HESI RN EXIT Exam with NGN - Version B |Questions and
Correct Answers Latest Updated 2026/2027
(Graded A+)
1. A female client presents in the emergency department and tells the nurse that she was
raped last night. Which question is most important for the nurse to ask?
A. Has she taken a bath since the rape occurred?
B. Is the place where she lives a safe place?
C. Does she know the person who raped her?
D. Did she report the rape to the police department?
Correct Answer: A. Has she taken a bath since the rape occurred?
Rationale: The most important initial question is whether the client has bathed, as bathing can
destroy crucial forensic evidence needed for legal proceedings and evidence collection.
Healthcare providers must prioritize evidence preservation within the critical time window
(typically 72-120 hours). While safety assessment (B), knowing the perpetrator (C), and police
reporting (D) are important, preserving forensic evidence takes priority for immediate medical-
legal intervention. The nurse should explain the importance of a forensic examination before
any bathing or changing clothes occurs.
2. The nurse is completing the admission assessment of a 3-year-old who is admitted with
bacterial meningitis and hydrocephalus. Which assessment finding is evidence that the child is
experiencing increased intracranial pressure (ICP)?
A. Tachycardia and tachypnea
B. Sluggish and unequal pupillary responses
C. Increased head circumference and bulging fontanels
D. Blood pressure fluctuations and syncope
Correct Answer: B. Sluggish and unequal pupillary responses
,Rationale: Sluggish and unequal pupillary responses indicate cranial nerve III (oculomotor)
compression, a late and critical sign of increased ICP requiring immediate intervention. While
increased head circumference and bulging fontanels (C) are classic signs in infants with open
fontanels, this child is 3 years old with closed fontanels, making pupillary changes more
relevant. Tachycardia (A) is incorrect because increased ICP typically causes bradycardia
(Cushing's triad: bradycardia, hypertension, irregular respirations). Blood pressure fluctuations
(D) may occur but pupillary changes indicate direct neurological compromise.
3. A client with acute pancreatitis is admitted with severe, piercing abdominal pain and an
elevated serum amylase. Which additional information is the client most likely to report to
the nurse?
A. Abdominal pain decreases when lying supine
B. Pain lasts an hour and leaves the abdomen tender
C. Right upper quadrant pain refers to right scapula
D. Drinks alcohol until intoxicated at least twice weekly
Correct Answer: A. Abdominal pain decreases when lying supine
Rationale: Acute pancreatitis pain typically worsens in the supine position and improves when
the client leans forward or assumes the fetal position. This positional characteristic helps
differentiate pancreatitis from other abdominal conditions. The pain is usually constant, severe,
and epigastric (not just one hour - B is incorrect). Right upper quadrant pain radiating to the
scapula (C) is more characteristic of cholecystitis. While alcohol use (D) is a risk factor for
pancreatitis, it is not a symptom the client would report as part of the current clinical
presentation.
4. A child newly diagnosed with sickle cell anemia (SCA) is being discharged from the hospital.
Which information is most important for the nurse to provide the parents prior to discharge?
A. Instructions about how much fluid the child should drink daily
B. Signs of addiction to opioid pain medications
C. Information about non-pharmaceutical pain relief measures
D. Referral for social services for the child and family
Correct Answer: A. Instructions about how much fluid the child should drink daily
Rationale: Hydration is the most critical self-management strategy for sickle cell anemia.
Adequate fluid intake (typically 1.5-2 times normal requirements) reduces blood viscosity,
,prevents sickling crises, and decreases the risk of vaso-occlusive episodes. Dehydration is a
primary trigger for sickle cell crises. While pain management education (B, C) and social support
(D) are important components of care, maintaining hydration is the foundation of crisis
prevention and takes priority for daily home management.
5. To auscultate for a carotid bruit, the nurse places the stethoscope at what location. (Select
the location on the image with a red dot).
Correct Answer: The red dot should be placed at the base of the neck on the right side (over the
carotid artery).
Rationale: The carotid artery is located in the neck, lateral to the trachea and medial to the
sternocleidomastoid muscle. Auscultation should be performed at the base of the neck where
the common carotid artery bifurcates (typically at the level of the thyroid cartilage). The nurse
should avoid excessive pressure to prevent compromising cerebral blood flow. A bruit indicates
turbulent blood flow, often suggestive of atherosclerotic narrowing.
6. After receiving report on an inpatient acute care unit, which client should the nurse assess
first?
A. The client with an obstruction of the large intestine who is experiencing abdominal distention
B. The client who had surgery yesterday and is experiencing a paralytic ileus with absent bowel
sounds
C. The client with a small bowel obstruction who has a nasogastric tube that is draining greenish
fluid
D. The client with a bowel obstruction due to a volvulus who is experiencing abdominal rigidity
Correct Answer: D. The client with a bowel obstruction due to a volvulus who is experiencing
abdominal rigidity
Rationale: Abdominal rigidity indicates peritonitis and possible bowel strangulation, which is a
surgical emergency. Volvulus (twisting of the bowel) can cause ischemia, necrosis, and
perforation within hours. This client requires immediate assessment for signs of sepsis,
perforation, and hemodynamic instability. While all clients need attention, abdominal rigidity
represents the most life-threatening condition. Paralytic ileus (B) and NG tube drainage (C) are
expected postoperative findings. Large intestine obstruction (A) is serious but typically
progresses more slowly than volvulus with peritonitis.
, 7. A teenager presents to the emergency department with palpitations after vaping at a party.
The client is anxious, fearful, and hyperventilating. The nurse anticipates the client developing
which acid-base imbalance?
A. Respiratory acidosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory alkalosis
Correct Answer: D. Respiratory alkalosis
Rationale: Hyperventilation causes excessive elimination of CO2, leading to decreased PaCO2
and increased pH - the definition of respiratory alkalosis. The anxiety and stimulant effects of
vaping (nicotine) trigger the sympathetic nervous system, increasing respiratory rate and depth.
Respiratory acidosis (A) results from hypoventilation. Metabolic alkalosis (B) involves loss of acid
or gain of bicarbonate. Metabolic acidosis (C) involves accumulation of acid or loss of
bicarbonate. The clinical picture of hyperventilation directly correlates with respiratory alkalosis.
8. A client with dyspnea is being admitted to the medical unit. To best prepare for the client's
arrival, the nurse should ensure that the client's bed is in which position?
A. Supine
B. Supine; feet elevated higher than head
C. Supine; head elevated higher than feet
D. Fowler's
Correct Answer: D. Fowler's
Rationale: Fowler's position (head of bed elevated 45-60 degrees) optimizes lung expansion,
decreases work of breathing, and facilitates diaphragmatic descent. This position reduces
venous return to the heart (decreasing preload), which helps clients with heart failure or
pulmonary congestion. It also promotes better ventilation-perfusion matching. Supine positions
(A, B, C) worsen dyspnea by allowing abdominal contents to compress the diaphragm and
increasing cardiac workload. Trendelenburg (B) is contraindicated in respiratory distress.
9. The nurse is taking the blood pressure measurement of a client with Parkinson's disease.
Which information in the client's admission assessment is relevant to the nurse's plan for
taking the blood pressure reading? (Select all that apply)
Correct Answers Latest Updated 2026/2027
(Graded A+)
1. A female client presents in the emergency department and tells the nurse that she was
raped last night. Which question is most important for the nurse to ask?
A. Has she taken a bath since the rape occurred?
B. Is the place where she lives a safe place?
C. Does she know the person who raped her?
D. Did she report the rape to the police department?
Correct Answer: A. Has she taken a bath since the rape occurred?
Rationale: The most important initial question is whether the client has bathed, as bathing can
destroy crucial forensic evidence needed for legal proceedings and evidence collection.
Healthcare providers must prioritize evidence preservation within the critical time window
(typically 72-120 hours). While safety assessment (B), knowing the perpetrator (C), and police
reporting (D) are important, preserving forensic evidence takes priority for immediate medical-
legal intervention. The nurse should explain the importance of a forensic examination before
any bathing or changing clothes occurs.
2. The nurse is completing the admission assessment of a 3-year-old who is admitted with
bacterial meningitis and hydrocephalus. Which assessment finding is evidence that the child is
experiencing increased intracranial pressure (ICP)?
A. Tachycardia and tachypnea
B. Sluggish and unequal pupillary responses
C. Increased head circumference and bulging fontanels
D. Blood pressure fluctuations and syncope
Correct Answer: B. Sluggish and unequal pupillary responses
,Rationale: Sluggish and unequal pupillary responses indicate cranial nerve III (oculomotor)
compression, a late and critical sign of increased ICP requiring immediate intervention. While
increased head circumference and bulging fontanels (C) are classic signs in infants with open
fontanels, this child is 3 years old with closed fontanels, making pupillary changes more
relevant. Tachycardia (A) is incorrect because increased ICP typically causes bradycardia
(Cushing's triad: bradycardia, hypertension, irregular respirations). Blood pressure fluctuations
(D) may occur but pupillary changes indicate direct neurological compromise.
3. A client with acute pancreatitis is admitted with severe, piercing abdominal pain and an
elevated serum amylase. Which additional information is the client most likely to report to
the nurse?
A. Abdominal pain decreases when lying supine
B. Pain lasts an hour and leaves the abdomen tender
C. Right upper quadrant pain refers to right scapula
D. Drinks alcohol until intoxicated at least twice weekly
Correct Answer: A. Abdominal pain decreases when lying supine
Rationale: Acute pancreatitis pain typically worsens in the supine position and improves when
the client leans forward or assumes the fetal position. This positional characteristic helps
differentiate pancreatitis from other abdominal conditions. The pain is usually constant, severe,
and epigastric (not just one hour - B is incorrect). Right upper quadrant pain radiating to the
scapula (C) is more characteristic of cholecystitis. While alcohol use (D) is a risk factor for
pancreatitis, it is not a symptom the client would report as part of the current clinical
presentation.
4. A child newly diagnosed with sickle cell anemia (SCA) is being discharged from the hospital.
Which information is most important for the nurse to provide the parents prior to discharge?
A. Instructions about how much fluid the child should drink daily
B. Signs of addiction to opioid pain medications
C. Information about non-pharmaceutical pain relief measures
D. Referral for social services for the child and family
Correct Answer: A. Instructions about how much fluid the child should drink daily
Rationale: Hydration is the most critical self-management strategy for sickle cell anemia.
Adequate fluid intake (typically 1.5-2 times normal requirements) reduces blood viscosity,
,prevents sickling crises, and decreases the risk of vaso-occlusive episodes. Dehydration is a
primary trigger for sickle cell crises. While pain management education (B, C) and social support
(D) are important components of care, maintaining hydration is the foundation of crisis
prevention and takes priority for daily home management.
5. To auscultate for a carotid bruit, the nurse places the stethoscope at what location. (Select
the location on the image with a red dot).
Correct Answer: The red dot should be placed at the base of the neck on the right side (over the
carotid artery).
Rationale: The carotid artery is located in the neck, lateral to the trachea and medial to the
sternocleidomastoid muscle. Auscultation should be performed at the base of the neck where
the common carotid artery bifurcates (typically at the level of the thyroid cartilage). The nurse
should avoid excessive pressure to prevent compromising cerebral blood flow. A bruit indicates
turbulent blood flow, often suggestive of atherosclerotic narrowing.
6. After receiving report on an inpatient acute care unit, which client should the nurse assess
first?
A. The client with an obstruction of the large intestine who is experiencing abdominal distention
B. The client who had surgery yesterday and is experiencing a paralytic ileus with absent bowel
sounds
C. The client with a small bowel obstruction who has a nasogastric tube that is draining greenish
fluid
D. The client with a bowel obstruction due to a volvulus who is experiencing abdominal rigidity
Correct Answer: D. The client with a bowel obstruction due to a volvulus who is experiencing
abdominal rigidity
Rationale: Abdominal rigidity indicates peritonitis and possible bowel strangulation, which is a
surgical emergency. Volvulus (twisting of the bowel) can cause ischemia, necrosis, and
perforation within hours. This client requires immediate assessment for signs of sepsis,
perforation, and hemodynamic instability. While all clients need attention, abdominal rigidity
represents the most life-threatening condition. Paralytic ileus (B) and NG tube drainage (C) are
expected postoperative findings. Large intestine obstruction (A) is serious but typically
progresses more slowly than volvulus with peritonitis.
, 7. A teenager presents to the emergency department with palpitations after vaping at a party.
The client is anxious, fearful, and hyperventilating. The nurse anticipates the client developing
which acid-base imbalance?
A. Respiratory acidosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory alkalosis
Correct Answer: D. Respiratory alkalosis
Rationale: Hyperventilation causes excessive elimination of CO2, leading to decreased PaCO2
and increased pH - the definition of respiratory alkalosis. The anxiety and stimulant effects of
vaping (nicotine) trigger the sympathetic nervous system, increasing respiratory rate and depth.
Respiratory acidosis (A) results from hypoventilation. Metabolic alkalosis (B) involves loss of acid
or gain of bicarbonate. Metabolic acidosis (C) involves accumulation of acid or loss of
bicarbonate. The clinical picture of hyperventilation directly correlates with respiratory alkalosis.
8. A client with dyspnea is being admitted to the medical unit. To best prepare for the client's
arrival, the nurse should ensure that the client's bed is in which position?
A. Supine
B. Supine; feet elevated higher than head
C. Supine; head elevated higher than feet
D. Fowler's
Correct Answer: D. Fowler's
Rationale: Fowler's position (head of bed elevated 45-60 degrees) optimizes lung expansion,
decreases work of breathing, and facilitates diaphragmatic descent. This position reduces
venous return to the heart (decreasing preload), which helps clients with heart failure or
pulmonary congestion. It also promotes better ventilation-perfusion matching. Supine positions
(A, B, C) worsen dyspnea by allowing abdominal contents to compress the diaphragm and
increasing cardiac workload. Trendelenburg (B) is contraindicated in respiratory distress.
9. The nurse is taking the blood pressure measurement of a client with Parkinson's disease.
Which information in the client's admission assessment is relevant to the nurse's plan for
taking the blood pressure reading? (Select all that apply)
