HESI RN Next Generation (NGN) Version A – 150 Carefully
Developed NGN-Style Practice Questions, Each Paired With
Accurate, Fully Verified Answers and Rationales Test Bank (2026)
With A+ Pass Guarantee
Pediatrics & OB / Maternity – Case-Based / Single Best
Action (Questions 1–15)
Question 1 – Pediatrics
A 3-year-old presents with fever 102.5°F, irritability, and poor oral intake. The child has
vomiting and diarrhea for 24 hours. What is the highest priority nursing action?
A. Encourage oral fluids
B. Assess hydration status and vital signs
C. Administer antipyretic as ordered
D. Notify provider about fever
Answer: ✅ B. Assess hydration status and vital signs
Rationale: The child’s vomiting and diarrhea put them at risk for dehydration, which is
potentially life-threatening. Version A NGN emphasizes ABC + assessment before
interventions.
Question 2 – Pediatrics
A 6-year-old with asthma presents with wheezing, accessory muscle use, and SpO₂ 88%.
Which is the priority nursing action?
A. Apply oxygen
B. Administer nebulized bronchodilator
C. Notify provider
D. Monitor vital signs
Answer: ✅ A. Apply oxygen
HESI RN Next Generation (NGN) Version A – 150 Carefully Developed NGN-Style Practice Questions, Each Paired With Accurate, Fully Verified
Answers and Rationales Test Bank (2026) With A+ Pass Guarantee
,Rationale: Hypoxia is immediately life-threatening. Version A NGN emphasizes ABCs first,
then medications and notification.
Question 3 – OB / Maternity
A 32-week pregnant patient reports a sudden gush of fluid from the vagina. Which is the
priority nursing action?
A. Reassure the patient
B. Assess fetal heart rate
C. Encourage ambulation
D. Document findings
Answer: ✅ B. Assess fetal heart rate
Rationale: Premature rupture of membranes requires fetal assessment first, as Version A NGN
emphasizes maternal-fetal prioritization.
Question 4 – Pediatrics
A 5-year-old with type 1 diabetes presents with BG 420 mg/dL, fruity breath, and vomiting.
Which is the priority intervention?
A. Administer oral insulin
B. Notify provider and start IV fluids
C. Encourage oral hydration
D. Monitor BG in 2 hours
Answer: ✅ B. Notify provider and start IV fluids
Rationale: This is diabetic ketoacidosis, a life-threatening emergency. Version A NGN focuses
on rapid multi-step interventions.
Question 5 – OB / Maternity
A laboring patient at 39 weeks shows late decelerations on fetal monitoring. Maternal vitals
are stable. Which is the highest priority action?
A. Reposition patient
B. Notify provider immediately
HESI RN Next Generation (NGN) Version A – 150 Carefully Developed NGN-Style Practice Questions, Each Paired With Accurate, Fully Verified
Answers and Rationales Test Bank (2026) With A+ Pass Guarantee
,C. Apply oxygen
D. Start IV fluids if ordered
Answer: ✅ B. Notify provider immediately
Rationale: Late decelerations indicate uteroplacental insufficiency. Provider notification is
essential before other interventions.
Question 6 – Pediatrics
A 7-year-old presents with moderate dehydration: sunken eyes, lethargy, dry mucous
membranes. Which is the priority nursing intervention?
A. Administer oral rehydration solution
B. Start IV fluids and notify provider
C. Monitor vital signs
D. Encourage oral intake
Answer: ✅ B. Start IV fluids and notify provider
Rationale: Moderate dehydration requires rapid IV rehydration. Version A NGN emphasizes
early intervention to prevent shock.
Question 7 – OB / Maternity
A postpartum patient reports heavy vaginal bleeding 2 hours after vaginal delivery. BP 82/50,
HR 128. Which action is priority?
A. Massage fundus
B. Notify provider
C. Apply oxygen
D. Start IV fluids
Answer: ✅ A. Massage fundus
Rationale: Uterine atony is the most common cause of postpartum hemorrhage. Immediate
fundal massage is life-saving.
Question 8 – Pediatrics
HESI RN Next Generation (NGN) Version A – 150 Carefully Developed NGN-Style Practice Questions, Each Paired With Accurate, Fully Verified
Answers and Rationales Test Bank (2026) With A+ Pass Guarantee
, A 4-year-old with febrile seizure is postictal. SpO₂ 87%, HR 150, temp 103°F. What is the first
nursing action?
A. Administer antipyretic
B. Apply oxygen and monitor airway
C. Encourage oral fluids
D. Notify provider in 2 hours
Answer: ✅ B. Apply oxygen and monitor airway
Rationale: Hypoxia is life-threatening. Version A NGN emphasizes airway and breathing
support in pediatric seizures.
Question 9 – OB / Maternity
A 36-week pregnant patient with preeclampsia reports headache and visual changes. BP
160/110. What is the priority nursing action?
A. Administer prescribed antihypertensive
B. Assess reflexes and notify provider
C. Encourage rest
D. Document findings
Answer: ✅ B. Assess reflexes and notify provider
Rationale: Severe preeclampsia with neurological symptoms can progress to eclampsia.
Version A NGN emphasizes rapid assessment and provider notification.
Question 10 – Pediatrics
A 6-year-old with asthma is receiving a nebulizer treatment. Which finding indicates immediate
intervention is required?
A. Mild wheezing
B. SpO₂ drops to 85%
C. Occasional cough
D. Comfortable at rest
Answer: ✅ B. SpO₂ drops to 85%
Rationale: Hypoxia is life-threatening. Version A NGN focuses on rapid recognition and
intervention.
HESI RN Next Generation (NGN) Version A – 150 Carefully Developed NGN-Style Practice Questions, Each Paired With Accurate, Fully Verified
Answers and Rationales Test Bank (2026) With A+ Pass Guarantee
Developed NGN-Style Practice Questions, Each Paired With
Accurate, Fully Verified Answers and Rationales Test Bank (2026)
With A+ Pass Guarantee
Pediatrics & OB / Maternity – Case-Based / Single Best
Action (Questions 1–15)
Question 1 – Pediatrics
A 3-year-old presents with fever 102.5°F, irritability, and poor oral intake. The child has
vomiting and diarrhea for 24 hours. What is the highest priority nursing action?
A. Encourage oral fluids
B. Assess hydration status and vital signs
C. Administer antipyretic as ordered
D. Notify provider about fever
Answer: ✅ B. Assess hydration status and vital signs
Rationale: The child’s vomiting and diarrhea put them at risk for dehydration, which is
potentially life-threatening. Version A NGN emphasizes ABC + assessment before
interventions.
Question 2 – Pediatrics
A 6-year-old with asthma presents with wheezing, accessory muscle use, and SpO₂ 88%.
Which is the priority nursing action?
A. Apply oxygen
B. Administer nebulized bronchodilator
C. Notify provider
D. Monitor vital signs
Answer: ✅ A. Apply oxygen
HESI RN Next Generation (NGN) Version A – 150 Carefully Developed NGN-Style Practice Questions, Each Paired With Accurate, Fully Verified
Answers and Rationales Test Bank (2026) With A+ Pass Guarantee
,Rationale: Hypoxia is immediately life-threatening. Version A NGN emphasizes ABCs first,
then medications and notification.
Question 3 – OB / Maternity
A 32-week pregnant patient reports a sudden gush of fluid from the vagina. Which is the
priority nursing action?
A. Reassure the patient
B. Assess fetal heart rate
C. Encourage ambulation
D. Document findings
Answer: ✅ B. Assess fetal heart rate
Rationale: Premature rupture of membranes requires fetal assessment first, as Version A NGN
emphasizes maternal-fetal prioritization.
Question 4 – Pediatrics
A 5-year-old with type 1 diabetes presents with BG 420 mg/dL, fruity breath, and vomiting.
Which is the priority intervention?
A. Administer oral insulin
B. Notify provider and start IV fluids
C. Encourage oral hydration
D. Monitor BG in 2 hours
Answer: ✅ B. Notify provider and start IV fluids
Rationale: This is diabetic ketoacidosis, a life-threatening emergency. Version A NGN focuses
on rapid multi-step interventions.
Question 5 – OB / Maternity
A laboring patient at 39 weeks shows late decelerations on fetal monitoring. Maternal vitals
are stable. Which is the highest priority action?
A. Reposition patient
B. Notify provider immediately
HESI RN Next Generation (NGN) Version A – 150 Carefully Developed NGN-Style Practice Questions, Each Paired With Accurate, Fully Verified
Answers and Rationales Test Bank (2026) With A+ Pass Guarantee
,C. Apply oxygen
D. Start IV fluids if ordered
Answer: ✅ B. Notify provider immediately
Rationale: Late decelerations indicate uteroplacental insufficiency. Provider notification is
essential before other interventions.
Question 6 – Pediatrics
A 7-year-old presents with moderate dehydration: sunken eyes, lethargy, dry mucous
membranes. Which is the priority nursing intervention?
A. Administer oral rehydration solution
B. Start IV fluids and notify provider
C. Monitor vital signs
D. Encourage oral intake
Answer: ✅ B. Start IV fluids and notify provider
Rationale: Moderate dehydration requires rapid IV rehydration. Version A NGN emphasizes
early intervention to prevent shock.
Question 7 – OB / Maternity
A postpartum patient reports heavy vaginal bleeding 2 hours after vaginal delivery. BP 82/50,
HR 128. Which action is priority?
A. Massage fundus
B. Notify provider
C. Apply oxygen
D. Start IV fluids
Answer: ✅ A. Massage fundus
Rationale: Uterine atony is the most common cause of postpartum hemorrhage. Immediate
fundal massage is life-saving.
Question 8 – Pediatrics
HESI RN Next Generation (NGN) Version A – 150 Carefully Developed NGN-Style Practice Questions, Each Paired With Accurate, Fully Verified
Answers and Rationales Test Bank (2026) With A+ Pass Guarantee
, A 4-year-old with febrile seizure is postictal. SpO₂ 87%, HR 150, temp 103°F. What is the first
nursing action?
A. Administer antipyretic
B. Apply oxygen and monitor airway
C. Encourage oral fluids
D. Notify provider in 2 hours
Answer: ✅ B. Apply oxygen and monitor airway
Rationale: Hypoxia is life-threatening. Version A NGN emphasizes airway and breathing
support in pediatric seizures.
Question 9 – OB / Maternity
A 36-week pregnant patient with preeclampsia reports headache and visual changes. BP
160/110. What is the priority nursing action?
A. Administer prescribed antihypertensive
B. Assess reflexes and notify provider
C. Encourage rest
D. Document findings
Answer: ✅ B. Assess reflexes and notify provider
Rationale: Severe preeclampsia with neurological symptoms can progress to eclampsia.
Version A NGN emphasizes rapid assessment and provider notification.
Question 10 – Pediatrics
A 6-year-old with asthma is receiving a nebulizer treatment. Which finding indicates immediate
intervention is required?
A. Mild wheezing
B. SpO₂ drops to 85%
C. Occasional cough
D. Comfortable at rest
Answer: ✅ B. SpO₂ drops to 85%
Rationale: Hypoxia is life-threatening. Version A NGN focuses on rapid recognition and
intervention.
HESI RN Next Generation (NGN) Version A – 150 Carefully Developed NGN-Style Practice Questions, Each Paired With Accurate, Fully Verified
Answers and Rationales Test Bank (2026) With A+ Pass Guarantee
