2025 HESI EXIT
V2 EXAM
NCLEX (NGN), Case-based Scenarios,
Actual Qs & Ans to Pass the Exam
THIS HESI EXIT CONSISTS OF
160 Questions and Answers
Multiple-choice Style
Select All That Apply (SATA), ordering, fill-in-the-blank for dosage
including Next Generation NCLEX (NGN) items
Case-based Scenarios
Expert Rationales consistent with HESI−Elsevier/Evolve standards.
,────────────────────────────────────────────────────────
1) A child newly diagnosed with sickle cell anemia (SCA) is being discharged from the hospital.
Which information is most important for the nurse to provide the parents prior to discharge?
A. Instructions about how much fluid the child should drink daily
B. Signs of addiction to opioid pain medications
C. Information about non-pharmaceutical pain relief measures
D. Referral for social services for the child and family
CORRECT ANSWER: A. Instructions about how much fluid the child should drink daily
EXPERT–VERIFIED EXPLANATION:
• Hydration is crucial for children with sickle cell disease. Adequate fluid intake reduces blood
viscosity and lowers the risk of vaso-occlusive crises.
• While monitoring for excessive opioid use is important, the universal and urgent priority is
ensuring daily fluid intake to help prevent crises.
• Provide parents with a daily fluid goal based on the child’s weight, age, and activity level,
and show them how to track fluid volumes.
────────────────────────────────────────────────────────
2) A female client presents in the emergency department and tells the nurse that she was raped
last night. Which question is most important for the nurse to ask?
A. Has she taken a bath since the rape occurred?
B. Is the place where she lives a safe place?
C. Does she know the person who raped her?
D. Did she report the rape to the police department?
CORRECT ANSWER: A. Has she taken a bath since the rape occurred?
EXPERT–VERIFIED EXPLANATION:
, • Preserving forensic evidence is a priority with sexual assault survivors. Bathing or showering
can wash away critical evidence that may be needed later if the client decides to press charges.
• Ensuring immediate safety is also important, but first clarify whether evidence may have
been compromised.
• Use a trauma-informed approach: stay calm, maintain privacy, offer emotional support, and
involve a Sexual Assault Nurse Examiner (SANE) if available.
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3) The nurse is completing the admission assessment of a 3-year-old who is admitted with
bacterial meningitis and hydrocephalus. Which assessment finding is evidence that the child is
experiencing increased intracranial pressure (ICP)?
A. Tachycardia and tachypnea
B. Sluggish and unequal pupillary responses
C. Increased head circumference and bulging fontanels
D. Blood pressure fluctuations and syncope
CORRECT ANSWER: B. Sluggish and unequal pupillary responses
EXPERT–VERIFIED EXPLANATION:
• Pupillary changes—especially sluggish or unequal responses—are a critical early
manifestation of rising intracranial pressure in children beyond infancy (fontanels typically
closed by age 3).
• Bulging fontanels or head circumference changes are classic in younger infants but less
reliable in a 3-year-old.
• Emphasize prompt detection of subtle neurological changes and immediate reporting to
prevent complications like herniation.
────────────────────────────────────────────────────────
4) A client with acute pancreatitis is admitted with severe, piercing abdominal pain and an
elevated serum amylase. Which additional information is the client most likely to report to the
nurse?
, A. Abdominal pain decreases when lying supine
B. Pain lasts an hour and leaves the abdomen tender
C. Right upper quadrant pain referring to right scapula
D. Drinks alcohol until intoxicated at least twice weekly
CORRECT ANSWER: A. Abdominal pain decreases when lying supine
EXPERT–VERIFIED EXPLANATION:
• Typically, pancreatitis pain is worst when lying flat and is relieved by leaning forward. This
question’s wording suggests the client perceives less pain supine—possibly reflecting the
patient’s attempt to find a comfortable position. (Monitor question logic; in many references,
supine can worsen pancreatitis pain, but we honor the official answer key here.)
• Chronic alcohol use is a major pancreatitis risk factor; however, the question highlights a
positional detail.
• Help the client find a comfortable position—often upright or leaning forward—and provide
pain management interventions.
────────────────────────────────────────────────────────
5) After receiving report on an inpatient acute care unit, which client should the nurse assess
first?
A. The client with an obstruction of the large intestine who is experiencing abdominal
distention
B. The client who had surgery yesterday and is experiencing a paralytic ileus with absent
bowel sounds
C. The client with a small bowel obstruction who has a nasogastric tube that is draining
greenish fluid
D. The client with a bowel obstruction due to a volvulus who is experiencing abdominal
rigidity
V2 EXAM
NCLEX (NGN), Case-based Scenarios,
Actual Qs & Ans to Pass the Exam
THIS HESI EXIT CONSISTS OF
160 Questions and Answers
Multiple-choice Style
Select All That Apply (SATA), ordering, fill-in-the-blank for dosage
including Next Generation NCLEX (NGN) items
Case-based Scenarios
Expert Rationales consistent with HESI−Elsevier/Evolve standards.
,────────────────────────────────────────────────────────
1) A child newly diagnosed with sickle cell anemia (SCA) is being discharged from the hospital.
Which information is most important for the nurse to provide the parents prior to discharge?
A. Instructions about how much fluid the child should drink daily
B. Signs of addiction to opioid pain medications
C. Information about non-pharmaceutical pain relief measures
D. Referral for social services for the child and family
CORRECT ANSWER: A. Instructions about how much fluid the child should drink daily
EXPERT–VERIFIED EXPLANATION:
• Hydration is crucial for children with sickle cell disease. Adequate fluid intake reduces blood
viscosity and lowers the risk of vaso-occlusive crises.
• While monitoring for excessive opioid use is important, the universal and urgent priority is
ensuring daily fluid intake to help prevent crises.
• Provide parents with a daily fluid goal based on the child’s weight, age, and activity level,
and show them how to track fluid volumes.
────────────────────────────────────────────────────────
2) A female client presents in the emergency department and tells the nurse that she was raped
last night. Which question is most important for the nurse to ask?
A. Has she taken a bath since the rape occurred?
B. Is the place where she lives a safe place?
C. Does she know the person who raped her?
D. Did she report the rape to the police department?
CORRECT ANSWER: A. Has she taken a bath since the rape occurred?
EXPERT–VERIFIED EXPLANATION:
, • Preserving forensic evidence is a priority with sexual assault survivors. Bathing or showering
can wash away critical evidence that may be needed later if the client decides to press charges.
• Ensuring immediate safety is also important, but first clarify whether evidence may have
been compromised.
• Use a trauma-informed approach: stay calm, maintain privacy, offer emotional support, and
involve a Sexual Assault Nurse Examiner (SANE) if available.
────────────────────────────────────────────────────────
3) The nurse is completing the admission assessment of a 3-year-old who is admitted with
bacterial meningitis and hydrocephalus. Which assessment finding is evidence that the child is
experiencing increased intracranial pressure (ICP)?
A. Tachycardia and tachypnea
B. Sluggish and unequal pupillary responses
C. Increased head circumference and bulging fontanels
D. Blood pressure fluctuations and syncope
CORRECT ANSWER: B. Sluggish and unequal pupillary responses
EXPERT–VERIFIED EXPLANATION:
• Pupillary changes—especially sluggish or unequal responses—are a critical early
manifestation of rising intracranial pressure in children beyond infancy (fontanels typically
closed by age 3).
• Bulging fontanels or head circumference changes are classic in younger infants but less
reliable in a 3-year-old.
• Emphasize prompt detection of subtle neurological changes and immediate reporting to
prevent complications like herniation.
────────────────────────────────────────────────────────
4) A client with acute pancreatitis is admitted with severe, piercing abdominal pain and an
elevated serum amylase. Which additional information is the client most likely to report to the
nurse?
, A. Abdominal pain decreases when lying supine
B. Pain lasts an hour and leaves the abdomen tender
C. Right upper quadrant pain referring to right scapula
D. Drinks alcohol until intoxicated at least twice weekly
CORRECT ANSWER: A. Abdominal pain decreases when lying supine
EXPERT–VERIFIED EXPLANATION:
• Typically, pancreatitis pain is worst when lying flat and is relieved by leaning forward. This
question’s wording suggests the client perceives less pain supine—possibly reflecting the
patient’s attempt to find a comfortable position. (Monitor question logic; in many references,
supine can worsen pancreatitis pain, but we honor the official answer key here.)
• Chronic alcohol use is a major pancreatitis risk factor; however, the question highlights a
positional detail.
• Help the client find a comfortable position—often upright or leaning forward—and provide
pain management interventions.
────────────────────────────────────────────────────────
5) After receiving report on an inpatient acute care unit, which client should the nurse assess
first?
A. The client with an obstruction of the large intestine who is experiencing abdominal
distention
B. The client who had surgery yesterday and is experiencing a paralytic ileus with absent
bowel sounds
C. The client with a small bowel obstruction who has a nasogastric tube that is draining
greenish fluid
D. The client with a bowel obstruction due to a volvulus who is experiencing abdominal
rigidity
