ELSEVIER HESI EXIT RN EXAM PREP 2025-2026 (VERSIONS V1, V2, V3, V4, V5, V6 & V7)
WITH NGN QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
*
Core Domains
Adult Medical-Surgical Nursing
Pharmacology and Medication Administration
Maternal-Newborn (Postpartum & Prenatal) Care
Pediatric Nursing
Mental Health and Psychiatric Nursing
Fundamentals of Nursing Practice
Critical Care and Emergency Nursing
Nursing Ethics, Legal Compliance, and Professional Standards
,Introduction
This comprehensive assessment is designed to prepare nursing students and graduates for the Elsevier HESI
EXIT RN Exam with Next Generation NCLEX (NGN) content. The exam evaluates essential clinical judgment,
critical thinking, and decision-making skills required for safe and effective nursing practice. Questions include
multiple-choice and scenario-based formats that emphasize real-world application of nursing knowledge across
all major care domains. Success on this exam demonstrates readiness for professional nursing practice and
predicts NCLEX-RN success.
*
SECTION ONE: QUESTIONS 1–100
Question 1
A client with persistent vomiting has a serum potassium level of 3.0 mg/dL. Which finding is most important
for the nurse to report to the healthcare provider?
A. Shift intake of 640mL IV fluids plus 30mL PO ice chips
B. Serum pH of 7.45
C. Gastric output of 100 mL in the last 8 hours
D. Serum potassium of 3.0 mg/dL
🟢 D. Serum potassium of 3.0 mg/dL
🔴 RATIONALE: A potassium level of 3.0 mg/dL indicates hypokalemia, which can cause life-threatening
cardiac arrhythmias. This requires immediate medical intervention including potassium replacement. The other
findings are within acceptable ranges or do not indicate immediate danger.
,Question 2
A client in the emergency center demonstrates rapid speech, flight of ideas, and reports sleeping only three
hours during the past 48 hours. Based on these findings, it is most important for the nurse to review the
laboratory value for which medication?
A. Lorazepam
B. Fluoxetine
C. Divalproex
D. Olanzapine
🟢 C. Divalproex
🔴 RATIONALE: The client is exhibiting signs of acute bipolar mania. Divalproex (valproate) is a mood
stabilizer used for bipolar disorder and requires monitoring of serum levels, liver function, and platelets. The
other medications are not primary treatments for acute mania.
Question 3
A client in the third trimester of pregnancy reports that she feels some "lumpy places" in her breasts and that
her nipples sometimes leak a yellowish fluid. She has an appointment with her healthcare provider in two
weeks. What action should the nurse take?
A. Tell the client to begin nipple stimulation to prepare for breastfeeding
B. Reschedule the client's prenatal appointment for the following day
C. Explain that this normal secretion can be assessed at the next visit
D. Recommend that the client start wearing a supportive brassiere
, 🟢 C. Explain that this normal secretion can be assessed at the next visit
🔴 RATIONALE: Breast lumps and yellowish leakage (colostrum) in the third trimester are normal pregnancy
findings. The nurse should reassure the client and plan to assess at the routine upcoming visit. Nipple
stimulation is not recommended before 37 weeks, and rescheduling is unnecessary.
Question 4
A client fell in the bathroom when left unattended by the UAP. Which information should the nurse include in
the client's health record?
A. The UAP left the client to assist another client
B. The last time client was assisted to the bathroom
C. The unit was understaffed when the client fell
D. The client fell sustaining a fracture to the left hip
🟢 D. The client fell sustaining a fracture to the left hip
🔴 RATIONALE: Health records should document objective facts about the client's condition and the incident.
The fracture is a factual finding that must be recorded. Speculation about staff actions, staffing issues, or timing
should not be included in the client's medical record.
Question 5
A 3-year-old boy was successfully toilet trained prior to his admission to the hospital for injuries sustained from
a fall. His parents are very concerned that the child has regressed in his toileting behaviors. Which information
should the nurse provide to the parents?
WITH NGN QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
*
Core Domains
Adult Medical-Surgical Nursing
Pharmacology and Medication Administration
Maternal-Newborn (Postpartum & Prenatal) Care
Pediatric Nursing
Mental Health and Psychiatric Nursing
Fundamentals of Nursing Practice
Critical Care and Emergency Nursing
Nursing Ethics, Legal Compliance, and Professional Standards
,Introduction
This comprehensive assessment is designed to prepare nursing students and graduates for the Elsevier HESI
EXIT RN Exam with Next Generation NCLEX (NGN) content. The exam evaluates essential clinical judgment,
critical thinking, and decision-making skills required for safe and effective nursing practice. Questions include
multiple-choice and scenario-based formats that emphasize real-world application of nursing knowledge across
all major care domains. Success on this exam demonstrates readiness for professional nursing practice and
predicts NCLEX-RN success.
*
SECTION ONE: QUESTIONS 1–100
Question 1
A client with persistent vomiting has a serum potassium level of 3.0 mg/dL. Which finding is most important
for the nurse to report to the healthcare provider?
A. Shift intake of 640mL IV fluids plus 30mL PO ice chips
B. Serum pH of 7.45
C. Gastric output of 100 mL in the last 8 hours
D. Serum potassium of 3.0 mg/dL
🟢 D. Serum potassium of 3.0 mg/dL
🔴 RATIONALE: A potassium level of 3.0 mg/dL indicates hypokalemia, which can cause life-threatening
cardiac arrhythmias. This requires immediate medical intervention including potassium replacement. The other
findings are within acceptable ranges or do not indicate immediate danger.
,Question 2
A client in the emergency center demonstrates rapid speech, flight of ideas, and reports sleeping only three
hours during the past 48 hours. Based on these findings, it is most important for the nurse to review the
laboratory value for which medication?
A. Lorazepam
B. Fluoxetine
C. Divalproex
D. Olanzapine
🟢 C. Divalproex
🔴 RATIONALE: The client is exhibiting signs of acute bipolar mania. Divalproex (valproate) is a mood
stabilizer used for bipolar disorder and requires monitoring of serum levels, liver function, and platelets. The
other medications are not primary treatments for acute mania.
Question 3
A client in the third trimester of pregnancy reports that she feels some "lumpy places" in her breasts and that
her nipples sometimes leak a yellowish fluid. She has an appointment with her healthcare provider in two
weeks. What action should the nurse take?
A. Tell the client to begin nipple stimulation to prepare for breastfeeding
B. Reschedule the client's prenatal appointment for the following day
C. Explain that this normal secretion can be assessed at the next visit
D. Recommend that the client start wearing a supportive brassiere
, 🟢 C. Explain that this normal secretion can be assessed at the next visit
🔴 RATIONALE: Breast lumps and yellowish leakage (colostrum) in the third trimester are normal pregnancy
findings. The nurse should reassure the client and plan to assess at the routine upcoming visit. Nipple
stimulation is not recommended before 37 weeks, and rescheduling is unnecessary.
Question 4
A client fell in the bathroom when left unattended by the UAP. Which information should the nurse include in
the client's health record?
A. The UAP left the client to assist another client
B. The last time client was assisted to the bathroom
C. The unit was understaffed when the client fell
D. The client fell sustaining a fracture to the left hip
🟢 D. The client fell sustaining a fracture to the left hip
🔴 RATIONALE: Health records should document objective facts about the client's condition and the incident.
The fracture is a factual finding that must be recorded. Speculation about staff actions, staffing issues, or timing
should not be included in the client's medical record.
Question 5
A 3-year-old boy was successfully toilet trained prior to his admission to the hospital for injuries sustained from
a fall. His parents are very concerned that the child has regressed in his toileting behaviors. Which information
should the nurse provide to the parents?
