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HESI RN NGN Exit Exam 2025 –
Verified Questions with Correct
Answers and Expert Clinical
Rationales | A+ Test Bank
Case Study 1: Chest Pain in the Emergency Department (6
Questions)
Scenario: A 55-year-old male presents to the ED with chest pain for 1 hour, described as heavy
and radiating to the left arm. Vital signs: BP 160/90 mmHg, HR 92 bpm, RR 20/min, SpO2 95%,
temp 98.6°F. He reports nausea and a history of hypertension and smoking.
1. What is the nurse’s priority action?
A. Administer sublingual nitroglycerin
B. Obtain a 12-lead ECG
C. Provide supplemental oxygen
D. Perform a focused cardiac assessment
Answer: D. Perform a focused cardiac assessment
Rationale: A focused cardiac assessment is the priority to confirm symptoms suggestive
of acute coronary syndrome (ACS) and guide further interventions, such as ECG or
medication administration.
2. The ECG shows ST elevation. What should the nurse prepare for?
A. Discharge with follow-up
B. Percutaneous coronary intervention (PCI)
C. Long-term beta-blocker therapy
D. Routine vital sign monitoring
Answer: B. Percutaneous coronary intervention (PCI)
Rationale: ST elevation indicates an acute myocardial infarction (MI), requiring urgent
PCI to restore coronary blood flow within 90 minutes.
3. Which medication should the nurse anticipate administering?
A. Metoprolol
B. Aspirin
C. Furosemide
D. Insulin
, 2
Answer: B. Aspirin
Rationale: Aspirin is a first-line treatment for suspected MI to inhibit platelet
aggregation and reduce clot formation.
4. The client’s pain persists after one dose of nitroglycerin. What should the nurse do
next?
A. Administer morphine immediately
B. Administer a second dose of nitroglycerin
C. Stop nitroglycerin and notify the provider
D. Increase oxygen to 6 L/min
Answer: B. Administer a second dose of nitroglycerin
Rationale: Nitroglycerin can be given up to three doses, 5 minutes apart, for persistent
chest pain, provided blood pressure remains stable.
5. Select all that apply: Which assessments should the nurse prioritize?
A. Monitor cardiac rhythm
B. Assess pain level
C. Check blood glucose
D. Evaluate respiratory status
E. Measure urine output
Answer: A, B, D
Rationale: Cardiac rhythm, pain level, and respiratory status are critical in ACS to
detect arrhythmias, assess pain relief, and ensure adequate oxygenation. Glucose and
urine output are less urgent.
6. The client’s BP drops to 90/60 mmHg after nitroglycerin. What is the nurse’s next
action?
A. Continue nitroglycerin doses
B. Stop nitroglycerin and notify the provider
C. Administer IV fluids at 50 mL/hr
D. Place the client in a supine position
Answer: B. Stop nitroglycerin and notify the provider
Rationale: Hypotension is a side effect of nitroglycerin; stopping the medication and
notifying the provider prevent further hemodynamic compromise.
Case Study 2: Postoperative Hip Replacement (5 Questions)
Scenario: A 68-year-old female is 1 day post-total hip replacement. She reports moderate pain
(5/10) and has a history of osteoarthritis. Vital signs: BP 130/82 mmHg, HR 78 bpm, RR 16/min,
SpO2 97%, temp 99.8°F. She is on enoxaparin and oxycodone.
, 3
7. What is the priority nursing intervention?
A. Encourage immediate ambulation
B. Assess the surgical site for infection
C. Administer oxycodone as needed
D. Monitor blood glucose levels
Answer: B. Assess the surgical site for infection
Rationale: A low-grade fever on postoperative day 1 may indicate infection; assessing
the surgical site is critical to detect redness, swelling, or drainage.
8. Which finding indicates a potential complication?
A. Pain level of 5/10
B. Calf swelling and tenderness
C. Clear surgical site
D. Normal range of motion
Answer: B. Calf swelling and tenderness
Rationale: Calf swelling and tenderness suggest deep vein thrombosis (DVT), a common
post-orthopedic surgery complication.
9. What should the nurse teach about enoxaparin?
A. Expect increased bruising
B. Report unusual bleeding
C. Take with meals
D. Monitor for weight gain
Answer: B. Report unusual bleeding
Rationale: Enoxaparin, an anticoagulant, increases bleeding risk; clients must report
signs like bruising or epistaxis.
10. The client refuses to use the incentive spirometer. What should the nurse do?
A. Document refusal and take no action
B. Educate on the importance of preventing atelectasis
C. Administer oxygen instead
D. Restrict ambulation
Answer: B. Educate on the importance of preventing atelectasis
Rationale: Incentive spirometry prevents atelectasis; education encourages compliance
to improve lung expansion.
11. Select all that apply: Which interventions promote recovery?
A. Encourage early ambulation
B. Maintain hip precautions
C. Restrict fluid intake
D. Administer pain medication as prescribed
E. Avoid wound care
HESI RN NGN Exit Exam 2025 –
Verified Questions with Correct
Answers and Expert Clinical
Rationales | A+ Test Bank
Case Study 1: Chest Pain in the Emergency Department (6
Questions)
Scenario: A 55-year-old male presents to the ED with chest pain for 1 hour, described as heavy
and radiating to the left arm. Vital signs: BP 160/90 mmHg, HR 92 bpm, RR 20/min, SpO2 95%,
temp 98.6°F. He reports nausea and a history of hypertension and smoking.
1. What is the nurse’s priority action?
A. Administer sublingual nitroglycerin
B. Obtain a 12-lead ECG
C. Provide supplemental oxygen
D. Perform a focused cardiac assessment
Answer: D. Perform a focused cardiac assessment
Rationale: A focused cardiac assessment is the priority to confirm symptoms suggestive
of acute coronary syndrome (ACS) and guide further interventions, such as ECG or
medication administration.
2. The ECG shows ST elevation. What should the nurse prepare for?
A. Discharge with follow-up
B. Percutaneous coronary intervention (PCI)
C. Long-term beta-blocker therapy
D. Routine vital sign monitoring
Answer: B. Percutaneous coronary intervention (PCI)
Rationale: ST elevation indicates an acute myocardial infarction (MI), requiring urgent
PCI to restore coronary blood flow within 90 minutes.
3. Which medication should the nurse anticipate administering?
A. Metoprolol
B. Aspirin
C. Furosemide
D. Insulin
, 2
Answer: B. Aspirin
Rationale: Aspirin is a first-line treatment for suspected MI to inhibit platelet
aggregation and reduce clot formation.
4. The client’s pain persists after one dose of nitroglycerin. What should the nurse do
next?
A. Administer morphine immediately
B. Administer a second dose of nitroglycerin
C. Stop nitroglycerin and notify the provider
D. Increase oxygen to 6 L/min
Answer: B. Administer a second dose of nitroglycerin
Rationale: Nitroglycerin can be given up to three doses, 5 minutes apart, for persistent
chest pain, provided blood pressure remains stable.
5. Select all that apply: Which assessments should the nurse prioritize?
A. Monitor cardiac rhythm
B. Assess pain level
C. Check blood glucose
D. Evaluate respiratory status
E. Measure urine output
Answer: A, B, D
Rationale: Cardiac rhythm, pain level, and respiratory status are critical in ACS to
detect arrhythmias, assess pain relief, and ensure adequate oxygenation. Glucose and
urine output are less urgent.
6. The client’s BP drops to 90/60 mmHg after nitroglycerin. What is the nurse’s next
action?
A. Continue nitroglycerin doses
B. Stop nitroglycerin and notify the provider
C. Administer IV fluids at 50 mL/hr
D. Place the client in a supine position
Answer: B. Stop nitroglycerin and notify the provider
Rationale: Hypotension is a side effect of nitroglycerin; stopping the medication and
notifying the provider prevent further hemodynamic compromise.
Case Study 2: Postoperative Hip Replacement (5 Questions)
Scenario: A 68-year-old female is 1 day post-total hip replacement. She reports moderate pain
(5/10) and has a history of osteoarthritis. Vital signs: BP 130/82 mmHg, HR 78 bpm, RR 16/min,
SpO2 97%, temp 99.8°F. She is on enoxaparin and oxycodone.
, 3
7. What is the priority nursing intervention?
A. Encourage immediate ambulation
B. Assess the surgical site for infection
C. Administer oxycodone as needed
D. Monitor blood glucose levels
Answer: B. Assess the surgical site for infection
Rationale: A low-grade fever on postoperative day 1 may indicate infection; assessing
the surgical site is critical to detect redness, swelling, or drainage.
8. Which finding indicates a potential complication?
A. Pain level of 5/10
B. Calf swelling and tenderness
C. Clear surgical site
D. Normal range of motion
Answer: B. Calf swelling and tenderness
Rationale: Calf swelling and tenderness suggest deep vein thrombosis (DVT), a common
post-orthopedic surgery complication.
9. What should the nurse teach about enoxaparin?
A. Expect increased bruising
B. Report unusual bleeding
C. Take with meals
D. Monitor for weight gain
Answer: B. Report unusual bleeding
Rationale: Enoxaparin, an anticoagulant, increases bleeding risk; clients must report
signs like bruising or epistaxis.
10. The client refuses to use the incentive spirometer. What should the nurse do?
A. Document refusal and take no action
B. Educate on the importance of preventing atelectasis
C. Administer oxygen instead
D. Restrict ambulation
Answer: B. Educate on the importance of preventing atelectasis
Rationale: Incentive spirometry prevents atelectasis; education encourages compliance
to improve lung expansion.
11. Select all that apply: Which interventions promote recovery?
A. Encourage early ambulation
B. Maintain hip precautions
C. Restrict fluid intake
D. Administer pain medication as prescribed
E. Avoid wound care
