ELITE COMPREHENSIVE
HESI RN EXIT EXAMINATION REVIEW, NEXT-
GENERATION NCLEX-RN® PREPARATION
Clinical Judgment, Prioritization, Pharmacology,
Medical-Surgical Nursing
High-Yield Nursing Practice Success Guide
Spring Semester Examination May
2026
When preparing to administer a prescribed medication to a homeless client at a
community psychiatric clinic. The client tells the nurse that the usual dosage taken is
different from the dose the nurse is giving. Which action should the nurse take?
A) Inform the client that he may refuse the medication and document whether or not the
client takes it.
B) Withhold the medication until the dosage can be confirmed.
C) Explain to the client that the dosage has been changed.
D) Tell the client to take the medication then verify the dosage at the next healthcare
team meeting.
• B) Withhold the medication until the dosage can be confirmed.
1|Page
,The charge nurse is making assignments for one practical nurse and three registered
nurses who are caring for neurologically compromised clients. Which client with which
change in status is best to assign to the PN?
A) Subdural hematoma whose blood pressure changed from 150/80 to 170/60.
B) Viral meningitis whose temperature change from 101 S to 102F.
C) Diabetic keto acidosis who is Glasgow coma scale score changed from 10 to 7.
D) Myxedema, whose blood pressure change from 80/50 to 70/40.
• B) Viral meningitis whose temperature change from 101 S to 102F.
The nurse is caring for a client with pneumonia who now develops initial signs of septic
shock and multi organ failure. The healthcare provider prescribes a sepsis protocol.
Which intervention is most important for the nurse to include in the plan of care?
A) Maintain strict intake and output.
B) Keep head of bed raised 45°.
C) Excess warmth of extremities.
D) Monitor blood glucose level.
• Maintain strict intake and output.
And adolescent client is admitted to the hospital because of writing a suicide note to a
teacher at school. On the second day of hospitalization, the nurse asked the client to
meet with the treatment team. After the team meeting, the client leaves in tears and
goes to their room. Which nursing intervention is best?
A) Let the client rest quietly in their room for a while.
B) Explore the clients goals and desire for treatment.
2|Page
,C) Ask the treatment team about the clients behavior.
D) Go to the client room and ask what happened.
• D) Go to the client room and ask what happened.
The healthcare provider prescribes dalteparin 200 units per kilogram subcutaneous
once a day for a client who weighs 154 pounds. The medication is available and 25,000
units per milliliter vial. How many milliliters should the nurse administer? (Enter
numerical value only. If rounding is required, round to the nearest 10th.)
• 0.6
NGN: The client is a 49-year-old male who reports flu like symptoms including fever and
chest congestion for four days. He came to the emergency department last night when
he was having more difficulty breathing he has a history of 1/2 pack a day cigarette
smoking for 20 years. He has no significant medical or surgical history.
Which two orders should the nurse complete first?
A) Sputum culture.
B) Start oxygen 3 L per minute via nasal cannula.
C) Place the client on a cardio respiratory monitor.
D) Chest x-ray.
E) Acetominophen 350 mg PO every six hours for temperature control.
F) Run 0.9% sodium chloride IV infusion at 150 mL per hour.
G) Start peripheral IV.
H) NPO.
• B) Start oxygen 3 L per minute via nasal cannula.
• C) Place the client on a cardio respiratory monitor.
3|Page
, NGN: 0330: place the client on a cardio respiratory monitor, NPO, sputum culture, start
a peripheral IV infusion, start oxygen 3 L per minute via nasal cannula, begin 0.9%
sodium chloride IV infusion at 150 mL per hour, acetaminophen 350 mg PO every six
hours for temperature.
To start the client on oxygen as ordered which items should the nurse collects from the
supply room? SATA
A) humidifier bottle.
B)Suction canister.
C)Sterile water.
D) Nasal cannula.
E) Flow meter.
F) Lambs wool.
G) Tape.
• D) Nasal cannula.
• E) Flow meter.
The nurse has completed the diet teaching of a client who is being discharged following
treatment of a leg wound. A high-protein diet is encouraged to promote wound healing.
Which lunch toys by the client indicates that the teaching was effective?
A) A peanut butter sandwich with soda and cookies.
B) Vegetable soup, crackers, and milk.
C) A tuna fish sandwich with chips and ice cream.
D) A salad with three kinds of lettuce and fruit.
• C) A tuna fish sandwich with chips and ice cream.
4|Page
HESI RN EXIT EXAMINATION REVIEW, NEXT-
GENERATION NCLEX-RN® PREPARATION
Clinical Judgment, Prioritization, Pharmacology,
Medical-Surgical Nursing
High-Yield Nursing Practice Success Guide
Spring Semester Examination May
2026
When preparing to administer a prescribed medication to a homeless client at a
community psychiatric clinic. The client tells the nurse that the usual dosage taken is
different from the dose the nurse is giving. Which action should the nurse take?
A) Inform the client that he may refuse the medication and document whether or not the
client takes it.
B) Withhold the medication until the dosage can be confirmed.
C) Explain to the client that the dosage has been changed.
D) Tell the client to take the medication then verify the dosage at the next healthcare
team meeting.
• B) Withhold the medication until the dosage can be confirmed.
1|Page
,The charge nurse is making assignments for one practical nurse and three registered
nurses who are caring for neurologically compromised clients. Which client with which
change in status is best to assign to the PN?
A) Subdural hematoma whose blood pressure changed from 150/80 to 170/60.
B) Viral meningitis whose temperature change from 101 S to 102F.
C) Diabetic keto acidosis who is Glasgow coma scale score changed from 10 to 7.
D) Myxedema, whose blood pressure change from 80/50 to 70/40.
• B) Viral meningitis whose temperature change from 101 S to 102F.
The nurse is caring for a client with pneumonia who now develops initial signs of septic
shock and multi organ failure. The healthcare provider prescribes a sepsis protocol.
Which intervention is most important for the nurse to include in the plan of care?
A) Maintain strict intake and output.
B) Keep head of bed raised 45°.
C) Excess warmth of extremities.
D) Monitor blood glucose level.
• Maintain strict intake and output.
And adolescent client is admitted to the hospital because of writing a suicide note to a
teacher at school. On the second day of hospitalization, the nurse asked the client to
meet with the treatment team. After the team meeting, the client leaves in tears and
goes to their room. Which nursing intervention is best?
A) Let the client rest quietly in their room for a while.
B) Explore the clients goals and desire for treatment.
2|Page
,C) Ask the treatment team about the clients behavior.
D) Go to the client room and ask what happened.
• D) Go to the client room and ask what happened.
The healthcare provider prescribes dalteparin 200 units per kilogram subcutaneous
once a day for a client who weighs 154 pounds. The medication is available and 25,000
units per milliliter vial. How many milliliters should the nurse administer? (Enter
numerical value only. If rounding is required, round to the nearest 10th.)
• 0.6
NGN: The client is a 49-year-old male who reports flu like symptoms including fever and
chest congestion for four days. He came to the emergency department last night when
he was having more difficulty breathing he has a history of 1/2 pack a day cigarette
smoking for 20 years. He has no significant medical or surgical history.
Which two orders should the nurse complete first?
A) Sputum culture.
B) Start oxygen 3 L per minute via nasal cannula.
C) Place the client on a cardio respiratory monitor.
D) Chest x-ray.
E) Acetominophen 350 mg PO every six hours for temperature control.
F) Run 0.9% sodium chloride IV infusion at 150 mL per hour.
G) Start peripheral IV.
H) NPO.
• B) Start oxygen 3 L per minute via nasal cannula.
• C) Place the client on a cardio respiratory monitor.
3|Page
, NGN: 0330: place the client on a cardio respiratory monitor, NPO, sputum culture, start
a peripheral IV infusion, start oxygen 3 L per minute via nasal cannula, begin 0.9%
sodium chloride IV infusion at 150 mL per hour, acetaminophen 350 mg PO every six
hours for temperature.
To start the client on oxygen as ordered which items should the nurse collects from the
supply room? SATA
A) humidifier bottle.
B)Suction canister.
C)Sterile water.
D) Nasal cannula.
E) Flow meter.
F) Lambs wool.
G) Tape.
• D) Nasal cannula.
• E) Flow meter.
The nurse has completed the diet teaching of a client who is being discharged following
treatment of a leg wound. A high-protein diet is encouraged to promote wound healing.
Which lunch toys by the client indicates that the teaching was effective?
A) A peanut butter sandwich with soda and cookies.
B) Vegetable soup, crackers, and milk.
C) A tuna fish sandwich with chips and ice cream.
D) A salad with three kinds of lettuce and fruit.
• C) A tuna fish sandwich with chips and ice cream.
4|Page
