D'TNOC TIXE • NP
HESI
HESI Health Education Systems Incorporated
EXCELLENCE IN NURSING ASSESSMENT
EST. 1983
Practical Nurse Exit Examination
H E S I P N E X I T — CO N T I N U E D A SS E SS M E N T
INSTITUTION HESI / Elsevier Health Sciences COURSE CODE HESI-PN-EXIT
PROGRAM Practical Nursing — NCLEX-PN ACADEMIC YEAR
Preparation
EXAM TITLE HESI PN EXIT Examination — Continued TOTAL QUESTIONS 100+ Questions
COURSE TITLE Practical Nursing — Exit Exam FORMAT Multiple Choice / Select All That Apply /
Prioritization
EXAMINATION INSTRUCTIONS
▸ Select the single best answer unless "Select all that apply" or prioritization is indicated.
▸ Questions cover medical-surgical, maternal-child, pediatric, mental health, and professional practice.
▸ Verified answers with rationales are provided for comprehensive NCLEX-PN preparation.
▸ Pay close attention to scope of practice, delegation, and safety interventions.
HESI PN EXIT — CONTINUED EXAMINATION Questions 1 – 100+
1. A 4-year-old client returned to the day surgery unit after an inguinal herniorrhaphy and has remained stable for the
last four hours. The child is taking PO liquids without any nausea, and the parent wants to take the client home.
Which finding is most important for the practical nurse (PN) to obtain before discharging the client?
A. Presence of bowel sounds.
B. Testes in the scrotal sac.
C. Ambulation tolerance.
D. Ability to void.
CORRECT ANSWER A — Presence of bowel sounds
RATIONALE Return of bowel sounds is essential before discharge after abdominal surgery, including inguinal
herniorrhaphy. It indicates return of peristalsis and reduces the risk of postoperative ileus. The client must
demonstrate bowel function before oral intake can be considered fully tolerated.
,2. The practical nurse (PN) is assisting with the admission of a client with complications of left-sided heart failure.
Which focused assessment should the PN implement first?
A. Mood and affect.
B. Chest pain.
C. Heart sounds.
D. Bilateral lung sounds.
CORRECT ANSWER D — Bilateral lung sounds
RATIONALE Left-sided heart failure causes pulmonary congestion. Assessing bilateral lung sounds is the priority to
evaluate for crackles, wheezes, or diminished breath sounds indicating pulmonary edema, which is the most
immediate life-threatening complication.
3. A client is diagnosed with a seizure disorder and is completing testing before discharge from the healthcare facility.
What information should the practical nurse (PN) reinforce to avoid the incidence of seizure episodes? (Select all
that apply.)
A. Seek a safe place if sensing dizziness or sensory disturbances.
B. Generic medications are safe to substitute for trade name brands.
C. Avoid flashing lights and excessive visual stimuli.
D. Stay well rested and avoid a large caffeine intake.
CORRECT ANSWER A, C, D
RATIONALE Seizure prevention includes avoiding known triggers: sensory disturbances/auras should prompt seeking
safety, flashing lights are a common trigger, and fatigue/caffeine lower the seizure threshold. Generic
substitution of anticonvulsants is not recommended without provider approval.
4. A practical nurse (PN) applies a preparation with keratolytic properties to both legs of a client with psoriasis. Which
finding indicates the desired effect has been achieved?
A. Full range of motion without pain of lower extremity joints.
B. No purulent drainage present from lesions on the legs.
C. Affected areas are free of localized redness and swelling.
D. Scaly areas of the skin appear softer with less peeling.
CORRECT ANSWER D — Scaly areas of the skin appear softer with less peeling
RATIONALE Keratolytic preparations (e.g., salicylic acid) work by softening and loosening the thick, scaly plaques of
psoriasis. The desired effect is softer skin with decreased scaling and peeling as the hyperkeratotic layer is
removed.
5. The practical nurse (PN) is reinforcing discharge information provided to a client who received an intraocular lens
implant. Which comment indicates that additional teaching is necessary?
A. "Light activity, such as walking and reading, are permitted."
B. "A metal eye shield should be worn at night while sleeping."
C. "Driving a motor vehicle can resume a week after discharge."
D. "Prescription glasses may still be required following surgery."
CORRECT ANSWER C — "Driving a motor vehicle can resume a week after discharge."
RATIONALE After intraocular lens implant, driving is typically restricted for a longer period (often 2-4 weeks) until vision
stabilizes and the client is cleared by the surgeon. Resuming driving after only one week indicates a need for
additional teaching about safety.
,6. The practical nurse (PN) should recognize that immunosuppressed clients are likely to exhibit which symptom
during the early stage of the disease?
A. Decreased blood pressure.
B. Enlarged spleen.
C. A persistent common cold.
D. Weight loss.
CORRECT ANSWER C — A persistent common cold
RATIONALE Immunosuppressed clients have a decreased ability to fight even minor infections. A common cold that
persists or does not resolve normally is often an early indicator of compromised immune function before
more serious opportunistic infections develop.
7. A client is admitted with a hemothorax following a motor vehicle collision, and the surgeon inserts a chest tube
that is attached to a chest drainage system with suction at 20 cm water pressure. The practical nurse (PN) observes
that the suction chamber fluid level is at 15 cm. Which action should the PN implement to ensure effective
functioning of the chest drainage system?
A. The tubing should be manipulated until the chest drainage collects in the chamber.
B. The chest tube should be irrigated with 20 mL normal saline to ensure patency.
C. Suction at the wall unit should be increased to enhance the velocity of bubbling.
D. Additional sterile water should be added to the suction chamber to the 20 cm level.
CORRECT ANSWER D — Additional sterile water should be added to the suction chamber to the 20 cm level
RATIONALE The suction control chamber fluid level determines the amount of suction applied. If the fluid level has
dropped to 15 cm but the prescription is for 20 cm suction, sterile water must be added to restore the correct
level for effective chest drainage.
8. The practical nurse (PN) should perform oral suctioning for a client with which problem?
A. Gastric reflux.
B. Atelectasis.
C. Dysphasia.
D. Dysphagia.
CORRECT ANSWER D — Dysphagia
RATIONALE Dysphagia (difficulty swallowing) causes pooling of oral secretions and increases the risk for aspiration. Oral
suctioning is needed to remove these secretions and maintain a clear airway. Dysphasia is a speech disorder,
not a swallowing disorder.
, 9. A client at 39 weeks gestation is admitted in early labor. During the focused assessment, the practical nurse (PN)
reviews the obstetrical history with the client who reports that she has been pregnant five times but has only two
living children, both of whom were full term. The other three pregnancies were miscarriages during the first
trimester. Which parity should the PN document for term, premature, abortion, and living children (TPAL) for this
client?
A. Term 2, Premature 1, Abortion 0, Living 3.
B. Term 3, Premature 0, Abortion 3, Living 2.
C. Term 2, Premature 3, Abortion 3, Living 2.
D. Term 6, Premature 3, Abortion 3, Living 2.
CORRECT ANSWER B — Term 3, Premature 0, Abortion 3, Living 2
RATIONALE Gravida 5 (five pregnancies). TPAL: Term = 2 full-term children (living) + current pregnancy at 39 weeks counts
as term = 3 total term deliveries. Premature = 0. Abortion = 3 (first trimester miscarriages). Living = 2 children.
10. The practical nurse (PN) is monitoring a client's neurologic status following a closed head injury. What
assessment(s) should be included? (Select all that apply.)
A. Bowel sounds.
B. Consciousness level.
C. Vital sign measurement.
D. Pupillary reactions.
CORRECT ANSWER B, C, D
RATIONALE Neurologic assessment after closed head injury includes level of consciousness (using Glasgow Coma Scale),
vital signs (Cushing's triad indicates increased ICP), and pupillary reactions (changes indicate brainstem
involvement or herniation).
11. A client tells the practical nurse (PN) of being afraid of getting cancer so the client plans to quit smoking cigarettes
by switching to a smokeless tobacco product. How should the PN respond?
A. Explain to the client that obesity is a more significant health risk than smoking.
B. Encourage the client to continue with this plan to reduce the risk for cancer.
C. Provide information to the client about risks associated with smokeless tobacco.
D. Remind the client that it is likely the client will gain weight when attempting to stop smoking.
CORRECT ANSWER C — Provide information to the client about risks associated with smokeless tobacco
RATIONALE Smokeless tobacco products carry significant health risks including oral, esophageal, and pancreatic cancers.
The PN should educate the client that switching to smokeless tobacco does not eliminate cancer risk and
provide evidence-based information.
HESI
HESI Health Education Systems Incorporated
EXCELLENCE IN NURSING ASSESSMENT
EST. 1983
Practical Nurse Exit Examination
H E S I P N E X I T — CO N T I N U E D A SS E SS M E N T
INSTITUTION HESI / Elsevier Health Sciences COURSE CODE HESI-PN-EXIT
PROGRAM Practical Nursing — NCLEX-PN ACADEMIC YEAR
Preparation
EXAM TITLE HESI PN EXIT Examination — Continued TOTAL QUESTIONS 100+ Questions
COURSE TITLE Practical Nursing — Exit Exam FORMAT Multiple Choice / Select All That Apply /
Prioritization
EXAMINATION INSTRUCTIONS
▸ Select the single best answer unless "Select all that apply" or prioritization is indicated.
▸ Questions cover medical-surgical, maternal-child, pediatric, mental health, and professional practice.
▸ Verified answers with rationales are provided for comprehensive NCLEX-PN preparation.
▸ Pay close attention to scope of practice, delegation, and safety interventions.
HESI PN EXIT — CONTINUED EXAMINATION Questions 1 – 100+
1. A 4-year-old client returned to the day surgery unit after an inguinal herniorrhaphy and has remained stable for the
last four hours. The child is taking PO liquids without any nausea, and the parent wants to take the client home.
Which finding is most important for the practical nurse (PN) to obtain before discharging the client?
A. Presence of bowel sounds.
B. Testes in the scrotal sac.
C. Ambulation tolerance.
D. Ability to void.
CORRECT ANSWER A — Presence of bowel sounds
RATIONALE Return of bowel sounds is essential before discharge after abdominal surgery, including inguinal
herniorrhaphy. It indicates return of peristalsis and reduces the risk of postoperative ileus. The client must
demonstrate bowel function before oral intake can be considered fully tolerated.
,2. The practical nurse (PN) is assisting with the admission of a client with complications of left-sided heart failure.
Which focused assessment should the PN implement first?
A. Mood and affect.
B. Chest pain.
C. Heart sounds.
D. Bilateral lung sounds.
CORRECT ANSWER D — Bilateral lung sounds
RATIONALE Left-sided heart failure causes pulmonary congestion. Assessing bilateral lung sounds is the priority to
evaluate for crackles, wheezes, or diminished breath sounds indicating pulmonary edema, which is the most
immediate life-threatening complication.
3. A client is diagnosed with a seizure disorder and is completing testing before discharge from the healthcare facility.
What information should the practical nurse (PN) reinforce to avoid the incidence of seizure episodes? (Select all
that apply.)
A. Seek a safe place if sensing dizziness or sensory disturbances.
B. Generic medications are safe to substitute for trade name brands.
C. Avoid flashing lights and excessive visual stimuli.
D. Stay well rested and avoid a large caffeine intake.
CORRECT ANSWER A, C, D
RATIONALE Seizure prevention includes avoiding known triggers: sensory disturbances/auras should prompt seeking
safety, flashing lights are a common trigger, and fatigue/caffeine lower the seizure threshold. Generic
substitution of anticonvulsants is not recommended without provider approval.
4. A practical nurse (PN) applies a preparation with keratolytic properties to both legs of a client with psoriasis. Which
finding indicates the desired effect has been achieved?
A. Full range of motion without pain of lower extremity joints.
B. No purulent drainage present from lesions on the legs.
C. Affected areas are free of localized redness and swelling.
D. Scaly areas of the skin appear softer with less peeling.
CORRECT ANSWER D — Scaly areas of the skin appear softer with less peeling
RATIONALE Keratolytic preparations (e.g., salicylic acid) work by softening and loosening the thick, scaly plaques of
psoriasis. The desired effect is softer skin with decreased scaling and peeling as the hyperkeratotic layer is
removed.
5. The practical nurse (PN) is reinforcing discharge information provided to a client who received an intraocular lens
implant. Which comment indicates that additional teaching is necessary?
A. "Light activity, such as walking and reading, are permitted."
B. "A metal eye shield should be worn at night while sleeping."
C. "Driving a motor vehicle can resume a week after discharge."
D. "Prescription glasses may still be required following surgery."
CORRECT ANSWER C — "Driving a motor vehicle can resume a week after discharge."
RATIONALE After intraocular lens implant, driving is typically restricted for a longer period (often 2-4 weeks) until vision
stabilizes and the client is cleared by the surgeon. Resuming driving after only one week indicates a need for
additional teaching about safety.
,6. The practical nurse (PN) should recognize that immunosuppressed clients are likely to exhibit which symptom
during the early stage of the disease?
A. Decreased blood pressure.
B. Enlarged spleen.
C. A persistent common cold.
D. Weight loss.
CORRECT ANSWER C — A persistent common cold
RATIONALE Immunosuppressed clients have a decreased ability to fight even minor infections. A common cold that
persists or does not resolve normally is often an early indicator of compromised immune function before
more serious opportunistic infections develop.
7. A client is admitted with a hemothorax following a motor vehicle collision, and the surgeon inserts a chest tube
that is attached to a chest drainage system with suction at 20 cm water pressure. The practical nurse (PN) observes
that the suction chamber fluid level is at 15 cm. Which action should the PN implement to ensure effective
functioning of the chest drainage system?
A. The tubing should be manipulated until the chest drainage collects in the chamber.
B. The chest tube should be irrigated with 20 mL normal saline to ensure patency.
C. Suction at the wall unit should be increased to enhance the velocity of bubbling.
D. Additional sterile water should be added to the suction chamber to the 20 cm level.
CORRECT ANSWER D — Additional sterile water should be added to the suction chamber to the 20 cm level
RATIONALE The suction control chamber fluid level determines the amount of suction applied. If the fluid level has
dropped to 15 cm but the prescription is for 20 cm suction, sterile water must be added to restore the correct
level for effective chest drainage.
8. The practical nurse (PN) should perform oral suctioning for a client with which problem?
A. Gastric reflux.
B. Atelectasis.
C. Dysphasia.
D. Dysphagia.
CORRECT ANSWER D — Dysphagia
RATIONALE Dysphagia (difficulty swallowing) causes pooling of oral secretions and increases the risk for aspiration. Oral
suctioning is needed to remove these secretions and maintain a clear airway. Dysphasia is a speech disorder,
not a swallowing disorder.
, 9. A client at 39 weeks gestation is admitted in early labor. During the focused assessment, the practical nurse (PN)
reviews the obstetrical history with the client who reports that she has been pregnant five times but has only two
living children, both of whom were full term. The other three pregnancies were miscarriages during the first
trimester. Which parity should the PN document for term, premature, abortion, and living children (TPAL) for this
client?
A. Term 2, Premature 1, Abortion 0, Living 3.
B. Term 3, Premature 0, Abortion 3, Living 2.
C. Term 2, Premature 3, Abortion 3, Living 2.
D. Term 6, Premature 3, Abortion 3, Living 2.
CORRECT ANSWER B — Term 3, Premature 0, Abortion 3, Living 2
RATIONALE Gravida 5 (five pregnancies). TPAL: Term = 2 full-term children (living) + current pregnancy at 39 weeks counts
as term = 3 total term deliveries. Premature = 0. Abortion = 3 (first trimester miscarriages). Living = 2 children.
10. The practical nurse (PN) is monitoring a client's neurologic status following a closed head injury. What
assessment(s) should be included? (Select all that apply.)
A. Bowel sounds.
B. Consciousness level.
C. Vital sign measurement.
D. Pupillary reactions.
CORRECT ANSWER B, C, D
RATIONALE Neurologic assessment after closed head injury includes level of consciousness (using Glasgow Coma Scale),
vital signs (Cushing's triad indicates increased ICP), and pupillary reactions (changes indicate brainstem
involvement or herniation).
11. A client tells the practical nurse (PN) of being afraid of getting cancer so the client plans to quit smoking cigarettes
by switching to a smokeless tobacco product. How should the PN respond?
A. Explain to the client that obesity is a more significant health risk than smoking.
B. Encourage the client to continue with this plan to reduce the risk for cancer.
C. Provide information to the client about risks associated with smokeless tobacco.
D. Remind the client that it is likely the client will gain weight when attempting to stop smoking.
CORRECT ANSWER C — Provide information to the client about risks associated with smokeless tobacco
RATIONALE Smokeless tobacco products carry significant health risks including oral, esophageal, and pancreatic cancers.
The PN should educate the client that switching to smokeless tobacco does not eliminate cancer risk and
provide evidence-based information.
