2026 GRADED A+ UPDATED FOR 2026/2027
PN HESI EXIT COMPREHENSIVE
HIGH-YIELD PRACTICE EXAM — Q&A +
RATIONALES
1. A postoperative client has a temperature of 101.8°F on day 3. The nurse suspects infection.
What is the priority action?
A. Administer antipyretic
B. Obtain wound culture
C. Increase oral fluids
D. Encourage ambulation
Correct Answer: B
Rationale: Fever postoperative day 3 may indicate infection; identifying the organism with culture
informs treatment.
2. A client with congestive heart failure (CHF) has 3+ pitting edema. What should the nurse
assess first?
A. Daily weight
B. Lung sounds
C. Dietary intake
D. Urine output
Correct Answer: B
Rationale: Lung assessment detects pulmonary congestion which can be life-threatening.
3. A client is admitted with DKA. Which lab result should the nurse monitor closely?
A. Hemoglobin
B. Potassium
C. Calcium
D. Platelets
Correct Answer: B
Rationale: Insulin therapy shifts potassium into cells, risking hypokalemia.
,2026 GRADED A+ UPDATED FOR 2026/2027
4. A client taking warfarin reports black, tarry stools. What is the nurse’s priority?
A. Assess blood pressure
B. Withhold warfarin and notify provider
C. Encourage fluids
D. Document and continue care
Correct Answer: B
Rationale: Black stools indicate GI bleeding and warfarin must be held and reported.
5. What electrolyte imbalance is indicated by peaked T waves on ECG?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
Correct Answer: B
Rationale: Peaked T waves are classic for hyperkalemia affecting cardiac conduction.
6. A postoperative client suddenly becomes restless and confused. What should the nurse assess
first?
A. Pain level
B. Oxygen saturation
C. Fluid intake
D. Bowel sounds
Correct Answer: B
Rationale: Restlessness/confusion can be early sign of hypoxia; ABCs are priority.
7. A client with COPD is in respiratory distress. Which position promotes oxygenation?
A. Supine
B. High Fowler’s
C. Trendelenburg
D. Prone
Correct Answer: B
Rationale: High Fowler’s maximizes lung expansion and improves breathing.
,2026 GRADED A+ UPDATED FOR 2026/2027
8. Which drug class should be avoided in a client with renal failure due to nephrotoxicity?
A. NSAIDs
B. Beta-blockers
C. ACE inhibitors
D. Calcium channel blockers
Correct Answer: A
Rationale: NSAIDs reduce renal blood flow and worsen kidney function.
9. A client on heparin has an aPTT of 90 sec (normal 25-35). What is the nurse’s next action?
A. Increase heparin
B. Stop infusion and notify provider
C. Continue current dose
D. Encourage ambulation
Correct Answer: B
Rationale: Elevated aPTT increases bleeding risk; heparin should be held and provider notified.
10. A client with acute pancreatitis should avoid which diet?
A. Clear liquids
B. Low-fat meals
C. High-fat meals
D. Protein drinks
Correct Answer: C
Rationale: High fat stimulates pancreatic secretions and worsens symptoms.
11. A client with hypovolemic shock will exhibit:
A. Bounding pulse
B. Warm, flushed skin
C. Cool, clammy skin
D. Bradycardia
Correct Answer: C
Rationale: Sympathetic response to low volume causes vasoconstriction and cool, clammy skin.
, 2026 GRADED A+ UPDATED FOR 2026/2027
12. Signs of digoxin toxicity include:
A. Bradycardia and anorexia
B. Hypokalemia only
C. Hyperglycemia
D. Dry cough
Correct Answer: A
Rationale: GI upset and cardiac changes like bradycardia are classic digoxin toxicity symptoms.
13. A client with DVT should:
A. Ambulate vigorously
B. Stay on bedrest and receive anticoagulants
C. Take high-fat foods
D. Avoid hydration
Correct Answer: B
Rationale: Bedrest prevents clot dislodgment; anticoagulants prevent extension.
14. Which symptom is common in anemia?
A. Fatigue and pallor
B. Polyuria
C. Hypertension
D. Constipation
Correct Answer: A
Rationale: Reduced oxygen-carrying capacity causes fatigue and pallor.
15. SIADH results in:
A. Hypernatremia
B. Hyponatremia
C. Hyperkalemia
D. Hypoglycemia
Correct Answer: B
Rationale: Excess ADH causes water retention and dilutes serum sodium.
16. Addison’s disease requires:
PN HESI EXIT COMPREHENSIVE
HIGH-YIELD PRACTICE EXAM — Q&A +
RATIONALES
1. A postoperative client has a temperature of 101.8°F on day 3. The nurse suspects infection.
What is the priority action?
A. Administer antipyretic
B. Obtain wound culture
C. Increase oral fluids
D. Encourage ambulation
Correct Answer: B
Rationale: Fever postoperative day 3 may indicate infection; identifying the organism with culture
informs treatment.
2. A client with congestive heart failure (CHF) has 3+ pitting edema. What should the nurse
assess first?
A. Daily weight
B. Lung sounds
C. Dietary intake
D. Urine output
Correct Answer: B
Rationale: Lung assessment detects pulmonary congestion which can be life-threatening.
3. A client is admitted with DKA. Which lab result should the nurse monitor closely?
A. Hemoglobin
B. Potassium
C. Calcium
D. Platelets
Correct Answer: B
Rationale: Insulin therapy shifts potassium into cells, risking hypokalemia.
,2026 GRADED A+ UPDATED FOR 2026/2027
4. A client taking warfarin reports black, tarry stools. What is the nurse’s priority?
A. Assess blood pressure
B. Withhold warfarin and notify provider
C. Encourage fluids
D. Document and continue care
Correct Answer: B
Rationale: Black stools indicate GI bleeding and warfarin must be held and reported.
5. What electrolyte imbalance is indicated by peaked T waves on ECG?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
Correct Answer: B
Rationale: Peaked T waves are classic for hyperkalemia affecting cardiac conduction.
6. A postoperative client suddenly becomes restless and confused. What should the nurse assess
first?
A. Pain level
B. Oxygen saturation
C. Fluid intake
D. Bowel sounds
Correct Answer: B
Rationale: Restlessness/confusion can be early sign of hypoxia; ABCs are priority.
7. A client with COPD is in respiratory distress. Which position promotes oxygenation?
A. Supine
B. High Fowler’s
C. Trendelenburg
D. Prone
Correct Answer: B
Rationale: High Fowler’s maximizes lung expansion and improves breathing.
,2026 GRADED A+ UPDATED FOR 2026/2027
8. Which drug class should be avoided in a client with renal failure due to nephrotoxicity?
A. NSAIDs
B. Beta-blockers
C. ACE inhibitors
D. Calcium channel blockers
Correct Answer: A
Rationale: NSAIDs reduce renal blood flow and worsen kidney function.
9. A client on heparin has an aPTT of 90 sec (normal 25-35). What is the nurse’s next action?
A. Increase heparin
B. Stop infusion and notify provider
C. Continue current dose
D. Encourage ambulation
Correct Answer: B
Rationale: Elevated aPTT increases bleeding risk; heparin should be held and provider notified.
10. A client with acute pancreatitis should avoid which diet?
A. Clear liquids
B. Low-fat meals
C. High-fat meals
D. Protein drinks
Correct Answer: C
Rationale: High fat stimulates pancreatic secretions and worsens symptoms.
11. A client with hypovolemic shock will exhibit:
A. Bounding pulse
B. Warm, flushed skin
C. Cool, clammy skin
D. Bradycardia
Correct Answer: C
Rationale: Sympathetic response to low volume causes vasoconstriction and cool, clammy skin.
, 2026 GRADED A+ UPDATED FOR 2026/2027
12. Signs of digoxin toxicity include:
A. Bradycardia and anorexia
B. Hypokalemia only
C. Hyperglycemia
D. Dry cough
Correct Answer: A
Rationale: GI upset and cardiac changes like bradycardia are classic digoxin toxicity symptoms.
13. A client with DVT should:
A. Ambulate vigorously
B. Stay on bedrest and receive anticoagulants
C. Take high-fat foods
D. Avoid hydration
Correct Answer: B
Rationale: Bedrest prevents clot dislodgment; anticoagulants prevent extension.
14. Which symptom is common in anemia?
A. Fatigue and pallor
B. Polyuria
C. Hypertension
D. Constipation
Correct Answer: A
Rationale: Reduced oxygen-carrying capacity causes fatigue and pallor.
15. SIADH results in:
A. Hypernatremia
B. Hyponatremia
C. Hyperkalemia
D. Hypoglycemia
Correct Answer: B
Rationale: Excess ADH causes water retention and dilutes serum sodium.
16. Addison’s disease requires:
