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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The nurse is providing teaching to a client with type 2 diabetes mellitus (DM) about
important points for disease and symptom management. Which statement by the client
indicates understanding?
A. “Using salt, herbs, and spices will improve the flavor of foods.”
B. “I will get my eyes examined by an ophthalmologist every year.”
C. “I need to arrange my diet schedule around three regular meals a day.”
D. “I’ll inspect my feet every month for ingrown nails, cuts, and calluses.”
Answer: B
Expert-Verified Explanation:
• Diabetic clients are at high risk for diabetic retinopathy, which can lead to blindness if
undetected. Annual eye examinations by an ophthalmologist are essential for early detection
and management of retinopathy.
• (A) Too vague for confirming dietary understanding.
• (C) Might neglect potential need for more frequent/smaller meals or snacks.
• (D) Foot inspections should be daily, not monthly.
• Remember “ABCs” (A1c, Blood pressure, Cholesterol) plus regular foot/eye exams.
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QUESTION 2
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The nurse is educating a client who experiences moderate anxiety in recurring situations. In
addition to information about prescribed medications, which instruction should the nurse
include?
A. “Try to focus on upbeat, positive music to distract yourself.”
B. “Find ways to socialize as often as possible.”
C. “Practice using muscle relaxation techniques.”
D. “Think about all the reasons why the episodes might be happening.”
Answer: C
Expert-Verified Explanation:
• Muscle relaxation techniques are a mainstay for moderate anxiety management.
• Merely listening to music (A) helps temporarily but is less structured.
• More socializing (B) is helpful long-term but not always for acute episodes.
• Overanalyzing triggers (D) might worsen anxiety if no coping skills are in place.
• Progressive muscle relaxation, guided imagery are useful measures.
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QUESTION 3
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The charge nurse is planning the shift for an RN and a PN. Which client should be assigned
to the RN?
, A. A 75-year-old with renal calculi requiring urine straining.
B. A 64-year-old who had a total hip replacement yesterday.
C. A 30-year-old depressed client who admits to suicidal ideation.
D. An adolescent with multiple contusions from a fall 2 days ago.
Answer: C
Expert-Verified Explanation:
• A client with active suicidal ideation requires the RN’s assessment skills, critical thinking,
and immediate intervention.
• Other clients (A, B, D) may have more predictable or stable care needs suitable for the PN
or UAP.
• Prioritize highest risk or complex psychosocial needs for RNs.
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(NGN) QUESTION 4 – CASE STUDY ELEMENT
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Scenario (Nurses’ Notes, 1800):
• Female neonate, 37 weeks’ gestation, born to G2P1 mother with gestational diabetes.
• Apgar: 7 at 1 min, 8 at 5 min.
• Weight: 4037 g (~8 lb 9 oz). Pink, with acrocyanosis, moderate subcutaneous fat. Jittery at
30 min old.
• VS: Axillary temp 96°F, pulse 140, RR 80, glucose 35 mg/dL, bilirubin 7, soft fontanelles,
Mongolian spot on lower back, Ballard score 37 weeks.