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HESI Exit Exam 2026 Review – NGN Case Studies & NCLEX-Style Practice

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Comprehensive HESI Exit Exam review designed with NCLEX-NGN style case scenarios and clinical judgment practice. Covers prioritization, delegation, pharmacology, Med-Surg, maternity, pediatrics, mental health, and safety. Ideal for nursing students preparing for HESI Exit and NCLEX readiness

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2026 HESI EXIT
V1 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.






, HESI RN 2026 COMPREHENSIVE EXAM



────────────────────────────────────────────────────────
1. A young adult client with asthma, admitted yesterday, is sitting on the side of the bed leaning over the bedside
table. The client, on 2 L/min of oxygen via nasal cannula, is wheezing and using pursed-lip breathing.
Which intervention should the nurse implement first?


A. Increase oxygen to 6 L/min
B. Call for an Ambu resuscitation bag
C. Instruct the client to lie back in bed
D. Administer a nebulizer treatment


Answer: D
Rationale/Explanation: The client is in respiratory distress (wheezing, pursed-lip breathing). A nebulizer
treatment (e.g., albuterol) helps open the airways quickly. Increasing oxygen alone does not address
bronchospasm. Having the client lie down can worsen breathing, and an Ambu bag is used if the client is not
adequately ventilating or is in severe distress.


────────────────────────────────────────────────────────
2. Which client should the nurse assess most frequently for overflow incontinence?


A. A client with hematuria and decreasing hemoglobin/hematocrit
B. A client on a fast, with raised serum creatinine levels
C. A client who is confused and frequently forgets to use the bathroom
D. A client with a history of frequent urinary tract infections


Answer: C
Rationale/Explanation: Confusion and forgetfulness can cause the client to miss toileting opportunities,
resulting in overflow incontinence. This condition arises when the bladder becomes over-distended and small


, amounts of urine leak out.


────────────────────────────────────────────────────────
3. A homeless client at a community psychiatric clinic says, “This dose is different from what I usually take,” when
the nurse attempts to administer a prescribed medication. Which action should the nurse take?


A. Inform the client that refusal is an option, then document the outcome
B. Withhold the medication until the dosage can be confirmed
C. Explain that the dosage has been changed by the provider
D. Tell the client to take the medication and verify the dose at the next meeting


Answer: B
Rationale/Explanation: If there is any discrepancy between the prescribed and usual dose the client reports,
the safest action is to hold the dose until verification occurs to prevent adverse events.




────────────────────────────────────────────────────────
4. The charge nurse is assigning clients to one LPN and three RNs. Which client status change is best to assign to
the LPN?

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