HESI RN EXIT NGN V9 QUESTIONS
WITH ANSWERS AND EXPLANATIONS
1. A hospitalized client receives nifedipine as a tocolytic. Which assessment is especially important?
A. Check for severe hypertension caused by every dose.
B. Monitor blood pressure because hypotension can occur.
C. Expect the drug to induce labor immediately.
D. Monitor only newborn bilirubin.
Correct Answer: B. Monitor blood pressure because hypotension can occur.
Explanation: Nifedipine relaxes smooth muscle and can lower maternal blood pressure, so hemodynamic
monitoring is important.
2. The nurse has limited time before shift report. Which finding requires evaluation before routine tasks
are completed?
A. A previously oriented client who is suddenly difficult to awaken.
B. A stable client requesting a routine linen change.
C. A client asking what time dinner arrives.
D. A client with chronic dry skin requesting lotion.
Correct Answer: A. A previously oriented client who is suddenly difficult to awaken.
Explanation: An acute change in level of consciousness can signal neurologic, respiratory, or metabolic
deterioration and requires prompt assessment.
3. An infant with congenital adrenal hyperplasia has vomiting, dehydration, hyponatremia, and
hyperkalemia. What is the priority concern? Laboratory data Measure Result Sodium 126 mEq/L
Potassium
6. 1 mEq/L Hydration Poor
A. Salt-wasting adrenal crisis.
B. Simple colic.
C. Pyloric stenosis with alkalosis only.
D. Hyperthyroidism.
Correct Answer: A. Salt-wasting adrenal crisis.
Explanation: Cortisol and aldosterone deficiency can cause life-threatening salt wasting, dehydration,
hyperkalemia, and shock.
4. During nursing care, a client recently had surgery involving the right ear. Which temperature route
should the nurse avoid on that side?
A. Oral measurement if otherwise appropriate.
B. Axillary measurement if needed.
C. Temporal measurement if appropriate.
D. Tympanic measurement in the affected ear until it is considered safe.
Correct Answer: D. Tympanic measurement in the affected ear until it is considered safe.
Explanation: Ear surgery or injury can make tympanic measurement inappropriate. An alternate safe route
should be selected.
5. When should discharge planning begin for a hospitalized client?
A. Only after the discharge order is written.
B. After the client has already left the hospital.
C. Only when the family asks for paperwork.
D. Early in the admission, with needs reassessed throughout the stay.
Correct Answer: D. Early in the admission, with needs reassessed throughout the stay.
Explanation: Early discharge planning helps identify education, equipment, caregiver, transportation, and
follow-up needs in time to address barriers.
6. A hospitalized client is instructed to take 10 mL of a liquid medication. Approximately how many
teaspoons is this using 5 mL per teaspoon? Dose conversion Ordered volume Conversion 10 mL 5 mL = 1
tsp
A. 0.5 teaspoon.
B. 1 teaspoon.
C. 5 teaspoons.
,D. 2 teaspoons.
Correct Answer: D. 2 teaspoons.
Explanation: 10 mL divided by 5 mL per teaspoon equals 2 teaspoons. A calibrated dosing device is preferable
to household utensils.
7. A stable term newborn is placed skin-to-skin with the parent after birth. Which benefit should the nurse
expect?
A. Improved thermal stability and support for early bonding and feeding behaviors.
B. Guaranteed prevention of all neonatal infections.
C. Immediate closure of the ductus arteriosus.
D. Elimination of the need for newborn assessment.
Correct Answer: A. Improved thermal stability and support for early bonding and feeding behaviors.
Explanation: Skin-to-skin contact supports thermoregulation, physiologic stability, bonding, and early feeding
when parent and newborn are stable.
8. Which client problem should generally be addressed before a potential problem?
A. A future risk for constipation in a stable client.
B. An actual problem with impaired breathing that is occurring now.
C. A possible knowledge deficit about discharge paperwork.
D. A long-term goal to improve exercise tolerance.
Correct Answer: B. An actual problem with impaired breathing that is occurring now.
Explanation: Current life-threatening or physiologic problems usually take priority over risks and long-term
needs. Clinical context can modify any general priority framework.
9. A child’s personal-best peak expiratory flow is 300 L/min. Today the reading is 150 L/min with
wheezing. How should this be interpreted? Peak-flow record Personal best Today 300 L/min 150 L/min
A. The reading is normal because it is above 100 L/min.
B. The value indicates improved airway function.
C. Peak flow does not help assess asthma control.
D. The reading is about 50% of personal best and indicates significant airflow limitation requiring the action plan.
Correct Answer: D. The reading is about 50% of personal best and indicates significant airflow limitation
requiring the action plan.
Explanation: A peak flow at roughly half of personal best represents substantial reduction in airflow. The child
should follow the prescribed asthma action plan for the low zone.
10. A 5-year-old is behind on routine immunizations. Which principle should guide catch-up planning?
Immunization history Age Record 5 years Series incomplete Last documented dose 18 months ago Current
status Healthy
A. The vaccine series generally does not need to be restarted because of a long interval between doses.
B. Every vaccine series must restart from dose one.
C. Only live vaccines can be given after a missed interval.
D. Catch-up vaccination should wait until adolescence.
Correct Answer: A. The vaccine series generally does not need to be restarted because of a long interval between
doses.
Explanation: CDC catch-up guidance states that an interrupted vaccine series usually continues from the
previous valid dose rather than restarting.
11. The nurse promises to return in 15 minutes with pain medication and then makes sure the promise is
kept. Which ethical principle is illustrated?
A. Justice.
B. Autonomy.
C. Utility.
D. Fidelity.
Correct Answer: D. Fidelity.
Explanation: Fidelity involves keeping promises and commitments, supporting trust in the nurse-client
relationship.
12. Which laboratory trend best suggests response to iron therapy in a child with iron-deficiency anemia?
A. Hemoglobin and reticulocyte response improve over time with adherence.
B. Hemoglobin continues to fall steadily.
, C. Platelet function disappears.
D. Serum sodium rises sharply.
Correct Answer: A. Hemoglobin and reticulocyte response improve over time with adherence.
Explanation: Effective iron therapy produces hematologic recovery, typically with an early reticulocyte response
followed by rising hemoglobin.
13. Using the data in the exhibit, what initial crystalloid volume does 30 mL/kg equal? Initial sepsis data
Parameter Value Weight 60 kg Perfusion Hypotension with elevated lactate Initial crystalloid order 30
mL/kg with reassessment
A. 600 mL.
B. 1,200 mL.
C. 3,000 mL.
D. 1,800 mL.
Correct Answer: D. 1,800 mL.
Explanation: 30 mL/kg x 60 kg = 1,800 mL. Current sepsis guidance emphasizes prompt crystalloid resuscitation
with ongoing reassessment to avoid under- or over-resuscitation.
14. Which task may commonly be assigned to an LPN/LVN for a stable client, depending on jurisdiction
and facility policy?
A. Perform the initial comprehensive RN assessment.
B. Administer routine medications and reinforce previously taught care within scope.
C. Develop the nursing diagnosis independently.
D. Provide initial teaching for a complex new therapy.
Correct Answer: B. Administer routine medications and reinforce previously taught care within scope.
Explanation: LPN/LVN scope commonly includes predictable care and many routine medications, while initial
assessment, nursing diagnosis, and complex teaching remain RN responsibilities. Local law and policy govern
delegation.
15. A hospitalized client is being transported to radiology on a stretcher. Which safety measure is most
important before movement begins?
A. Transport with the stretcher unlocked so it rolls more freely.
B. Leave the client unattended in the hallway.
C. Allow IV tubing to hang where it can catch on doors.
D. Raise the stretcher side rails as appropriate, secure the client, and ensure tubes and lines are protected.
Correct Answer: D. Raise the stretcher side rails as appropriate, secure the client, and ensure tubes and lines are
protected.
Explanation: Safe transport includes appropriate side-rail use, secure positioning, and protection of lines and
tubes. The client should not be left unattended when safety risk is present.
16. A hospitalized child receiving growth hormone develops persistent severe headache and visual changes.
What should the nurse advise?
A. Double the next dose.
B. Prompt medical evaluation for a potential serious adverse effect.
C. Ignore symptoms because they prove the drug is working.
D. Stop all fluids.
Correct Answer: B. Prompt medical evaluation for a potential serious adverse effect.
Explanation: Severe headache and visual symptoms can signal increased intracranial pressure or other
complications and should be evaluated promptly.
17. Which plan best reflects client-centered care?
A. Use the same goals for every client with the same diagnosis.
B. Exclude the client from planning to save time.
C. Develop goals with the client that incorporate the client's priorities, abilities, and preferences.
D. Choose goals based only on staff convenience.
Correct Answer: C. Develop goals with the client that incorporate the client's priorities, abilities, and
preferences.
Explanation: Client-centered planning incorporates individual goals, values, readiness, and preferences while
maintaining safety and evidence-based care.
WITH ANSWERS AND EXPLANATIONS
1. A hospitalized client receives nifedipine as a tocolytic. Which assessment is especially important?
A. Check for severe hypertension caused by every dose.
B. Monitor blood pressure because hypotension can occur.
C. Expect the drug to induce labor immediately.
D. Monitor only newborn bilirubin.
Correct Answer: B. Monitor blood pressure because hypotension can occur.
Explanation: Nifedipine relaxes smooth muscle and can lower maternal blood pressure, so hemodynamic
monitoring is important.
2. The nurse has limited time before shift report. Which finding requires evaluation before routine tasks
are completed?
A. A previously oriented client who is suddenly difficult to awaken.
B. A stable client requesting a routine linen change.
C. A client asking what time dinner arrives.
D. A client with chronic dry skin requesting lotion.
Correct Answer: A. A previously oriented client who is suddenly difficult to awaken.
Explanation: An acute change in level of consciousness can signal neurologic, respiratory, or metabolic
deterioration and requires prompt assessment.
3. An infant with congenital adrenal hyperplasia has vomiting, dehydration, hyponatremia, and
hyperkalemia. What is the priority concern? Laboratory data Measure Result Sodium 126 mEq/L
Potassium
6. 1 mEq/L Hydration Poor
A. Salt-wasting adrenal crisis.
B. Simple colic.
C. Pyloric stenosis with alkalosis only.
D. Hyperthyroidism.
Correct Answer: A. Salt-wasting adrenal crisis.
Explanation: Cortisol and aldosterone deficiency can cause life-threatening salt wasting, dehydration,
hyperkalemia, and shock.
4. During nursing care, a client recently had surgery involving the right ear. Which temperature route
should the nurse avoid on that side?
A. Oral measurement if otherwise appropriate.
B. Axillary measurement if needed.
C. Temporal measurement if appropriate.
D. Tympanic measurement in the affected ear until it is considered safe.
Correct Answer: D. Tympanic measurement in the affected ear until it is considered safe.
Explanation: Ear surgery or injury can make tympanic measurement inappropriate. An alternate safe route
should be selected.
5. When should discharge planning begin for a hospitalized client?
A. Only after the discharge order is written.
B. After the client has already left the hospital.
C. Only when the family asks for paperwork.
D. Early in the admission, with needs reassessed throughout the stay.
Correct Answer: D. Early in the admission, with needs reassessed throughout the stay.
Explanation: Early discharge planning helps identify education, equipment, caregiver, transportation, and
follow-up needs in time to address barriers.
6. A hospitalized client is instructed to take 10 mL of a liquid medication. Approximately how many
teaspoons is this using 5 mL per teaspoon? Dose conversion Ordered volume Conversion 10 mL 5 mL = 1
tsp
A. 0.5 teaspoon.
B. 1 teaspoon.
C. 5 teaspoons.
,D. 2 teaspoons.
Correct Answer: D. 2 teaspoons.
Explanation: 10 mL divided by 5 mL per teaspoon equals 2 teaspoons. A calibrated dosing device is preferable
to household utensils.
7. A stable term newborn is placed skin-to-skin with the parent after birth. Which benefit should the nurse
expect?
A. Improved thermal stability and support for early bonding and feeding behaviors.
B. Guaranteed prevention of all neonatal infections.
C. Immediate closure of the ductus arteriosus.
D. Elimination of the need for newborn assessment.
Correct Answer: A. Improved thermal stability and support for early bonding and feeding behaviors.
Explanation: Skin-to-skin contact supports thermoregulation, physiologic stability, bonding, and early feeding
when parent and newborn are stable.
8. Which client problem should generally be addressed before a potential problem?
A. A future risk for constipation in a stable client.
B. An actual problem with impaired breathing that is occurring now.
C. A possible knowledge deficit about discharge paperwork.
D. A long-term goal to improve exercise tolerance.
Correct Answer: B. An actual problem with impaired breathing that is occurring now.
Explanation: Current life-threatening or physiologic problems usually take priority over risks and long-term
needs. Clinical context can modify any general priority framework.
9. A child’s personal-best peak expiratory flow is 300 L/min. Today the reading is 150 L/min with
wheezing. How should this be interpreted? Peak-flow record Personal best Today 300 L/min 150 L/min
A. The reading is normal because it is above 100 L/min.
B. The value indicates improved airway function.
C. Peak flow does not help assess asthma control.
D. The reading is about 50% of personal best and indicates significant airflow limitation requiring the action plan.
Correct Answer: D. The reading is about 50% of personal best and indicates significant airflow limitation
requiring the action plan.
Explanation: A peak flow at roughly half of personal best represents substantial reduction in airflow. The child
should follow the prescribed asthma action plan for the low zone.
10. A 5-year-old is behind on routine immunizations. Which principle should guide catch-up planning?
Immunization history Age Record 5 years Series incomplete Last documented dose 18 months ago Current
status Healthy
A. The vaccine series generally does not need to be restarted because of a long interval between doses.
B. Every vaccine series must restart from dose one.
C. Only live vaccines can be given after a missed interval.
D. Catch-up vaccination should wait until adolescence.
Correct Answer: A. The vaccine series generally does not need to be restarted because of a long interval between
doses.
Explanation: CDC catch-up guidance states that an interrupted vaccine series usually continues from the
previous valid dose rather than restarting.
11. The nurse promises to return in 15 minutes with pain medication and then makes sure the promise is
kept. Which ethical principle is illustrated?
A. Justice.
B. Autonomy.
C. Utility.
D. Fidelity.
Correct Answer: D. Fidelity.
Explanation: Fidelity involves keeping promises and commitments, supporting trust in the nurse-client
relationship.
12. Which laboratory trend best suggests response to iron therapy in a child with iron-deficiency anemia?
A. Hemoglobin and reticulocyte response improve over time with adherence.
B. Hemoglobin continues to fall steadily.
, C. Platelet function disappears.
D. Serum sodium rises sharply.
Correct Answer: A. Hemoglobin and reticulocyte response improve over time with adherence.
Explanation: Effective iron therapy produces hematologic recovery, typically with an early reticulocyte response
followed by rising hemoglobin.
13. Using the data in the exhibit, what initial crystalloid volume does 30 mL/kg equal? Initial sepsis data
Parameter Value Weight 60 kg Perfusion Hypotension with elevated lactate Initial crystalloid order 30
mL/kg with reassessment
A. 600 mL.
B. 1,200 mL.
C. 3,000 mL.
D. 1,800 mL.
Correct Answer: D. 1,800 mL.
Explanation: 30 mL/kg x 60 kg = 1,800 mL. Current sepsis guidance emphasizes prompt crystalloid resuscitation
with ongoing reassessment to avoid under- or over-resuscitation.
14. Which task may commonly be assigned to an LPN/LVN for a stable client, depending on jurisdiction
and facility policy?
A. Perform the initial comprehensive RN assessment.
B. Administer routine medications and reinforce previously taught care within scope.
C. Develop the nursing diagnosis independently.
D. Provide initial teaching for a complex new therapy.
Correct Answer: B. Administer routine medications and reinforce previously taught care within scope.
Explanation: LPN/LVN scope commonly includes predictable care and many routine medications, while initial
assessment, nursing diagnosis, and complex teaching remain RN responsibilities. Local law and policy govern
delegation.
15. A hospitalized client is being transported to radiology on a stretcher. Which safety measure is most
important before movement begins?
A. Transport with the stretcher unlocked so it rolls more freely.
B. Leave the client unattended in the hallway.
C. Allow IV tubing to hang where it can catch on doors.
D. Raise the stretcher side rails as appropriate, secure the client, and ensure tubes and lines are protected.
Correct Answer: D. Raise the stretcher side rails as appropriate, secure the client, and ensure tubes and lines are
protected.
Explanation: Safe transport includes appropriate side-rail use, secure positioning, and protection of lines and
tubes. The client should not be left unattended when safety risk is present.
16. A hospitalized child receiving growth hormone develops persistent severe headache and visual changes.
What should the nurse advise?
A. Double the next dose.
B. Prompt medical evaluation for a potential serious adverse effect.
C. Ignore symptoms because they prove the drug is working.
D. Stop all fluids.
Correct Answer: B. Prompt medical evaluation for a potential serious adverse effect.
Explanation: Severe headache and visual symptoms can signal increased intracranial pressure or other
complications and should be evaluated promptly.
17. Which plan best reflects client-centered care?
A. Use the same goals for every client with the same diagnosis.
B. Exclude the client from planning to save time.
C. Develop goals with the client that incorporate the client's priorities, abilities, and preferences.
D. Choose goals based only on staff convenience.
Correct Answer: C. Develop goals with the client that incorporate the client's priorities, abilities, and
preferences.
Explanation: Client-centered planning incorporates individual goals, values, readiness, and preferences while
maintaining safety and evidence-based care.
