NGN-Style Questions | HESI Exit Nursing (PDF),
2026 Exam · 386 Questions · With Rationales
ati.
2026 HESI RN Exit V1-V10 Actual Exams | NGN-Style Questions | HESI Exit Nursing (PDF), Exams of Nursing
Question: 1 of 386
A patient with a history of heart failure and chronic obstructive pulmonary disease is admitted with acute
dyspnea. The nurse notes jugular venous distention, bilateral crackles, and an SpO2 of 88% on room air.
A. Administer intravenous furosemide 40 mg
B. Place the patient in high Fowler's position
C. Obtain a stat arterial blood gas
D. Apply non-rebreather mask at 15 L/min
PREVIOUS CONTINUE
A patient with a history of heart failure and chronic obstructive pulmonary disease is
admitted with acute dyspnea. The nurse notes jugular venous distention, bilateral
crackles, and an SpO2 of 88% on room air. Which intervention should the nurse
implement first?
A. Administer intravenous furosemide 40 mg
' B. Place the patient in high Fowler's position
C. Obtain a stat arterial blood gas
D. Apply non-rebreather mask at 15 L/min
Correct Answer: B
High Fowler's position maximizes chest expansion and improves oxygenation, addressing the immediate threat
of hypoxia. While oxygen and diuretics are important, positioning is the quickest noninvasive action to enhance
ventilation. ABG is diagnostic, not therapeutic.
Page 1 | 2026 HESI RN Exit V1-V10 Actual Exams | NGN-Style Questions | HESI Exit Nursing (PDF), Exams of Nursing 2026
, 2026 HESI RN Exit V1-V10 Actual Exams |
NGN-Style Questions | HESI Exit Nursing (PDF),
2026 Exam · 386 Questions · With Rationales
ati.
2026 HESI RN Exit V1-V10 Actual Exams | NGN-Style Questions | HESI Exit Nursing (PDF), Exams of Nursing
Question: 2 of 386
A patient receiving a continuous heparin infusion has an aPTT of 120 seconds (therapeutic range 60-80
seconds). The nurse notes coffee-ground emesis and a drop in blood pressure from 128/78 to 94/52 mm Hg.
A. Administer vitamin K intramuscularly
B. Stop the heparin infusion and administer protamine sulfate
C. Increase the infusion rate to achieve therapeutic aPTT
D. Draw aPTT and PT/INR and notify the healthcare provider
PREVIOUS CONTINUE
A patient receiving a continuous heparin infusion has an aPTT of 120 seconds
(therapeutic range 60-80 seconds). The nurse notes coffee-ground emesis and a drop in
blood pressure from 128/78 to 94/52 mm Hg. What should the nurse do first?
A. Administer vitamin K intramuscularly
' B. Stop the heparin infusion and administer protamine sulfate
C. Increase the infusion rate to achieve therapeutic aPTT
D. Draw aPTT and PT/INR and notify the healthcare provider
Correct Answer: B
The patient exhibits signs of heparin overdose with bleeding (coffee-ground emesis, hypotension). The
immediate priority is to stop the infusion and reverse anticoagulation with protamine sulfate. Vitamin K reverses
warfarin, not heparin. Delaying action could worsen hemorrhage.
Page 2 | 2026 HESI RN Exit V1-V10 Actual Exams | NGN-Style Questions | HESI Exit Nursing (PDF), Exams of Nursing 2026
, 2026 HESI RN Exit V1-V10 Actual Exams |
NGN-Style Questions | HESI Exit Nursing (PDF),
2026 Exam · 386 Questions · With Rationales
ati.
2026 HESI RN Exit V1-V10 Actual Exams | NGN-Style Questions | HESI Exit Nursing (PDF), Exams of Nursing
Question: 3 of 386
Which of the following assessment findings is most indicative of a patient experiencing neuroleptic malignant
syndrome (NMS) rather than serotonin syndrome?
A. Hyperreflexia and clonus
B. Diaphoresis and flushing
C. Lead-pipe rigidity and bradyreflexia
D. Tachycardia and hypertension
PREVIOUS CONTINUE
Which of the following assessment findings is most indicative of a patient experiencing
neuroleptic malignant syndrome (NMS) rather than serotonin syndrome?
A. Hyperreflexia and clonus
B. Diaphoresis and flushing
' C. Lead-pipe rigidity and bradyreflexia
D. Tachycardia and hypertension
Correct Answer: C
NMS is characterized by 'lead-pipe' muscle rigidity, bradyreflexia, and autonomic instability, whereas serotonin
syndrome presents with hyperreflexia, clonus, and tremor. Both may have autonomic changes, but rigidity and
bradyreflexia are hallmark of NMS.
Page 3 | 2026 HESI RN Exit V1-V10 Actual Exams | NGN-Style Questions | HESI Exit Nursing (PDF), Exams of Nursing 2026
, 2026 HESI RN Exit V1-V10 Actual Exams |
NGN-Style Questions | HESI Exit Nursing (PDF),
2026 Exam · 386 Questions · With Rationales
ati.
2026 HESI RN Exit V1-V10 Actual Exams | NGN-Style Questions | HESI Exit Nursing (PDF), Exams of Nursing
Question: 4 of 386
A patient with end-stage renal disease is scheduled for hemodialysis. The nurse reviews the medication
administration record. Which medication should be withheld prior to dialysis?
A. Erythropoietin alfa 10,000 units subcutaneously
B. Sevelamer carbonate 800 mg orally
C. Enalapril 10 mg orally
D. Calcitriol 0.5 mcg intravenously
PREVIOUS CONTINUE
A patient with end-stage renal disease is scheduled for hemodialysis. The nurse reviews
the medication administration record. Which medication should be withheld prior to
dialysis?
A. Erythropoietin alfa 10,000 units subcutaneously
B. Sevelamer carbonate 800 mg orally
' C. Enalapril 10 mg orally
D. Calcitriol 0.5 mcg intravenously
Correct Answer: C
ACE inhibitors like enalapril can cause hypotension during dialysis due to reduced angiotensin II. They are
often held on dialysis days. Erythropoietin, sevelamer, and calcitriol are typically given per schedule and do not
pose acute risk during dialysis.
Page 4 | 2026 HESI RN Exit V1-V10 Actual Exams | NGN-Style Questions | HESI Exit Nursing (PDF), Exams of Nursing 2026