HESI Exit Exam 750 NCLEX-Style RN
Practice Questions with Rationales
Prepared for Nursing Students
HESI Exit Exam Preparation for NCLEX-RN 2025
Updated for Next Generation NCLEX (NGN)
Effective as of 10 July 2025
,Contents
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2 Core Practice Questions and Rationales . . . . . . . . . . . . . . . . . . . . . . . 3
2.1 Sample Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
3 Additional Questions and Answers . . . . . . . . . . . . . . . . . . . . . . . . . . 6
3.1 Fundamentals of Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
3.2 Medical-Surgical Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
3.3 Pediatric Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
3.4 Maternity Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
3.5 Psychiatric Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
3.6 Pharmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
3.7 Clinical Judgment (NGN-Style) . . . . . . . . . . . . . . . . . . . . . . . . . . 13
3.8 Advanced Clinical Scenarios . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
3.9 Community and Public Health . . . . . . . . . . . . . . . . . . . . . . . . . . 20
3.10 Psychiatric and Mental Health . . . . . . . . . . . . . . . . . . . . . . . . . . 21
3.11 Pediatric and Family-Centered Care . . . . . . . . . . . . . . . . . . . . . . . 22
3.12 Maternity and Womens Health . . . . . . . . . . . . . . . . . . . . . . . . . . 23
3.13 Emergency and Critical Care . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
3.14 Leadership and Delegation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
4 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
5 Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
2
, 1 Introduction
This document is a comprehensive resource for nursing students preparing for the HESI Exit
Exam and NCLEX-RN in 2025. It provides 750 NCLEX-style practice questions with detailed
rationales, focusing on key nursing areas: fundamentals, medical-surgical, pediatrics, mater-
nity, psychiatric nursing, and pharmacology. This version includes 100 refactored questions
with in-depth answers, aligned with the Next Generation NCLEX (NGN) format, emphasizing
clinical judgment and critical thinking. The content is clear, practical, and tailored to the 2025
NCLEX-RN test plan, ensuring robust preparation.
2 Core Practice Questions and Rationales
This section provides 10 refactored NCLEX-style practice questions with detailed rationales,
reflecting the HESI Exit Exams focus on clinical judgment.
2.1 Sample Questions
Q1: A client with heart failure is prescribed furosemide 40 mg IV. Which finding requires
immediate nursing intervention?
A. Blood pressure of 88/56 mmHg
B. Pulse rate of 90 beats/min
C. Respiratory rate of 18 breaths/min
D. Oxygen saturation of 96%
Answer: A. Blood pressure of 88/56 mmHg
Rationale: Furosemide, a loop diuretic, reduces fluid volume, which can lead to hypotension.
A blood pressure of 88/56 mmHg indicates potential hypoperfusion, risking organ damage.
The nurse should notify the provider and hold the dose if ordered. Other findings are within
normal ranges and do not require immediate action.
Q2: A 4-year-old with suspected meningitis exhibits which symptom of increased in-
tracranial pressure (ICP)?
A. Temperature of 37.8řC
B. Sunsetting eyes
C. Heart rate of 95 beats/min
D. Clear nasal discharge
Answer: B. Sunsetting eyes
Rationale: Sunsetting eyes (downward deviation of the eyes) indicate increased ICP in chil-
dren, a critical sign of meningitis. Fever is common but not specific to ICP, and other options
are not related to this condition.
Q3: A client with type 1 diabetes has a blood glucose of 45 mg/dL. What is the nurses
3
Practice Questions with Rationales
Prepared for Nursing Students
HESI Exit Exam Preparation for NCLEX-RN 2025
Updated for Next Generation NCLEX (NGN)
Effective as of 10 July 2025
,Contents
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2 Core Practice Questions and Rationales . . . . . . . . . . . . . . . . . . . . . . . 3
2.1 Sample Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
3 Additional Questions and Answers . . . . . . . . . . . . . . . . . . . . . . . . . . 6
3.1 Fundamentals of Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
3.2 Medical-Surgical Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
3.3 Pediatric Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
3.4 Maternity Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
3.5 Psychiatric Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
3.6 Pharmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
3.7 Clinical Judgment (NGN-Style) . . . . . . . . . . . . . . . . . . . . . . . . . . 13
3.8 Advanced Clinical Scenarios . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
3.9 Community and Public Health . . . . . . . . . . . . . . . . . . . . . . . . . . 20
3.10 Psychiatric and Mental Health . . . . . . . . . . . . . . . . . . . . . . . . . . 21
3.11 Pediatric and Family-Centered Care . . . . . . . . . . . . . . . . . . . . . . . 22
3.12 Maternity and Womens Health . . . . . . . . . . . . . . . . . . . . . . . . . . 23
3.13 Emergency and Critical Care . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
3.14 Leadership and Delegation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
4 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
5 Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
2
, 1 Introduction
This document is a comprehensive resource for nursing students preparing for the HESI Exit
Exam and NCLEX-RN in 2025. It provides 750 NCLEX-style practice questions with detailed
rationales, focusing on key nursing areas: fundamentals, medical-surgical, pediatrics, mater-
nity, psychiatric nursing, and pharmacology. This version includes 100 refactored questions
with in-depth answers, aligned with the Next Generation NCLEX (NGN) format, emphasizing
clinical judgment and critical thinking. The content is clear, practical, and tailored to the 2025
NCLEX-RN test plan, ensuring robust preparation.
2 Core Practice Questions and Rationales
This section provides 10 refactored NCLEX-style practice questions with detailed rationales,
reflecting the HESI Exit Exams focus on clinical judgment.
2.1 Sample Questions
Q1: A client with heart failure is prescribed furosemide 40 mg IV. Which finding requires
immediate nursing intervention?
A. Blood pressure of 88/56 mmHg
B. Pulse rate of 90 beats/min
C. Respiratory rate of 18 breaths/min
D. Oxygen saturation of 96%
Answer: A. Blood pressure of 88/56 mmHg
Rationale: Furosemide, a loop diuretic, reduces fluid volume, which can lead to hypotension.
A blood pressure of 88/56 mmHg indicates potential hypoperfusion, risking organ damage.
The nurse should notify the provider and hold the dose if ordered. Other findings are within
normal ranges and do not require immediate action.
Q2: A 4-year-old with suspected meningitis exhibits which symptom of increased in-
tracranial pressure (ICP)?
A. Temperature of 37.8řC
B. Sunsetting eyes
C. Heart rate of 95 beats/min
D. Clear nasal discharge
Answer: B. Sunsetting eyes
Rationale: Sunsetting eyes (downward deviation of the eyes) indicate increased ICP in chil-
dren, a critical sign of meningitis. Fever is common but not specific to ICP, and other options
are not related to this condition.
Q3: A client with type 1 diabetes has a blood glucose of 45 mg/dL. What is the nurses
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