Exit Hesi RN WITH NGN/HESI RN EXIT EXAM WITH NGN
LATEST VERSION 2026-2027 EXAM WITH ACTUAL 160
QUESTION AND CORRECT DETAILED ANSWERS WITH
RATIONALES. (MOST TESTED QUESTIONS).
QUESTION
A male client with a brain tumor is scheduled for a biopsy in the morning. During the
admission procedure, the client has a tonic-clonic seizure that lasts 50 seconds.
Following the seizure, the client is lethargic and confused and his wife tells the nurse
that her husband has never had a seizure before and has always been alert and
communicative. Which action should the nurse take?
A. Ask the wife to wait outside the room until the nurse can talk with her.
B. Keep orienting the client to time and space until he is less confused.
C. Notify the emergency response team of the client's seizure.
D. Explain the postictal state that usually follows seizures.
CORRECT ANS: D. Explain the postictal state that usually follows seizures.
Expert Rationale
Following a generalized tonic-clonic seizure, it is common for the client to enter a
postictal state characterized by lethargy, confusion, and disorientation. This is a normal
physiological response as the brain recovers from the excessive electrical activity. The
nurse's priority is to provide reassurance and education to the family about this
expected phase. While the seizure was not a new emergency requiring a rapid response
team, the nurse should document the event and continue to monitor the client's
neurological status. The wife's anxiety can be alleviated by explaining that the postictal
state is a typical sequela of a seizure.
DIF: Cognitive Level: Apply (Application) TOP: Neurological Emergencies MSC: N/A
QUESTION
The nurse is providing lifestyle change education for a client to slow the progression of
coronary artery disease. Which statement(s) made by the client should the nurse
recognize as needing additional education? (Select all that apply.)
,A. Keep a food diary.
B. Eat more canned vegetables.
C. Consume foods with saturated fats.
D. Walk 30 minutes per day.
E. Include oatmeal for breakfast.
F. Use a salt substitute.
CORRECT ANS: B. Eat more canned vegetables. C. Consume foods with saturated fats.
Expert Rationale
Canned vegetables often contain high amounts of sodium, which can exacerbate
hypertension and contribute to fluid retention, worsening coronary artery disease.
Clients should be encouraged to choose fresh or frozen vegetables with no added salt.
Saturated fats are known to increase LDL cholesterol levels, which accelerates
atherosclerosis and the progression of coronary artery disease. The other options
represent positive lifestyle modifications: keeping a food diary promotes awareness,
walking is beneficial for cardiovascular health, oatmeal is a heart-healthy whole grain,
and using a salt substitute can help reduce sodium intake.
DIF: Cognitive Level: Evaluate (Evaluation) TOP: Cardiovascular Health MSC: N/A
QUESTION
While caring for a toddler receiving oxygen via face mask, the nurse observes that the
child's lips and nares are dry and cracked. Which intervention should the nurse
implement?
A. Use a water soluble lubricant on affected oral and nasal mucosa.
B. Use a topical lidocaine analgesic for cracked lips.
C. Ask the mother what she usually uses on the child's lips and nose.
D. Apply a petroleum jelly to the child's nose and lips.
CORRECT ANS: A. Use a water soluble lubricant on affected oral and nasal mucosa.
Expert Rationale
Oxygen therapy can dry the mucous membranes, leading to cracked lips and nares. The
best intervention is to use a water-soluble lubricant on the affected areas. Water-soluble
lubricants are safe for use with oxygen therapy and do not pose a fire risk. Petroleum-
based products should be avoided because they are flammable and can increase the risk
of fire when used with oxygen. Topical lidocaine is not indicated for simple dryness.
,While it is appropriate to ask the mother about home remedies, the nurse should
provide evidence-based care.
DIF: Cognitive Level: Apply (Application) TOP: Oxygen Therapy MSC: N/A
QUESTION
The nurse is providing teaching to a client with type 2 diabetes mellitus about important
points for disease and symptom management. Which statement by the client indicates
understanding?
A. Using salt, herbs, and spices will improve the flavor of foods.
B. Get an eye examination with an ophthalmologist annually.
C. Arrange diet schedule around three regular meals a day.
D. Inspect feet every month for ingrown nails, cuts, and calluses.
CORRECT ANS: B. Get an eye examination with an ophthalmologist annually.
Expert Rationale
Clients with diabetes are at increased risk for diabetic retinopathy and other ocular
complications. The American Diabetes Association recommends annual dilated eye
examinations by an ophthalmologist or optometrist to screen for these changes. This is
a crucial component of diabetes management. The other options require correction:
while salt substitutes may be beneficial, salt itself should be limited; the diet should be
spaced throughout the day, not just three meals; and feet should be inspected daily, not
monthly, to prevent complications.
DIF: Cognitive Level: Evaluate (Evaluation) TOP: Diabetes Management MSC: N/A
QUESTION
The nurse is providing education to a client who experiences recurrent levels of
moderate anxiety to situations and perceived stress. In addition to information about
prescribed medication and administration, which instruction should the nurse include in
the teaching?
A. Center attention on positive upbeat music.
B. Find outlets for more social interaction.
, C. Practice using muscle relaxation techniques.
D. Think about reasons the episodes occur.
CORRECT ANS: C. Practice using muscle relaxation techniques.
Expert Rationale
Relaxation techniques, including progressive muscle relaxation, are effective non-
pharmacological interventions for managing moderate anxiety. These techniques help
reduce the physiological manifestations of anxiety by decreasing muscle tension and
promoting a calm state. While music therapy and social interaction can be beneficial,
muscle relaxation is a specific, teachable skill that directly addresses the physiological
symptoms of anxiety. Exploring reasons for the episodes (insight) may be useful in
therapy but is not a primary intervention for symptom management.
DIF: Cognitive Level: Apply (Application) TOP: Anxiety Management MSC: N/A
QUESTION
The charge nurse is planning for the shift and has a registered nurse (RN) and a practical
nurse (PN) on the team. Which client should the charge nurse assign to the RN?
A. A 75-year-old client with renal calculi who requires urine straining.
B. A 64-year-old client who had a total hip replacement the previous day.
C. A 30-year-old depressed client who admits to suicide ideation.
D. An adolescent with multiple contusions due to a fall that occurred 2 days ago.
CORRECT ANS: C. A 30-year-old depressed client who admits to suicide ideation.
Expert Rationale
The client with suicidal ideation requires the comprehensive assessment, crisis
intervention, and safety planning skills of a registered nurse. This client is at high risk for
self-harm and requires immediate and ongoing evaluation, which is within the RN's
scope of practice. The PN can care for stable clients with predictable outcomes, such as
the client with renal calculi (urine straining is a routine task), the post-operative hip
replacement client (who is stable and requires routine care), and the adolescent with
contusions (stable). The RN must evaluate the suicidal client's plan, intent, and risk
factors.
DIF: Cognitive Level: Analyze (Analysis) TOP: Assignment and Delegation MSC: N/A
LATEST VERSION 2026-2027 EXAM WITH ACTUAL 160
QUESTION AND CORRECT DETAILED ANSWERS WITH
RATIONALES. (MOST TESTED QUESTIONS).
QUESTION
A male client with a brain tumor is scheduled for a biopsy in the morning. During the
admission procedure, the client has a tonic-clonic seizure that lasts 50 seconds.
Following the seizure, the client is lethargic and confused and his wife tells the nurse
that her husband has never had a seizure before and has always been alert and
communicative. Which action should the nurse take?
A. Ask the wife to wait outside the room until the nurse can talk with her.
B. Keep orienting the client to time and space until he is less confused.
C. Notify the emergency response team of the client's seizure.
D. Explain the postictal state that usually follows seizures.
CORRECT ANS: D. Explain the postictal state that usually follows seizures.
Expert Rationale
Following a generalized tonic-clonic seizure, it is common for the client to enter a
postictal state characterized by lethargy, confusion, and disorientation. This is a normal
physiological response as the brain recovers from the excessive electrical activity. The
nurse's priority is to provide reassurance and education to the family about this
expected phase. While the seizure was not a new emergency requiring a rapid response
team, the nurse should document the event and continue to monitor the client's
neurological status. The wife's anxiety can be alleviated by explaining that the postictal
state is a typical sequela of a seizure.
DIF: Cognitive Level: Apply (Application) TOP: Neurological Emergencies MSC: N/A
QUESTION
The nurse is providing lifestyle change education for a client to slow the progression of
coronary artery disease. Which statement(s) made by the client should the nurse
recognize as needing additional education? (Select all that apply.)
,A. Keep a food diary.
B. Eat more canned vegetables.
C. Consume foods with saturated fats.
D. Walk 30 minutes per day.
E. Include oatmeal for breakfast.
F. Use a salt substitute.
CORRECT ANS: B. Eat more canned vegetables. C. Consume foods with saturated fats.
Expert Rationale
Canned vegetables often contain high amounts of sodium, which can exacerbate
hypertension and contribute to fluid retention, worsening coronary artery disease.
Clients should be encouraged to choose fresh or frozen vegetables with no added salt.
Saturated fats are known to increase LDL cholesterol levels, which accelerates
atherosclerosis and the progression of coronary artery disease. The other options
represent positive lifestyle modifications: keeping a food diary promotes awareness,
walking is beneficial for cardiovascular health, oatmeal is a heart-healthy whole grain,
and using a salt substitute can help reduce sodium intake.
DIF: Cognitive Level: Evaluate (Evaluation) TOP: Cardiovascular Health MSC: N/A
QUESTION
While caring for a toddler receiving oxygen via face mask, the nurse observes that the
child's lips and nares are dry and cracked. Which intervention should the nurse
implement?
A. Use a water soluble lubricant on affected oral and nasal mucosa.
B. Use a topical lidocaine analgesic for cracked lips.
C. Ask the mother what she usually uses on the child's lips and nose.
D. Apply a petroleum jelly to the child's nose and lips.
CORRECT ANS: A. Use a water soluble lubricant on affected oral and nasal mucosa.
Expert Rationale
Oxygen therapy can dry the mucous membranes, leading to cracked lips and nares. The
best intervention is to use a water-soluble lubricant on the affected areas. Water-soluble
lubricants are safe for use with oxygen therapy and do not pose a fire risk. Petroleum-
based products should be avoided because they are flammable and can increase the risk
of fire when used with oxygen. Topical lidocaine is not indicated for simple dryness.
,While it is appropriate to ask the mother about home remedies, the nurse should
provide evidence-based care.
DIF: Cognitive Level: Apply (Application) TOP: Oxygen Therapy MSC: N/A
QUESTION
The nurse is providing teaching to a client with type 2 diabetes mellitus about important
points for disease and symptom management. Which statement by the client indicates
understanding?
A. Using salt, herbs, and spices will improve the flavor of foods.
B. Get an eye examination with an ophthalmologist annually.
C. Arrange diet schedule around three regular meals a day.
D. Inspect feet every month for ingrown nails, cuts, and calluses.
CORRECT ANS: B. Get an eye examination with an ophthalmologist annually.
Expert Rationale
Clients with diabetes are at increased risk for diabetic retinopathy and other ocular
complications. The American Diabetes Association recommends annual dilated eye
examinations by an ophthalmologist or optometrist to screen for these changes. This is
a crucial component of diabetes management. The other options require correction:
while salt substitutes may be beneficial, salt itself should be limited; the diet should be
spaced throughout the day, not just three meals; and feet should be inspected daily, not
monthly, to prevent complications.
DIF: Cognitive Level: Evaluate (Evaluation) TOP: Diabetes Management MSC: N/A
QUESTION
The nurse is providing education to a client who experiences recurrent levels of
moderate anxiety to situations and perceived stress. In addition to information about
prescribed medication and administration, which instruction should the nurse include in
the teaching?
A. Center attention on positive upbeat music.
B. Find outlets for more social interaction.
, C. Practice using muscle relaxation techniques.
D. Think about reasons the episodes occur.
CORRECT ANS: C. Practice using muscle relaxation techniques.
Expert Rationale
Relaxation techniques, including progressive muscle relaxation, are effective non-
pharmacological interventions for managing moderate anxiety. These techniques help
reduce the physiological manifestations of anxiety by decreasing muscle tension and
promoting a calm state. While music therapy and social interaction can be beneficial,
muscle relaxation is a specific, teachable skill that directly addresses the physiological
symptoms of anxiety. Exploring reasons for the episodes (insight) may be useful in
therapy but is not a primary intervention for symptom management.
DIF: Cognitive Level: Apply (Application) TOP: Anxiety Management MSC: N/A
QUESTION
The charge nurse is planning for the shift and has a registered nurse (RN) and a practical
nurse (PN) on the team. Which client should the charge nurse assign to the RN?
A. A 75-year-old client with renal calculi who requires urine straining.
B. A 64-year-old client who had a total hip replacement the previous day.
C. A 30-year-old depressed client who admits to suicide ideation.
D. An adolescent with multiple contusions due to a fall that occurred 2 days ago.
CORRECT ANS: C. A 30-year-old depressed client who admits to suicide ideation.
Expert Rationale
The client with suicidal ideation requires the comprehensive assessment, crisis
intervention, and safety planning skills of a registered nurse. This client is at high risk for
self-harm and requires immediate and ongoing evaluation, which is within the RN's
scope of practice. The PN can care for stable clients with predictable outcomes, such as
the client with renal calculi (urine straining is a routine task), the post-operative hip
replacement client (who is stable and requires routine care), and the adolescent with
contusions (stable). The RN must evaluate the suicidal client's plan, intent, and risk
factors.
DIF: Cognitive Level: Analyze (Analysis) TOP: Assignment and Delegation MSC: N/A
