NGN HESI LEADERSHIP AND MANAGEMENT
EXAM COMPREHENSIVE EXAM SCRIPT 2026
SOLVED QUESTIONS FULL SOLUTION
◉ The nurse is completing the admission assessment of a 3-year old
who is admitted with bacterial meningitis and hydrocephalus. Which
assessment finding is evidence that the child is experiencing
increased intracranial pressure (ICP)?
A. Tachycardia and tachypnea
B. Sluggish and unequal pupillary responses
C. Increased head circumference and bulging fontanels
D. Blood pressure fluctuations and syncope Answer: B. Sluggish and
unequal pupillary responses
◉ A client with acute pancreatitis is admitted with severe, piercing
abdominal pain and an elevated serum amylase. Which additional
information is the client most likely to report to the nurse?
A. Abdominal pain decreases when lying supine
B. Pain lasts an hour and leaves the abdomen tender
C. Right upper quadrant pain refers to right scapula
D. Drinks alcohol until intoxicated at least twice weekly. Answer: A.
Abdominal pain decreases when lying supine
,◉ A child newly diagnosed with sickle cell anemia (SCA) is being
discharged from the hospital. Which information is most important
for the nurse to provide the parents prior to discharge?
A. Instructions about how much fluid the child should drink daily.
B. Signs of addiction to opioid pain medications
C. Information about non-pharmaceutical pain relief measures
D. Referral for social services for the child and family Answer: A.
Instructions about how much fluid the child should drink daily
◉ To auscultate for a carotid bruit, the nurse places the stethoscope
at what location. (Select the location on the image with a red dot).
Answer: I placed the red dot on the base of the neck on the right side
◉ After receiving report on an inpatient acute care unit, which client
should the nurse assess first?
A. The client with an obstruction of the large intestine who is
experiencing abdominal distention
B. The client who had surgery yesterday and is experiencing a
paralytic ileus with absent bowel sounds
C. The client with a small bowel obstruction who has a nasogastric
tube that is draining greenish fluid
D. The client with a bowel obstruction due to a volvulus who is
experiencing abdominal rigidity Answer: D. The client with a bowel
obstruction due to a volvulus who is experiencing abdominal rigidity
,◉ A teenager presents to the emergency department with
palpitations after vaping at a party. The client is anxious, fearful, and
hyperventilating. The nurse anticipates the client developing which
acid base imbalance?
A. Respiratory acidosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory alkalosis Answer: D. Respiratory alkalosis
◉ A client with dyspnea is being admitted to the medical unit. To
best prepare for the client's arrival, the nurse should ensure that the
client's bed is in which position?
A. Supine
B. supine; feet elevated higher than head
C. supine; head elevated higher than feet
D. Fowlers Answer: Fowlers
◉ The nurse is taking the blood pressure measurement of a client
with Parkinson's disease. Which information in the client's
admission assessment is relevant to the nurse's plan for taking the
blood pressure reading? (Select all the apply)
A. Frequent syncope
B. Occasional nocturia
C. Flat affect
, D. Blurred vision
E. Frequent drooling Answer: A. Frequent syncope
C. Flat affect
D. Blurred vision
◉ While caring for a client's postoperative dressing, the nurse
observes purulent drainage at the wound. Before reporting this
finding to the healthcare provider, the nurse should review which of
the client's laboratory values?
A. Serum albumin
B. Culture for sensitive organisms
C. Serum blood glucose level
D. Creatinine level Answer: B. Culture for sensitive organisms
◉ A preschool-aged boy is admitted to the pediatric unit following
successful resuscitation from a near-drowning incident. While
providing care to the child, the nurse begins talking with his
preadolescent brother who rescued the child from the swimming
pool and initiated resuscitation. The nurse notices the older boy
becomes withdrawn when asked about what happened. Which
action should the nurse take?
A. Develop a water safety teaching plan for the family
B. Ask the older brother how he felt during the incident
C. Tell the older brother that he seems depressed
EXAM COMPREHENSIVE EXAM SCRIPT 2026
SOLVED QUESTIONS FULL SOLUTION
◉ The nurse is completing the admission assessment of a 3-year old
who is admitted with bacterial meningitis and hydrocephalus. Which
assessment finding is evidence that the child is experiencing
increased intracranial pressure (ICP)?
A. Tachycardia and tachypnea
B. Sluggish and unequal pupillary responses
C. Increased head circumference and bulging fontanels
D. Blood pressure fluctuations and syncope Answer: B. Sluggish and
unequal pupillary responses
◉ A client with acute pancreatitis is admitted with severe, piercing
abdominal pain and an elevated serum amylase. Which additional
information is the client most likely to report to the nurse?
A. Abdominal pain decreases when lying supine
B. Pain lasts an hour and leaves the abdomen tender
C. Right upper quadrant pain refers to right scapula
D. Drinks alcohol until intoxicated at least twice weekly. Answer: A.
Abdominal pain decreases when lying supine
,◉ A child newly diagnosed with sickle cell anemia (SCA) is being
discharged from the hospital. Which information is most important
for the nurse to provide the parents prior to discharge?
A. Instructions about how much fluid the child should drink daily.
B. Signs of addiction to opioid pain medications
C. Information about non-pharmaceutical pain relief measures
D. Referral for social services for the child and family Answer: A.
Instructions about how much fluid the child should drink daily
◉ To auscultate for a carotid bruit, the nurse places the stethoscope
at what location. (Select the location on the image with a red dot).
Answer: I placed the red dot on the base of the neck on the right side
◉ After receiving report on an inpatient acute care unit, which client
should the nurse assess first?
A. The client with an obstruction of the large intestine who is
experiencing abdominal distention
B. The client who had surgery yesterday and is experiencing a
paralytic ileus with absent bowel sounds
C. The client with a small bowel obstruction who has a nasogastric
tube that is draining greenish fluid
D. The client with a bowel obstruction due to a volvulus who is
experiencing abdominal rigidity Answer: D. The client with a bowel
obstruction due to a volvulus who is experiencing abdominal rigidity
,◉ A teenager presents to the emergency department with
palpitations after vaping at a party. The client is anxious, fearful, and
hyperventilating. The nurse anticipates the client developing which
acid base imbalance?
A. Respiratory acidosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory alkalosis Answer: D. Respiratory alkalosis
◉ A client with dyspnea is being admitted to the medical unit. To
best prepare for the client's arrival, the nurse should ensure that the
client's bed is in which position?
A. Supine
B. supine; feet elevated higher than head
C. supine; head elevated higher than feet
D. Fowlers Answer: Fowlers
◉ The nurse is taking the blood pressure measurement of a client
with Parkinson's disease. Which information in the client's
admission assessment is relevant to the nurse's plan for taking the
blood pressure reading? (Select all the apply)
A. Frequent syncope
B. Occasional nocturia
C. Flat affect
, D. Blurred vision
E. Frequent drooling Answer: A. Frequent syncope
C. Flat affect
D. Blurred vision
◉ While caring for a client's postoperative dressing, the nurse
observes purulent drainage at the wound. Before reporting this
finding to the healthcare provider, the nurse should review which of
the client's laboratory values?
A. Serum albumin
B. Culture for sensitive organisms
C. Serum blood glucose level
D. Creatinine level Answer: B. Culture for sensitive organisms
◉ A preschool-aged boy is admitted to the pediatric unit following
successful resuscitation from a near-drowning incident. While
providing care to the child, the nurse begins talking with his
preadolescent brother who rescued the child from the swimming
pool and initiated resuscitation. The nurse notices the older boy
becomes withdrawn when asked about what happened. Which
action should the nurse take?
A. Develop a water safety teaching plan for the family
B. Ask the older brother how he felt during the incident
C. Tell the older brother that he seems depressed
