2026 NURSING EXIT EXAM
PRACTICE QUESTION BANK
NGN-STYLE QUESTIONS & CASE STUDY SCENARIOS
99+ ORIGINAL PRACTICE ITEMS
Covering Medical-Surgical • Pharmacology • Maternal-Newborn • Pediatrics • Mental Health •
Leadership & Prioritization • NGN Case Studies
WHAT'S INSIDE:
✓ Rationale explanations for every question, written for review and retention
✓ NGN-style unfolding case studies with select-all-that-apply items
✓ Content organized by clinical domain for targeted study
✓ A complete answer key summary for quick self-checking
This is an original, independently written practice resource created for study and self-assessment purposes. It is NOT
affiliated with, endorsed by, or sourced from HESI, Elsevier, ATI, or the NCSBN/NCLEX, and does not contain any
proprietary or copyrighted exam content from those organizations. Questions are written to reflect similar clinical
content domains and NGN item formats for practice purposes only.
,Table of Contents
Medical-Surgical Nursing — 28 questions
Pharmacology — 20 questions
Maternal-Newborn Nursing — 12 questions
Pediatric Nursing — 12 questions
Mental Health / Psychiatric Nursing — 10 questions
Leadership, Prioritization, and Delegation — 8 questions
NGN Case Studies — 3 unfolding cases, 9 linked items
Answer Key Summary — All Sections
, Medical-Surgical Nursing
1. A nurse is caring for a client who is 6 hours postoperative following abdominal surgery and
reports sudden, sharp chest pain and shortness of breath. Which action should the nurse take
first?
A. Administer the prescribed PRN pain medication
B. Assess the client's oxygen saturation and vital signs
C. Notify the surgeon of the new symptoms
D. Reposition the client to the left side
Correct Answer: B
Rationale: The nurse should first assess to determine the clinical picture, since sudden chest pain and
dyspnea postoperatively raise concern for pulmonary embolism. A rapid assessment of oxygen saturation
and vital signs guides the urgency of subsequent interventions and communication with the provider.
2. A client with chronic kidney disease has a serum potassium level of 6.8 mEq/L. Which
prescribed intervention should the nurse anticipate as the priority?
A. Administer sodium polystyrene sulfonate
B. Encourage a high-potassium diet
C. Administer IV calcium gluconate to stabilize the cardiac membrane
D. Restrict fluids only
Correct Answer: C
Rationale: Severe hyperkalemia (>6.5 mEq/L) poses an immediate risk of life-threatening cardiac
arrhythmia. IV calcium gluconate does not lower potassium but rapidly stabilizes the cardiac cell
membrane, making it the priority action before measures that actually reduce serum potassium.
3. The nurse is caring for a client following a below-the-knee amputation. Which finding
requires immediate notification of the surgeon?
A. Mild phantom limb sensation
B. Serosanguineous drainage on the dressing
C. Saturation of the dressing with bright red blood
D. Residual limb pain rated 4/10
Correct Answer: C
Rationale: Bright red blood saturating the dressing suggests active arterial bleeding, a surgical emergency
that requires immediate intervention to prevent hemorrhage and shock.
4. A client with COPD has an oxygen saturation of 88% on room air. The nurse should set the
oxygen flow rate at which target range to avoid suppressing the hypoxic respiratory drive?
A. 88-92%
B. 95-98%
C. 100%
D. Below 85%
Correct Answer: A
Rationale: Clients with chronic CO2 retention rely more on hypoxemia than hypercapnia to drive respiration.
Titrating oxygen to a target of 88-92% avoids suppressing this hypoxic drive, which could worsen
hypoventilation and CO2 retention.
PRACTICE QUESTION BANK
NGN-STYLE QUESTIONS & CASE STUDY SCENARIOS
99+ ORIGINAL PRACTICE ITEMS
Covering Medical-Surgical • Pharmacology • Maternal-Newborn • Pediatrics • Mental Health •
Leadership & Prioritization • NGN Case Studies
WHAT'S INSIDE:
✓ Rationale explanations for every question, written for review and retention
✓ NGN-style unfolding case studies with select-all-that-apply items
✓ Content organized by clinical domain for targeted study
✓ A complete answer key summary for quick self-checking
This is an original, independently written practice resource created for study and self-assessment purposes. It is NOT
affiliated with, endorsed by, or sourced from HESI, Elsevier, ATI, or the NCSBN/NCLEX, and does not contain any
proprietary or copyrighted exam content from those organizations. Questions are written to reflect similar clinical
content domains and NGN item formats for practice purposes only.
,Table of Contents
Medical-Surgical Nursing — 28 questions
Pharmacology — 20 questions
Maternal-Newborn Nursing — 12 questions
Pediatric Nursing — 12 questions
Mental Health / Psychiatric Nursing — 10 questions
Leadership, Prioritization, and Delegation — 8 questions
NGN Case Studies — 3 unfolding cases, 9 linked items
Answer Key Summary — All Sections
, Medical-Surgical Nursing
1. A nurse is caring for a client who is 6 hours postoperative following abdominal surgery and
reports sudden, sharp chest pain and shortness of breath. Which action should the nurse take
first?
A. Administer the prescribed PRN pain medication
B. Assess the client's oxygen saturation and vital signs
C. Notify the surgeon of the new symptoms
D. Reposition the client to the left side
Correct Answer: B
Rationale: The nurse should first assess to determine the clinical picture, since sudden chest pain and
dyspnea postoperatively raise concern for pulmonary embolism. A rapid assessment of oxygen saturation
and vital signs guides the urgency of subsequent interventions and communication with the provider.
2. A client with chronic kidney disease has a serum potassium level of 6.8 mEq/L. Which
prescribed intervention should the nurse anticipate as the priority?
A. Administer sodium polystyrene sulfonate
B. Encourage a high-potassium diet
C. Administer IV calcium gluconate to stabilize the cardiac membrane
D. Restrict fluids only
Correct Answer: C
Rationale: Severe hyperkalemia (>6.5 mEq/L) poses an immediate risk of life-threatening cardiac
arrhythmia. IV calcium gluconate does not lower potassium but rapidly stabilizes the cardiac cell
membrane, making it the priority action before measures that actually reduce serum potassium.
3. The nurse is caring for a client following a below-the-knee amputation. Which finding
requires immediate notification of the surgeon?
A. Mild phantom limb sensation
B. Serosanguineous drainage on the dressing
C. Saturation of the dressing with bright red blood
D. Residual limb pain rated 4/10
Correct Answer: C
Rationale: Bright red blood saturating the dressing suggests active arterial bleeding, a surgical emergency
that requires immediate intervention to prevent hemorrhage and shock.
4. A client with COPD has an oxygen saturation of 88% on room air. The nurse should set the
oxygen flow rate at which target range to avoid suppressing the hypoxic respiratory drive?
A. 88-92%
B. 95-98%
C. 100%
D. Below 85%
Correct Answer: A
Rationale: Clients with chronic CO2 retention rely more on hypoxemia than hypercapnia to drive respiration.
Titrating oxygen to a target of 88-92% avoids suppressing this hypoxic drive, which could worsen
hypoventilation and CO2 retention.
