LPN / LVN HESI Exit Exam Review Questions and Answers
60+ Practice Questions with Verified Answers and Detailed
Rationales | 2026/2027 Edition | Graded A+
EXAM OVERVIEW
The HESI PN Exit Exam is a comprehensive assessment used by nursing programs
to evaluate practical nursing students' readiness for the NCLEX-PN licensure
exam. Research demonstrates that students scoring 850 or higher have a 95-99%
probability of passing the NCLEX-PN on their first attempt . The exam consists
of 130 items (100 scored, 2 unscored, 24 NGN unfolding items, 4 NGN stand-
alone items) with a recommended 214-minute testing time .
Content Domains Covered:
• Safe Effective Care Environment (Coordinated Care 12-18%; Safety and
Infection Control 8-14%)
• Health Promotion and Maintenance (7-13%)
• Psychosocial Integrity (7-13%)
• Physiological Integrity (Basic Care and Comfort 11-17%; Pharmacological
Therapies 9-15%; Reduction of Risk Potential 10-16%; Physiological
Adaptation 11-17%)
,KEY CONCEPTS QUICK REFERENCE
Topic Key Points
Blood Pressure Measurement Arm at heart level for accurate reading
Wound Evisceration Cover with sterile saline-moistened dressing; never reinsert organs
COPD Oxygen Therapy Start at 1-2 L/min; maintain SpO2 88-92%
Pacemaker Care Immobilize affected arm; avoid abduction
Pulmonary Embolism Signs Sudden chest pain, dyspnea, tachycardia, anxiety
Pulmonary Edema Signs Frothy pink sputum, crackles, tachycardia
Digoxin Toxicity Risk Hypokalemia increases risk
Warfarin Teaching Keep vitamin K intake consistent
Total Hip Precautions No hip flexion >90°; avoid low chairs
Hypoglycemia Treatment 15 grams fast-acting carbohydrate; recheck in 15 min
SSRI Onset 2-4 weeks for therapeutic effect
Pediatric Respiratory Distress Nasal flaring, grunting, retractions
Neonatal Hypoglycemia Jitteriness, lethargy; treat with feeding
Geriatric UTI Confusion may be the only manifestation
Fall Risk in Elderly Medications, gait problems, environmental hazards
,SECTION 1: FUNDAMENTALS OF NURSING
Questions 1-40
Q1. 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 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 .
Q2. 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 .
Q3. A client with a diagnosis of 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 .
Q4. The nurse is caring for a client who is NPO 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
60+ Practice Questions with Verified Answers and Detailed
Rationales | 2026/2027 Edition | Graded A+
EXAM OVERVIEW
The HESI PN Exit Exam is a comprehensive assessment used by nursing programs
to evaluate practical nursing students' readiness for the NCLEX-PN licensure
exam. Research demonstrates that students scoring 850 or higher have a 95-99%
probability of passing the NCLEX-PN on their first attempt . The exam consists
of 130 items (100 scored, 2 unscored, 24 NGN unfolding items, 4 NGN stand-
alone items) with a recommended 214-minute testing time .
Content Domains Covered:
• Safe Effective Care Environment (Coordinated Care 12-18%; Safety and
Infection Control 8-14%)
• Health Promotion and Maintenance (7-13%)
• Psychosocial Integrity (7-13%)
• Physiological Integrity (Basic Care and Comfort 11-17%; Pharmacological
Therapies 9-15%; Reduction of Risk Potential 10-16%; Physiological
Adaptation 11-17%)
,KEY CONCEPTS QUICK REFERENCE
Topic Key Points
Blood Pressure Measurement Arm at heart level for accurate reading
Wound Evisceration Cover with sterile saline-moistened dressing; never reinsert organs
COPD Oxygen Therapy Start at 1-2 L/min; maintain SpO2 88-92%
Pacemaker Care Immobilize affected arm; avoid abduction
Pulmonary Embolism Signs Sudden chest pain, dyspnea, tachycardia, anxiety
Pulmonary Edema Signs Frothy pink sputum, crackles, tachycardia
Digoxin Toxicity Risk Hypokalemia increases risk
Warfarin Teaching Keep vitamin K intake consistent
Total Hip Precautions No hip flexion >90°; avoid low chairs
Hypoglycemia Treatment 15 grams fast-acting carbohydrate; recheck in 15 min
SSRI Onset 2-4 weeks for therapeutic effect
Pediatric Respiratory Distress Nasal flaring, grunting, retractions
Neonatal Hypoglycemia Jitteriness, lethargy; treat with feeding
Geriatric UTI Confusion may be the only manifestation
Fall Risk in Elderly Medications, gait problems, environmental hazards
,SECTION 1: FUNDAMENTALS OF NURSING
Questions 1-40
Q1. 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 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 .
Q2. 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 .
Q3. A client with a diagnosis of 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 .
Q4. The nurse is caring for a client who is NPO 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
