2025 HESI EXIT
V1 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.
,───────────────────────────────────────────────────────
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QUESTION 1
A homeless client presents at a community psychiatric clinic for a scheduled medication
administration. When you prepare to give the prescribed dose, the client says the usual
dose taken is different from what you’ve drawn up. Which action should the nurse take?
A. Tell the client they can refuse the medication.
B. Withhold the medication until the dose can be verified.
C. Explain the dosage change is probably correct.
D. Instruct the client to take the medication now and verify later.
Answer: B
Expert-Verified Explanation: If there is any discrepancy between the client’s report
and the prescription, always verify with the healthcare provider or medication record
before administering. This ensures client safety and avoids possible dosing errors.
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QUESTION 2
You are the charge nurse making assignments for one Practical Nurse (PN) and three
RNs on a neuro unit. Which client change in status is best to assign to the PN?
A. A subdural hematoma client whose BP changed from 150/80 to 170/60.
B. A viral meningitis client whose temperature changed from 101.5°F to 102°F.
C. A diabetic ketoacidosis client whose GCS changed from 10 to 7.
D. A myxedema client whose BP changed from 80/50 to 70/40.
Answer: B
,Expert-Verified Explanation: A PN can monitor a slight temperature increase in viral
meningitis. The more critical changes (large BP shifts, significant drop in GCS from 10
to 7) require an RN’s advanced assessment and potential immediate intervention.
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QUESTION 3
A pneumonia client shows initial signs of septic shock and multi-organ failure. A sepsis
protocol is prescribed. Which intervention is most important to include?
A. Maintain strict intake and output.
B. Keep the head of bed at 45°.
C. Assess warmth of extremities.
D. Monitor blood glucose level.
Answer: A
Expert-Verified Explanation: Strict I&O measurement is vital to gauge fluid balance,
renal perfusion, and response to fluid resuscitation, which are central to sepsis
management.
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QUESTION 4
An adolescent admitted after writing a suicide note leaves a treatment team meeting in
tears and retreats to the room. Which nursing intervention is best?
A. Let the client rest quietly.
B. Explore the client’s goals and desires for treatment.
C. Ask the treatment team about the client’s mood.
D. Go to the client’s room and ask what happened.
, Answer: D
Expert-Verified Explanation: Promptly offering support and exploring the client’s
distress fosters trust and provides immediate therapeutic intervention for a suicidal
adolescent.
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─
QUESTION 5 (NGN-Style: Originally “Select 3 Goals,” now multiple choice)
A client with respiratory issues: RR 28, SpO₂ 90% on 3 L NC, thick sputum, mild fever.
Which of the following goals is most realistic and important in the acute plan of care?
A. Achieve a 2-point drop in pain rating within 24 hours.
B. Remain free from skin breakdown.
C. Maintain oxygen saturation ≥94% with appropriate O₂ therapy.
D. Quit smoking immediately before discharge.
Answer: C
Expert-Verified Explanation: For acute respiratory compromise, stabilizing oxygen
saturation is a top priority. Other goals (pain relief, smoking cessation, skin care) are
important but not the most urgent in the short term.
───────────────────────────────────────────────────────
─
QUESTION 6 (NGN-Style: Oxygen Administration)
A new graduate nurse is teaching about simple face mask use at 8 L/min. Which
teaching indicates proper understanding?
A. “It’s okay to remove the mask 1–2 minutes per hour.”
B. “I can place soft gauze under the elastic strap to prevent skin irritation.”
V1 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.
,───────────────────────────────────────────────────────
─
QUESTION 1
A homeless client presents at a community psychiatric clinic for a scheduled medication
administration. When you prepare to give the prescribed dose, the client says the usual
dose taken is different from what you’ve drawn up. Which action should the nurse take?
A. Tell the client they can refuse the medication.
B. Withhold the medication until the dose can be verified.
C. Explain the dosage change is probably correct.
D. Instruct the client to take the medication now and verify later.
Answer: B
Expert-Verified Explanation: If there is any discrepancy between the client’s report
and the prescription, always verify with the healthcare provider or medication record
before administering. This ensures client safety and avoids possible dosing errors.
───────────────────────────────────────────────────────
─
QUESTION 2
You are the charge nurse making assignments for one Practical Nurse (PN) and three
RNs on a neuro unit. Which client change in status is best to assign to the PN?
A. A subdural hematoma client whose BP changed from 150/80 to 170/60.
B. A viral meningitis client whose temperature changed from 101.5°F to 102°F.
C. A diabetic ketoacidosis client whose GCS changed from 10 to 7.
D. A myxedema client whose BP changed from 80/50 to 70/40.
Answer: B
,Expert-Verified Explanation: A PN can monitor a slight temperature increase in viral
meningitis. The more critical changes (large BP shifts, significant drop in GCS from 10
to 7) require an RN’s advanced assessment and potential immediate intervention.
───────────────────────────────────────────────────────
─
QUESTION 3
A pneumonia client shows initial signs of septic shock and multi-organ failure. A sepsis
protocol is prescribed. Which intervention is most important to include?
A. Maintain strict intake and output.
B. Keep the head of bed at 45°.
C. Assess warmth of extremities.
D. Monitor blood glucose level.
Answer: A
Expert-Verified Explanation: Strict I&O measurement is vital to gauge fluid balance,
renal perfusion, and response to fluid resuscitation, which are central to sepsis
management.
───────────────────────────────────────────────────────
─
QUESTION 4
An adolescent admitted after writing a suicide note leaves a treatment team meeting in
tears and retreats to the room. Which nursing intervention is best?
A. Let the client rest quietly.
B. Explore the client’s goals and desires for treatment.
C. Ask the treatment team about the client’s mood.
D. Go to the client’s room and ask what happened.
, Answer: D
Expert-Verified Explanation: Promptly offering support and exploring the client’s
distress fosters trust and provides immediate therapeutic intervention for a suicidal
adolescent.
───────────────────────────────────────────────────────
─
QUESTION 5 (NGN-Style: Originally “Select 3 Goals,” now multiple choice)
A client with respiratory issues: RR 28, SpO₂ 90% on 3 L NC, thick sputum, mild fever.
Which of the following goals is most realistic and important in the acute plan of care?
A. Achieve a 2-point drop in pain rating within 24 hours.
B. Remain free from skin breakdown.
C. Maintain oxygen saturation ≥94% with appropriate O₂ therapy.
D. Quit smoking immediately before discharge.
Answer: C
Expert-Verified Explanation: For acute respiratory compromise, stabilizing oxygen
saturation is a top priority. Other goals (pain relief, smoking cessation, skin care) are
important but not the most urgent in the short term.
───────────────────────────────────────────────────────
─
QUESTION 6 (NGN-Style: Oxygen Administration)
A new graduate nurse is teaching about simple face mask use at 8 L/min. Which
teaching indicates proper understanding?
A. “It’s okay to remove the mask 1–2 minutes per hour.”
B. “I can place soft gauze under the elastic strap to prevent skin irritation.”
