Version 2 – 2026/2027 HESI RN EXIT
EXAM V4 (NGN Integrated, 160
Questions) | Latest Exam | Verified
Questions and Correct Answers |
Updated NGN Edition | Graded A+
Description: This comprehensive revision set contains 200 multiple-choice questions
(MCQs) designed to mirror the 2025 HESI RN Exit Exam V4 (NGN Integrated) format.
Each question includes four options, one correct answer marked with ✅, and a
rationale for clarity. Questions are randomized so correct answers are distributed across
A, B, C, and D — not aligned to a single letter.
Key Words: HESI RN Exit Exam, NGN Integrated, 2025 V4, verified questions, correct
answers, nursing revision, MCQ, Graded A+, patient safety, prioritization, delegation,
pharmacology, maternal newborn, pediatrics, mental health, medical surgical,
fundamentals, critical care.
Q1. A nurse is assessing a client with heart failure. Which
finding indicates fluid overload?
A. Dry mucous membranes
B. ✅ Jugular venous distention
C. Decreased urine output
D. Weight loss
Rationale: JVD is a classic sign of fluid volume excess.
,Q2. Which action should the nurse take first when a client
develops anaphylaxis after a penicillin injection?
A. Administer diphenhydramine
B. ✅ Administer epinephrine IM
C. Obtain vital signs
D. Call the provider
Rationale: Epinephrine is the first-line treatment for anaphylaxis.
Q3. A client on heparin has an aPTT of 90 seconds. Which
action is priority?
A. ✅ Hold the heparin and notify the provider
B. Administer vitamin K
C. Increase the heparin dose
D. Continue the infusion
Rationale: Therapeutic aPTT is 1.5–2.5 times control; 90 seconds is elevated and risks
bleeding.
Q4. Which client is most at risk for developing pressure
ulcers?
,A. Client with asthma
B. ✅ Client with immobility and incontinence
C. Client with hypertension
D. Client with diabetes controlled by diet
Rationale: Immobility and moisture increase pressure ulcer risk.
Q5. A nurse is teaching a client about warfarin. Which
statement indicates understanding?
A. “I will increase my intake of green leafy vegetables.”
B. “I will take aspirin for headaches.”
C. ✅ “I will use a soft toothbrush.”
D. “I will double my dose if I miss one.”
Rationale: Soft toothbrush reduces bleeding risk.
Q6. Which assessment finding in a newborn requires
immediate intervention?
A. Heart rate 120
B. ✅ Respiratory rate 80 with grunting
C. Axillary temperature 97.8°F
D. Blood glucose 60
Rationale: Grunting and tachypnea indicate respiratory distress.
, Q7. A client with COPD is receiving oxygen. Which flow rate
is safest?
A. 6 L/min
B. 4 L/min
C. ✅ 2 L/min
D. 8 L/min
Rationale: COPD clients require low-flow oxygen to avoid CO2 retention.
Q8. Which finding indicates digoxin toxicity?
A. Heart rate 88
B. ✅ Visual disturbances and bradycardia
C. Blood pressure 130/80
D. Increased appetite
Rationale: Visual changes and bradycardia are classic digoxin toxicity signs.
Q9. A nurse is delegating to a UAP. Which task is
appropriate?
A. Administering oral meds
B. ✅ Measuring vital signs
EXAM V4 (NGN Integrated, 160
Questions) | Latest Exam | Verified
Questions and Correct Answers |
Updated NGN Edition | Graded A+
Description: This comprehensive revision set contains 200 multiple-choice questions
(MCQs) designed to mirror the 2025 HESI RN Exit Exam V4 (NGN Integrated) format.
Each question includes four options, one correct answer marked with ✅, and a
rationale for clarity. Questions are randomized so correct answers are distributed across
A, B, C, and D — not aligned to a single letter.
Key Words: HESI RN Exit Exam, NGN Integrated, 2025 V4, verified questions, correct
answers, nursing revision, MCQ, Graded A+, patient safety, prioritization, delegation,
pharmacology, maternal newborn, pediatrics, mental health, medical surgical,
fundamentals, critical care.
Q1. A nurse is assessing a client with heart failure. Which
finding indicates fluid overload?
A. Dry mucous membranes
B. ✅ Jugular venous distention
C. Decreased urine output
D. Weight loss
Rationale: JVD is a classic sign of fluid volume excess.
,Q2. Which action should the nurse take first when a client
develops anaphylaxis after a penicillin injection?
A. Administer diphenhydramine
B. ✅ Administer epinephrine IM
C. Obtain vital signs
D. Call the provider
Rationale: Epinephrine is the first-line treatment for anaphylaxis.
Q3. A client on heparin has an aPTT of 90 seconds. Which
action is priority?
A. ✅ Hold the heparin and notify the provider
B. Administer vitamin K
C. Increase the heparin dose
D. Continue the infusion
Rationale: Therapeutic aPTT is 1.5–2.5 times control; 90 seconds is elevated and risks
bleeding.
Q4. Which client is most at risk for developing pressure
ulcers?
,A. Client with asthma
B. ✅ Client with immobility and incontinence
C. Client with hypertension
D. Client with diabetes controlled by diet
Rationale: Immobility and moisture increase pressure ulcer risk.
Q5. A nurse is teaching a client about warfarin. Which
statement indicates understanding?
A. “I will increase my intake of green leafy vegetables.”
B. “I will take aspirin for headaches.”
C. ✅ “I will use a soft toothbrush.”
D. “I will double my dose if I miss one.”
Rationale: Soft toothbrush reduces bleeding risk.
Q6. Which assessment finding in a newborn requires
immediate intervention?
A. Heart rate 120
B. ✅ Respiratory rate 80 with grunting
C. Axillary temperature 97.8°F
D. Blood glucose 60
Rationale: Grunting and tachypnea indicate respiratory distress.
, Q7. A client with COPD is receiving oxygen. Which flow rate
is safest?
A. 6 L/min
B. 4 L/min
C. ✅ 2 L/min
D. 8 L/min
Rationale: COPD clients require low-flow oxygen to avoid CO2 retention.
Q8. Which finding indicates digoxin toxicity?
A. Heart rate 88
B. ✅ Visual disturbances and bradycardia
C. Blood pressure 130/80
D. Increased appetite
Rationale: Visual changes and bradycardia are classic digoxin toxicity signs.
Q9. A nurse is delegating to a UAP. Which task is
appropriate?
A. Administering oral meds
B. ✅ Measuring vital signs
