HESI RN Exit Exam Actual 2026/2027 with Detailed Rationales |
Complete NGN Exam-Style Questions | Pass Guaranteed – A+
Graded
EXAM INFORMATION
Total Questions: 55
Recommended Time: 110 Minutes
Passing Threshold: 85%
Exam Format: Multiple Choice Questions (MCQs) with Next Generation NCLEX (NGN)
Style Items
Question Style: Scenario-Based, Applied, Clinical Judgment, and Professional
Decision-Making Questions
Difficulty Level: Comprehensive and Rigorous
==============================
SECTION 1: Medical-Surgical Nursing
Question 1
A 68-year-old client with a history of chronic heart failure presents to the emergency
department with severe dyspnea, orthopnea, and pink frothy sputum. Vital signs are BP
178/96 mmHg, HR 118 bpm, RR 32/min, SpO2 84% on room air. The nurse recognizes
these findings as consistent with acute pulmonary edema. Which action should the
nurse take first?
A. Administer furosemide 40 mg IV push
B. Apply high-flow oxygen via non-rebreather mask
C. Insert a Foley catheter to monitor output
,D. Obtain a 12-lead ECG
Correct Answer: B
Rationale: The client is experiencing acute pulmonary edema with severe hypoxemia
(SpO2 84%). The priority intervention is to improve oxygenation immediately. High-flow
oxygen via non-rebreather mask is the first action to address life-threatening hypoxia.
While furosemide is indicated for fluid removal, oxygenation takes precedence. A Foley
catheter and ECG are important but not the immediate priority over airway and
breathing.
Question 2
A nurse is caring for a client on the second postoperative day following an abdominal
hysterectomy. The client suddenly reports chest pain, dyspnea, and tachycardia. The
nurse notes the client is anxious and has a respiratory rate of 28. Which assessment
finding requires the most immediate follow-up?
A. Temperature of 37.8 degrees C
B. Pain rating of 6 out of 10
C. Oxygen saturation of 88%
D. Blood pressure of 140/88 mmHg
Correct Answer: C
,Rationale: Following abdominal surgery, this client is at high risk for pulmonary
embolism. An oxygen saturation of 88% indicates severe hypoxemia and requires
immediate intervention with supplemental oxygen and notification of the provider. While
chest pain and tachycardia are concerning, the hypoxemia represents an immediate
threat to life and must be addressed first. Temperature elevation, pain, and mildly
elevated blood pressure are not immediately life-threatening.
Question 3
A client with type 1 diabetes mellitus is admitted with diabetic ketoacidosis (DKA). The
client has a blood glucose of 480 mg/dL, pH 7.28, potassium 3.2 mEq/L, and is
lethargic. The healthcare provider orders IV fluids, regular insulin infusion, and
potassium replacement. Which intervention should the nurse prioritize?
A. Begin the regular insulin infusion at 0.1 units/kg/hour
B. Initiate 0.9% sodium chloride at 1000 mL over the first hour
C. Administer potassium chloride 20 mEq IV over 1 hour
D. Draw arterial blood gases every 2 hours
Correct Answer: B
Rationale: The primary treatment for DKA is fluid resuscitation. The client is significantly
dehydrated due to osmotic diuresis, and fluid replacement restores intravascular
volume, improves perfusion, and begins to lower blood glucose even before insulin
takes effect. While insulin and potassium are critical, initiating IV fluids is the first
, priority. Potassium must be administered cautiously and only after ensuring adequate
urine output. ABG monitoring is important but not the priority intervention.
Question 4
A nurse is caring for a client with a new colostomy in the descending colon. The client
expresses concern about managing the ostomy at home. Which statement by the nurse
demonstrates the best understanding of colostomy care?
A. You should irrigate the colostomy daily to regulate bowel movements
B. The stoma should be pink to red and moist, which indicates good blood flow
C. You can expect liquid to semi-liquid stool consistently from the ostomy
D. It is normal for the skin around the stoma to remain red and irritated
Correct Answer: B
Rationale: A healthy stoma should be pink to red and moist, indicating adequate
vascularization. Daily irrigation is not recommended for descending colostomies as it is
typically reserved for sigmoid colostomies and is not standard practice. A descending
colostomy produces formed to semi-formed stool, not liquid stool consistently. The
peristomal skin should be intact and not red or irritated; irritation indicates leakage or
poor appliance fit requiring intervention.
Question 5
Complete NGN Exam-Style Questions | Pass Guaranteed – A+
Graded
EXAM INFORMATION
Total Questions: 55
Recommended Time: 110 Minutes
Passing Threshold: 85%
Exam Format: Multiple Choice Questions (MCQs) with Next Generation NCLEX (NGN)
Style Items
Question Style: Scenario-Based, Applied, Clinical Judgment, and Professional
Decision-Making Questions
Difficulty Level: Comprehensive and Rigorous
==============================
SECTION 1: Medical-Surgical Nursing
Question 1
A 68-year-old client with a history of chronic heart failure presents to the emergency
department with severe dyspnea, orthopnea, and pink frothy sputum. Vital signs are BP
178/96 mmHg, HR 118 bpm, RR 32/min, SpO2 84% on room air. The nurse recognizes
these findings as consistent with acute pulmonary edema. Which action should the
nurse take first?
A. Administer furosemide 40 mg IV push
B. Apply high-flow oxygen via non-rebreather mask
C. Insert a Foley catheter to monitor output
,D. Obtain a 12-lead ECG
Correct Answer: B
Rationale: The client is experiencing acute pulmonary edema with severe hypoxemia
(SpO2 84%). The priority intervention is to improve oxygenation immediately. High-flow
oxygen via non-rebreather mask is the first action to address life-threatening hypoxia.
While furosemide is indicated for fluid removal, oxygenation takes precedence. A Foley
catheter and ECG are important but not the immediate priority over airway and
breathing.
Question 2
A nurse is caring for a client on the second postoperative day following an abdominal
hysterectomy. The client suddenly reports chest pain, dyspnea, and tachycardia. The
nurse notes the client is anxious and has a respiratory rate of 28. Which assessment
finding requires the most immediate follow-up?
A. Temperature of 37.8 degrees C
B. Pain rating of 6 out of 10
C. Oxygen saturation of 88%
D. Blood pressure of 140/88 mmHg
Correct Answer: C
,Rationale: Following abdominal surgery, this client is at high risk for pulmonary
embolism. An oxygen saturation of 88% indicates severe hypoxemia and requires
immediate intervention with supplemental oxygen and notification of the provider. While
chest pain and tachycardia are concerning, the hypoxemia represents an immediate
threat to life and must be addressed first. Temperature elevation, pain, and mildly
elevated blood pressure are not immediately life-threatening.
Question 3
A client with type 1 diabetes mellitus is admitted with diabetic ketoacidosis (DKA). The
client has a blood glucose of 480 mg/dL, pH 7.28, potassium 3.2 mEq/L, and is
lethargic. The healthcare provider orders IV fluids, regular insulin infusion, and
potassium replacement. Which intervention should the nurse prioritize?
A. Begin the regular insulin infusion at 0.1 units/kg/hour
B. Initiate 0.9% sodium chloride at 1000 mL over the first hour
C. Administer potassium chloride 20 mEq IV over 1 hour
D. Draw arterial blood gases every 2 hours
Correct Answer: B
Rationale: The primary treatment for DKA is fluid resuscitation. The client is significantly
dehydrated due to osmotic diuresis, and fluid replacement restores intravascular
volume, improves perfusion, and begins to lower blood glucose even before insulin
takes effect. While insulin and potassium are critical, initiating IV fluids is the first
, priority. Potassium must be administered cautiously and only after ensuring adequate
urine output. ABG monitoring is important but not the priority intervention.
Question 4
A nurse is caring for a client with a new colostomy in the descending colon. The client
expresses concern about managing the ostomy at home. Which statement by the nurse
demonstrates the best understanding of colostomy care?
A. You should irrigate the colostomy daily to regulate bowel movements
B. The stoma should be pink to red and moist, which indicates good blood flow
C. You can expect liquid to semi-liquid stool consistently from the ostomy
D. It is normal for the skin around the stoma to remain red and irritated
Correct Answer: B
Rationale: A healthy stoma should be pink to red and moist, indicating adequate
vascularization. Daily irrigation is not recommended for descending colostomies as it is
typically reserved for sigmoid colostomies and is not standard practice. A descending
colostomy produces formed to semi-formed stool, not liquid stool consistently. The
peristomal skin should be intact and not red or irritated; irritation indicates leakage or
poor appliance fit requiring intervention.
Question 5
