LPN / LVN HESI Exit Exam Review Questions and 100% Correct
Answers/ PN Hesi Exit Exam Prep Latest / LVN Hesi Exit/ LPN Hesi Exit
LPN / LVN HESI Exit Exam Review Questions and 100% Correct Answers
Section 1: Fundamentals of Nursing (Questions 1-30)
Question 1: A client who is post-operative day 2 after abdominal surgery reports feeling a "pop"
in the incision site followed by increased drainage. The nurse observes bowel loops protruding
from the wound. What is the nurse's priority action?
A. Reinsert the protruding bowel loops and apply a sterile dressing
B. Cover the wound with a sterile saline-moistened dressing and notify the surgeon
C. Apply an abdominal binder to provide support and reduce tension
D. Place the client in a supine position with knees bent and call the charge nurse
Answer: B. Cover the wound with a sterile saline-moistened dressing and notify the surgeon.
Rationale: This presentation indicates wound dehiscence with evisceration, a surgical
emergency. The priority is to protect the exposed organs by covering them with sterile saline-
soaked gauze to prevent drying and infection. The surgeon must be notified immediately. The
nurse should never attempt to reinsert organs. Placing the client in a supine position with knees
bent (not a flat position) helps reduce abdominal tension and should be done AFTER covering
the wound. An abdominal binder would place pressure on the protruding organs and is
contraindicated.
Question 2: A nurse is preparing to administer an oral medication to a client who has difficulty
swallowing. Which action should the nurse take?
A. Crush the enteric-coated tablet and mix with applesauce
B. Open the sustained-release capsule and sprinkle the contents on pudding
C. Request a liquid formulation of the medication from the pharmacy
D. Mix all medications together in one cup to make administration easier
Answer: C. Request a liquid formulation of the medication from the pharmacy.
Rationale: The safest action is to request an appropriate liquid formulation for clients with
dysphagia. Enteric-coated tablets and sustained-release capsules should never be crushed or
opened because this destroys the protective coating or delayed-release mechanism, potentially
causing gastrointestinal irritation or toxicity. Medications should not be mixed together unless
specifically ordered, as this can cause chemical incompatibilities.
Question 3: A client with a diagnosis of chronic obstructive pulmonary disease (COPD) has an
oxygen saturation of 88% on room air. The nurse should anticipate which intervention?
A. Administer oxygen at 4 L/min via nasal cannula
B. Administer oxygen at 2 L/min via nasal cannula
C. Administer oxygen via non-rebreather mask at 15 L/min
D. Instruct the client to take rapid, deep breaths
,Answer: B. Administer oxygen at 2 L/min via nasal cannula.
Rationale: Clients with COPD often have chronic hypercapnia and rely on a hypoxic drive to
stimulate respirations. Administering high-flow oxygen can eliminate this hypoxic drive and lead
to respiratory depression and apnea. The initial oxygen delivery should be low-flow at 1-2 L/min
via nasal cannula, with careful monitoring of oxygen saturation and respiratory status. Oxygen
should be titrated to maintain saturation between 88-92% for most COPD patients. Rapid, deep
breathing could lead to ineffective gas exchange and fatigue.
Question 4: The nurse is caring for a client who is NPO (nothing by mouth) and has a nasogastric
tube attached to low intermittent suction. Which assessment finding indicates the client is at
risk for fluid volume deficit?
A. Blood pressure of 110/72 mmHg
B. Urine output of 40 mL per hour
C. Dry mucous membranes and poor skin turgor
D. Heart rate of 80 beats per minute
Answer: C. Dry mucous membranes and poor skin turgor.
Rationale: Dry mucous membranes and poor skin turgor are early clinical signs of fluid volume
deficit. The client with an NG tube on suction is losing gastric secretions and is at risk for
hypovolemia. Normal blood pressure (110/72), normal urine output (40 mL/hour), and normal
heart rate (80 bpm) are generally within acceptable ranges and do not specifically indicate fluid
deficit. Additional signs of fluid volume deficit include increased heart rate, decreased blood
pressure, decreased urine output, and weight loss.
Question 5: A nurse is providing teaching to a client who is prescribed warfarin (Coumadin) for
atrial fibrillation. Which statement by the client indicates a need for further teaching?
A. "I should take this medication at the same time every day"
B. "I need to have regular blood tests to check my levels"
C. "I will increase my intake of green leafy vegetables"
D. "I should use a soft-bristled toothbrush to prevent bleeding"
Answer: C. "I will increase my intake of green leafy vegetables."
Rationale: Green leafy vegetables are high in vitamin K, which is the antagonist to warfarin.
Increasing intake of these foods can reduce the effectiveness of warfarin and increase the risk of
thromboembolic events. Clients should maintain a consistent intake of vitamin K-containing
foods rather than increasing them. The other statements demonstrate correct understanding:
taking medication at the same time daily ensures consistent blood levels; regular INR
monitoring is essential; and using a soft-bristled toothbrush helps prevent gingival bleeding.
Question 6: The nurse is caring for a client who is experiencing acute pain following a total hip
replacement. Which pain management strategy should the nurse implement first?
A. Administer prescribed opioid analgesic
B. Apply ice packs to the surgical site
C. Position the client in a comfortable position with pillows
,D. Teach the client guided imagery techniques
Answer: C. Position the client in a comfortable position with pillows.
Rationale: The nursing process guides care, and the first step is assessment followed by non-
pharmacological interventions. Positioning the client for comfort is a simple, non-invasive
intervention that can significantly reduce pain and should be implemented before administering
medications. While administering prescribed analgesics is appropriate, the nurse should also
use adjunctive measures. Ice packs may be ordered but require a specific order. Guided imagery
is a useful distraction technique but is not the first intervention for acute post-operative pain.
Question 7: A client has an order for a 24-hour urine collection. Which action should the nurse
take to ensure accurate results?
A. Discard the first voiding and start the collection at that time
B. Collect all urine for 24 hours including the final voiding at the end of the time
C. Keep the urine collection container in the client's bathroom at room temperature
D. Instruct the client to void and then add that specimen to the container
Answer: B. Collect all urine for 24 hours including the final voiding at the end of the time.
Rationale: For a 24-hour urine collection, the client should void and discard the first specimen,
note the start time, and then collect all subsequent urine for the next 24 hours, including the
final voiding at the end of the collection period. The container should be refrigerated or kept on
ice to prevent bacterial growth and breakdown of analytes. The client should be instructed to
void directly into the collection container or a clean receptacle for transfer. The final voiding at
the end of the collection period must be included.
Question 8: A nurse is preparing to insert a urinary catheter. Which technique should the nurse
use to maintain sterility?
A. Place the client in a supine position with knees extended
B. Use sterile gloves and maintain the sterile field at all times
C. Clean the perineal area with antiseptic solution from the anal area to the urethra
D. Use the same sterile catheter if it accidentally touches the bed linens
Answer: B. Use sterile gloves and maintain the sterile field at all times.
Rationale: Maintaining asepsis during urinary catheterization is essential to prevent urinary
tract infections. The nurse should use sterile gloves, sterile drapes, and maintain the sterile field
throughout the procedure. The client should be positioned in dorsal recumbent position with
knees flexed. The perineal area should be cleaned from the urethra toward the anus (front to
back) to prevent introducing bacteria from the anal area to the urethra. If the catheter touches
any non-sterile surface, it must be discarded and a new sterile catheter obtained.
Question 9: A client with diabetes mellitus type 2 is experiencing hypoglycemia. The nurse
should provide which intervention first?
A. Administer glucagon intramuscularly
B. Give the client 4 ounces of orange juice
C. Check the client's blood glucose level
, D. Notify the healthcare provider immediately
Answer: C. Check the client's blood glucose level.
Rationale: The first action when hypoglycemia is suspected is to assess the client's blood
glucose level to confirm the diagnosis. Treatment should be based on the actual blood glucose
reading. If the client is conscious and able to swallow, the "rule of 15" should be followed: give
15 grams of fast-acting carbohydrate (such as 4 ounces of orange juice or 3 glucose tablets),
recheck blood glucose in 15 minutes, and repeat if needed. Glucagon is reserved for severe
hypoglycemia in unconscious clients or those unable to swallow. Notifying the provider can wait
until initial assessment and treatment are implemented.
Question 10: A nurse is providing care to a client with a tracheostomy. Which action is essential
for maintaining a patent airway?
A. Deflate the cuff when the client is lying flat
B. Keep the client's head in a hyperextended position
C. Suction the tracheostomy tube PRN and with sterile technique
D. Apply a dry gauze dressing around the tracheostomy site
Answer: C. Suction the tracheostomy tube PRN and with sterile technique.
Rationale: Suctioning the tracheostomy tube as needed is essential to maintain a patent airway
by removing secretions. Sterile technique must be used to prevent infection. The cuff should
remain inflated when the client is lying flat to prevent aspiration. The head should be positioned
in a neutral or slightly extended position, not hyperextended, which can cause airway
obstruction and tracheal damage. A dry gauze dressing around the tracheostomy site is used to
absorb drainage, but it does not maintain airway patency.
Question 11: The nurse is assessing a client's peripheral intravenous (IV) site. Which finding
indicates phlebitis?
A. Coolness and pallor of the extremity
B. Redness, warmth, and tenderness along the vein
C. Edema and hardness around the insertion site
D. Clear, colorless drainage at the insertion site
Answer: B. Redness, warmth, and tenderness along the vein.
Rationale: Phlebitis is inflammation of the vein characterized by redness, warmth, pain, and
tenderness along the course of the vein. This is often caused by mechanical irritation, chemical
irritation from infusates, or infection. Coolness and pallor indicate possible arterial insufficiency
or infiltration. Edema and hardness at the insertion site indicate infiltration (IV fluid leaking into
surrounding tissues). Clear drainage at the insertion site is not typical of phlebitis and may
indicate other issues.
Question 12: A client is receiving a blood transfusion. Fifteen minutes after the transfusion
starts, the client reports chills and back pain. What should the nurse do first?
A. Slow the infusion rate and reassess in 15 minutes
B. Stop the transfusion and maintain the IV line with normal saline
Answers/ PN Hesi Exit Exam Prep Latest / LVN Hesi Exit/ LPN Hesi Exit
LPN / LVN HESI Exit Exam Review Questions and 100% Correct Answers
Section 1: Fundamentals of Nursing (Questions 1-30)
Question 1: A client who is post-operative day 2 after abdominal surgery reports feeling a "pop"
in the incision site followed by increased drainage. The nurse observes bowel loops protruding
from the wound. What is the nurse's priority action?
A. Reinsert the protruding bowel loops and apply a sterile dressing
B. Cover the wound with a sterile saline-moistened dressing and notify the surgeon
C. Apply an abdominal binder to provide support and reduce tension
D. Place the client in a supine position with knees bent and call the charge nurse
Answer: B. Cover the wound with a sterile saline-moistened dressing and notify the surgeon.
Rationale: This presentation indicates wound dehiscence with evisceration, a surgical
emergency. The priority is to protect the exposed organs by covering them with sterile saline-
soaked gauze to prevent drying and infection. The surgeon must be notified immediately. The
nurse should never attempt to reinsert organs. Placing the client in a supine position with knees
bent (not a flat position) helps reduce abdominal tension and should be done AFTER covering
the wound. An abdominal binder would place pressure on the protruding organs and is
contraindicated.
Question 2: A nurse is preparing to administer an oral medication to a client who has difficulty
swallowing. Which action should the nurse take?
A. Crush the enteric-coated tablet and mix with applesauce
B. Open the sustained-release capsule and sprinkle the contents on pudding
C. Request a liquid formulation of the medication from the pharmacy
D. Mix all medications together in one cup to make administration easier
Answer: C. Request a liquid formulation of the medication from the pharmacy.
Rationale: The safest action is to request an appropriate liquid formulation for clients with
dysphagia. Enteric-coated tablets and sustained-release capsules should never be crushed or
opened because this destroys the protective coating or delayed-release mechanism, potentially
causing gastrointestinal irritation or toxicity. Medications should not be mixed together unless
specifically ordered, as this can cause chemical incompatibilities.
Question 3: A client with a diagnosis of chronic obstructive pulmonary disease (COPD) has an
oxygen saturation of 88% on room air. The nurse should anticipate which intervention?
A. Administer oxygen at 4 L/min via nasal cannula
B. Administer oxygen at 2 L/min via nasal cannula
C. Administer oxygen via non-rebreather mask at 15 L/min
D. Instruct the client to take rapid, deep breaths
,Answer: B. Administer oxygen at 2 L/min via nasal cannula.
Rationale: Clients with COPD often have chronic hypercapnia and rely on a hypoxic drive to
stimulate respirations. Administering high-flow oxygen can eliminate this hypoxic drive and lead
to respiratory depression and apnea. The initial oxygen delivery should be low-flow at 1-2 L/min
via nasal cannula, with careful monitoring of oxygen saturation and respiratory status. Oxygen
should be titrated to maintain saturation between 88-92% for most COPD patients. Rapid, deep
breathing could lead to ineffective gas exchange and fatigue.
Question 4: The nurse is caring for a client who is NPO (nothing by mouth) and has a nasogastric
tube attached to low intermittent suction. Which assessment finding indicates the client is at
risk for fluid volume deficit?
A. Blood pressure of 110/72 mmHg
B. Urine output of 40 mL per hour
C. Dry mucous membranes and poor skin turgor
D. Heart rate of 80 beats per minute
Answer: C. Dry mucous membranes and poor skin turgor.
Rationale: Dry mucous membranes and poor skin turgor are early clinical signs of fluid volume
deficit. The client with an NG tube on suction is losing gastric secretions and is at risk for
hypovolemia. Normal blood pressure (110/72), normal urine output (40 mL/hour), and normal
heart rate (80 bpm) are generally within acceptable ranges and do not specifically indicate fluid
deficit. Additional signs of fluid volume deficit include increased heart rate, decreased blood
pressure, decreased urine output, and weight loss.
Question 5: A nurse is providing teaching to a client who is prescribed warfarin (Coumadin) for
atrial fibrillation. Which statement by the client indicates a need for further teaching?
A. "I should take this medication at the same time every day"
B. "I need to have regular blood tests to check my levels"
C. "I will increase my intake of green leafy vegetables"
D. "I should use a soft-bristled toothbrush to prevent bleeding"
Answer: C. "I will increase my intake of green leafy vegetables."
Rationale: Green leafy vegetables are high in vitamin K, which is the antagonist to warfarin.
Increasing intake of these foods can reduce the effectiveness of warfarin and increase the risk of
thromboembolic events. Clients should maintain a consistent intake of vitamin K-containing
foods rather than increasing them. The other statements demonstrate correct understanding:
taking medication at the same time daily ensures consistent blood levels; regular INR
monitoring is essential; and using a soft-bristled toothbrush helps prevent gingival bleeding.
Question 6: The nurse is caring for a client who is experiencing acute pain following a total hip
replacement. Which pain management strategy should the nurse implement first?
A. Administer prescribed opioid analgesic
B. Apply ice packs to the surgical site
C. Position the client in a comfortable position with pillows
,D. Teach the client guided imagery techniques
Answer: C. Position the client in a comfortable position with pillows.
Rationale: The nursing process guides care, and the first step is assessment followed by non-
pharmacological interventions. Positioning the client for comfort is a simple, non-invasive
intervention that can significantly reduce pain and should be implemented before administering
medications. While administering prescribed analgesics is appropriate, the nurse should also
use adjunctive measures. Ice packs may be ordered but require a specific order. Guided imagery
is a useful distraction technique but is not the first intervention for acute post-operative pain.
Question 7: A client has an order for a 24-hour urine collection. Which action should the nurse
take to ensure accurate results?
A. Discard the first voiding and start the collection at that time
B. Collect all urine for 24 hours including the final voiding at the end of the time
C. Keep the urine collection container in the client's bathroom at room temperature
D. Instruct the client to void and then add that specimen to the container
Answer: B. Collect all urine for 24 hours including the final voiding at the end of the time.
Rationale: For a 24-hour urine collection, the client should void and discard the first specimen,
note the start time, and then collect all subsequent urine for the next 24 hours, including the
final voiding at the end of the collection period. The container should be refrigerated or kept on
ice to prevent bacterial growth and breakdown of analytes. The client should be instructed to
void directly into the collection container or a clean receptacle for transfer. The final voiding at
the end of the collection period must be included.
Question 8: A nurse is preparing to insert a urinary catheter. Which technique should the nurse
use to maintain sterility?
A. Place the client in a supine position with knees extended
B. Use sterile gloves and maintain the sterile field at all times
C. Clean the perineal area with antiseptic solution from the anal area to the urethra
D. Use the same sterile catheter if it accidentally touches the bed linens
Answer: B. Use sterile gloves and maintain the sterile field at all times.
Rationale: Maintaining asepsis during urinary catheterization is essential to prevent urinary
tract infections. The nurse should use sterile gloves, sterile drapes, and maintain the sterile field
throughout the procedure. The client should be positioned in dorsal recumbent position with
knees flexed. The perineal area should be cleaned from the urethra toward the anus (front to
back) to prevent introducing bacteria from the anal area to the urethra. If the catheter touches
any non-sterile surface, it must be discarded and a new sterile catheter obtained.
Question 9: A client with diabetes mellitus type 2 is experiencing hypoglycemia. The nurse
should provide which intervention first?
A. Administer glucagon intramuscularly
B. Give the client 4 ounces of orange juice
C. Check the client's blood glucose level
, D. Notify the healthcare provider immediately
Answer: C. Check the client's blood glucose level.
Rationale: The first action when hypoglycemia is suspected is to assess the client's blood
glucose level to confirm the diagnosis. Treatment should be based on the actual blood glucose
reading. If the client is conscious and able to swallow, the "rule of 15" should be followed: give
15 grams of fast-acting carbohydrate (such as 4 ounces of orange juice or 3 glucose tablets),
recheck blood glucose in 15 minutes, and repeat if needed. Glucagon is reserved for severe
hypoglycemia in unconscious clients or those unable to swallow. Notifying the provider can wait
until initial assessment and treatment are implemented.
Question 10: A nurse is providing care to a client with a tracheostomy. Which action is essential
for maintaining a patent airway?
A. Deflate the cuff when the client is lying flat
B. Keep the client's head in a hyperextended position
C. Suction the tracheostomy tube PRN and with sterile technique
D. Apply a dry gauze dressing around the tracheostomy site
Answer: C. Suction the tracheostomy tube PRN and with sterile technique.
Rationale: Suctioning the tracheostomy tube as needed is essential to maintain a patent airway
by removing secretions. Sterile technique must be used to prevent infection. The cuff should
remain inflated when the client is lying flat to prevent aspiration. The head should be positioned
in a neutral or slightly extended position, not hyperextended, which can cause airway
obstruction and tracheal damage. A dry gauze dressing around the tracheostomy site is used to
absorb drainage, but it does not maintain airway patency.
Question 11: The nurse is assessing a client's peripheral intravenous (IV) site. Which finding
indicates phlebitis?
A. Coolness and pallor of the extremity
B. Redness, warmth, and tenderness along the vein
C. Edema and hardness around the insertion site
D. Clear, colorless drainage at the insertion site
Answer: B. Redness, warmth, and tenderness along the vein.
Rationale: Phlebitis is inflammation of the vein characterized by redness, warmth, pain, and
tenderness along the course of the vein. This is often caused by mechanical irritation, chemical
irritation from infusates, or infection. Coolness and pallor indicate possible arterial insufficiency
or infiltration. Edema and hardness at the insertion site indicate infiltration (IV fluid leaking into
surrounding tissues). Clear drainage at the insertion site is not typical of phlebitis and may
indicate other issues.
Question 12: A client is receiving a blood transfusion. Fifteen minutes after the transfusion
starts, the client reports chills and back pain. What should the nurse do first?
A. Slow the infusion rate and reassess in 15 minutes
B. Stop the transfusion and maintain the IV line with normal saline
