HESI EXIT EXAM NGN UPDATED
2026 – FULL TOPIC TEST
QUESTIONS AND ANSWERS
WITH RATIONALES/GRADED
A+/2026 UPDATE/100% CORRECT
/INSTANT DOWNLOAD
SECTION 1: Medical-Surgical Nursing
1. A nurse is caring for a client with heart failure who has crackles in both lung bases,
dyspnea on exertion, and +3 pitting edema. Which intervention should the nurse
implement first?
a) Administer furosemide IV push
b) Place the client in high-Fowler’s position
c) Restrict oral fluids to 1,500 mL/day
d) Apply sequential compression devices
Correct Answer: b) Place the client in high-Fowler’s position
Rationale: High-Fowler’s position reduces venous return (preload) and promotes lung
expansion, improving oxygenation. Airway/breathing always first.
2. A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 86% on room air. The nurse applies 2 L/min via nasal cannula. Which
assessment finding indicates an appropriate response?
a) Respiratory rate increases from 22 to 30
b) Oxygen saturation rises to 92%
c) Client reports headache and dizziness
d) PaCO₂ level increases from 48 to 56 mm Hg
Correct Answer: b) Oxygen saturation rises to 92%
Rationale: Target SpO₂ for COPD is 88–92% to avoid hypercapnia; 92% is acceptable,
indicating improved oxygenation without suppressing hypoxic drive.
, 3. A nurse is monitoring a client receiving a blood transfusion. 15 minutes after
initiation, the client reports chills and low back pain. What is the priority action?
a) Slow the transfusion rate
b) Administer acetaminophen as ordered
c) Stop the transfusion and infuse normal saline
d) Notify the healthcare provider
Correct Answer: c) Stop the transfusion and infuse normal saline
Rationale: Symptoms suggest acute hemolytic reaction. Stop transfusion immediately,
keep IV line open with saline, then notify provider.
4. A client with diabetes mellitus type 2 has a blood glucose of 48 mg/dL and is
unconscious. Which action should the nurse take first?
a) Give 15 g of oral glucose gel
b) Administer 1 mg glucagon IM
c) Start IV dextrose 50% push
d) Recheck blood glucose in 15 minutes
Correct Answer: b) Administer 1 mg glucagon IM
Rationale: Unconscious patient cannot swallow. Glucagon IM (or IV dextrose if IV
access ready) is correct; glucagon is faster if no IV.
5. A client post–myocardial infarction develops crackles halfway up the lung fields, S3
gallop, and BP 90/60 mm Hg. The nurse suspects:
a) Cardiogenic shock
b) Pericarditis
c) Pulmonary embolism
d) Cardiac tamponade
Correct Answer: a) Cardiogenic shock
*Rationale: S3, crackles, hypotension post-MI indicate left ventricular failure with
cardiogenic shock.*
6. A nurse is caring for a client with acute pancreatitis. Which laboratory finding is
most specific to this condition?
a) Elevated serum amylase and lipase
b) Elevated WBC count
c) Decreased serum calcium
d) Elevated blood glucose
Correct Answer: a) Elevated serum amylase and lipase
Rationale: Amylase rises within hours; lipase is more specific for pancreatitis and
remains elevated longer.
2026 – FULL TOPIC TEST
QUESTIONS AND ANSWERS
WITH RATIONALES/GRADED
A+/2026 UPDATE/100% CORRECT
/INSTANT DOWNLOAD
SECTION 1: Medical-Surgical Nursing
1. A nurse is caring for a client with heart failure who has crackles in both lung bases,
dyspnea on exertion, and +3 pitting edema. Which intervention should the nurse
implement first?
a) Administer furosemide IV push
b) Place the client in high-Fowler’s position
c) Restrict oral fluids to 1,500 mL/day
d) Apply sequential compression devices
Correct Answer: b) Place the client in high-Fowler’s position
Rationale: High-Fowler’s position reduces venous return (preload) and promotes lung
expansion, improving oxygenation. Airway/breathing always first.
2. A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 86% on room air. The nurse applies 2 L/min via nasal cannula. Which
assessment finding indicates an appropriate response?
a) Respiratory rate increases from 22 to 30
b) Oxygen saturation rises to 92%
c) Client reports headache and dizziness
d) PaCO₂ level increases from 48 to 56 mm Hg
Correct Answer: b) Oxygen saturation rises to 92%
Rationale: Target SpO₂ for COPD is 88–92% to avoid hypercapnia; 92% is acceptable,
indicating improved oxygenation without suppressing hypoxic drive.
, 3. A nurse is monitoring a client receiving a blood transfusion. 15 minutes after
initiation, the client reports chills and low back pain. What is the priority action?
a) Slow the transfusion rate
b) Administer acetaminophen as ordered
c) Stop the transfusion and infuse normal saline
d) Notify the healthcare provider
Correct Answer: c) Stop the transfusion and infuse normal saline
Rationale: Symptoms suggest acute hemolytic reaction. Stop transfusion immediately,
keep IV line open with saline, then notify provider.
4. A client with diabetes mellitus type 2 has a blood glucose of 48 mg/dL and is
unconscious. Which action should the nurse take first?
a) Give 15 g of oral glucose gel
b) Administer 1 mg glucagon IM
c) Start IV dextrose 50% push
d) Recheck blood glucose in 15 minutes
Correct Answer: b) Administer 1 mg glucagon IM
Rationale: Unconscious patient cannot swallow. Glucagon IM (or IV dextrose if IV
access ready) is correct; glucagon is faster if no IV.
5. A client post–myocardial infarction develops crackles halfway up the lung fields, S3
gallop, and BP 90/60 mm Hg. The nurse suspects:
a) Cardiogenic shock
b) Pericarditis
c) Pulmonary embolism
d) Cardiac tamponade
Correct Answer: a) Cardiogenic shock
*Rationale: S3, crackles, hypotension post-MI indicate left ventricular failure with
cardiogenic shock.*
6. A nurse is caring for a client with acute pancreatitis. Which laboratory finding is
most specific to this condition?
a) Elevated serum amylase and lipase
b) Elevated WBC count
c) Decreased serum calcium
d) Elevated blood glucose
Correct Answer: a) Elevated serum amylase and lipase
Rationale: Amylase rises within hours; lipase is more specific for pancreatitis and
remains elevated longer.
