Hesi Pn Exit Ngn Complete Practice Exam | Next Generation Nclex Pack | Actual Exam Questions & Verified Rationales (Graded A+)

HESI PN EXIT NGN – COMPLETE PRACTICE EXAM
(QUESTIONS 1–250)
1. A client with a history of chronic obstructive pulmonary disease (COPD) is
prescribed ipratropium via metered-dose inhaler (MDI). The nurse should instruct
the client to:
A) Take a deep breath and hold for 10 seconds after inhalation
B) Use this medication for acute shortness of breath
C) Avoid using a spacer with this medication
D) Take this medication with a bronchodilator first
Answer: A (Ipratropium is a maintenance bronchodilator; proper technique includes
holding breath for 10 seconds; a spacer is recommended.)




2. A client with a new diagnosis of type 1 diabetes mellitus is being discharged.
The nurse should prioritize teaching the client to:
A) Rotate insulin injection sites
B) Check blood glucose before meals
C) Recognize signs of hypoglycemia and hyperglycemia
D) All of the above
Answer: D (All are essential for diabetes self-management.)




3. A client is 24 hours post-operative following a left hip arthroplasty. Which
finding is most concerning?
A) Pain of 4 on a 0–10 scale
B) Mild swelling of the left calf
C) Temperature 99.6°F
D) Incision site slightly red
Answer: B (Swelling of the calf could indicate a deep vein thrombosis (DVT); requires
immediate assessment.)

,4. NGN Bow-Tie Question: A client with heart failure is receiving furosemide IV.
Complete the following:


Category Correct Response

Monitor Serum potassium

Action Administer potassium supplement if level < 3.5 mEq/L

Expected Outcome Potassium level returns to 3.5–5.0 mEq/L




5. A client with a history of major depressive disorder is prescribed phenelzine. The
nurse should teach the client to avoid which food?
A) Apples
B) Bananas
C) Avocados
D) Aged cheese
Answer: D (Phenelzine is an MAOI; aged cheese contains tyramine, which can cause
hypertensive crisis.)




6. A client receiving total parenteral nutrition (TPN) has a blood glucose level of
320 mg/dL. The nurse should first:
A) Slow the TPN infusion rate
B) Administer insulin as prescribed
C) Notify the healthcare provider
D) Check the client's urine for ketones
Answer: B (Hyperglycemia is common with TPN; insulin is often part of the TPN order or
given as a sliding scale.)

,7. A client with a history of seizures is prescribed valproic acid. The nurse should
monitor which laboratory value?
A) Liver function tests
B) Serum potassium
C) Complete blood count
D) Serum creatinine
Answer: A (Valproic acid can cause hepatotoxicity; LFTs must be monitored.)




8. NGN Select-All-That-Apply: A client with a head injury has a Glasgow Coma Scale
(GCS) score of 9. Which nursing interventions are appropriate? Select all that apply.
A) Monitor neurological status every hour ✅
B) Elevate the head of the bed 30 degrees ✅
C) Maintain a quiet, darkened environment ✅
D) Administer IV fluids at 200 mL/hr ❌
E) Monitor for seizures ✅
Answer: A, B, C, E




9. A client with a colostomy reports that the pouch is leaking frequently. Which
action should the nurse take?
A) Apply a skin barrier paste
B) Change to a larger pouch
C) Assess the stoma size and fit
D) Instruct the client to empty the pouch more often
Answer: C (Assessing the stoma size and fit is the first step; an ill-fitting pouch is the
most common cause of leaks.)




10. A client with a history of bipolar disorder is prescribed lithium. The nurse
should monitor for signs of toxicity, including:
A) Fine hand tremors
B) Polyuria
C) Nausea and vomiting

, D) All of the above
Answer: C (Nausea, vomiting, diarrhea, and confusion indicate lithium toxicity; fine
tremors and polyuria can be normal side effects.)




11. A client is receiving a blood transfusion. Fifteen minutes after the start, the
client reports low back pain and chills. The nurse should first:
A) Slow the transfusion rate
B) Stop the transfusion
C) Administer diphenhydramine
D) Check vital signs
Answer: B (Stop the transfusion immediately — these are signs of a hemolytic
transfusion reaction.)




12. A client with asthma is prescribed albuterol and fluticasone inhalers. The nurse
should teach the client to:
A) Use the fluticasone first, then the albuterol
B) Use the albuterol first, then the fluticasone
C) Use both at the same time
D) Use either one first
Answer: B (Bronchodilator (albuterol) should be used first to open airways, then the
corticosteroid (fluticasone).)




13. A client with chronic kidney disease has a potassium level of 6.8 mEq/L. Which
intervention is the priority?
A) Administer calcium gluconate
B) Administer kayexalate
C) Prepare for hemodialysis
D) Assess cardiac rhythm
Answer: D (Assess cardiac rhythm first; hyperkalemia can cause fatal arrhythmias.)