³
Answer: C
Rationale: Elevated lactate suggests tissue hypoperfusion and is an important
marker of severe sepsis.
4. Which assessment finding best indicates worsening tissue perfusion?
A. Warm skin
B. Urine output of 15 mL/hr
C. Temperature of 38.5°C
D. Respiratory rate of 22/min
Answer: B
Rationale: Urine output below approximately 30 mL/hr in an adult suggests
decreased renal perfusion.
5. Which medication should the nurse anticipate administering promptly after
cultures are obtained?
A. Broad-spectrum IV antibiotics
B. Oral antihypertensive medication
C. Long-acting insulin
D. Potassium supplement
Answer: A
Rationale: Early administration of appropriate broad-spectrum antibiotics is
central to treatment of suspected bacterial sepsis.
6. The client's blood pressure remains 82/46 mm Hg after fluid resuscitation.
Which medication should the nurse anticipate?
,A. Norepinephrine
B. Furosemide
C. Metoprolol
D. Nitroglycerin
Answer: A
Rationale: Norepinephrine is a first-line vasopressor when hypotension
persists despite adequate fluid resuscitation.
7. Which finding indicates improvement?
A. Lactate increases to 5.0 mmol/L
B. Urine output increases to 40 mL/hr
C. Blood pressure decreases to 78/40 mm Hg
D. Mental status becomes more confused
Answer: B
Rationale: Improved urine output indicates better renal perfusion and overall
circulatory status.
8. Which oxygen saturation goal is generally appropriate for this acutely
hypoxemic client?
A. 70%
B. 80%
C. 90% or greater
D. Exactly 100%
Answer: C
Rationale: Maintaining adequate oxygenation is essential; a saturation of at
least about 90% is commonly targeted unless the client's condition requires a
different goal.
9. Which finding should the nurse report immediately after treatment begins?
A. Temperature decreases to 38.1°C
B. Urine output is 35 mL/hr
C. New onset of crackles and severe dyspnea
D. Heart rate decreases to 108/min
Answer: C
Rationale: New crackles and severe dyspnea may indicate pulmonary edema
after fluid administration and require immediate reassessment.
, 10. Which statement best describes the priority nursing goal?
A. Normalize temperature immediately
B. Restore adequate tissue perfusion
C. Increase oral intake
D. Prevent all pain
Answer: B
Rationale: The immediate priority in septic shock is restoration and
maintenance of adequate organ perfusion.
CASE STUDY 2 — ACUTE HEART FAILURE
A 68-year-old client with chronic heart failure reports increasing dyspnea and
orthopnea. The client has bilateral crackles, jugular venous distention, 3+ lower-
extremity edema, respiratory rate 32/min, and oxygen saturation 84%.
11. Which action should the nurse take first?
A. Place the client supine
B. Place the client in high-Fowler position
C. Encourage ambulation
D. Restrict all oxygen
Answer: B
Rationale: Upright positioning decreases venous return and improves lung
expansion, helping relieve pulmonary congestion.
12. Which medication would the nurse anticipate for acute pulmonary
congestion?
A. Furosemide
B. Ferrous sulfate
C. Lactulose
D. Levothyroxine
Answer: A
Rationale: Furosemide promotes diuresis and reduces fluid overload
associated with heart failure.
13. Which assessment best evaluates response to diuretic therapy?
