Small Exam Coverage Summary
This exam blueprint covers core practical nursing competencies across the lifespan. Key areas
include: Safe and Effective Care Environment (management of care, safety, infection control), Health
Promotion and Maintenance (aging process, developmental stages, disease prevention), Psychosocial
Integrity (coping mechanisms, therapeutic communication, mental health disorders), and Physiological
Integrity (basic care, pharmacology, medical-surgical conditions, fluid/electrolyte balance, and
perioperative care). Questions emphasize prioritization, delegation, clinical judgment, and identification
of normal vs. abnormal findings.
HESI PN Exit Exam V1 Practice Questions
1. A client with heart failure is prescribed furosemide and digoxin. Which assessment finding is most
critical for the LPN to report to the RN immediately?
A) Serum potassium of 3.2 mEq/L
B) Urine output of 40 mL in the last hour
C) Blood pressure of 110/70 mmHg
D) Weight loss of 1 pound since yesterday
Correct Answer: A) Serum potassium of 3.2 mEq/L
Rationale: Hypokalemia (K+ < 3.5) increases the risk of digoxin toxicity and cardiac dysrhythmias; this
finding requires immediate provider notification.
2. A client post-right total hip arthroplasty is in bed. Which action by the nursing assistant requires the
LPN to intervene?
A) Placing a pillow between the client’s legs
B) Turning the client onto the operative side
C) Keeping the client’s heels off the bed
D) Using an abduction pillow while supine
,Correct Answer: B) Turning the client onto the operative side
Rationale: Turning onto the operative side is contraindicated after hip arthroplasty due to risk of
dislocation; the client should be logrolled onto the non-operative side.
3. A diabetic client reports diaphoresis, tremors, and palpitations. The LPN checks the blood glucose and
it reads 60 mg/dL. What is the priority nursing action?
A) Administer 15 grams of fast-acting carbohydrate
B) Give 50 mL of 50% dextrose IV push
C) Notify the healthcare provider
D) Recheck the blood glucose in 30 minutes
Correct Answer: A) Administer 15 grams of fast-acting carbohydrate
Rationale: For a conscious client with hypoglycemia, administer 15g of simple carbohydrate (e.g.,
glucose gel, juice) and recheck in 15 minutes; IV dextrose is for unconscious clients.
4. A client with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of 88%. The
LPN notes the client is on 4L/min via nasal cannula. Which action should the LPN take first?
A) Increase oxygen to 6L/min
B) Encourage incentive spirometry
C) Notify the respiratory therapist
D) Assess the client’s respiratory rate and depth
Correct Answer: D) Assess the client’s respiratory rate and depth
Rationale: Assessment is always the first step; COPD clients rely on hypoxic drive, so assess for signs of
carbon dioxide retention before adjusting oxygen.
5. The LPN is caring for a client with a nasogastric (NG) tube set to low intermittent suction. Which
finding indicates proper tube placement?
A) Client reports a sore throat
B) Aspirated fluid has a pH of 3.0
C) The tube is taped securely to the nose
D) Auscultation of air over the epigastrium
Correct Answer: B) Aspirated fluid has a pH of 3.0
Rationale: Gastric aspirate typically has a pH ≤ 4.0, confirming placement; auscultation is no longer the
gold standard due to risk of misplacement.
6. A postpartum client reports a heavy, gush of blood and a feeling that "something just gave way." The
LPN observes a steady trickle of bright red blood. What is the most likely cause?
,A) Uterine atony
B) Retained placental fragments
C) Vaginal laceration
D) Bladder distention
Correct Answer: A) Uterine atony
Rationale: A heavy gush of blood with a boggy uterus indicates uterine atony, the leading cause of
postpartum hemorrhage; fundal massage is the immediate intervention.
7. The LPN is preparing to administer an enteral feeding via a gastrostomy tube. Before the feeding, the
residual volume is 200 mL. What should the LPN do?
A) Discard the residual and continue the feeding
B) Reinstill the residual and hold the feeding
C) Notify the healthcare provider
D) Decrease the feeding rate by half
Correct Answer: B) Reinstill the residual and hold the feeding
Rationale: A residual volume greater than 150-200 mL indicates delayed gastric emptying; reinstill the
residual and hold the feeding to prevent aspiration.
8. A client on warfarin has an INR of 5.5. Which action should the LPN anticipate?
A) Administer vitamin K
B) Increase the warfarin dose
C) Administer protamine sulfate
D) Obtain a platelet count
Correct Answer: A) Administer vitamin K
Rationale: For an elevated INR (>5.0) with no bleeding, vitamin K is the antidote for warfarin;
protamine sulfate is for heparin overdose.
9. The LPN is reinforcing teaching for a client with a new colostomy. Which statement by the client
indicates a correct understanding?
A) "I will change the pouch every time it is one-third full."
B) "I will cut the skin barrier one inch larger than my stoma."
C) "I can expect my stool to be liquid and continuous."
D) "I should clean the stoma with alcohol daily."
Correct Answer: A) "I will change the pouch every time it is one-third full."
Rationale: The pouch should be emptied or changed when one-third to one-half full to prevent leakage
and skin breakdown; stoma size is measured and cut to the exact size.
, 10. A client receiving a blood transfusion develops chills, low back pain, and hypotension. What is the
LPN’s priority action?
A) Stop the transfusion immediately
B) Slow the transfusion rate
C) Administer Benadryl
D) Increase the IV fluid rate
Correct Answer: A) Stop the transfusion immediately
Rationale: Chills, back pain, and hypotension indicate a hemolytic transfusion reaction; stop the infusion,
maintain IV line with normal saline, and notify the provider.
11. The LPN is assessing a client with a head injury. Which sign indicates increased intracranial pressure
(ICP)?
A) Tachycardia and hypotension
B) Pupils equal and reactive
C) Restlessness and confusion
D) Decorticate posturing
Correct Answer: C) Restlessness and confusion
Rationale: Early signs of ICP include decreased level of consciousness, restlessness, and confusion;
Cushing’s triad (bradycardia, hypertension, irregular respirations) occurs late.
12. A client with major depressive disorder is prescribed phenelzine. Which dietary choice should the
LPN question?
A) Grilled chicken and steamed vegetables
B) Tuna salad sandwich with pickles
C) Macaroni and cheese with peas
D) Hamburger with french fries
Correct Answer: B) Tuna salad sandwich with pickles
Rationale: Phenelzine (MAOI) interacts with tyramine-rich foods like aged cheese, cured meats, and
pickled foods, leading to hypertensive crisis.
13. The LPN is caring for a client with pneumonia who has a new onset of confusion and a temperature of
102.2°F. What is the priority action?
A) Administer Tylenol
B) Obtain a sputum culture
C) Initiate oxygen therapy
D) Notify the healthcare provider
This exam blueprint covers core practical nursing competencies across the lifespan. Key areas
include: Safe and Effective Care Environment (management of care, safety, infection control), Health
Promotion and Maintenance (aging process, developmental stages, disease prevention), Psychosocial
Integrity (coping mechanisms, therapeutic communication, mental health disorders), and Physiological
Integrity (basic care, pharmacology, medical-surgical conditions, fluid/electrolyte balance, and
perioperative care). Questions emphasize prioritization, delegation, clinical judgment, and identification
of normal vs. abnormal findings.
HESI PN Exit Exam V1 Practice Questions
1. A client with heart failure is prescribed furosemide and digoxin. Which assessment finding is most
critical for the LPN to report to the RN immediately?
A) Serum potassium of 3.2 mEq/L
B) Urine output of 40 mL in the last hour
C) Blood pressure of 110/70 mmHg
D) Weight loss of 1 pound since yesterday
Correct Answer: A) Serum potassium of 3.2 mEq/L
Rationale: Hypokalemia (K+ < 3.5) increases the risk of digoxin toxicity and cardiac dysrhythmias; this
finding requires immediate provider notification.
2. A client post-right total hip arthroplasty is in bed. Which action by the nursing assistant requires the
LPN to intervene?
A) Placing a pillow between the client’s legs
B) Turning the client onto the operative side
C) Keeping the client’s heels off the bed
D) Using an abduction pillow while supine
,Correct Answer: B) Turning the client onto the operative side
Rationale: Turning onto the operative side is contraindicated after hip arthroplasty due to risk of
dislocation; the client should be logrolled onto the non-operative side.
3. A diabetic client reports diaphoresis, tremors, and palpitations. The LPN checks the blood glucose and
it reads 60 mg/dL. What is the priority nursing action?
A) Administer 15 grams of fast-acting carbohydrate
B) Give 50 mL of 50% dextrose IV push
C) Notify the healthcare provider
D) Recheck the blood glucose in 30 minutes
Correct Answer: A) Administer 15 grams of fast-acting carbohydrate
Rationale: For a conscious client with hypoglycemia, administer 15g of simple carbohydrate (e.g.,
glucose gel, juice) and recheck in 15 minutes; IV dextrose is for unconscious clients.
4. A client with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of 88%. The
LPN notes the client is on 4L/min via nasal cannula. Which action should the LPN take first?
A) Increase oxygen to 6L/min
B) Encourage incentive spirometry
C) Notify the respiratory therapist
D) Assess the client’s respiratory rate and depth
Correct Answer: D) Assess the client’s respiratory rate and depth
Rationale: Assessment is always the first step; COPD clients rely on hypoxic drive, so assess for signs of
carbon dioxide retention before adjusting oxygen.
5. The LPN is caring for a client with a nasogastric (NG) tube set to low intermittent suction. Which
finding indicates proper tube placement?
A) Client reports a sore throat
B) Aspirated fluid has a pH of 3.0
C) The tube is taped securely to the nose
D) Auscultation of air over the epigastrium
Correct Answer: B) Aspirated fluid has a pH of 3.0
Rationale: Gastric aspirate typically has a pH ≤ 4.0, confirming placement; auscultation is no longer the
gold standard due to risk of misplacement.
6. A postpartum client reports a heavy, gush of blood and a feeling that "something just gave way." The
LPN observes a steady trickle of bright red blood. What is the most likely cause?
,A) Uterine atony
B) Retained placental fragments
C) Vaginal laceration
D) Bladder distention
Correct Answer: A) Uterine atony
Rationale: A heavy gush of blood with a boggy uterus indicates uterine atony, the leading cause of
postpartum hemorrhage; fundal massage is the immediate intervention.
7. The LPN is preparing to administer an enteral feeding via a gastrostomy tube. Before the feeding, the
residual volume is 200 mL. What should the LPN do?
A) Discard the residual and continue the feeding
B) Reinstill the residual and hold the feeding
C) Notify the healthcare provider
D) Decrease the feeding rate by half
Correct Answer: B) Reinstill the residual and hold the feeding
Rationale: A residual volume greater than 150-200 mL indicates delayed gastric emptying; reinstill the
residual and hold the feeding to prevent aspiration.
8. A client on warfarin has an INR of 5.5. Which action should the LPN anticipate?
A) Administer vitamin K
B) Increase the warfarin dose
C) Administer protamine sulfate
D) Obtain a platelet count
Correct Answer: A) Administer vitamin K
Rationale: For an elevated INR (>5.0) with no bleeding, vitamin K is the antidote for warfarin;
protamine sulfate is for heparin overdose.
9. The LPN is reinforcing teaching for a client with a new colostomy. Which statement by the client
indicates a correct understanding?
A) "I will change the pouch every time it is one-third full."
B) "I will cut the skin barrier one inch larger than my stoma."
C) "I can expect my stool to be liquid and continuous."
D) "I should clean the stoma with alcohol daily."
Correct Answer: A) "I will change the pouch every time it is one-third full."
Rationale: The pouch should be emptied or changed when one-third to one-half full to prevent leakage
and skin breakdown; stoma size is measured and cut to the exact size.
, 10. A client receiving a blood transfusion develops chills, low back pain, and hypotension. What is the
LPN’s priority action?
A) Stop the transfusion immediately
B) Slow the transfusion rate
C) Administer Benadryl
D) Increase the IV fluid rate
Correct Answer: A) Stop the transfusion immediately
Rationale: Chills, back pain, and hypotension indicate a hemolytic transfusion reaction; stop the infusion,
maintain IV line with normal saline, and notify the provider.
11. The LPN is assessing a client with a head injury. Which sign indicates increased intracranial pressure
(ICP)?
A) Tachycardia and hypotension
B) Pupils equal and reactive
C) Restlessness and confusion
D) Decorticate posturing
Correct Answer: C) Restlessness and confusion
Rationale: Early signs of ICP include decreased level of consciousness, restlessness, and confusion;
Cushing’s triad (bradycardia, hypertension, irregular respirations) occurs late.
12. A client with major depressive disorder is prescribed phenelzine. Which dietary choice should the
LPN question?
A) Grilled chicken and steamed vegetables
B) Tuna salad sandwich with pickles
C) Macaroni and cheese with peas
D) Hamburger with french fries
Correct Answer: B) Tuna salad sandwich with pickles
Rationale: Phenelzine (MAOI) interacts with tyramine-rich foods like aged cheese, cured meats, and
pickled foods, leading to hypertensive crisis.
13. The LPN is caring for a client with pneumonia who has a new onset of confusion and a temperature of
102.2°F. What is the priority action?
A) Administer Tylenol
B) Obtain a sputum culture
C) Initiate oxygen therapy
D) Notify the healthcare provider
