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PN HESI EXIT EXAM WITH NGN Actual Exam
2026/2027 Complete Questions and Verified
Answers with Detailed Rationales Already
Graded A+ Pass Guaranteed - A+ Graded
Section 1: PN HESI Exit Exam with NGN
Q1: A patient with heart failure is prescribed furosemide 40 mg PO daily. Which laboratory value
should the practical nurse monitor most closely?
A. White blood cell count
B. Serum potassium [CORRECT]
C. Hemoglobin
D. Platelet count
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium excretion in the urine, potentially
leading to hypokalemia. The PN must monitor serum potassium levels to prevent cardiac
dysrhythmias associated with electrolyte imbalances.
Q2: A postoperative patient reports pain rated 8/10. The physician orders morphine 4 mg IV
every 4 hours PRN. Which action should the practical nurse take first?
A. Administer the medication immediately
B. Assess respiratory rate and depth [CORRECT]
C. Check the patient's allergy history
D. Document the pain assessment
Correct Answer: B
Rationale: Before administering opioid analgesics, the PN must assess baseline respiratory status
because morphine can cause respiratory depression. This follows the nursing process and ensures
patient safety.
Q3: A patient with type 2 diabetes has a blood glucose reading of 45 mg/dL before lunch. Which
intervention should the practical nurse implement first?
A. Notify the healthcare provider
,2
B. Administer 15 grams of fast-acting carbohydrate [CORRECT]
C. Recheck the blood glucose in 30 minutes
D. Document the findings
Correct Answer: B
Rationale: A blood glucose of 45 mg/dL indicates severe hypoglycemia requiring immediate
treatment per the 15-15 rule. The PN should administer 15 grams of fast-acting carbohydrate
(glucose tablets, juice, or regular soda) to raise blood glucose quickly.
Q4: A patient is receiving heparin therapy. Which laboratory test should the practical nurse
monitor to evaluate therapeutic effectiveness?
A. Prothrombin time (PT)
B. International normalized ratio (INR)
C. Activated partial thromboplastin time (aPTT) [CORRECT]
D. Bleeding time
Correct Answer: C
Rationale: Heparin therapy is monitored using the activated partial thromboplastin time (aPTT),
which measures the intrinsic pathway of coagulation. Therapeutic range is typically 1.5-2.5 times
the control value.
Q5: A practical nurse is caring for a patient with a nasogastric tube connected to low intermittent
suction. Which assessment finding indicates a possible complication?
A. Decreased bowel sounds
B. Nausea and abdominal distension [CORRECT]
C. Dry oral mucous membranes
D. Decreased urine output
Correct Answer: B
Rationale: Nausea and abdominal distension indicate possible tube displacement or obstruction,
preventing proper gastric decompression. The PN should check tube placement and patency
immediately.
Q6: A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy.
Which oxygen flow rate is most appropriate for this patient?
A. 2-4 L/min via nasal cannula [CORRECT]
,3
B. 6-8 L/min via simple mask
C. 10-15 L/min via non-rebreather mask
D. 4-6 L/min via Venturi mask
Correct Answer: A
Rationale: Patients with COPD require low-flow oxygen (1-3 L/min, max 4 L/min) to maintain
hypoxic drive. Higher oxygen concentrations can suppress the respiratory drive in COPD
patients who rely on low oxygen levels to stimulate breathing.
Q7: A practical nurse is preparing to administer digoxin to a patient. Which assessment finding
requires the nurse to withhold the medication and notify the healthcare provider?
A. Blood pressure 140/90 mmHg
B. Heart rate 52 beats per minute [CORRECT]
C. Respiratory rate 18 breaths per minute
D. Temperature 99.2°F
Correct Answer: B
Rationale: Digoxin should be withheld if the apical pulse is less than 60 beats per minute in
adults because bradycardia indicates potential digoxin toxicity. The healthcare provider must be
notified before administration.
Q8: A patient with a urinary tract infection is prescribed ciprofloxacin 500 mg PO twice daily.
Which instruction should the practical nurse provide?
A. Take the medication with dairy products
B. Take the medication with antacids
C. Drink plenty of fluids and avoid dairy products within 2 hours [CORRECT]
D. Take the medication on an empty stomach only
Correct Answer: C
Rationale: Ciprofloxacin is a fluoroquinolone antibiotic that requires adequate hydration to
prevent crystalluria. Calcium in dairy products and antacids binds to the drug, reducing
absorption, so they should be separated by at least 2 hours.
Q9: A practical nurse is caring for a patient with a stage 2 pressure injury on the coccyx. Which
dressing is most appropriate?
A. Transparent film dressing
, 4
B. Hydrocolloid dressing [CORRECT]
C. Alginate dressing
D. Dry gauze dressing
Correct Answer: B
Rationale: Stage 2 pressure injuries involve partial-thickness skin loss with exposed dermis.
Hydrocolloid dressings maintain a moist wound environment, promote autolytic debridement,
and protect the wound from contamination.
Q10: A patient is scheduled for a colonoscopy. Which instruction should the practical nurse
provide regarding bowel preparation?
A. Eat a high-fiber diet the day before the procedure
B. Take the prescribed laxative the morning of the procedure
C. Consume only clear liquids 24 hours before and complete the prescribed bowel prep
[CORRECT]
D. Drink red or purple colored liquids for better visualization
Correct Answer: C
Rationale: Complete bowel preparation requires clear liquids for 24 hours before the procedure
to ensure the colon is empty for visualization. Red or purple liquids are avoided as they may be
mistaken for blood during the examination.
CASE STUDY 1: Medical-Surgical Nursing
Patient Profile: Mrs. Johnson, 68 years old, is admitted to the medical-surgical unit with
exacerbation of congestive heart failure. She reports shortness of breath, fatigue, and 3+ pitting
edema in bilateral lower extremities. Vital signs: BP 168/94, HR 112, RR 28, O2 sat 88% on
room air, temperature 98.6°F. She has a history of hypertension, type 2 diabetes, and myocardial
infarction 2 years ago. Current medications include metformin, lisinopril, metoprolol, and
furosemide at home.
Q11: Based on the case study, which nursing intervention should the practical nurse implement
first?
A. Administer furosemide as ordered
B. Apply oxygen via nasal cannula [CORRECT]
C. Insert a Foley catheter
D. Obtain a 12-lead ECG
PN HESI EXIT EXAM WITH NGN Actual Exam
2026/2027 Complete Questions and Verified
Answers with Detailed Rationales Already
Graded A+ Pass Guaranteed - A+ Graded
Section 1: PN HESI Exit Exam with NGN
Q1: A patient with heart failure is prescribed furosemide 40 mg PO daily. Which laboratory value
should the practical nurse monitor most closely?
A. White blood cell count
B. Serum potassium [CORRECT]
C. Hemoglobin
D. Platelet count
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium excretion in the urine, potentially
leading to hypokalemia. The PN must monitor serum potassium levels to prevent cardiac
dysrhythmias associated with electrolyte imbalances.
Q2: A postoperative patient reports pain rated 8/10. The physician orders morphine 4 mg IV
every 4 hours PRN. Which action should the practical nurse take first?
A. Administer the medication immediately
B. Assess respiratory rate and depth [CORRECT]
C. Check the patient's allergy history
D. Document the pain assessment
Correct Answer: B
Rationale: Before administering opioid analgesics, the PN must assess baseline respiratory status
because morphine can cause respiratory depression. This follows the nursing process and ensures
patient safety.
Q3: A patient with type 2 diabetes has a blood glucose reading of 45 mg/dL before lunch. Which
intervention should the practical nurse implement first?
A. Notify the healthcare provider
,2
B. Administer 15 grams of fast-acting carbohydrate [CORRECT]
C. Recheck the blood glucose in 30 minutes
D. Document the findings
Correct Answer: B
Rationale: A blood glucose of 45 mg/dL indicates severe hypoglycemia requiring immediate
treatment per the 15-15 rule. The PN should administer 15 grams of fast-acting carbohydrate
(glucose tablets, juice, or regular soda) to raise blood glucose quickly.
Q4: A patient is receiving heparin therapy. Which laboratory test should the practical nurse
monitor to evaluate therapeutic effectiveness?
A. Prothrombin time (PT)
B. International normalized ratio (INR)
C. Activated partial thromboplastin time (aPTT) [CORRECT]
D. Bleeding time
Correct Answer: C
Rationale: Heparin therapy is monitored using the activated partial thromboplastin time (aPTT),
which measures the intrinsic pathway of coagulation. Therapeutic range is typically 1.5-2.5 times
the control value.
Q5: A practical nurse is caring for a patient with a nasogastric tube connected to low intermittent
suction. Which assessment finding indicates a possible complication?
A. Decreased bowel sounds
B. Nausea and abdominal distension [CORRECT]
C. Dry oral mucous membranes
D. Decreased urine output
Correct Answer: B
Rationale: Nausea and abdominal distension indicate possible tube displacement or obstruction,
preventing proper gastric decompression. The PN should check tube placement and patency
immediately.
Q6: A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy.
Which oxygen flow rate is most appropriate for this patient?
A. 2-4 L/min via nasal cannula [CORRECT]
,3
B. 6-8 L/min via simple mask
C. 10-15 L/min via non-rebreather mask
D. 4-6 L/min via Venturi mask
Correct Answer: A
Rationale: Patients with COPD require low-flow oxygen (1-3 L/min, max 4 L/min) to maintain
hypoxic drive. Higher oxygen concentrations can suppress the respiratory drive in COPD
patients who rely on low oxygen levels to stimulate breathing.
Q7: A practical nurse is preparing to administer digoxin to a patient. Which assessment finding
requires the nurse to withhold the medication and notify the healthcare provider?
A. Blood pressure 140/90 mmHg
B. Heart rate 52 beats per minute [CORRECT]
C. Respiratory rate 18 breaths per minute
D. Temperature 99.2°F
Correct Answer: B
Rationale: Digoxin should be withheld if the apical pulse is less than 60 beats per minute in
adults because bradycardia indicates potential digoxin toxicity. The healthcare provider must be
notified before administration.
Q8: A patient with a urinary tract infection is prescribed ciprofloxacin 500 mg PO twice daily.
Which instruction should the practical nurse provide?
A. Take the medication with dairy products
B. Take the medication with antacids
C. Drink plenty of fluids and avoid dairy products within 2 hours [CORRECT]
D. Take the medication on an empty stomach only
Correct Answer: C
Rationale: Ciprofloxacin is a fluoroquinolone antibiotic that requires adequate hydration to
prevent crystalluria. Calcium in dairy products and antacids binds to the drug, reducing
absorption, so they should be separated by at least 2 hours.
Q9: A practical nurse is caring for a patient with a stage 2 pressure injury on the coccyx. Which
dressing is most appropriate?
A. Transparent film dressing
, 4
B. Hydrocolloid dressing [CORRECT]
C. Alginate dressing
D. Dry gauze dressing
Correct Answer: B
Rationale: Stage 2 pressure injuries involve partial-thickness skin loss with exposed dermis.
Hydrocolloid dressings maintain a moist wound environment, promote autolytic debridement,
and protect the wound from contamination.
Q10: A patient is scheduled for a colonoscopy. Which instruction should the practical nurse
provide regarding bowel preparation?
A. Eat a high-fiber diet the day before the procedure
B. Take the prescribed laxative the morning of the procedure
C. Consume only clear liquids 24 hours before and complete the prescribed bowel prep
[CORRECT]
D. Drink red or purple colored liquids for better visualization
Correct Answer: C
Rationale: Complete bowel preparation requires clear liquids for 24 hours before the procedure
to ensure the colon is empty for visualization. Red or purple liquids are avoided as they may be
mistaken for blood during the examination.
CASE STUDY 1: Medical-Surgical Nursing
Patient Profile: Mrs. Johnson, 68 years old, is admitted to the medical-surgical unit with
exacerbation of congestive heart failure. She reports shortness of breath, fatigue, and 3+ pitting
edema in bilateral lower extremities. Vital signs: BP 168/94, HR 112, RR 28, O2 sat 88% on
room air, temperature 98.6°F. She has a history of hypertension, type 2 diabetes, and myocardial
infarction 2 years ago. Current medications include metformin, lisinopril, metoprolol, and
furosemide at home.
Q11: Based on the case study, which nursing intervention should the practical nurse implement
first?
A. Administer furosemide as ordered
B. Apply oxygen via nasal cannula [CORRECT]
C. Insert a Foley catheter
D. Obtain a 12-lead ECG
