V4 EXAM
NCLEX (NGN), Case-based Scenarios,
Actual Qs & Ans to Pass the Exam
THIS HESI PN EXIT CONSISTS OF
75 Questions and Answers
multiple-choice questions (MCQs)** with four options
(A–D), answers, and detailed rationales aligned with
HESI PN Exit Exam 2025 standards.
Some questions are flagged as **NCLEX-style (NGN)**, and
relevant **case studies/vitals** are integrated where applicable.
,### 1. *(NGN - Risk Assessment)*
The practical nurse (PN) is caring for a client with obstructive sleep apnea
(OSA). The PN should recognize the client is at increased risk for which
complication?
A. Urinary tract infection
B. Peptic ulcer disease
C. Peripheral vascular disease
D. Chronic kidney disease
Answer: B. Peptic ulcer disease
Rationale:
Clients with obstructive sleep apnea experience hypoxia and increased
sympathetic nervous system activity, which can increase gastric acid
secretion and predispose them to peptic ulcer disease. Chronic intermittent
hypoxia also promotes stress ulcers. While OSA can contribute to
cardiovascular problems, peptic ulcers are a noted complication due to
physiological stress and medication used for treatment.
---
### 2. *(Case Scenario — Vascular Assessment)*
Which finding for a client with an arteriovenous (AV) fistula should the
practical nurse report to the healthcare provider immediately?
,A. Bruit audible on auscultation over the fistula
B. Radial pulse distal to AV fistula is absent while ulnar pulse is present
C. Swelling and redness over the fistula site
D. Presence of thrill on palpation
Answer: B. Radial pulse distal to AV fistula is absent while ulnar pulse is
present
Rationale:
An absent radial pulse distal to the AV fistula suggests compromised
arterial blood flow and possible vascular occlusion or steal syndrome; this
is a medical emergency requiring immediate intervention. Bruit (A) and thrill
(D) are expected findings indicating patency. Swelling and redness (C) may
indicate infection but distal pulse loss is more urgent.
---
### 3. *(NGN - Disaster Preparedness)*
During a mass casualty response to a natural flooding disaster, which
information should the practical nurse include in health education for
evacuees?
A. Use bottled water or boiled water for drinking and oral rehydration
solutions
B. Use only bottled water for washing hands
C. All fruits and vegetables must be cooked before eating
D. Use only alcohol-based sanitizers for cleaning food items
, Answer: A. Use bottled water or boiled water for drinking and oral
rehydration solutions
Rationale:
After flooding, waterborne diseases are common; drinking boiled or bottled
water and using oral rehydration solutions prevent dehydration and
infection. Hand hygiene with soap and clean water or alcohol-based
sanitizers is recommended (not just bottled water). Fruits and vegetables
can be washed (not necessarily cooked) with clean water.
---
### 4. *(Case Scenario — Pediatric Care)*
In administering nystatin oral suspension for an infant with oral candidiasis
(thrush), which approach should the practical nurse use?
A. Administer suspension with a bottle nipple
B. Use a gloved finger to apply the suspension over infected areas
C. Mix medication with feeding formula
D. Wipe the infant’s mouth with a cotton swab before administration
Answer: B. Use a gloved finger to apply the suspension over infected
areas
Rationale: