HESI RN Next Generation (NGN) Version B – 150 Carefully
Developed NGN-Style Practice Questions, Each Paired With
Accurate, Fully Verified Answers and Rationales Test Bank (2026)
With A+ Pass Guarantee
HESI RN NGN Exit Exam – Version B Difficulty
Question 1
A 72-year-old patient with chronic heart failure presents with dyspnea, bilateral leg edema, and
weight gain of 5 lbs in 3 days.
Vitals: BP 102/60 mmHg, HR 96 bpm, RR 28/min, SpO₂ 90% on room air.
Which action should the nurse take first?
A. Administer furosemide as prescribed
B. Apply supplemental oxygen
C. Assess lung sounds
D. Obtain a daily weight
Answer: ✅ B. Apply supplemental oxygen
Rationale: Hypoxia is the most immediate threat. Version B questions prioritize ABCs before
medications or monitoring.
Question 2
A 65-year-old post-op patient from abdominal surgery reports severe abdominal pain 2 hours
after receiving morphine. Vital signs: BP 90/56, HR 110, RR 30.
Which intervention is the priority?
A. Notify the provider
B. Administer an antiemetic
C. Assess the abdomen for distention or rigidity
D. Encourage ambulation
Answer: ✅ C. Assess the abdomen for distention or rigidity
Rationale: Acute post-op complications (bleeding, peritonitis) must be assessed immediately,
even before contacting the provider. Version B questions emphasize rapid clinical judgment
HESI RN Next Generation (NGN) Version B – 150 Carefully Developed NGN-Style Practice Questions, Each Paired With Accurate, Fully Verified
Answers and Rationales Test Bank (2026) With A+ Pass Guarantee
,Question 3
A 55-year-old patient with chronic kidney disease presents with shortness of breath, edema, and
confusion.
Vitals: BP 150/90, HR 102, RR 26, SpO₂ 88%.
Which action should the nurse take first?
A. Obtain a daily weight
B. Administer antihypertensive medication
C. Apply supplemental oxygen
D. Restrict fluid intake
Answer: ✅ C. Apply supplemental oxygen
Rationale: Hypoxia is an immediate threat; oxygen is priority before medications or monitoring.
Version B emphasizes ABCs first.
Question 4
A post-op patient (abdominal surgery) complains of sudden chest pain and dyspnea. Vitals: BP
90/58, HR 120, RR 32, SpO₂ 85%.
Priority action:
A. Administer oxygen
B. Notify the provider
C. Assess for DVT
D. Administer pain medication
Answer: ✅ A. Administer oxygen
Rationale: Hypoxia takes priority. Version B case studies require rapid life-threatening issue
recognition.
Question 5
A patient with acute myocardial infarction reports chest pain rated 8/10. Vital signs: BP 100/60,
HR 110, RR 24, SpO₂ 91%.
First action:
A. Administer nitroglycerin
B. Apply oxygen
C. Obtain ECG
D. Assess for contraindications
HESI RN Next Generation (NGN) Version B – 150 Carefully Developed NGN-Style Practice Questions, Each Paired With Accurate, Fully Verified
Answers and Rationales Test Bank (2026) With A+ Pass Guarantee
,Answer: ✅ B. Apply oxygen
Rationale: Version B prioritizes immediate oxygenation. Other interventions follow
stabilization.
Question 6
A 60-year-old diabetic patient presents with BG 450 mg/dL, polyuria, polydipsia, and fruity
breath odor.
Next action:
A. Administer sliding-scale insulin
B. Start IV fluids
C. Obtain a urine ketone test
D. Notify the provider
Answer: ✅ B. Start IV fluids
Rationale: Patient likely has DKA; fluid resuscitation is life-saving. Version B questions
prioritize physiologic stability over medications.
Question 7
A client with pneumonia is receiving IV antibiotics. Temp: 102.4°F, HR 120, BP 108/70, RR 28.
Patient is confused and lethargic.
Next action:
A. Administer antipyretic
B. Assess oxygen saturation
C. Encourage oral fluids
D. Notify provider
Answer: ✅ B. Assess oxygen saturation
Rationale: Confusion may indicate hypoxia or sepsis. Version B focuses on critical assessment
before other interventions.
Question 8
A patient with chronic liver disease has ascites and abdominal distention. Vital signs: BP 95/60,
HR 100, RR 22.
HESI RN Next Generation (NGN) Version B – 150 Carefully Developed NGN-Style Practice Questions, Each Paired With Accurate, Fully Verified
Answers and Rationales Test Bank (2026) With A+ Pass Guarantee
, First intervention:
A. Measure abdominal girth
B. Administer diuretics
C. Elevate legs
D. Assess electrolyte levels
Answer: ✅ A. Measure abdominal girth
Rationale: Quantifying fluid retention guides safe diuretic therapy. Version B stresses
assessment-driven intervention.
Question 9
A post-op patient reports unilateral leg swelling, redness, and warmth after hip replacement.
Action:
A. Elevate leg and apply warm compress
B. Administer pain medication
C. Notify provider for possible DVT
D. Encourage ambulation
Answer: ✅ C. Notify provider
Rationale: These are classic DVT signs; early detection prevents pulmonary embolism.
Question 10
A patient with COPD presents with worsening dyspnea and pursed-lip breathing. SpO₂ is 87% on
room air.
Next step:
A. Encourage coughing
B. Apply oxygen at 2 L/min
C. Administer bronchodilator
D. Elevate head of bed
Answer: ✅ D. Elevate head of bed
Rationale: Positioning improves ventilation immediately. Oxygen and bronchodilator follow
after stabilization.
HESI RN Next Generation (NGN) Version B – 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
HESI RN NGN Exit Exam – Version B Difficulty
Question 1
A 72-year-old patient with chronic heart failure presents with dyspnea, bilateral leg edema, and
weight gain of 5 lbs in 3 days.
Vitals: BP 102/60 mmHg, HR 96 bpm, RR 28/min, SpO₂ 90% on room air.
Which action should the nurse take first?
A. Administer furosemide as prescribed
B. Apply supplemental oxygen
C. Assess lung sounds
D. Obtain a daily weight
Answer: ✅ B. Apply supplemental oxygen
Rationale: Hypoxia is the most immediate threat. Version B questions prioritize ABCs before
medications or monitoring.
Question 2
A 65-year-old post-op patient from abdominal surgery reports severe abdominal pain 2 hours
after receiving morphine. Vital signs: BP 90/56, HR 110, RR 30.
Which intervention is the priority?
A. Notify the provider
B. Administer an antiemetic
C. Assess the abdomen for distention or rigidity
D. Encourage ambulation
Answer: ✅ C. Assess the abdomen for distention or rigidity
Rationale: Acute post-op complications (bleeding, peritonitis) must be assessed immediately,
even before contacting the provider. Version B questions emphasize rapid clinical judgment
HESI RN Next Generation (NGN) Version B – 150 Carefully Developed NGN-Style Practice Questions, Each Paired With Accurate, Fully Verified
Answers and Rationales Test Bank (2026) With A+ Pass Guarantee
,Question 3
A 55-year-old patient with chronic kidney disease presents with shortness of breath, edema, and
confusion.
Vitals: BP 150/90, HR 102, RR 26, SpO₂ 88%.
Which action should the nurse take first?
A. Obtain a daily weight
B. Administer antihypertensive medication
C. Apply supplemental oxygen
D. Restrict fluid intake
Answer: ✅ C. Apply supplemental oxygen
Rationale: Hypoxia is an immediate threat; oxygen is priority before medications or monitoring.
Version B emphasizes ABCs first.
Question 4
A post-op patient (abdominal surgery) complains of sudden chest pain and dyspnea. Vitals: BP
90/58, HR 120, RR 32, SpO₂ 85%.
Priority action:
A. Administer oxygen
B. Notify the provider
C. Assess for DVT
D. Administer pain medication
Answer: ✅ A. Administer oxygen
Rationale: Hypoxia takes priority. Version B case studies require rapid life-threatening issue
recognition.
Question 5
A patient with acute myocardial infarction reports chest pain rated 8/10. Vital signs: BP 100/60,
HR 110, RR 24, SpO₂ 91%.
First action:
A. Administer nitroglycerin
B. Apply oxygen
C. Obtain ECG
D. Assess for contraindications
HESI RN Next Generation (NGN) Version B – 150 Carefully Developed NGN-Style Practice Questions, Each Paired With Accurate, Fully Verified
Answers and Rationales Test Bank (2026) With A+ Pass Guarantee
,Answer: ✅ B. Apply oxygen
Rationale: Version B prioritizes immediate oxygenation. Other interventions follow
stabilization.
Question 6
A 60-year-old diabetic patient presents with BG 450 mg/dL, polyuria, polydipsia, and fruity
breath odor.
Next action:
A. Administer sliding-scale insulin
B. Start IV fluids
C. Obtain a urine ketone test
D. Notify the provider
Answer: ✅ B. Start IV fluids
Rationale: Patient likely has DKA; fluid resuscitation is life-saving. Version B questions
prioritize physiologic stability over medications.
Question 7
A client with pneumonia is receiving IV antibiotics. Temp: 102.4°F, HR 120, BP 108/70, RR 28.
Patient is confused and lethargic.
Next action:
A. Administer antipyretic
B. Assess oxygen saturation
C. Encourage oral fluids
D. Notify provider
Answer: ✅ B. Assess oxygen saturation
Rationale: Confusion may indicate hypoxia or sepsis. Version B focuses on critical assessment
before other interventions.
Question 8
A patient with chronic liver disease has ascites and abdominal distention. Vital signs: BP 95/60,
HR 100, RR 22.
HESI RN Next Generation (NGN) Version B – 150 Carefully Developed NGN-Style Practice Questions, Each Paired With Accurate, Fully Verified
Answers and Rationales Test Bank (2026) With A+ Pass Guarantee
, First intervention:
A. Measure abdominal girth
B. Administer diuretics
C. Elevate legs
D. Assess electrolyte levels
Answer: ✅ A. Measure abdominal girth
Rationale: Quantifying fluid retention guides safe diuretic therapy. Version B stresses
assessment-driven intervention.
Question 9
A post-op patient reports unilateral leg swelling, redness, and warmth after hip replacement.
Action:
A. Elevate leg and apply warm compress
B. Administer pain medication
C. Notify provider for possible DVT
D. Encourage ambulation
Answer: ✅ C. Notify provider
Rationale: These are classic DVT signs; early detection prevents pulmonary embolism.
Question 10
A patient with COPD presents with worsening dyspnea and pursed-lip breathing. SpO₂ is 87% on
room air.
Next step:
A. Encourage coughing
B. Apply oxygen at 2 L/min
C. Administer bronchodilator
D. Elevate head of bed
Answer: ✅ D. Elevate head of bed
Rationale: Positioning improves ventilation immediately. Oxygen and bronchodilator follow
after stabilization.
HESI RN Next Generation (NGN) Version B – 150 Carefully Developed NGN-Style Practice Questions, Each Paired With Accurate, Fully Verified
Answers and Rationales Test Bank (2026) With A+ Pass Guarantee
