HESI RN EXIT EXAM V10 NGN QUESTIONS
WITH ANSWERS AND EXPLANATIONS
Question 1.
Integrated clinical judgment scenario: The care team is managing Borderline personality
disorder after the nurse recognizes borderline personality disorder may involve unstable
relationships affective reactivity impulsivity and self-harm. Which nursing intervention has
the highest priority?
A. Allow time for essential rituals initially while treatment begins and avoid reinforcing the
belief behind the ritual.
B. Set clear consistent boundaries and assess self-harm risk without reinforcing splitting.
C. Create safety use trauma-informed communication and support evidence-based
psychotherapy.
D. Set clear limits describe consequences and avoid bargaining outside established rules.
Correct Answer: B. Set clear consistent boundaries and assess self-harm risk
without reinforcing splitting.
Explanation: Clinical judgment favors this response because it targets the identified
problem rather than a secondary concern. For Borderline personality disorder, the priority
intervention is set clear consistent boundaries and assess self-harm risk without
reinforcing splitting. Psychosocial nursing prioritizes immediate safety, therapeutic
communication, dignity, boundaries, recovery, and the least restrictive effective approach.
The other choices may be reasonable in different clinical contexts, but they do not address
the stated problem as directly or safely; after the intervention, the nurse should reassess
the relevant physiologic, safety, or behavioral response and escalate care if the expected
improvement does not occur.
Question 2.
Integrated clinical judgment scenario: During report, the next planned response is to
review nephrotoxic exposures volume status and medication dosing when creatinine
acutely increases. Which finding best explains why this plan is appropriate?
A. Post-catheterization bleeding or loss of distal perfusion can signal vascular
complications.
B. INR reflects warfarin effect and excessive values increase bleeding risk.
C. Pain out of proportion pain with passive stretch tense swelling paresthesia and later
perfusion changes suggest compartment syndrome.
D. Rising creatinine can indicate worsening kidney filtration and may affect medication
and contrast safety.
Correct Answer: D. Rising creatinine can indicate worsening kidney filtration and
may affect medication and contrast safety.
Explanation: This choice best fits the cue pattern and the nursing priority being tested.
The most characteristic cue or principle for Creatinine rise is rising creatinine can indicate
worsening kidney filtration and may affect medication and contrast safety. Risk-reduction
items depend on recognizing early complications, abnormal trends, procedure-related
,hazards, and the need for timely escalation. The distractors describe findings associated
with other nursing problems and therefore do not best identify the concept being tested;
the nurse should cluster this cue with the remaining history, assessment data, and trends
before choosing the next intervention.
Question 3.
Integrated clinical judgment scenario: Following the intervention to report reasonable
suspicion to the designated child-protection authority and follow policy on a rehabilitation
unit, which finding most strongly supports a favorable response?
A. Triage categories are reevaluated as resources and clinical status change.
B. The chart contains the signed consent and documentation of questions or refusals.
C. Objective assessment findings and mandated notifications are documented.
D. The client can explain the plan and ask questions in the preferred language.
Correct Answer: C. Objective assessment findings and mandated notifications
are documented.
Explanation: Clinical judgment favors this response because it targets the identified
problem rather than a secondary concern. The most meaningful expected response for
Suspected child abuse is objective assessment findings and mandated notifications are
documented. Management decisions must account for acuity, scope of practice, client
rights, communication, continuity, and RN accountability. The other outcomes may be
desirable generally, but they do not most directly measure whether the priority problem in
this question is improving; serial reassessment should be compared with baseline so that a
worsening trend prompts timely modification or escalation of the plan.
Question 4.
Integrated clinical judgment scenario: The nurse reviews prevention measures related to
PPE donning sequence after discussing that PPE should be applied in an order that
prepares the nurse before exposure. Which guidance is most important?
A. Gloves generally go on last so they cover gown cuffs.
B. Parents should question anyone who transports the newborn without proper
identification.
C. Postexposure prophylaxis is time-sensitive when indicated.
D. Perform hand hygiene immediately after removing PPE and between steps if
contamination occurs.
Correct Answer: A. Gloves generally go on last so they cover gown cuffs.
Explanation: This answer is the best match for the client data and the expected nursing
standard. The most important education for PPE donning sequence is gloves generally go
on last so they cover gown cuffs. Safety decisions should interrupt exposure or injury risk
while preserving appropriate infection-control and surveillance measures. The alternative
instructions can be useful for other conditions, but they do not target the main
self-management or safety need in this scenario; teach-back should confirm that the client
or caregiver can apply the instruction and identify when additional professional help is
needed.
,Question 5.
Integrated clinical judgment scenario: During care on an acute-care medical-surgical unit,
a client presents with delusions are fixed false beliefs that persist despite contrary
evidence. Which nursing action should occur first?
A. Stop serotonergic agents and obtain urgent medical evaluation with supportive
treatment.
B. Stay with a client at imminent risk remove means and initiate the prescribed
observation and emergency evaluation.
C. Identify and treat the underlying cause while providing safety orientation and sleep
support.
D. Focus on feelings and reality-based needs rather than arguing about the belief.
Correct Answer: D. Focus on feelings and reality-based needs rather than
arguing about the belief.
Explanation: Clinical judgment favors this response because it targets the identified
problem rather than a secondary concern. For Delusions, the priority intervention is focus
on feelings and reality-based needs rather than arguing about the belief. Psychosocial
nursing prioritizes immediate safety, therapeutic communication, dignity, boundaries,
recovery, and the least restrictive effective approach. The other choices may be
reasonable in different clinical contexts, but they do not address the stated problem as
directly or safely; after the intervention, the nurse should reassess the relevant
physiologic, safety, or behavioral response and escalate care if the expected improvement
does not occur.
Question 6.
Integrated clinical judgment scenario: A 38-year-old client receives care that includes the
plan to encourage talking reading and safe exploration rather than screen-based
stimulation. Which follow-up finding best demonstrates therapeutic or safety benefit?
A. The infant gains trunk control purposeful reaching and age-appropriate interaction.
B. Tobacco use decreases or stops and follow-up addresses withdrawal and relapse risk.
C. Growth language social interaction and gross-motor skills progress along expected
trajectories.
D. The client uses protective behaviors and suspicious lesions receive timely assessment.
Correct Answer: C. Growth language social interaction and gross-motor skills
progress along expected trajectories.
Explanation: This answer is the best match for the client data and the expected nursing
standard. The most meaningful expected response for Twelve-month developmental
expectations is growth language social interaction and gross-motor skills progress along
expected trajectories. Health-promotion care emphasizes prevention, development,
screening, immunization, anticipatory guidance, and early recognition of warning signs.
The other outcomes may be desirable generally, but they do not most directly measure
whether the priority problem in this question is improving; serial reassessment should be
compared with baseline so that a worsening trend prompts timely modification or
escalation of the plan.
, Question 7.
Integrated clinical judgment scenario: The nurse anticipates the need to encourage
incentive spirometry coughing deep breathing mobilization and adequate pain control.
Which assessment pattern or principle should receive the greatest weight?
A. Unilateral leg swelling warmth tenderness and risk factors may indicate DVT.
B. Postoperative shallow breathing and immobility can cause atelectasis with decreased
breath sounds and low-grade fever.
C. Sudden dyspnea chest pain hypotension or a mill-wheel murmur after central-line
manipulation may indicate air embolism.
D. Elevated lactate can reflect tissue hypoperfusion and is useful when trended with the
clinical response.
Correct Answer: B. Postoperative shallow breathing and immobility can cause
atelectasis with decreased breath sounds and low-grade fever.
Explanation: The selected response is the most appropriate next step for the situation
presented. The most characteristic cue or principle for Postoperative atelectasis is
postoperative shallow breathing and immobility can cause atelectasis with decreased
breath sounds and low-grade fever. Risk-reduction items depend on recognizing early
complications, abnormal trends, procedure-related hazards, and the need for timely
escalation. The distractors describe findings associated with other nursing problems and
therefore do not best identify the concept being tested; the nurse should cluster this cue
with the remaining history, assessment data, and trends before choosing the next
intervention.
Question 8.
Integrated clinical judgment scenario: A 44-year-old client on a maternal-newborn unit
develops low-molecular-weight heparin is given subcutaneously and can cause bleeding
and thrombocytopenia. Which intervention best addresses the immediate problem?
A. Inject into abdominal subcutaneous tissue and avoid expelling the manufacturer air
bubble when instructed for prefilled syringes.
B. Hold lithium and obtain urgent evaluation for toxicity especially with dehydration or
renal impairment.
C. Monitor renal function and ordered peak or trough levels and report hearing or balance
changes.
D. Measure and administer 7.5 mL when 375 mg is prescribed from a 250 mg per 5 mL
liquid.
Correct Answer: A. Inject into abdominal subcutaneous tissue and avoid
expelling the manufacturer air bubble when instructed for prefilled syringes.
Explanation: This choice best fits the cue pattern and the nursing priority being tested.
For Enoxaparin, the priority intervention is inject into abdominal subcutaneous tissue and
avoid expelling the manufacturer air bubble when instructed for prefilled syringes.
Medication decisions require attention to indication, dose, administration safety, adverse
effects, interactions, and response to therapy. The other choices may be reasonable in
different clinical contexts, but they do not address the stated problem as directly or safely;
after the intervention, the nurse should reassess the relevant physiologic, safety, or
WITH ANSWERS AND EXPLANATIONS
Question 1.
Integrated clinical judgment scenario: The care team is managing Borderline personality
disorder after the nurse recognizes borderline personality disorder may involve unstable
relationships affective reactivity impulsivity and self-harm. Which nursing intervention has
the highest priority?
A. Allow time for essential rituals initially while treatment begins and avoid reinforcing the
belief behind the ritual.
B. Set clear consistent boundaries and assess self-harm risk without reinforcing splitting.
C. Create safety use trauma-informed communication and support evidence-based
psychotherapy.
D. Set clear limits describe consequences and avoid bargaining outside established rules.
Correct Answer: B. Set clear consistent boundaries and assess self-harm risk
without reinforcing splitting.
Explanation: Clinical judgment favors this response because it targets the identified
problem rather than a secondary concern. For Borderline personality disorder, the priority
intervention is set clear consistent boundaries and assess self-harm risk without
reinforcing splitting. Psychosocial nursing prioritizes immediate safety, therapeutic
communication, dignity, boundaries, recovery, and the least restrictive effective approach.
The other choices may be reasonable in different clinical contexts, but they do not address
the stated problem as directly or safely; after the intervention, the nurse should reassess
the relevant physiologic, safety, or behavioral response and escalate care if the expected
improvement does not occur.
Question 2.
Integrated clinical judgment scenario: During report, the next planned response is to
review nephrotoxic exposures volume status and medication dosing when creatinine
acutely increases. Which finding best explains why this plan is appropriate?
A. Post-catheterization bleeding or loss of distal perfusion can signal vascular
complications.
B. INR reflects warfarin effect and excessive values increase bleeding risk.
C. Pain out of proportion pain with passive stretch tense swelling paresthesia and later
perfusion changes suggest compartment syndrome.
D. Rising creatinine can indicate worsening kidney filtration and may affect medication
and contrast safety.
Correct Answer: D. Rising creatinine can indicate worsening kidney filtration and
may affect medication and contrast safety.
Explanation: This choice best fits the cue pattern and the nursing priority being tested.
The most characteristic cue or principle for Creatinine rise is rising creatinine can indicate
worsening kidney filtration and may affect medication and contrast safety. Risk-reduction
items depend on recognizing early complications, abnormal trends, procedure-related
,hazards, and the need for timely escalation. The distractors describe findings associated
with other nursing problems and therefore do not best identify the concept being tested;
the nurse should cluster this cue with the remaining history, assessment data, and trends
before choosing the next intervention.
Question 3.
Integrated clinical judgment scenario: Following the intervention to report reasonable
suspicion to the designated child-protection authority and follow policy on a rehabilitation
unit, which finding most strongly supports a favorable response?
A. Triage categories are reevaluated as resources and clinical status change.
B. The chart contains the signed consent and documentation of questions or refusals.
C. Objective assessment findings and mandated notifications are documented.
D. The client can explain the plan and ask questions in the preferred language.
Correct Answer: C. Objective assessment findings and mandated notifications
are documented.
Explanation: Clinical judgment favors this response because it targets the identified
problem rather than a secondary concern. The most meaningful expected response for
Suspected child abuse is objective assessment findings and mandated notifications are
documented. Management decisions must account for acuity, scope of practice, client
rights, communication, continuity, and RN accountability. The other outcomes may be
desirable generally, but they do not most directly measure whether the priority problem in
this question is improving; serial reassessment should be compared with baseline so that a
worsening trend prompts timely modification or escalation of the plan.
Question 4.
Integrated clinical judgment scenario: The nurse reviews prevention measures related to
PPE donning sequence after discussing that PPE should be applied in an order that
prepares the nurse before exposure. Which guidance is most important?
A. Gloves generally go on last so they cover gown cuffs.
B. Parents should question anyone who transports the newborn without proper
identification.
C. Postexposure prophylaxis is time-sensitive when indicated.
D. Perform hand hygiene immediately after removing PPE and between steps if
contamination occurs.
Correct Answer: A. Gloves generally go on last so they cover gown cuffs.
Explanation: This answer is the best match for the client data and the expected nursing
standard. The most important education for PPE donning sequence is gloves generally go
on last so they cover gown cuffs. Safety decisions should interrupt exposure or injury risk
while preserving appropriate infection-control and surveillance measures. The alternative
instructions can be useful for other conditions, but they do not target the main
self-management or safety need in this scenario; teach-back should confirm that the client
or caregiver can apply the instruction and identify when additional professional help is
needed.
,Question 5.
Integrated clinical judgment scenario: During care on an acute-care medical-surgical unit,
a client presents with delusions are fixed false beliefs that persist despite contrary
evidence. Which nursing action should occur first?
A. Stop serotonergic agents and obtain urgent medical evaluation with supportive
treatment.
B. Stay with a client at imminent risk remove means and initiate the prescribed
observation and emergency evaluation.
C. Identify and treat the underlying cause while providing safety orientation and sleep
support.
D. Focus on feelings and reality-based needs rather than arguing about the belief.
Correct Answer: D. Focus on feelings and reality-based needs rather than
arguing about the belief.
Explanation: Clinical judgment favors this response because it targets the identified
problem rather than a secondary concern. For Delusions, the priority intervention is focus
on feelings and reality-based needs rather than arguing about the belief. Psychosocial
nursing prioritizes immediate safety, therapeutic communication, dignity, boundaries,
recovery, and the least restrictive effective approach. The other choices may be
reasonable in different clinical contexts, but they do not address the stated problem as
directly or safely; after the intervention, the nurse should reassess the relevant
physiologic, safety, or behavioral response and escalate care if the expected improvement
does not occur.
Question 6.
Integrated clinical judgment scenario: A 38-year-old client receives care that includes the
plan to encourage talking reading and safe exploration rather than screen-based
stimulation. Which follow-up finding best demonstrates therapeutic or safety benefit?
A. The infant gains trunk control purposeful reaching and age-appropriate interaction.
B. Tobacco use decreases or stops and follow-up addresses withdrawal and relapse risk.
C. Growth language social interaction and gross-motor skills progress along expected
trajectories.
D. The client uses protective behaviors and suspicious lesions receive timely assessment.
Correct Answer: C. Growth language social interaction and gross-motor skills
progress along expected trajectories.
Explanation: This answer is the best match for the client data and the expected nursing
standard. The most meaningful expected response for Twelve-month developmental
expectations is growth language social interaction and gross-motor skills progress along
expected trajectories. Health-promotion care emphasizes prevention, development,
screening, immunization, anticipatory guidance, and early recognition of warning signs.
The other outcomes may be desirable generally, but they do not most directly measure
whether the priority problem in this question is improving; serial reassessment should be
compared with baseline so that a worsening trend prompts timely modification or
escalation of the plan.
, Question 7.
Integrated clinical judgment scenario: The nurse anticipates the need to encourage
incentive spirometry coughing deep breathing mobilization and adequate pain control.
Which assessment pattern or principle should receive the greatest weight?
A. Unilateral leg swelling warmth tenderness and risk factors may indicate DVT.
B. Postoperative shallow breathing and immobility can cause atelectasis with decreased
breath sounds and low-grade fever.
C. Sudden dyspnea chest pain hypotension or a mill-wheel murmur after central-line
manipulation may indicate air embolism.
D. Elevated lactate can reflect tissue hypoperfusion and is useful when trended with the
clinical response.
Correct Answer: B. Postoperative shallow breathing and immobility can cause
atelectasis with decreased breath sounds and low-grade fever.
Explanation: The selected response is the most appropriate next step for the situation
presented. The most characteristic cue or principle for Postoperative atelectasis is
postoperative shallow breathing and immobility can cause atelectasis with decreased
breath sounds and low-grade fever. Risk-reduction items depend on recognizing early
complications, abnormal trends, procedure-related hazards, and the need for timely
escalation. The distractors describe findings associated with other nursing problems and
therefore do not best identify the concept being tested; the nurse should cluster this cue
with the remaining history, assessment data, and trends before choosing the next
intervention.
Question 8.
Integrated clinical judgment scenario: A 44-year-old client on a maternal-newborn unit
develops low-molecular-weight heparin is given subcutaneously and can cause bleeding
and thrombocytopenia. Which intervention best addresses the immediate problem?
A. Inject into abdominal subcutaneous tissue and avoid expelling the manufacturer air
bubble when instructed for prefilled syringes.
B. Hold lithium and obtain urgent evaluation for toxicity especially with dehydration or
renal impairment.
C. Monitor renal function and ordered peak or trough levels and report hearing or balance
changes.
D. Measure and administer 7.5 mL when 375 mg is prescribed from a 250 mg per 5 mL
liquid.
Correct Answer: A. Inject into abdominal subcutaneous tissue and avoid
expelling the manufacturer air bubble when instructed for prefilled syringes.
Explanation: This choice best fits the cue pattern and the nursing priority being tested.
For Enoxaparin, the priority intervention is inject into abdominal subcutaneous tissue and
avoid expelling the manufacturer air bubble when instructed for prefilled syringes.
Medication decisions require attention to indication, dose, administration safety, adverse
effects, interactions, and response to therapy. The other choices may be reasonable in
different clinical contexts, but they do not address the stated problem as directly or safely;
after the intervention, the nurse should reassess the relevant physiologic, safety, or
