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NGN HESI RN 2025 Exit Exam – Real Testing
Questions with Verified Multiple Choice Answers |
100% Correct & Complete Solutions | A+ Graded
Nursing Exam Prep | Actual NCLEX-RN Style
Questions
1. Medication Dose Discrepancy Question: When preparing to administer a prescribed medication to a homeless client at a community psychiatric clinic, the client states that the usual dosage taken is different from what the nurse is giving. What is the nurse’s best action? A) Inform the client that he may refuse the medication and document whether or not the client takes it. B) Withhold the medication until the dosage can be confirmed. C) Explain to the client that the dosage has been changed. D) Tell the client to take the medication then verify the dosage at the next healthcare team meeting. Correct Answer: B Rationale: When a client questions a medication dose, it may indicate an error. Withholding the medication and verifying the prescription helps prevent harm due to potential dosing inaccuracies. Always prioritize client safety. 2. Client Assignment for Practical Nurse (PN) Question: The charge nurse is making assignments for one practical nurse and three RNs. Which client is most appropriate to assign to the PN? A) Subdural hematoma with BP change from 150/80 to 170/ B) Viral meningitis with temperature change from 101°F to 102°F C) Diabetic ketoacidosis with Glasgow Coma Score drop from 10 to 7 D) Myxedema with BP drop from 80/50 to 70/ Correct Answer: B Rationale: The PN can manage clients with stable or predictable conditions. A mild
temperature change in viral meningitis is within the PN’s scope. The other clients have potentially life-threatening changes requiring RN-level assessment.
3. Sepsis Protocol Priority Question: A client with pneumonia develops early signs of septic shock and multi-organ failure. The provider orders a sepsis protocol. Which nursing intervention is most important to prioritize? A) Maintain strict intake and output B) Keep head of bed at 45° C) Assess warmth of extremities D) Monitor blood glucose level Correct Answer: A Rationale: Strict I&O monitoring is crucial in sepsis to assess perfusion and organ function. It provides early clues to organ failure and fluid shifts common in septic shock. 4. Suicidal Adolescent Client Behavior Question: A hospitalized adolescent admitted for suicidal ideation leaves a treatment team meeting in tears. What is the best nursing intervention? A) Let the client rest quietly in their room for a while B) Explore the client’s goals and desire for treatment C) Ask the treatment team about the client's behavior D) Go to the client’s room and ask what happened Correct Answer: D Rationale: Immediate support and therapeutic communication are critical. Addressing the client’s emotional needs and clarifying what caused distress can help prevent further risk and establish trust. 5. Dosage Calculation (Dalteparin) Question: The provider orders dalteparin 200 units/kg subcut daily for a 154 lb client. The vial is 25,000 units/mL. How many mL should the nurse administer?
F) Lambs wool G) Tape Correct Answers: D, E Rationale: A nasal cannula and flow meter are essential to deliver oxygen. The other items are not required for basic nasal cannula oxygen therapy.
8. Signs of Hypoxia (NGN) Question: A client has respiratory distress. Which of the following assessment findings indicate hypoxia? Cardiovascular: - Heart rate 100 bpm - Capillary refill 4 seconds - Blood pressure 145/ Neurological: - Anxious - Awake and alert - Restless Respiratory: - O2 saturation 90% on room air - Respiratory rate 28 bpm - Productive cough Correct Findings Indicating Hypoxia: - Capillary refill 4 seconds - Blood pressure 145/ - Anxious - Restless - O2 saturation 90% - Respiratory rate 28
Rationale: Signs such as increased respiratory rate, anxiety, restlessness, prolonged capillary refill, and low oxygen saturation all reflect poor oxygenation and tissue perfusion.
9. Positioning for Lung Expansion Question: The nurse should place the client in a ___________ position to promote _____________. A) Supine, airway clearance B) Prone, secretion drainage C) Semi-Fowler, lung expansion ✅ D) Trendelenburg, perfusion Correct Answer: C Rationale: The semi-Fowler position helps improve lung expansion and gas exchange, particularly in clients with respiratory issues like pneumonia. NGN: Orders: 0330: place the client on a cardio respiratory monitor, NPO, sputum culture, start a PIV, start oxygen 3L via nasal cannula, normal saline 150 ML per hour, acetaminophen 350mg PO every six hours for temp greater than 101F, chest x-ray. 0500: Oxygen 8Lvia simple facemask, titrate to keep oxygen saturation greater than 94%. (mark whether the statements by the new grad nurse indicate understanding or no understanding of the use of facemask in the care of this client)
- I should clean the facemask once per shift.
- The client should take a 1 to 2 minute break from the facemask each hour.
- I should put gauze under the elastic straps over the ears.
- I can adjust the oxygen level on the flow meter to keep the clients oxygen saturation greater than 94%.
- The mask should cover only the mouth and leave the nose open for expiration.
The nurse has completed the diet teaching of a client who is being discharged following treatment of a leg wound. A high-protein diet is encouraged to promote wound healing. Which lunch toys by the client indicates that the teaching was effective? A) A peanut butter sandwich with soda and cookies. B) Vegetable soup, crackers, and milk. C) A tuna fish sandwich with chips and ice cream. D) A salad with three kinds of lettuce and fruit. - - correct ans- - C) A tuna fish sandwich with chips and ice cream. A client with foul-smelling drainage from an incision on the upper left arm is admitted with a suspected MRSA. Which nursing intervention should the nurse include in the plan of care? SATA. A) Institute contact precautions for staff and visitors. B) Use standard precautions and wear a mask. C) Send wound drainage for culture and sensitivity. D) Monitor the clients white blood cell count. E) Explain the purpose of a low bacteria diet. - - correct ans- - A) Institute contact precautions for staff and visitors. C) Send wound drainage for culture and sensitivity. D) Monitor the clients white blood cell count. An adult client who is admitted to the mental health unit for treatment of bipolar disorder has a slightly slurred speech pattern and an unsteady gait. Which assessment finding is most important for the nurse to report to the healthcare provider? A) Weight loss of 10 pounds in the past month. B) Six hours of sleep in the past three days. C) Blood alcohol level of 0.09%.
D) Serum lithium level of 1.6. - - correct ans- - D) Serum lithium level of 1.6. When conducting diet teaching for a client who is on a post operative full liquid diet, which foods should the nurse encouraged the client to eat? SATA. A) Clear beef broth. B) Vanilla frozen yogurt. C) Vegetable juice. D) Creamy peanut butter. E) Canned fruit cocktail. - - correct ans- - A) Clear beef broth. B) Vanilla frozen yogurt. C) Vegetable juice. An infant born with esophageal atresia and tracheoesophageal fistula receives a prescription for internal feedings after corrective surgery. To promote normal growth and development of the infant, which action should the nurse include in the plan of care? - - correct ans- - Offer a pacifier for non-Nutritive sucking The nurse is preparing a four year-old client with a serum bilirubin level of 19 for discharge from the hospital. When teaching the parents about home photo therapy, which instruction should the nurse include in the discharge teaching plan? A) Cover with a receiving blanket. B) Perform diaper changes under the light. C) Feed the infant every four hours. D) Reposition the infant every two hours. - - correct ans- - D) Reposition the infant every two hours. The nurse initiate the procedure to remove a clients peripherally inserted central catheter when a code blue is called for another client in the unit who collapse in the
A) Ate an extra peanut butter sandwich before gym class. B) Incorrectly administered too much insulin. C) Had a cold and ear infection for the past two days. D) Skipped eating lunch while at school. - - correct ans- - C) Had a cold and ear infection for the past two days. When is it most important for the nurse to assess a pregnant client's deep tendon reflexes? A) Within the first trimester of pregnancy. B) When the client has ankle edema. C) During admission to labor and delivery. D) If the client has an elevated blood pressure. - - correct ans- - D) If the client has an elevated blood pressure. NGN: The client has returned to work at in accounting firm and has started going to a grief support group. She reports she is seeking care from a healthcare professional because her father is worried about her. The client says she only gets 2 to 3 hours of sleep due to nightmares about the crash. She informed that exercising right after work helps her get better sleep and to relax. She feels that she is "jumpy" after the accident, especially when she is in the car. She also stated, "I feel so sad that I can't seem to feel anything at all". In addition to her father, the client has a large family and friend support system. She denies alcohol or drug use. (highlight areas in the above paragraph that the nurse should...) - - correct ans- --she only gets 2 to 3 hours of sleep due to nightmares about the crash.
- She feels that she is "jumpy" after the accident, especially when she is in the car.
- "I feel so sad that I can't seem to feel anything at all"
The client is a 26 year old female who was in a car accident six months ago that killed her mother, husband, and two year old son. She and her father were the only survivors of the crash. She is seeking care for depression. The client is exhibiting symptoms of ________________________ related to ______________ and ___________________. - - correct ans- - Post traumatic stress disorder , experiencing a life-threatening event , losing a loved one. NGN: Orders, diagnosis, depression and posttraumatic stress disorder. Diphenhydramine 12.5 mg PO every night at sleep. BuspironeHydrochloride 7.5 mg PO twice a day. (how can the nurse build a therapeutic relationship with the client? Select all that apply) A) The nurse can show no emotion when talking to the client. B) The nurse can be open honest and sincere. C) The nurse can talk as much as needed to get the client talking. D) The nurse can focus energy on the client. E) The nurse can communicate acceptance of the client as she is F) The nurse can establish a meaningful connection. - - correct ans- - B) the nurse can be open, honest and sincere. E) The nurse can communicate acceptance of the client as she is F) The nurse can establish a meaningful connection. NGN: The client has returned to work at in accounting firm and has started going to a grief support group. She reports she is seeking care from a healthcare professional because her father is worried about her. The client says she only gets 2 to 3 hours of sleep due to nightmares about the crash. She informed that exercising right after work helps her get better sleep and to relax. She feels that she is "jumpy" after the accident, especially when she is in the car. She also stated, "I feel so sad that I can't seem to feel anything at all". In addition to her father, the client has a large family and friend support system. She denies alcohol or drug use. The client states, "I don't want to kill myself, but sometimes I wish I had died in the crash."
- The client states that she avoids driving altogether and takes the bus. - - correct ans- -- The client states she feels less jumpy and more relaxed. (EFFECTIVE)
- The client states she feels numb when thinking about the crash. (INEFFECTIVE)
- The client talks to her father and her best friend when she starts to feel sad. (EFFECTIVE)
- The client reports sleeping 6 to 7 hours per night. (EFFECTIVE)
- The client states that she avoids driving altogether and takes the bus. (INEFFECTIVE) The healthcare provider prescribes acarbose, an alpha-glucosidase inhibitor, for a client with type two diabetes. Which information provides the best indicator of the drugs effectiveness? A) Body mass index between 20 and 24. B) Blood pressure readings less than 120/80. C) Self-reported glucose levels 120 to 150. D) Hemoglobin A1c readings less than 7%. - - correct ans- - D) Hemoglobin A1c readings less than 7%. After receiving report on an inpatient acute care unit which client should the nurse assess first? A) The client who had surgery yesterday and is experiencing a paralytic ileus with absent bowel sounds. B) The client with a small bowel obstruction who has a nasogastric tube that is draining greenish fluid. C) The client with an obstruction of the large intestine who is experiencing abdominal distention. D) The client with a bowel obstruction due to a volvulus who is experiencing abdominal rigidity. - - correct ans- - D) The client with a bowel obstruction due to a volvulus who is experiencing abdominal rigidity.
Client presents at the emergency department reporting a raspy voice, cold intolerance, and fatigue. Laboratory tests indicate an elevated thyroid stimulating hormone and a low T3 and T4 levels. After the client is admitted to the telemetary unit, which intervention is most appropriate for the nurse to implement? A) administer prescribed dose of level thyroxine. B) Note clients most recent hemoglobin level. C) Offer additional blankets and a warm drink. D) Assess for the presence of nonpitting edema. - - correct ans- - A) administer prescribed dose of level thyroxine. While caring for a client post operative dressing, the nurse observes purulent wound drainage. Previously, the wound was inflamed and tender but without drainage. Which is the most important action for the nurse to take? A) Determine if the drainage has an unpleasant odor. B) Cleanse the wound with a sterile saline solution. C) Monitor the clients white blood cell count. D) Request a culture and sensitivity of the wound. - - correct ans- - D) Request a culture and sensitivity of the wound. The school nurse is screening students for scoliosis and notes that one student has lordosis. Which finding should the nurse document in the student screening record? A) Lateral curvature that creates a symmetry of the shoulders. B) Posterior curvature that is convex in the thoracic area. C) Excessive concave curvature of the lumbar spine. D) Rounded spine from head to hips without concave curbs. - - correct ans- - C) Excessive concave curvature of the lumbar spine.
E) Avoid range of motion exercises. - - correct ans- - A) Use a residual limb shrinker. B) Inspect skin for redness. D) Wash the residual limb with soap and water. The nurse is assessing the feet of a client with type one diabetes mellitis. Which finding requires immediate intervention by the nurse? A) Hard, painless nodule over metatarsophalangeal joint of first toe. B) Painful corns and calluses over hammer toes on both feet. C) Erythema and edema at the base of the left great toe. D) Decreased response to pain discrimination on dorsal surface of foot. - - correct ans- - D) Decreased response to pain discrimination on dorsal surface of foot. The school nurse is called to the soccer field because a child has epistaxis. In which position should the nurse place the child? A) Side-lying with the head slightly elevated. B) Sitting up and leaning forward. C) Standing with the head leaning backwards. D) Supine with the legs raised. - - correct ans- - B) Sitting up and leaning forward. The nurse is auscultating a clients lung sounds. Which description should the nurse use to document this sound? Please listen to the audio file to select the option that applies. A) High pitch squeeze. B) Rhonchi. C) High-pitched or fine crackles. D) Stridor. - - correct ans- - C) High-pitched or fine crackles.
NGN: Flow Sheet, vital signs, heart rate 104 bpm, respiratory rate 31 bpm. The client is experiencing __________________ and ____________________. - - correct ans-
- Tachypnea , tachycardia NGN: Orders, 1300 admit to the surgical unit, vital signs every four hours, advanced diet as tolerated, administer lactated ringers IV at 85 mL per hour, ibuprofen 800 mg PO every eight hours PRN for pain. (the nurse would anticipate which of the following could be affecting the clients current condition? SATA. A) stress. B) Medication. C) Anemia. D) Fever. E) Hypothermia. F) Hypertension. G) Pain. - - correct ans- - A) stress. B) Medication. G) Pain. NGN: the client is a 34-year-old female who had a surgical procedure to remove a benign abdominal tumor. (Select which is understanding or not understanding)
- The tubing should be tucked under the chin and secured with the sliding adjustment piece.
- Humidification of oxygen is not needed for administration under 4 L per minute.
- The nasal cannula can deliver up to 10 L per minute of oxygen.
A) urine output. B) Respiratory rate. C) Blood pressure. D) Pain. E) Temperature. F) Flow rate of oxygen. G) Oxygen saturation. - - correct ans- - B) Respiratory rate. C) Blood pressure. D) Pain. E) Temperature. G) Oxygen saturation. NGN: Match the activity with the most appropriate person to do the activity.
- Provide mouth care.
- Document changes in respiratory status.
- Set up the oxygen administration system.
- Change the gauze under the nasal cannula. - - correct ans- --Provide mouth care. (UAP)
- Document changes in respiratory status. (RN/RT)
- Set up the oxygen administration system. (RN/RT)
- Change the gauze under the nasal cannula. (UAP) A client experiencing an acute dystonic reaction presents with a laryngeal spasm. Which treatment should the nurse prepare? A) IV administration of benztropine. B) IV administration of isotonic crystalloid fluid.
C) PO administration of lorazepam. D) PO administration of divalproex. - - correct ans- - A) IV administration of benztropine. A client with heart failure become short of breath, anxious, and has audible reasoning with pink frothy sputum. The nurse sits the client upright and provides oxygen per nasal cannula. The nurse receives a prescription to administer a one time dose of morphine sulfate IV. Which action should the nurse take? A) Administer the dose of morphine sulfate as prescribed. B) Consult with the charge nurse regarding the morphine prescription. C) Review the need for the prescription with the healthcare provider. D) Withhold the morphine until the clients dyspnea resolves. - - correct ans- - A) Administer the dose of morphine sulfate as prescribed. A client with acute asthma exacerbation is manifesting inspiratory and expiratory wheezes and a decreased forced expiratory volume. Which prescribed drug class should the nurse administer first to the client? A) Inhaled short acting beta two agonists. B) Inhaled corticosteroids. C) Anti-cholinergics. D) Leukotriene modifiers. - - correct ans- - B) Inhaled corticosteroids. The nurse enters a clients room to administer oral medication's and find an unlicensed assistive personnel providing personal care to the client, whose condition has obviously deteriorated. The client is lying in a supine position and is weak, pale, and diaphoretic. Which is the priority nursing action? A) Determine why the UAP did not notify the nurse of the change in the clients condition. B) Advised the UAP to stop providing care so the nurse can assess the clients condition.
