CASE STUDIES
NCLEX (NGN), Case-based
Scenarios,
Actual Qs & Ans to Pass the Exam
THIS HESI EXIT CASE STUDIES CONSISTS OF
Questions and Answers
Multiple-choice Style
NCLEX (NGN)-style scenarios
Case-based Scenarios
Expert Explanation
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,QUESTION 1 – Patient #1 (Nausea/Vomiting in Pregnancy)
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Vital Signs: T 98.2°F (36.8°C), HR 82 bpm, RR 16/min, BP 112/70 mm Hg
A 20-year-old pregnant client in her first trimester arrives for a sick visit, reporting
frequent nausea and vomiting that she cannot control. She denies tobacco or
alcohol use. Which nursing recommendations can help reduce her symptoms?
(Select all that apply. One, some, or all responses may be correct.)
A. Avoid having an empty or overly full stomach.
B. Eat three large, high-fat meals daily to maintain calorie intake.
C. Use real ginger (e.g., ginger tea) or sour/citrus scents.
D. Eat small carbohydrate-rich, low-fat meals (e.g., toast, oatmeal) throughout the
day.
E. Press firmly on the wrist’s acupressure point for about 3 minutes.
Correct Answers: A, C, D, E
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EXPERT EXPLANATION
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• Keeping the stomach partially full with small, low-fat, carbohydrate-rich meals
prevents exacerbation of nausea (A, D).
• Ginger (tea or real ginger) often relieves nausea; sour or citrus scents/candies
can help reduce nausea (C).
,• Wrist acupressure (E) may help alleviate nausea as a complementary therapy.
• Three large and high-fat meals (B) are not recommended because fatty foods
and an empty/overly full stomach worsen nausea.
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QUESTION 2 – Patient #2 (Presumptive Signs of Pregnancy)
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Vital Signs: T 98.4°F (36.9°C), HR 78 bpm, RR 16/min, BP 110/72 mm Hg
An 18-year-old client at about 10 weeks’ gestation arrives at a community clinic
stating she believes she is pregnant. She denies tobacco or alcohol use. Which
findings are classified as presumptive signs of pregnancy? (Select all that apply.
One, some, or all responses may be correct.)
A. Amenorrhea
B. Hegar’s sign
C. Breast changes
D. Urinary frequency
E. Chadwick’s sign
F. Abdominal enlargement
G. Headaches
H. Nausea
Correct Answers: A, C, D, H
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EXPERT EXPLANATION
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• Presumptive signs are subjective changes felt by the client, including:
– Amenorrhea (A)
– Breast changes (C)
– Urinary frequency (D)
– Nausea (H)
• Hegar’s sign (softening of the lower uterine segment), Chadwick’s sign (bluish
discoloration of the cervix), and abdominal enlargement are probable or objective
signs.
• Headaches (G) are not a classic presumptive or probable sign of pregnancy.
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QUESTION 3 – Patient #3 (Adolescent Pregnancy Factors)
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Vital Signs: T 98.1°F (36.7°C), HR 85 bpm, RR 18/min, BP 108/70 mm Hg
A 16-year-old pregnant client at 8 weeks’ gestation arrives with a parent for her
first prenatal visit. She denies tobacco or alcohol use. Which factors should the
nurse prioritize when planning care for an adolescent pregnancy? (Select all that
apply. One, some, or all responses may be correct.)
A. High risk of gestational diabetes
B. Higher rate of postpartum depression