HESI RN Comprehensive Predictor Exit Exam
2026 | Next Generation (NGN) Practice
Questions, Answers & Rationales
# Question Correct Rationale
Answer
1 A nurse is caring for a group of clients on a B Sudden shortness of breath and chest pain
medical-surgical unit. Which client should the are hallmark signs of a pulmonary
nurse assess first? embolism, a life-threatening complication
A. A client with a history of heart failure of DVT that requires immediate assessment
reporting a 2-pound weight gain in 24 hours and intervention according to the ABC
B. A client with a deep vein thrombosis reporting framework .
sudden onset of shortness of breath and chest
pain
C. A client with COPD with an oxygen saturation
of 91%
D. A client post-abdominal surgery reporting
pain as an 8 on a scale of 1 to 10
2 A nurse is preparing to administer digoxin to a B Hypokalemia significantly increases the risk
client with heart failure. Which laboratory value of digoxin toxicity. The nurse should hold
should the nurse review before administration? the dose and notify the provider if the
A. Serum sodium level potassium level is low .
B. Serum potassium level
C. Serum calcium level
D. Serum glucose level
3 A nurse is delegating tasks to an unlicensed C Measuring intake and output is a routine
assistive personnel (UAP). Which task is task that falls within the scope of practice
appropriate for the nurse to delegate? for a UAP. Teaching, initial swallow
A. Teaching a client how to use an incentive assessments, and neurovascular checks
spirometer require the clinical judgment of a licensed
B. Assisting a client with a history of stroke with nurse .
, their first meal post-admission
C. Measuring the intake and output of a client
with continuous bladder irrigation
D. Checking the neurovascular status of a client
in skeletal traction
4 A client is receiving a blood transfusion and C Low back pain and chills are classic signs of
begins to complain of low back pain and chills. an acute hemolytic transfusion reaction,
Which action should the nurse take first? which is a medical emergency. The priority
A. Slow the infusion rate is to stop the transfusion immediately to
B. Notify the healthcare provider prevent further administration of
C. Stop the transfusion immediately incompatible blood .
D. Administer diphenhydramine as ordered
5 A nurse is caring for a client with a history of A Chlordiazepoxide is a benzodiazepine used
alcoholism who is experiencing tremors and to manage symptoms of alcohol
hallucinations. Which medication should the withdrawal, including tremors, agitation,
nurse expect to administer? and seizures .
A. Chlordiazepoxide
B. Disulfiram
C. Methadone
D. Naloxone
6 A client is diagnosed with autonomic dysreflexia. D Raising the head of the bed to a high-
Which is the priority nursing intervention? Fowler's position is the priority action to
A. Administer an antihypertensive medication help lower blood pressure through gravity.
B. Check the client for bladder distention This is a life-threatening emergency in
C. Assess the skin for pressure ulcers clients with spinal cord injuries above T6 .
D. Raise the head of the bed to 90 degrees
7 A nurse is assessing a client with Cushing's B Cushing's syndrome is characterized by
syndrome. Which finding should the nurse excess cortisol, leading to fat redistribution
expect? resulting in truncal obesity, a "moon face,"
A. Weight loss and hypotension and a "buffalo hump" .
B. Truncal obesity and moon face
C. Hyperkalemia and hyponatremia
D. Increased muscle mass in the extremities
, 8 A nurse is providing discharge teaching for a B Warfarin therapy requires regular
client prescribed warfarin. Which statement by monitoring of the International Normalized
the client indicates understanding? Ratio (INR) to ensure the medication is in a
A. "I will take ibuprofen for my headaches." safe and therapeutic range .
B. "I will need to have my blood tested
regularly."
C. "I should eat more leafy green vegetables."
D. "I will stop taking the medication if I notice
bruising."
9 A charge nurse is assigning clients on a medical- B LPNs/LVNs can perform stable, routine
surgical unit. Which client should be assigned to procedures like ostomy care. Clients
the LPN/LVN? requiring assessment, initial teaching, or
A. Client with acute asthma requiring q2h monitoring for critical complications should
albuterol nebulizer treatments be assigned to an RN .
B. Client with a stable ileostomy requiring stoma
care and pouch change
C. Client newly diagnosed with diabetes mellitus
requiring initial insulin teaching
D. Client 2 hours post-cardiac catheterization
with a femoral sheath in place
10 An emergency department nurse is triaging after B In mass casualty triage (START system), a
a mass casualty event. Which client should client with a severe but survivable injury
receive care FIRST? like a chest wound who is still following
A. Ambulatory client with a minor scalp commands is triaged as "Immediate" (Red
laceration tag) and receives priority care .
B. Client with severe chest wound, able to follow
commands but with labored breathing
C. Client with no pulse, no respirations, and fixed
dilated pupils
D. Client with a simple femur fracture and
capillary refill < 3 seconds
11 A nurse on a telemetry unit receives report. C Unstable atrial fibrillation with rapid
Which client should the nurse assess FIRST? ventricular response causing hypotension
A. Client with heart failure reporting mild (BP 90/60) is a priority. This client is at risk
2026 | Next Generation (NGN) Practice
Questions, Answers & Rationales
# Question Correct Rationale
Answer
1 A nurse is caring for a group of clients on a B Sudden shortness of breath and chest pain
medical-surgical unit. Which client should the are hallmark signs of a pulmonary
nurse assess first? embolism, a life-threatening complication
A. A client with a history of heart failure of DVT that requires immediate assessment
reporting a 2-pound weight gain in 24 hours and intervention according to the ABC
B. A client with a deep vein thrombosis reporting framework .
sudden onset of shortness of breath and chest
pain
C. A client with COPD with an oxygen saturation
of 91%
D. A client post-abdominal surgery reporting
pain as an 8 on a scale of 1 to 10
2 A nurse is preparing to administer digoxin to a B Hypokalemia significantly increases the risk
client with heart failure. Which laboratory value of digoxin toxicity. The nurse should hold
should the nurse review before administration? the dose and notify the provider if the
A. Serum sodium level potassium level is low .
B. Serum potassium level
C. Serum calcium level
D. Serum glucose level
3 A nurse is delegating tasks to an unlicensed C Measuring intake and output is a routine
assistive personnel (UAP). Which task is task that falls within the scope of practice
appropriate for the nurse to delegate? for a UAP. Teaching, initial swallow
A. Teaching a client how to use an incentive assessments, and neurovascular checks
spirometer require the clinical judgment of a licensed
B. Assisting a client with a history of stroke with nurse .
, their first meal post-admission
C. Measuring the intake and output of a client
with continuous bladder irrigation
D. Checking the neurovascular status of a client
in skeletal traction
4 A client is receiving a blood transfusion and C Low back pain and chills are classic signs of
begins to complain of low back pain and chills. an acute hemolytic transfusion reaction,
Which action should the nurse take first? which is a medical emergency. The priority
A. Slow the infusion rate is to stop the transfusion immediately to
B. Notify the healthcare provider prevent further administration of
C. Stop the transfusion immediately incompatible blood .
D. Administer diphenhydramine as ordered
5 A nurse is caring for a client with a history of A Chlordiazepoxide is a benzodiazepine used
alcoholism who is experiencing tremors and to manage symptoms of alcohol
hallucinations. Which medication should the withdrawal, including tremors, agitation,
nurse expect to administer? and seizures .
A. Chlordiazepoxide
B. Disulfiram
C. Methadone
D. Naloxone
6 A client is diagnosed with autonomic dysreflexia. D Raising the head of the bed to a high-
Which is the priority nursing intervention? Fowler's position is the priority action to
A. Administer an antihypertensive medication help lower blood pressure through gravity.
B. Check the client for bladder distention This is a life-threatening emergency in
C. Assess the skin for pressure ulcers clients with spinal cord injuries above T6 .
D. Raise the head of the bed to 90 degrees
7 A nurse is assessing a client with Cushing's B Cushing's syndrome is characterized by
syndrome. Which finding should the nurse excess cortisol, leading to fat redistribution
expect? resulting in truncal obesity, a "moon face,"
A. Weight loss and hypotension and a "buffalo hump" .
B. Truncal obesity and moon face
C. Hyperkalemia and hyponatremia
D. Increased muscle mass in the extremities
, 8 A nurse is providing discharge teaching for a B Warfarin therapy requires regular
client prescribed warfarin. Which statement by monitoring of the International Normalized
the client indicates understanding? Ratio (INR) to ensure the medication is in a
A. "I will take ibuprofen for my headaches." safe and therapeutic range .
B. "I will need to have my blood tested
regularly."
C. "I should eat more leafy green vegetables."
D. "I will stop taking the medication if I notice
bruising."
9 A charge nurse is assigning clients on a medical- B LPNs/LVNs can perform stable, routine
surgical unit. Which client should be assigned to procedures like ostomy care. Clients
the LPN/LVN? requiring assessment, initial teaching, or
A. Client with acute asthma requiring q2h monitoring for critical complications should
albuterol nebulizer treatments be assigned to an RN .
B. Client with a stable ileostomy requiring stoma
care and pouch change
C. Client newly diagnosed with diabetes mellitus
requiring initial insulin teaching
D. Client 2 hours post-cardiac catheterization
with a femoral sheath in place
10 An emergency department nurse is triaging after B In mass casualty triage (START system), a
a mass casualty event. Which client should client with a severe but survivable injury
receive care FIRST? like a chest wound who is still following
A. Ambulatory client with a minor scalp commands is triaged as "Immediate" (Red
laceration tag) and receives priority care .
B. Client with severe chest wound, able to follow
commands but with labored breathing
C. Client with no pulse, no respirations, and fixed
dilated pupils
D. Client with a simple femur fracture and
capillary refill < 3 seconds
11 A nurse on a telemetry unit receives report. C Unstable atrial fibrillation with rapid
Which client should the nurse assess FIRST? ventricular response causing hypotension
A. Client with heart failure reporting mild (BP 90/60) is a priority. This client is at risk
