2025 HESI EXIT
CASE STUDIES
NCLEX (NGN), Case-based Scenarios,
Actual Qs & Ans to Pass the Exam
THIS HESI EXIT CASE STUDIES CONSISTS OF
Questions and Answers
Multiple-choice Style
NCLEX (NGN)-style scenarios
Case-based Scenarios
Expert Explanation
,───────────────────────────────────
1) CASE SCENARIO:
A 66-year-old woman arrives in the emergency department reporting three days of
fever and a productive cough with thick, green sputum. She notes feeling very
fatigued and has been losing weight. Upon further questioning, she mentions
experiencing palpitations and dizziness.
Physical examination reveals a rapid heart rate, increased respiratory rate, and crackles
on the right side.
• Past medical history: Hypertension, arthritis
• Surgical history: Knee surgery at age 52
• Medications: Ibuprofen, Hydrochlorothiazide
• Allergies: None
• Family history: Father had heart disease
• Social history: Denies tobacco, alcohol, or illicit drug use
Vital signs:
• Blood Pressure (BP): 142/92 mm Hg
• Heart Rate (HR): 126 beats/min
,• Respiratory Rate (RR): 28 breaths/min
• Blood Oxygen Saturation (pO2): 96% on room air
• Temperature (Temp): 101.5°F (38.6°C)
Which potential endocrine condition is most consistent with these findings?
A. Hypothyroidism
B. Hyperthyroidism
C. Thyroid cancer
D. Type 2 diabetes mellitus
CORRECT ANSWER: B. Hyperthyroidism
Best Expert Explanation or Solution:
• Low TSH, palpitations, and weight loss indicate hyperthyroidism.
• Although she has fever and cough likely from a respiratory infection, her endocrine
findings (tachycardia, low TSH, weight loss) point to hyperthyroidism rather than
hypothyroidism, thyroid cancer, or diabetes.
────────────────────────────────────
2) DIAGRAM COMPLETION:
A 64-year-old woman is admitted for further management. The completed diagram
indicates:
, • Potential Condition: Hyperthyroidism
• Relevant Cues: Palpitations, Weight Loss
• Supporting Objective Data: Heart Rate 126, TSH 0.1 μU/mL
Which four assessment parameters require the most immediate nursing follow-up in
this diabetic client?
A. Heart rate, hemoglobin, sodium, RBC count
B. TSH, normal potassium, RBC morphology, chloride
C. Glucose level, potassium level, chest X-ray findings, creatinine level
D. Bowel sounds, normal oxygen saturation, normal chloride, ear exam
Correct Answer: C. Glucose level, potassium level, chest X-ray findings, creatinine level
CASE STUDIES
NCLEX (NGN), Case-based Scenarios,
Actual Qs & Ans to Pass the Exam
THIS HESI EXIT CASE STUDIES CONSISTS OF
Questions and Answers
Multiple-choice Style
NCLEX (NGN)-style scenarios
Case-based Scenarios
Expert Explanation
,───────────────────────────────────
1) CASE SCENARIO:
A 66-year-old woman arrives in the emergency department reporting three days of
fever and a productive cough with thick, green sputum. She notes feeling very
fatigued and has been losing weight. Upon further questioning, she mentions
experiencing palpitations and dizziness.
Physical examination reveals a rapid heart rate, increased respiratory rate, and crackles
on the right side.
• Past medical history: Hypertension, arthritis
• Surgical history: Knee surgery at age 52
• Medications: Ibuprofen, Hydrochlorothiazide
• Allergies: None
• Family history: Father had heart disease
• Social history: Denies tobacco, alcohol, or illicit drug use
Vital signs:
• Blood Pressure (BP): 142/92 mm Hg
• Heart Rate (HR): 126 beats/min
,• Respiratory Rate (RR): 28 breaths/min
• Blood Oxygen Saturation (pO2): 96% on room air
• Temperature (Temp): 101.5°F (38.6°C)
Which potential endocrine condition is most consistent with these findings?
A. Hypothyroidism
B. Hyperthyroidism
C. Thyroid cancer
D. Type 2 diabetes mellitus
CORRECT ANSWER: B. Hyperthyroidism
Best Expert Explanation or Solution:
• Low TSH, palpitations, and weight loss indicate hyperthyroidism.
• Although she has fever and cough likely from a respiratory infection, her endocrine
findings (tachycardia, low TSH, weight loss) point to hyperthyroidism rather than
hypothyroidism, thyroid cancer, or diabetes.
────────────────────────────────────
2) DIAGRAM COMPLETION:
A 64-year-old woman is admitted for further management. The completed diagram
indicates:
, • Potential Condition: Hyperthyroidism
• Relevant Cues: Palpitations, Weight Loss
• Supporting Objective Data: Heart Rate 126, TSH 0.1 μU/mL
Which four assessment parameters require the most immediate nursing follow-up in
this diabetic client?
A. Heart rate, hemoglobin, sodium, RBC count
B. TSH, normal potassium, RBC morphology, chloride
C. Glucose level, potassium level, chest X-ray findings, creatinine level
D. Bowel sounds, normal oxygen saturation, normal chloride, ear exam
Correct Answer: C. Glucose level, potassium level, chest X-ray findings, creatinine level
