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.
,QUESTION 1
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A postoperative adult client with type 2 diabetes mellitus has a current blood glucose level of
720 mg/dL. Which assessment finding is the nurse’s priority?
A. Assess for signs of fluid volume deficit
B. Observe the wound drainage characteristics
C. Measure the level of acute pain
D. Determine when the client last ate
Correct Answer: A
Rationale (Expert Explanation):
• A blood glucose of 720 mg/dL raises concern for hyperglycemic hyperosmolar state (HHS),
which often presents with severe dehydration.
• Therefore, assessing signs of fluid volume deficit is the immediate priority.
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QUESTION 2
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A male client reports concern for possible peptic ulcer disease because of heartburn and a dull,
gnawing pain relieved by eating. Which response by the nurse is best?
A. “Encourage a complete physical exam; your symptoms are consistent with an ulcer.”
B. “Your symptoms might just be reflux, because ulcer pain is not relieved by food.”
C. “These mild symptoms will go away if you avoid spicy foods.”
D. “There is no need to worry; over-the-counter antacids should help.”
Correct Answer: A
,Rationale (Expert Explanation):
• Dull, gnawing epigastric pain relieved by food intake can signal a peptic ulcer.
• Referral for a full evaluation is appropriate.
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QUESTION 3
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A male client with stomach cancer returns from surgery after a total gastrectomy. He has an NG
tube to suction, is receiving Lactated Ringer’s at 75 mL/hr IV, and one hour after admission the
nurse notes 300 mL of blood in the suction canister, HR 155 bpm, BP 78/48 mmHg. In addition
to notifying the surgeon, which action should the nurse implement first?
A. Measure and document the client’s urine output.
B. Check for an order to discontinue suction.
C. Assess operative dressing.
D. Increase the infusion rate of Lactated Ringer’s solution.
Correct Answer: D
Rationale (Expert Explanation):
• The rapid blood loss and hypotension (BP 78/48 mmHg) indicate potential hypovolemic shock.
• Increasing IV fluid rate helps maintain circulating volume.
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QUESTION 4
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A heparin infusion is prescribed for a 220-pound (100 kg) client. After an 80 units/kg bolus, the
infusion is set at 18 units/kg/hour. Available heparin solution: 25,000 Units in 250 mL D5W. How
many mL/hour should the nurse program?
, A. 12 mL/hour
B. 18 mL/hour
C. 24 mL/hour
D. 36 mL/hour
Correct Answer: B (18 mL/hour)
Rationale (Expert Explanation):
• 220 lb ÷ 2.2 = 100 kg.
• Infusion = 18 units/kg/hour → 18 × 100 = 1800 units/hour.
• 25,000 units : 250 mL = 1800 units : X mL → X = (1800 × 250) ÷ 25,000 = 18 mL/hour.
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QUESTION 5
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A male client fell 20 feet and has multiple injuries including a right pneumothorax. Chest tubes
are in place, set to −10 cm H2O suction, with continuous bubbling in the suction-control
chamber. After 1 hour in ICU, 75 mL of bright red blood is in the collection chamber. Which
intervention is indicated?
A. Add sterile water to the suction control chamber.
B. Notify the rapid response team.
C. Lower the suction to −5 cm H2O.
D. Strip the chest tube gently.
Correct Answer: A
Rationale (Expert Explanation):
• Bubbling at the −10 cm H2O mark can cause some evaporation.
• Ensuring the suction-control chamber maintains the correct fluid level often requires adding
sterile water.
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.
,QUESTION 1
────────────────────────────────────────────────────────
A postoperative adult client with type 2 diabetes mellitus has a current blood glucose level of
720 mg/dL. Which assessment finding is the nurse’s priority?
A. Assess for signs of fluid volume deficit
B. Observe the wound drainage characteristics
C. Measure the level of acute pain
D. Determine when the client last ate
Correct Answer: A
Rationale (Expert Explanation):
• A blood glucose of 720 mg/dL raises concern for hyperglycemic hyperosmolar state (HHS),
which often presents with severe dehydration.
• Therefore, assessing signs of fluid volume deficit is the immediate priority.
────────────────────────────────────────────────────────
QUESTION 2
────────────────────────────────────────────────────────
A male client reports concern for possible peptic ulcer disease because of heartburn and a dull,
gnawing pain relieved by eating. Which response by the nurse is best?
A. “Encourage a complete physical exam; your symptoms are consistent with an ulcer.”
B. “Your symptoms might just be reflux, because ulcer pain is not relieved by food.”
C. “These mild symptoms will go away if you avoid spicy foods.”
D. “There is no need to worry; over-the-counter antacids should help.”
Correct Answer: A
,Rationale (Expert Explanation):
• Dull, gnawing epigastric pain relieved by food intake can signal a peptic ulcer.
• Referral for a full evaluation is appropriate.
────────────────────────────────────────────────────────
QUESTION 3
────────────────────────────────────────────────────────
A male client with stomach cancer returns from surgery after a total gastrectomy. He has an NG
tube to suction, is receiving Lactated Ringer’s at 75 mL/hr IV, and one hour after admission the
nurse notes 300 mL of blood in the suction canister, HR 155 bpm, BP 78/48 mmHg. In addition
to notifying the surgeon, which action should the nurse implement first?
A. Measure and document the client’s urine output.
B. Check for an order to discontinue suction.
C. Assess operative dressing.
D. Increase the infusion rate of Lactated Ringer’s solution.
Correct Answer: D
Rationale (Expert Explanation):
• The rapid blood loss and hypotension (BP 78/48 mmHg) indicate potential hypovolemic shock.
• Increasing IV fluid rate helps maintain circulating volume.
────────────────────────────────────────────────────────
QUESTION 4
────────────────────────────────────────────────────────
A heparin infusion is prescribed for a 220-pound (100 kg) client. After an 80 units/kg bolus, the
infusion is set at 18 units/kg/hour. Available heparin solution: 25,000 Units in 250 mL D5W. How
many mL/hour should the nurse program?
, A. 12 mL/hour
B. 18 mL/hour
C. 24 mL/hour
D. 36 mL/hour
Correct Answer: B (18 mL/hour)
Rationale (Expert Explanation):
• 220 lb ÷ 2.2 = 100 kg.
• Infusion = 18 units/kg/hour → 18 × 100 = 1800 units/hour.
• 25,000 units : 250 mL = 1800 units : X mL → X = (1800 × 250) ÷ 25,000 = 18 mL/hour.
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QUESTION 5
────────────────────────────────────────────────────────
A male client fell 20 feet and has multiple injuries including a right pneumothorax. Chest tubes
are in place, set to −10 cm H2O suction, with continuous bubbling in the suction-control
chamber. After 1 hour in ICU, 75 mL of bright red blood is in the collection chamber. Which
intervention is indicated?
A. Add sterile water to the suction control chamber.
B. Notify the rapid response team.
C. Lower the suction to −5 cm H2O.
D. Strip the chest tube gently.
Correct Answer: A
Rationale (Expert Explanation):
• Bubbling at the −10 cm H2O mark can cause some evaporation.
• Ensuring the suction-control chamber maintains the correct fluid level often requires adding
sterile water.
