2026 HESI Exit Exam with NGN Bundle
V4 Exam New Latest Versions with All
Questions, 100% Correct Answers and
Rationale.
HESI EXIT EXAM NGN PRACTICE BANK
VERSION 4 (V4) | Answers & Rationales
The nurse is assessing a client who is 6 hours post-thyroidectomy. Which finding
requires immediate intervention?
A. Hoarse voice
B. Pain with swallowing
C. Numbness around incision
D. Stridor
Answer: D. Stridor
Rationale: Stridor indicates airway compromise from laryngeal edema or hemorrhage
and requires immediate intervention.
,A client with a history of heart failure is admitted with shortness of breath. Which
assessment finding indicates the need for immediate intervention?
A. Bilateral crackles
B. Jugular vein distention
C. Oxygen saturation 88%
D. 2+ pitting edema
Answer: C. Oxygen saturation 88%
Rationale: Oxygen saturation of 88% indicates hypoxemia and requires immediate
intervention with oxygen therapy.
The nurse is caring for a client receiving a blood transfusion. Fifteen minutes after
initiation, the client develops hypotension, dyspnea, and crackles. What is the priority
action?
A. Stop the transfusion
B. Slow the transfusion
C. Administer furosemide
D. Notify provider
Answer: A. Stop the transfusion
Rationale: Any signs of transfusion reaction require immediate cessation of the
transfusion.
A client with type 1 diabetes is admitted with blood glucose of 486 mg/dL and urine
ketones large. Which prescription should the nurse implement first?
A. Start IV line with D5 0.45% NS
B. Administer regular insulin IV push
C. Obtain serum electrolytes
D. Insert urinary catheter
Answer: B. Administer regular insulin IV push
,Rationale: In DKA, insulin administration is priority to stop ketogenesis and lower blood
glucose.
The nurse is caring for a client one hour after liver biopsy. Which finding requires
immediate action?
A. Pain at biopsy site 4/10
B. Heart rate increase from 88 to 110
C. Client lying on right side
D. BP 110/70
Answer: B. Heart rate increase from 88 to 110
Rationale: Tachycardia after liver biopsy may indicate hemorrhage.
A client with a chest tube has decreased tidaling in the water seal chamber. What is the
most appropriate action?
A. Milk the chest tube
B. Assess tubing for kinks
C. Increase suction pressure
D. Clamp the tube
Answer: B. Assess tubing for kinks
Rationale: Decreased tidaling may indicate obstruction. The nurse should first check for
kinks or dependent loops.
The nurse is assessing a client with acute pancreatitis. Which finding is most concerning?
A. Abdominal pain radiating to back
B. Serum amylase 3x normal
, C. Crackles in lung bases
D. Nausea and vomiting
Answer: C. Crackles in lung bases
Rationale: Crackles may indicate pulmonary complications such as pleural effusion or
ARDS.
A client with chronic kidney disease is prescribed epoetin alfa (Epogen). Which lab value
should the nurse monitor to evaluate effectiveness?
A. Serum creatinine
B. BUN
C. Hemoglobin and hematocrit
D. Serum potassium
Answer: C. Hemoglobin and hematocrit
Rationale: Epoetin alfa stimulates red blood cell production. Effectiveness is evaluated
by monitoring hemoglobin and hematocrit.
The nurse is providing discharge teaching to a client with a new prescription for
warfarin. Which statement indicates a need for further teaching?
A. "I will use an electric razor."
B. "I will increase my intake of green leafy vegetables."
C. "I will notify my dentist."
D. "I will report signs of bleeding."
Answer: B. "I will increase my intake of green leafy vegetables."
Rationale: Green leafy vegetables are high in vitamin K, which antagonizes warfarin.
Intake should be consistent, not increased.
V4 Exam New Latest Versions with All
Questions, 100% Correct Answers and
Rationale.
HESI EXIT EXAM NGN PRACTICE BANK
VERSION 4 (V4) | Answers & Rationales
The nurse is assessing a client who is 6 hours post-thyroidectomy. Which finding
requires immediate intervention?
A. Hoarse voice
B. Pain with swallowing
C. Numbness around incision
D. Stridor
Answer: D. Stridor
Rationale: Stridor indicates airway compromise from laryngeal edema or hemorrhage
and requires immediate intervention.
,A client with a history of heart failure is admitted with shortness of breath. Which
assessment finding indicates the need for immediate intervention?
A. Bilateral crackles
B. Jugular vein distention
C. Oxygen saturation 88%
D. 2+ pitting edema
Answer: C. Oxygen saturation 88%
Rationale: Oxygen saturation of 88% indicates hypoxemia and requires immediate
intervention with oxygen therapy.
The nurse is caring for a client receiving a blood transfusion. Fifteen minutes after
initiation, the client develops hypotension, dyspnea, and crackles. What is the priority
action?
A. Stop the transfusion
B. Slow the transfusion
C. Administer furosemide
D. Notify provider
Answer: A. Stop the transfusion
Rationale: Any signs of transfusion reaction require immediate cessation of the
transfusion.
A client with type 1 diabetes is admitted with blood glucose of 486 mg/dL and urine
ketones large. Which prescription should the nurse implement first?
A. Start IV line with D5 0.45% NS
B. Administer regular insulin IV push
C. Obtain serum electrolytes
D. Insert urinary catheter
Answer: B. Administer regular insulin IV push
,Rationale: In DKA, insulin administration is priority to stop ketogenesis and lower blood
glucose.
The nurse is caring for a client one hour after liver biopsy. Which finding requires
immediate action?
A. Pain at biopsy site 4/10
B. Heart rate increase from 88 to 110
C. Client lying on right side
D. BP 110/70
Answer: B. Heart rate increase from 88 to 110
Rationale: Tachycardia after liver biopsy may indicate hemorrhage.
A client with a chest tube has decreased tidaling in the water seal chamber. What is the
most appropriate action?
A. Milk the chest tube
B. Assess tubing for kinks
C. Increase suction pressure
D. Clamp the tube
Answer: B. Assess tubing for kinks
Rationale: Decreased tidaling may indicate obstruction. The nurse should first check for
kinks or dependent loops.
The nurse is assessing a client with acute pancreatitis. Which finding is most concerning?
A. Abdominal pain radiating to back
B. Serum amylase 3x normal
, C. Crackles in lung bases
D. Nausea and vomiting
Answer: C. Crackles in lung bases
Rationale: Crackles may indicate pulmonary complications such as pleural effusion or
ARDS.
A client with chronic kidney disease is prescribed epoetin alfa (Epogen). Which lab value
should the nurse monitor to evaluate effectiveness?
A. Serum creatinine
B. BUN
C. Hemoglobin and hematocrit
D. Serum potassium
Answer: C. Hemoglobin and hematocrit
Rationale: Epoetin alfa stimulates red blood cell production. Effectiveness is evaluated
by monitoring hemoglobin and hematocrit.
The nurse is providing discharge teaching to a client with a new prescription for
warfarin. Which statement indicates a need for further teaching?
A. "I will use an electric razor."
B. "I will increase my intake of green leafy vegetables."
C. "I will notify my dentist."
D. "I will report signs of bleeding."
Answer: B. "I will increase my intake of green leafy vegetables."
Rationale: Green leafy vegetables are high in vitamin K, which antagonizes warfarin.
Intake should be consistent, not increased.
