HESI PN LPN FUNDAMENTALS EXIT EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Fundamentals of Nursing Practice
Medical-Surgical Nursing
Maternal-Newborn Nursing
Pediatric Nursing
Psychiatric-Mental Health Nursing
Pharmacology and Medication Administration
Leadership, Delegation, and Management
Legal, Ethical, and Professional Standards
Nutrition and Diet Therapy
Emergency and Disaster Preparedness
Introduction
This comprehensive examination is designed to assess the candidate's readiness for the HESI PN LPN
Fundamentals Exit Exam. It evaluates the practical nurse's ability to synthesize foundational nursing theory with
clinical application, ensuring safe, competent, and patient-centered care. The examination covers a wide range of
critical content areas, including medical-surgical, maternal-newborn, pediatric, and psychiatric-mental health
nursing, alongside pharmacology, legal and ethical considerations, and leadership principles. The questions are
structured in a multiple-choice format with scenario-based items that challenge the candidate to apply critical
,thinking, clinical judgment, and evidence-based decision-making in real-world practice settings. Successful
completion of this exam indicates a mastery of essential nursing competencies required for entry-level practice.
SECTION ONE: QUESTIONS 1-100
1. A nurse is preparing to administer a subcutaneous injection of heparin to a client. Which of the following
actions is most appropriate to minimize tissue trauma?
A. Administer the injection in the same site to promote absorption.
B. Massage the injection site gently after administration.
C. Use the Z-track method for administration.
D. Insert the needle at a 45- to 90-degree angle using a pinched skin fold.
🟢D
🔴 RATIONALE: The correct answer is D. Subcutaneous injections are administered at a 45- to 90-degree angle
using a pinched skin fold to ensure medication is deposited into the subcutaneous tissue. Rotating injection
sites is crucial to prevent lipodystrophy and tissue damage. Massaging the site can cause hematoma formation,
especially with anticoagulants like heparin. The Z-track method is used for intramuscular injections, not
subcutaneous.
2. A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed 2 L/min of oxygen
via nasal cannula. The nurse understands that this low flow rate is essential because:
A. High oxygen concentrations can cause bradycardia.
B. It is the only way to deliver oxygen effectively.
,C. The client's respiratory drive is stimulated by hypoxemia.
D. It prevents the development of oxygen toxicity.
🟢C
🔴 RATIONALE: The correct answer is C. For clients with COPD, the respiratory drive is often stimulated by
hypoxia (low oxygen levels), not hypercapnia. Administering high-flow oxygen can eliminate this hypoxic drive,
leading to respiratory depression and apnea. A low flow rate (e.g., 2 L/min) maintains the hypoxic stimulus
necessary for breathing. Options A, B, and D are incorrect or not the primary reason for this clinical decision.
3. A nurse is providing discharge instructions to a client who had a total hip arthroplasty. Which of the
following statements by the client indicates a need for further teaching?
A. "I should avoid crossing my legs."
B. "I will use a raised toilet seat."
C. "I can sleep on my operated side with a pillow between my knees."
D. "I need to notify my surgeon if I have increased pain or redness in my calf."
🟢C
🔴 RATIONALE: The correct answer is C. After a total hip arthroplasty, the client should avoid sleeping on the
operative side to prevent dislocation. The client should sleep on the non-operative side or supine with an
abduction pillow between the legs to maintain proper alignment. Crossing legs, using a raised toilet seat, and
reporting signs of a deep vein thrombosis (calf pain, redness, swelling) are all correct actions and indicate
understanding.
4. A nurse is caring for a client who is NPO (nothing by mouth) and has a nasogastric (NG) tube set to
intermittent suction. The nurse should assess the client for which of the following acid-base imbalances?
A. Respiratory acidosis
B. Respiratory alkalosis
, C. Metabolic acidosis
D. Metabolic alkalosis
🟢D
🔴 RATIONALE: The correct answer is D. Nasogastric suctioning removes gastric acid (hydrochloric acid) from
the stomach. The loss of this acid leads to a relative increase in bicarbonate in the bloodstream, resulting in
metabolic alkalosis. Respiratory acidosis and alkalosis are related to carbon dioxide levels and respiratory
function, while metabolic acidosis is associated with conditions like diabetic ketoacidosis or renal failure.
5. A client diagnosed with major depressive disorder is started on a monoamine oxidase inhibitor (MAOI).
The nurse should instruct the client to avoid which of the following foods?
A. Broccoli and spinach
B. Apples and bananas
C. Aged cheeses and cured meats
D. White rice and pasta
🟢C
🔴 RATIONALE: The correct answer is C. MAOIs block the breakdown of tyramine. Consuming foods high in
tyramine, such as aged cheeses, cured meats, and fermented products, can precipitate a hypertensive crisis. The
client should also avoid red wine, fava beans, and yeast extracts. Options A, B, and D are generally considered
low in tyramine and safe to consume.
6. The nurse is preparing to administer a blood transfusion to a client. The client begins to experience chills,
low back pain, and nausea shortly after the infusion starts. What is the nurse's priority action?
A. Slow the infusion rate and monitor the client.
B. Stop the transfusion and maintain the IV line with normal saline.
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Fundamentals of Nursing Practice
Medical-Surgical Nursing
Maternal-Newborn Nursing
Pediatric Nursing
Psychiatric-Mental Health Nursing
Pharmacology and Medication Administration
Leadership, Delegation, and Management
Legal, Ethical, and Professional Standards
Nutrition and Diet Therapy
Emergency and Disaster Preparedness
Introduction
This comprehensive examination is designed to assess the candidate's readiness for the HESI PN LPN
Fundamentals Exit Exam. It evaluates the practical nurse's ability to synthesize foundational nursing theory with
clinical application, ensuring safe, competent, and patient-centered care. The examination covers a wide range of
critical content areas, including medical-surgical, maternal-newborn, pediatric, and psychiatric-mental health
nursing, alongside pharmacology, legal and ethical considerations, and leadership principles. The questions are
structured in a multiple-choice format with scenario-based items that challenge the candidate to apply critical
,thinking, clinical judgment, and evidence-based decision-making in real-world practice settings. Successful
completion of this exam indicates a mastery of essential nursing competencies required for entry-level practice.
SECTION ONE: QUESTIONS 1-100
1. A nurse is preparing to administer a subcutaneous injection of heparin to a client. Which of the following
actions is most appropriate to minimize tissue trauma?
A. Administer the injection in the same site to promote absorption.
B. Massage the injection site gently after administration.
C. Use the Z-track method for administration.
D. Insert the needle at a 45- to 90-degree angle using a pinched skin fold.
🟢D
🔴 RATIONALE: The correct answer is D. Subcutaneous injections are administered at a 45- to 90-degree angle
using a pinched skin fold to ensure medication is deposited into the subcutaneous tissue. Rotating injection
sites is crucial to prevent lipodystrophy and tissue damage. Massaging the site can cause hematoma formation,
especially with anticoagulants like heparin. The Z-track method is used for intramuscular injections, not
subcutaneous.
2. A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed 2 L/min of oxygen
via nasal cannula. The nurse understands that this low flow rate is essential because:
A. High oxygen concentrations can cause bradycardia.
B. It is the only way to deliver oxygen effectively.
,C. The client's respiratory drive is stimulated by hypoxemia.
D. It prevents the development of oxygen toxicity.
🟢C
🔴 RATIONALE: The correct answer is C. For clients with COPD, the respiratory drive is often stimulated by
hypoxia (low oxygen levels), not hypercapnia. Administering high-flow oxygen can eliminate this hypoxic drive,
leading to respiratory depression and apnea. A low flow rate (e.g., 2 L/min) maintains the hypoxic stimulus
necessary for breathing. Options A, B, and D are incorrect or not the primary reason for this clinical decision.
3. A nurse is providing discharge instructions to a client who had a total hip arthroplasty. Which of the
following statements by the client indicates a need for further teaching?
A. "I should avoid crossing my legs."
B. "I will use a raised toilet seat."
C. "I can sleep on my operated side with a pillow between my knees."
D. "I need to notify my surgeon if I have increased pain or redness in my calf."
🟢C
🔴 RATIONALE: The correct answer is C. After a total hip arthroplasty, the client should avoid sleeping on the
operative side to prevent dislocation. The client should sleep on the non-operative side or supine with an
abduction pillow between the legs to maintain proper alignment. Crossing legs, using a raised toilet seat, and
reporting signs of a deep vein thrombosis (calf pain, redness, swelling) are all correct actions and indicate
understanding.
4. A nurse is caring for a client who is NPO (nothing by mouth) and has a nasogastric (NG) tube set to
intermittent suction. The nurse should assess the client for which of the following acid-base imbalances?
A. Respiratory acidosis
B. Respiratory alkalosis
, C. Metabolic acidosis
D. Metabolic alkalosis
🟢D
🔴 RATIONALE: The correct answer is D. Nasogastric suctioning removes gastric acid (hydrochloric acid) from
the stomach. The loss of this acid leads to a relative increase in bicarbonate in the bloodstream, resulting in
metabolic alkalosis. Respiratory acidosis and alkalosis are related to carbon dioxide levels and respiratory
function, while metabolic acidosis is associated with conditions like diabetic ketoacidosis or renal failure.
5. A client diagnosed with major depressive disorder is started on a monoamine oxidase inhibitor (MAOI).
The nurse should instruct the client to avoid which of the following foods?
A. Broccoli and spinach
B. Apples and bananas
C. Aged cheeses and cured meats
D. White rice and pasta
🟢C
🔴 RATIONALE: The correct answer is C. MAOIs block the breakdown of tyramine. Consuming foods high in
tyramine, such as aged cheeses, cured meats, and fermented products, can precipitate a hypertensive crisis. The
client should also avoid red wine, fava beans, and yeast extracts. Options A, B, and D are generally considered
low in tyramine and safe to consume.
6. The nurse is preparing to administer a blood transfusion to a client. The client begins to experience chills,
low back pain, and nausea shortly after the infusion starts. What is the nurse's priority action?
A. Slow the infusion rate and monitor the client.
B. Stop the transfusion and maintain the IV line with normal saline.
