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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1. A young adult client with asthma, admitted yesterday, is sitting on the side of the bed
leaning over the bedside table. The client, on 2 L/min of oxygen via nasal cannula, is
wheezing and using pursed-lip breathing.
Which intervention should the nurse implement first?
A. Increase oxygen to 6 L/min
B. Call for an Ambu resuscitation bag
C. Instruct the client to lie back in bed
D. Administer a nebulizer treatment
Answer: D
Rationale/Explanation: The client is in respiratory distress (wheezing, pursed-lip
breathing). A nebulizer treatment (e.g., albuterol) helps open the airways quickly. Increasing
oxygen alone does not address bronchospasm. Having the client lie down can worsen
breathing, and an Ambu bag is used if the client is not adequately ventilating or is in severe
distress.
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2. Which client should the nurse assess most frequently for overflow incontinence?
A. A client with hematuria and decreasing hemoglobin/hematocrit
B. A client on a fast, with raised serum creatinine levels
C. A client who is confused and frequently forgets to use the bathroom
D. A client with a history of frequent urinary tract infections
Answer: C
Rationale/Explanation: Confusion and forgetfulness can cause the client to miss toileting
opportunities, resulting in overflow incontinence. This condition arises when the bladder
,becomes over-distended and small amounts of urine leak out.
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3. A homeless client at a community psychiatric clinic says, “This dose is different from what I
usually take,” when the nurse attempts to administer a prescribed medication. Which action
should the nurse take?
A. Inform the client that refusal is an option, then document the outcome
B. Withhold the medication until the dosage can be confirmed
C. Explain that the dosage has been changed by the provider
D. Tell the client to take the medication and verify the dose at the next meeting
Answer: B
Rationale/Explanation: If there is any discrepancy between the prescribed and usual dose
the client reports, the safest action is to hold the dose until verification occurs to prevent
adverse events.
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4. The charge nurse is assigning clients to one LPN and three RNs. Which client status
change is best to assign to the LPN?
, A. A subdural hematoma whose BP changed from 150/80 to 170/60
B. Viral meningitis whose temperature changed from 101°F to 102°F
C. Diabetic ketoacidosis whose Glasgow Coma Scale changed from 10 to 7
D. Myxedema whose blood pressure changed from 80/50 to 70/40
Answer: B
Rationale/Explanation: An increasing fever in viral meningitis is concerning but typically
lower risk than the other changes. The LPN can monitor and report back. The other status
changes (especially large BP changes in severe conditions or GCS drop) are more acute and
need an RN’s higher-level skills.
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5. A client with pneumonia is now showing initial signs of septic shock and potential multi-
organ failure. A sepsis protocol is prescribed. Which intervention is most important for the
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.
,────────────────────────────────────────────────────────
1. A young adult client with asthma, admitted yesterday, is sitting on the side of the bed
leaning over the bedside table. The client, on 2 L/min of oxygen via nasal cannula, is
wheezing and using pursed-lip breathing.
Which intervention should the nurse implement first?
A. Increase oxygen to 6 L/min
B. Call for an Ambu resuscitation bag
C. Instruct the client to lie back in bed
D. Administer a nebulizer treatment
Answer: D
Rationale/Explanation: The client is in respiratory distress (wheezing, pursed-lip
breathing). A nebulizer treatment (e.g., albuterol) helps open the airways quickly. Increasing
oxygen alone does not address bronchospasm. Having the client lie down can worsen
breathing, and an Ambu bag is used if the client is not adequately ventilating or is in severe
distress.
────────────────────────────────────────────────────────
2. Which client should the nurse assess most frequently for overflow incontinence?
A. A client with hematuria and decreasing hemoglobin/hematocrit
B. A client on a fast, with raised serum creatinine levels
C. A client who is confused and frequently forgets to use the bathroom
D. A client with a history of frequent urinary tract infections
Answer: C
Rationale/Explanation: Confusion and forgetfulness can cause the client to miss toileting
opportunities, resulting in overflow incontinence. This condition arises when the bladder
,becomes over-distended and small amounts of urine leak out.
────────────────────────────────────────────────────────
3. A homeless client at a community psychiatric clinic says, “This dose is different from what I
usually take,” when the nurse attempts to administer a prescribed medication. Which action
should the nurse take?
A. Inform the client that refusal is an option, then document the outcome
B. Withhold the medication until the dosage can be confirmed
C. Explain that the dosage has been changed by the provider
D. Tell the client to take the medication and verify the dose at the next meeting
Answer: B
Rationale/Explanation: If there is any discrepancy between the prescribed and usual dose
the client reports, the safest action is to hold the dose until verification occurs to prevent
adverse events.
────────────────────────────────────────────────────────
4. The charge nurse is assigning clients to one LPN and three RNs. Which client status
change is best to assign to the LPN?
, A. A subdural hematoma whose BP changed from 150/80 to 170/60
B. Viral meningitis whose temperature changed from 101°F to 102°F
C. Diabetic ketoacidosis whose Glasgow Coma Scale changed from 10 to 7
D. Myxedema whose blood pressure changed from 80/50 to 70/40
Answer: B
Rationale/Explanation: An increasing fever in viral meningitis is concerning but typically
lower risk than the other changes. The LPN can monitor and report back. The other status
changes (especially large BP changes in severe conditions or GCS drop) are more acute and
need an RN’s higher-level skills.
────────────────────────────────────────────────────────
5. A client with pneumonia is now showing initial signs of septic shock and potential multi-
organ failure. A sepsis protocol is prescribed. Which intervention is most important for the
