2025/2026 HESI Exit RN Exam V1-V7 with
Next Generation NCLEX (NGN) by Sandra
Upchurch and Health Education Systems Inc.
(Elsevier) - Ultimate Test Bank with Rationales
to Pass on First Attempt
### 21. A charge nurse is assigning clients on a medical-surgical unit.
Which client should be assigned to a registered nurse (RN) rather
than a licensed practical nurse (LPN)?
A. A client with a urinary tract infection receiving IV antibiotics day 2
B. A client who needs a sterile wound dressing change for a stage 3
pressure injury
C. A client with new-onset confusion and a blood pressure of 88/50
mm Hg
D. A client who requires a straight catheterization for post-void
residual
**Correct Answer:** C
**Rationale:** New-onset confusion with hypotension suggests
possible sepsis or neurological deterioration, requiring RN
assessment and intervention. Stable IV antibiotics, wound care, and
catheterization can be delegated to LPNs.
,**22. A nurse is administering furosemide 40 mg IV push to a client
with acute pulmonary edema. Which of the following findings
indicates the medication is having the desired effect? **
A. Decreased crackles on lung auscultation
B. Increased blood pressure
C. Decreased urine output
D. Serum potassium level of 3.1 mEq/L
**Correct Answer:** A
**Rationale:** Furosemide reduces preload, decreasing pulmonary
congestion and resulting in decreased crackles. Increased urine
output is desired, but decreased crackles directly indicates improved
respiratory status.
**23. A nurse is providing dietary teaching to a client who has a new
prescription for warfarin. Which of the following foods should the
nurse instruct the client to eat in consistent amounts? **
A. Broccoli
B. Cranberries
C. Spinach
D. Green beans
**Correct Answer:** C
**Rationale:** Spinach is high in vitamin K, which antagonizes the
effects of warfarin. Clients should maintain a consistent intake of
vitamin K-rich foods to ensure stable anticoagulation.
,**24. A nurse is caring for a client who is receiving magnesium
sulfate for preeclampsia. Which of the following findings indicates
magnesium toxicity? **
A. Respiratory rate 16/min
B. Deep tendon reflexes 3+
C. Urine output 20 mL in 2 hours
D. Serum magnesium level 4 mEq/L
**Correct Answer:** C
**Rationale:** Urine output below 30 mL/hour indicates oliguria,
which increases the risk of magnesium accumulation and toxicity.
The first sign of toxicity is decreased deep tendon reflexes.
**25. A nurse is assessing a client who is 1 day postpartum and
reports a boggy fundus displaced to the right. Which of the following
actions should the nurse take first? **
A. Administer oxytocin as prescribed
B. Assist the client to empty her bladder
C. Perform fundal massage
D. Notify the provider
**Correct Answer:** B
**Rationale:** A displaced, boggy fundus suggests a distended
bladder pushing the uterus upward and to the right; the first action is
to have the client void, then reassess fundal tone.
, **26. A nurse is preparing to administer a blood transfusion of
packed red blood cells. Which IV solution should the nurse use to
prime the blood tubing? **
A. 5% dextrose in water
B. 0.45% sodium chloride
C. Lactated Ringer's solution
D. 0.9% sodium chloride
**Correct Answer:** D
**Rationale:** Only 0.9% sodium chloride (normal saline) is
compatible with packed red blood cells; dextrose causes hemolysis,
and lactated Ringer's contains calcium which can cause clotting.
**27. A nurse is assessing a client who has a new diagnosis of
diabetes insipidus. Which finding should the nurse expect? **
A. Serum sodium 165 mEq/L
B. Urine specific gravity 1.035
C. Blood glucose 250 mg/dL
D. Serum osmolality 260 mOsm/kg
**Correct Answer:** A
**Rationale:** Diabetes insipidus causes excessive dilute urine
leading to hypernatremia (high sodium) and increased serum
osmolality; urine specific gravity is low (<1.005).
Next Generation NCLEX (NGN) by Sandra
Upchurch and Health Education Systems Inc.
(Elsevier) - Ultimate Test Bank with Rationales
to Pass on First Attempt
### 21. A charge nurse is assigning clients on a medical-surgical unit.
Which client should be assigned to a registered nurse (RN) rather
than a licensed practical nurse (LPN)?
A. A client with a urinary tract infection receiving IV antibiotics day 2
B. A client who needs a sterile wound dressing change for a stage 3
pressure injury
C. A client with new-onset confusion and a blood pressure of 88/50
mm Hg
D. A client who requires a straight catheterization for post-void
residual
**Correct Answer:** C
**Rationale:** New-onset confusion with hypotension suggests
possible sepsis or neurological deterioration, requiring RN
assessment and intervention. Stable IV antibiotics, wound care, and
catheterization can be delegated to LPNs.
,**22. A nurse is administering furosemide 40 mg IV push to a client
with acute pulmonary edema. Which of the following findings
indicates the medication is having the desired effect? **
A. Decreased crackles on lung auscultation
B. Increased blood pressure
C. Decreased urine output
D. Serum potassium level of 3.1 mEq/L
**Correct Answer:** A
**Rationale:** Furosemide reduces preload, decreasing pulmonary
congestion and resulting in decreased crackles. Increased urine
output is desired, but decreased crackles directly indicates improved
respiratory status.
**23. A nurse is providing dietary teaching to a client who has a new
prescription for warfarin. Which of the following foods should the
nurse instruct the client to eat in consistent amounts? **
A. Broccoli
B. Cranberries
C. Spinach
D. Green beans
**Correct Answer:** C
**Rationale:** Spinach is high in vitamin K, which antagonizes the
effects of warfarin. Clients should maintain a consistent intake of
vitamin K-rich foods to ensure stable anticoagulation.
,**24. A nurse is caring for a client who is receiving magnesium
sulfate for preeclampsia. Which of the following findings indicates
magnesium toxicity? **
A. Respiratory rate 16/min
B. Deep tendon reflexes 3+
C. Urine output 20 mL in 2 hours
D. Serum magnesium level 4 mEq/L
**Correct Answer:** C
**Rationale:** Urine output below 30 mL/hour indicates oliguria,
which increases the risk of magnesium accumulation and toxicity.
The first sign of toxicity is decreased deep tendon reflexes.
**25. A nurse is assessing a client who is 1 day postpartum and
reports a boggy fundus displaced to the right. Which of the following
actions should the nurse take first? **
A. Administer oxytocin as prescribed
B. Assist the client to empty her bladder
C. Perform fundal massage
D. Notify the provider
**Correct Answer:** B
**Rationale:** A displaced, boggy fundus suggests a distended
bladder pushing the uterus upward and to the right; the first action is
to have the client void, then reassess fundal tone.
, **26. A nurse is preparing to administer a blood transfusion of
packed red blood cells. Which IV solution should the nurse use to
prime the blood tubing? **
A. 5% dextrose in water
B. 0.45% sodium chloride
C. Lactated Ringer's solution
D. 0.9% sodium chloride
**Correct Answer:** D
**Rationale:** Only 0.9% sodium chloride (normal saline) is
compatible with packed red blood cells; dextrose causes hemolysis,
and lactated Ringer's contains calcium which can cause clotting.
**27. A nurse is assessing a client who has a new diagnosis of
diabetes insipidus. Which finding should the nurse expect? **
A. Serum sodium 165 mEq/L
B. Urine specific gravity 1.035
C. Blood glucose 250 mg/dL
D. Serum osmolality 260 mOsm/kg
**Correct Answer:** A
**Rationale:** Diabetes insipidus causes excessive dilute urine
leading to hypernatremia (high sodium) and increased serum
osmolality; urine specific gravity is low (<1.005).
