Verified HESI RN Exit Exam | NGN Nursing 200+ Questions &
Model Rationales (2026 Update)
Questions 1–50: Fundamentals, Safety & Clinical Judgment
1. A nurse receives report on four clients. Which client should
be assessed first?
A. Client with COPD and oxygen saturation of 91%
B. Client with diabetes whose glucose is 68 mg/dL and is awake
C. Client 2 hours after thyroidectomy with stridor
D. Client with chronic back pain requesting medication
Answer: C
Rationale: Stridor indicates acute upper-airway obstruction and
requires immediate intervention.
2. A client develops sudden shortness of breath and chest pain
after surgery. What is the priority action?
A. Obtain a temperature
B. Apply oxygen and assess respiratory status
C. Encourage ambulation
D. Offer oral fluids
Answer: B
Rationale: Acute respiratory compromise requires immediate
airway and breathing support.
3. Which finding requires immediate intervention in a client
receiving opioids?
A. Respiratory rate 8/min
,B. Mild nausea
C. Constipation
D. Drowsiness after activity
Answer: A
Rationale: Respiratory depression is a potentially life-
threatening opioid complication.
4. Which client should the nurse see first?
A. Client with potassium 3.4 mEq/L
B. Client with new confusion and oxygen saturation 84%
C. Client requesting a sleeping medication
D. Client with chronic arthritis pain
Answer: B
Rationale: Severe hypoxemia and acute mental-status change
indicate an immediate ABC priority.
5. A postoperative client suddenly becomes restless. What
should the nurse do first?
A. Administer an anxiolytic
B. Assess oxygenation
C. Call the family
D. Encourage sleep
Answer: B
Rationale: Restlessness may be an early sign of hypoxia.
6. Which action best prevents falls?
A. Keep the bed elevated
B. Keep the call light within reach
,C. Apply restraints routinely
D. Keep the room dark
Answer: B
Rationale: Easy access to the call light allows the client to
request assistance.
7. Which intervention is appropriate for a client at high risk for
falls?
A. Keep frequently used items within reach
B. Encourage independent bathroom use
C. Keep all four side rails raised
D. Turn off the bed alarm
Answer: A
Rationale: Accessible items reduce unnecessary attempts to get
out of bed.
8. A confused client repeatedly attempts to climb out of bed.
What is the nurse's initial action?
A. Apply restraints
B. Identify and address the cause of agitation
C. Sedate the client
D. Raise all four side rails
Answer: B
Rationale: Assessment and least-restrictive interventions
should precede restraints.
9. Which finding suggests impaired skin integrity?
A. Blanchable erythema
, B. Nonblanchable redness over the sacrum
C. Warm extremities
D. Intact skin
Answer: B
Rationale: Nonblanchable erythema is an early pressure-injury
finding.
10. Which intervention helps prevent pressure injuries?
A. Reposition regularly
B. Massage reddened areas
C. Limit protein intake
D. Keep skin moist
Answer: A
Rationale: Repositioning reduces prolonged pressure.
11. A client has a new prescription for a medication to which
the client reports an allergy. What should the nurse do?
A. Administer it with food
B. Hold the medication and clarify the prescription
C. Give half the dose
D. Ask another client about the medication
Answer: B
Rationale: The nurse must prevent administration of a
potentially harmful medication.
12. Which action is appropriate when verifying a high-alert
medication?
A. Skip independent verification
Model Rationales (2026 Update)
Questions 1–50: Fundamentals, Safety & Clinical Judgment
1. A nurse receives report on four clients. Which client should
be assessed first?
A. Client with COPD and oxygen saturation of 91%
B. Client with diabetes whose glucose is 68 mg/dL and is awake
C. Client 2 hours after thyroidectomy with stridor
D. Client with chronic back pain requesting medication
Answer: C
Rationale: Stridor indicates acute upper-airway obstruction and
requires immediate intervention.
2. A client develops sudden shortness of breath and chest pain
after surgery. What is the priority action?
A. Obtain a temperature
B. Apply oxygen and assess respiratory status
C. Encourage ambulation
D. Offer oral fluids
Answer: B
Rationale: Acute respiratory compromise requires immediate
airway and breathing support.
3. Which finding requires immediate intervention in a client
receiving opioids?
A. Respiratory rate 8/min
,B. Mild nausea
C. Constipation
D. Drowsiness after activity
Answer: A
Rationale: Respiratory depression is a potentially life-
threatening opioid complication.
4. Which client should the nurse see first?
A. Client with potassium 3.4 mEq/L
B. Client with new confusion and oxygen saturation 84%
C. Client requesting a sleeping medication
D. Client with chronic arthritis pain
Answer: B
Rationale: Severe hypoxemia and acute mental-status change
indicate an immediate ABC priority.
5. A postoperative client suddenly becomes restless. What
should the nurse do first?
A. Administer an anxiolytic
B. Assess oxygenation
C. Call the family
D. Encourage sleep
Answer: B
Rationale: Restlessness may be an early sign of hypoxia.
6. Which action best prevents falls?
A. Keep the bed elevated
B. Keep the call light within reach
,C. Apply restraints routinely
D. Keep the room dark
Answer: B
Rationale: Easy access to the call light allows the client to
request assistance.
7. Which intervention is appropriate for a client at high risk for
falls?
A. Keep frequently used items within reach
B. Encourage independent bathroom use
C. Keep all four side rails raised
D. Turn off the bed alarm
Answer: A
Rationale: Accessible items reduce unnecessary attempts to get
out of bed.
8. A confused client repeatedly attempts to climb out of bed.
What is the nurse's initial action?
A. Apply restraints
B. Identify and address the cause of agitation
C. Sedate the client
D. Raise all four side rails
Answer: B
Rationale: Assessment and least-restrictive interventions
should precede restraints.
9. Which finding suggests impaired skin integrity?
A. Blanchable erythema
, B. Nonblanchable redness over the sacrum
C. Warm extremities
D. Intact skin
Answer: B
Rationale: Nonblanchable erythema is an early pressure-injury
finding.
10. Which intervention helps prevent pressure injuries?
A. Reposition regularly
B. Massage reddened areas
C. Limit protein intake
D. Keep skin moist
Answer: A
Rationale: Repositioning reduces prolonged pressure.
11. A client has a new prescription for a medication to which
the client reports an allergy. What should the nurse do?
A. Administer it with food
B. Hold the medication and clarify the prescription
C. Give half the dose
D. Ask another client about the medication
Answer: B
Rationale: The nurse must prevent administration of a
potentially harmful medication.
12. Which action is appropriate when verifying a high-alert
medication?
A. Skip independent verification
