HESI RN Exit Exam 2026/2027: 150 Next Generation NCLEX
(NGN) Questions with Multiple-Choice Answers & Detailed
Rationales for Nursing Graduates
QUESTION 1
A nurse is preparing to administer an IV dose of ciprofloxacin to a client with a urinary tract infection.
Which client data requires the most immediate intervention by the nurse?
A) Temperature of 101.2°F
B) White blood cell count of 12,000/mm³
C) Serum creatinine of 4.5 mg/dL
D) Blood pressure of 130/80 mmHg
Correct Answer: C) Serum creatinine of 4.5 mg/dL
Rationale: Ciprofloxacin is primarily eliminated by the kidneys and requires dose adjustment in renal
impairment. A serum creatinine of 4.5 mg/dL indicates significant renal dysfunction, placing the client
at risk for drug toxicity and adverse effects. The nurse should notify the healthcare provider before
administering the medication. The other findings are expected in a client with infection and do not
require immediate intervention prior to medication administration.
QUESTION 2
A client with a duodenal ulcer tells the nurse, "I will drink plenty of dairy products like milk to help coat
and protect my ulcer." What is the best follow-up action by the nurse?
A) Remind the client to switch to decaffeinated coffee and tea
B) Suggest the client also plan to eat frequent small meals
C) Review the need to avoid foods rich in milk and cream
D) Reinforce teaching by asking the client to list dairy foods
Correct Answer: C) Review the need to avoid foods rich in milk and cream
Rationale: While milk may provide temporary relief, it actually stimulates gastric acid production,
which can worsen ulcer healing. The nurse should educate the client that high-fat dairy products
should be avoided. Small frequent meals may be helpful but do not address the client's misconception
about dairy products protecting the ulcer.
,QUESTION 3
The nurse is caring for a client with a cerebrovascular accident (CVA) receiving enteral tube feedings.
Which task performed by the UAP requires immediate intervention by the nurse?
A) Suctioning oral secretions from the mouth
B) Positioning the head of the bed flat when changing sheets
C) Taking temperature using the axillary method
D) Keeping the head of bed elevated at 30 degrees
Correct Answer: B) Positioning the head of the bed flat when changing sheets
Rationale: Positioning the head of the bed flat while enteral feedings are in progress puts the client at
significant risk for aspiration pneumonia. The head of the bed should remain elevated at 30-45
degrees during and for at least 30-60 minutes after tube feedings. The other tasks are appropriate for
UAP delegation.
QUESTION 4
The nurse is wearing personal protective equipment while caring for a patient. When exiting the room,
which PPE should be removed first?
A) Gown
B) Mask
C) Gloves
D) Eye protection
Correct Answer: C) Gloves
Rationale: Gloves are considered the most contaminated piece of PPE and should be removed first to
prevent contamination of other surfaces and clothing. The correct sequence for PPE removal is: gloves,
goggles/face shield, gown, then mask/respirator. Hand hygiene should be performed after each
removal step.
QUESTION 5
A client taking clopidogrel reports the onset of diarrhea. Which nursing action should the nurse
implement first?
A) Administer an anti-diarrheal medication
B) Notify the healthcare provider immediately
C) Observe the appearance of the stool
D) Increase the client's fluid intake
, Correct Answer: C) Observe the appearance of the stool
Rationale: Clopidogrel is an antiplatelet medication, and diarrhea could be a side effect; however, the
nurse must first rule out gastrointestinal bleeding, which may present as bloody or black, tarry stools.
Observing the stool provides critical assessment data before determining further interventions.
QUESTION 6
A client is admitted with a diagnosis of hyperemesis gravidarum at 12 weeks gestation. Which action is
most important for the nurse to implement?
A) Initiate prescribed IV fluids
B) Provide small, frequent meals
C) Monitor intake and output
D) Administer antiemetic medication
Correct Answer: A) Initiate prescribed IV fluids
Rationale: Hyperemesis gravidarum can lead to severe dehydration, electrolyte imbalances, and
metabolic alkalosis. The priority intervention is to restore fluid volume and correct electrolyte
abnormalities through IV fluid replacement before other interventions can be effective.
QUESTION 7
An older adult patient is brought to the ED with a sudden onset of confusion that occurred after
experiencing a fall at home. The daughter, who has power of attorney, has brought the client's
prescriptions. Which information should the nurse provide first when reporting to the healthcare
provider using SBAR communication?
A) The list of home medications
B) Increasing confusion of the patient
C) History of previous falls
D) Vital signs upon arrival
Correct Answer: B) Increasing confusion of the patient
Rationale: In SBAR communication, the "S" (Situation) should be reported first - a concise statement of
the current problem. The acute change in mental status (increasing confusion) is the most urgent
clinical concern that requires immediate attention, especially following a fall.
QUESTION 8
(NGN) Questions with Multiple-Choice Answers & Detailed
Rationales for Nursing Graduates
QUESTION 1
A nurse is preparing to administer an IV dose of ciprofloxacin to a client with a urinary tract infection.
Which client data requires the most immediate intervention by the nurse?
A) Temperature of 101.2°F
B) White blood cell count of 12,000/mm³
C) Serum creatinine of 4.5 mg/dL
D) Blood pressure of 130/80 mmHg
Correct Answer: C) Serum creatinine of 4.5 mg/dL
Rationale: Ciprofloxacin is primarily eliminated by the kidneys and requires dose adjustment in renal
impairment. A serum creatinine of 4.5 mg/dL indicates significant renal dysfunction, placing the client
at risk for drug toxicity and adverse effects. The nurse should notify the healthcare provider before
administering the medication. The other findings are expected in a client with infection and do not
require immediate intervention prior to medication administration.
QUESTION 2
A client with a duodenal ulcer tells the nurse, "I will drink plenty of dairy products like milk to help coat
and protect my ulcer." What is the best follow-up action by the nurse?
A) Remind the client to switch to decaffeinated coffee and tea
B) Suggest the client also plan to eat frequent small meals
C) Review the need to avoid foods rich in milk and cream
D) Reinforce teaching by asking the client to list dairy foods
Correct Answer: C) Review the need to avoid foods rich in milk and cream
Rationale: While milk may provide temporary relief, it actually stimulates gastric acid production,
which can worsen ulcer healing. The nurse should educate the client that high-fat dairy products
should be avoided. Small frequent meals may be helpful but do not address the client's misconception
about dairy products protecting the ulcer.
,QUESTION 3
The nurse is caring for a client with a cerebrovascular accident (CVA) receiving enteral tube feedings.
Which task performed by the UAP requires immediate intervention by the nurse?
A) Suctioning oral secretions from the mouth
B) Positioning the head of the bed flat when changing sheets
C) Taking temperature using the axillary method
D) Keeping the head of bed elevated at 30 degrees
Correct Answer: B) Positioning the head of the bed flat when changing sheets
Rationale: Positioning the head of the bed flat while enteral feedings are in progress puts the client at
significant risk for aspiration pneumonia. The head of the bed should remain elevated at 30-45
degrees during and for at least 30-60 minutes after tube feedings. The other tasks are appropriate for
UAP delegation.
QUESTION 4
The nurse is wearing personal protective equipment while caring for a patient. When exiting the room,
which PPE should be removed first?
A) Gown
B) Mask
C) Gloves
D) Eye protection
Correct Answer: C) Gloves
Rationale: Gloves are considered the most contaminated piece of PPE and should be removed first to
prevent contamination of other surfaces and clothing. The correct sequence for PPE removal is: gloves,
goggles/face shield, gown, then mask/respirator. Hand hygiene should be performed after each
removal step.
QUESTION 5
A client taking clopidogrel reports the onset of diarrhea. Which nursing action should the nurse
implement first?
A) Administer an anti-diarrheal medication
B) Notify the healthcare provider immediately
C) Observe the appearance of the stool
D) Increase the client's fluid intake
, Correct Answer: C) Observe the appearance of the stool
Rationale: Clopidogrel is an antiplatelet medication, and diarrhea could be a side effect; however, the
nurse must first rule out gastrointestinal bleeding, which may present as bloody or black, tarry stools.
Observing the stool provides critical assessment data before determining further interventions.
QUESTION 6
A client is admitted with a diagnosis of hyperemesis gravidarum at 12 weeks gestation. Which action is
most important for the nurse to implement?
A) Initiate prescribed IV fluids
B) Provide small, frequent meals
C) Monitor intake and output
D) Administer antiemetic medication
Correct Answer: A) Initiate prescribed IV fluids
Rationale: Hyperemesis gravidarum can lead to severe dehydration, electrolyte imbalances, and
metabolic alkalosis. The priority intervention is to restore fluid volume and correct electrolyte
abnormalities through IV fluid replacement before other interventions can be effective.
QUESTION 7
An older adult patient is brought to the ED with a sudden onset of confusion that occurred after
experiencing a fall at home. The daughter, who has power of attorney, has brought the client's
prescriptions. Which information should the nurse provide first when reporting to the healthcare
provider using SBAR communication?
A) The list of home medications
B) Increasing confusion of the patient
C) History of previous falls
D) Vital signs upon arrival
Correct Answer: B) Increasing confusion of the patient
Rationale: In SBAR communication, the "S" (Situation) should be reported first - a concise statement of
the current problem. The acute change in mental status (increasing confusion) is the most urgent
clinical concern that requires immediate attention, especially following a fall.
QUESTION 8
