HESI EXIT
V3 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 (Standard MCQ)
───────────────────────────────────────────────────────
─
A male client with stomach cancer returns to the unit following a total
gastrectomy. He has a nasogastric tube to suction and is receiving Lactated
Ringer’s solution at 75 mL/hour IV. One hour after admission to the unit, the
nurse notes 300 mL of blood in the suction canister, the client’s heart rate is
155 beats/minute, and his blood pressure is 78/48 mmHg. In addition to
reporting the finding to the surgeon, which action should the nurse
implement first?
A. Measure and document the client’s urinary output.
B. Request the client’s reserved unit of packed red blood cells.
C. Prepare the placement of a central venous catheter.
D. Increase the infusion rate of Lactated Ringer’s solution.
Correct Answer: D. Increase the infusion rate of Lactated Ringer’s solution.
Expert-Verified Explanation:
• Losing 300 mL of blood in an hour suggests acute blood loss.
• Tachycardia (155 bpm) and hypotension (78/48 mmHg) indicate a shocky
state.
• The priority is to restore intravascular volume by increasing IV fluids.
,• bReporting bto bthe bsurgeon, bmeasuring boutput, band bobtaining bRBCs bare balso
b important bbut bcome bafter bincreasing bthe bIV brate. b b
NGN/Case-Study bTip: b b
• bAn bunfolding bscenario bcould btrack bvital bsigns, bsuction boutput, band blabs.
b Test-takers bwould bprioritize binterventions bin breal btime.
───────────────────────────────────────────────────────
─
QUESTION b2 b(Standard bMCQ)
───────────────────────────────────────────────────────
─
An badult bmale bwho bfell b20 bfeet bfrom bthe broof bof bhis bhome bhas bmultiple
b injuries, bincluding ba bright bpneumothorax. bChest btubes bwere binserted bin bthe
b emergency bdepartment bbefore bhis btransfer bto bthe bICU. bThe bnurse bnotes
b that bthe bsuction bcontrol bchamber bis bbubbling bat bthe b–10 bcm bH2O bmark,
b with bfluctuation bin bthe bwater bseal; band bover bthe bpast bhour, b75 bmL bof bbright
b red bblood bwas bmeasured bin bthe bcollection bchamber. bWhich bintervention
b should bthe bnurse bimplement? b b
bb A. bAdd bsterile bwater bto bthe bsuction bcontrol bchamber. b b
bb B. bGive bblood bfrom bthe bcollection bchamber bas bauto-transfusion. b b
bb C. bManipulate bblood bin btubing bto bdrain binto bchamber. b b
bb D. bIncrease bwall bsuction bto beliminate bfluctuation bin bwater bseal. b b
Correct bAnswer: bA. bAdd bsterile bwater bto bthe bsuction bcontrol bchamber.
Expert-Verified bExplanation: b b
• bThe bnurse bmust bmaintain bthe bcorrect bwater blevel b(–10 bcm bH2O) bto bensure
b appropriate bnegative bpressure. b b
, • bBubbling bin bthe bsuction bchamber bis bnormal, bbut bif bwater blevel bis blow,
b refill bwith bsterile bwater. b b
• bTidaling bin bthe bwater bseal bis bexpected; bit bshould bnot bbe b“eliminated” bvia
b excessive bwall bsuction. b b
NGN/Case-Study bTip: b b
• bCould bpresent bchest btube bdata bover btime b(amount bdrained, bchanges bin
b water bseal, betc.) band bprompt bactions bbased bon bchanges.
───────────────────────────────────────────────────────
─
QUESTION b3 b(Standard bMCQ)
───────────────────────────────────────────────────────
─
A bclient bwho breceived bhemodialysis byesterday bis bexperiencing ba bblood
b pressure bof b200/100 bmmHg, bheart brate b110 bbeats/minute, band brespiratory
b rate b36 bbreaths/minute. bThe bclient breports bshortness bof bbreath, bhas
b bilateral b+2 bpedal bedema, band ban boxygen bsaturation bon broom bair bof b89%.
b Which baction bshould bthe bnurse btake bfirst? b b
bb A. bElevate bthe bfoot bof bthe bbed. b b
bb B. bRestrict bthe bclient’s bfluid. b b
bb C. bBegin bsupplemental boxygen. b b
bb D. bPrepare bthe bclient bfor bhemodialysis. b b
Correct bAnswer: bC. bBegin bsupplemental boxygen.
Expert-Verified bExplanation: b b
• bAn bSpO₂ bof b89%, btachypnea b(36/min), band bdyspnea bare bsigns bof bacute
b respiratory bdistress. b b
V3 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 (Standard MCQ)
───────────────────────────────────────────────────────
─
A male client with stomach cancer returns to the unit following a total
gastrectomy. He has a nasogastric tube to suction and is receiving Lactated
Ringer’s solution at 75 mL/hour IV. One hour after admission to the unit, the
nurse notes 300 mL of blood in the suction canister, the client’s heart rate is
155 beats/minute, and his blood pressure is 78/48 mmHg. In addition to
reporting the finding to the surgeon, which action should the nurse
implement first?
A. Measure and document the client’s urinary output.
B. Request the client’s reserved unit of packed red blood cells.
C. Prepare the placement of a central venous catheter.
D. Increase the infusion rate of Lactated Ringer’s solution.
Correct Answer: D. Increase the infusion rate of Lactated Ringer’s solution.
Expert-Verified Explanation:
• Losing 300 mL of blood in an hour suggests acute blood loss.
• Tachycardia (155 bpm) and hypotension (78/48 mmHg) indicate a shocky
state.
• The priority is to restore intravascular volume by increasing IV fluids.
,• bReporting bto bthe bsurgeon, bmeasuring boutput, band bobtaining bRBCs bare balso
b important bbut bcome bafter bincreasing bthe bIV brate. b b
NGN/Case-Study bTip: b b
• bAn bunfolding bscenario bcould btrack bvital bsigns, bsuction boutput, band blabs.
b Test-takers bwould bprioritize binterventions bin breal btime.
───────────────────────────────────────────────────────
─
QUESTION b2 b(Standard bMCQ)
───────────────────────────────────────────────────────
─
An badult bmale bwho bfell b20 bfeet bfrom bthe broof bof bhis bhome bhas bmultiple
b injuries, bincluding ba bright bpneumothorax. bChest btubes bwere binserted bin bthe
b emergency bdepartment bbefore bhis btransfer bto bthe bICU. bThe bnurse bnotes
b that bthe bsuction bcontrol bchamber bis bbubbling bat bthe b–10 bcm bH2O bmark,
b with bfluctuation bin bthe bwater bseal; band bover bthe bpast bhour, b75 bmL bof bbright
b red bblood bwas bmeasured bin bthe bcollection bchamber. bWhich bintervention
b should bthe bnurse bimplement? b b
bb A. bAdd bsterile bwater bto bthe bsuction bcontrol bchamber. b b
bb B. bGive bblood bfrom bthe bcollection bchamber bas bauto-transfusion. b b
bb C. bManipulate bblood bin btubing bto bdrain binto bchamber. b b
bb D. bIncrease bwall bsuction bto beliminate bfluctuation bin bwater bseal. b b
Correct bAnswer: bA. bAdd bsterile bwater bto bthe bsuction bcontrol bchamber.
Expert-Verified bExplanation: b b
• bThe bnurse bmust bmaintain bthe bcorrect bwater blevel b(–10 bcm bH2O) bto bensure
b appropriate bnegative bpressure. b b
, • bBubbling bin bthe bsuction bchamber bis bnormal, bbut bif bwater blevel bis blow,
b refill bwith bsterile bwater. b b
• bTidaling bin bthe bwater bseal bis bexpected; bit bshould bnot bbe b“eliminated” bvia
b excessive bwall bsuction. b b
NGN/Case-Study bTip: b b
• bCould bpresent bchest btube bdata bover btime b(amount bdrained, bchanges bin
b water bseal, betc.) band bprompt bactions bbased bon bchanges.
───────────────────────────────────────────────────────
─
QUESTION b3 b(Standard bMCQ)
───────────────────────────────────────────────────────
─
A bclient bwho breceived bhemodialysis byesterday bis bexperiencing ba bblood
b pressure bof b200/100 bmmHg, bheart brate b110 bbeats/minute, band brespiratory
b rate b36 bbreaths/minute. bThe bclient breports bshortness bof bbreath, bhas
b bilateral b+2 bpedal bedema, band ban boxygen bsaturation bon broom bair bof b89%.
b Which baction bshould bthe bnurse btake bfirst? b b
bb A. bElevate bthe bfoot bof bthe bbed. b b
bb B. bRestrict bthe bclient’s bfluid. b b
bb C. bBegin bsupplemental boxygen. b b
bb D. bPrepare bthe bclient bfor bhemodialysis. b b
Correct bAnswer: bC. bBegin bsupplemental boxygen.
Expert-Verified bExplanation: b b
• bAn bSpO₂ bof b89%, btachypnea b(36/min), band bdyspnea bare bsigns bof bacute
b respiratory bdistress. b b
