PN HESI EXIT STUDY GUIDE | TESTBANK | PRACTICE QUESTIONS & ANSWERS |
EXAM PREPARATION | COMPREHENSIVE PRACTICE EXAM | LATEST UPDATE
2026/2027 | ADVANCED REVIEW
Examiner:
HESI (Health Education Systems, Inc.)
TABLE OF CONTENTS
1. Adult Medical-Surgical Nursing
2. Pharmacology and Medication Administration
3. Fundamentals of Nursing
4. Maternal-Newborn Nursing
5. Pediatric Nursing
6. Mental Health Nursing
7. Leadership, Delegation, and Management of Care
8. Infection Prevention and Safety
9. Clinical Judgment and Prioritization
10. Ethical and Legal Nursing Practice
PN HESI EXIT || MEDICAL-SURGICAL NURSING || PHARMACOLOGY ||
FUNDAMENTALS || MATERNAL-NEWBORN || PEDIATRICS || MENTAL HEALTH ||
LEADERSHIP || DELEGATION || PRIORITIZATION || SAFETY || INFECTION CONTROL
|| CLINICAL JUDGMENT || THERAPEUTIC COMMUNICATION || ETHICS || LEGAL
RESPONSIBILITIES || EVIDENCE-BASED PRACTICE || MEDICATION SAFETY ||
PATIENT EDUCATION || QUALITY IMPROVEMENT || NCLEX-STYLE REASONING ||
ADVANCED REVIEW
QUESTION 1.
A practical nursing student is caring for four clients during a clinical capstone. Which
client should the student recommend the supervising nurse assess first?
A. A client with chronic heart failure who reports increasing orthopnea and has an
oxygen saturation of 88% on room air.
B. A client with osteoarthritis requesting PRN analgesia before physical therapy.
,C. A client with type 2 diabetes whose pre-lunch blood glucose is 218 mg/dL.
D. A client awaiting discharge who needs reinforcement of wound care instructions.
Correct Answer: A. A client with chronic heart failure who reports increasing
orthopnea and has an oxygen saturation of 88% on room air.
Explanation: Airway, breathing, and oxygenation problems require the highest
priority. Progressive orthopnea with hypoxemia suggests worsening pulmonary
congestion that may rapidly deteriorate. The remaining clients have needs that are
important but not immediately life-threatening.
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QUESTION 2.
A nurse administers regular insulin at 0730. At what time should the nurse anticipate
the greatest risk for hypoglycemia related to the medication's peak action?
A. 0800
B. 1000
C. 1400
D. 1800
Correct Answer: B. 1000
Explanation: Regular insulin generally peaks approximately 2 to 4 hours after
administration, making mid-morning the period of greatest hypoglycemia risk. The
other times either precede the expected peak or occur after the peak effect has
declined.
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QUESTION 3.
A client with chronic kidney disease has a serum potassium level of 6.5 mEq/L and
develops peaked T waves on the cardiac monitor. Which prescribed intervention
should the nurse implement first?
,A. Restrict dietary potassium.
B. Administer sodium polystyrene sulfonate.
C. Administer IV calcium gluconate.
D. Schedule hemodialysis.
Correct Answer: C. Administer IV calcium gluconate.
Explanation: Calcium gluconate stabilizes the myocardial membrane and is the
priority intervention when ECG changes accompany severe hyperkalemia. Dietary
restriction, potassium removal, and dialysis are important but do not immediately
reduce the risk of fatal dysrhythmias.
────────────────────────────────────────
QUESTION 4.
A postoperative client suddenly becomes restless, tachycardic, and reports shortness
of breath. Which nursing action has the highest priority?
A. Elevate the legs above heart level.
B. Encourage coughing and deep breathing.
C. Administer prescribed oral analgesics.
D. Assess oxygenation and apply supplemental oxygen while notifying the provider.
Correct Answer: D. Assess oxygenation and apply supplemental oxygen while
notifying the provider.
Explanation: Acute respiratory compromise requires immediate assessment and
intervention. Oxygen administration while initiating further evaluation helps
address hypoxia. The remaining interventions fail to address the potentially life-
threatening condition promptly.
────────────────────────────────────────
QUESTION 5.
, A nurse is teaching a client prescribed warfarin therapy. Which statement by the
client indicates correct understanding?
A. "I should report unusual bleeding or black, tarry stools immediately."
B. "I can safely double my dose if I miss one."
C. "I should stop taking the medication before any dental procedure without
notifying my provider."
D. "I do not need routine laboratory monitoring."
Correct Answer: A. "I should report unusual bleeding or black, tarry stools
immediately."
Explanation: Bleeding is the major complication of warfarin therapy and requires
prompt reporting. Missed doses should not be doubled, procedures require provider
guidance, and routine coagulation monitoring remains essential.
────────────────────────────────────────
QUESTION 6.
Which assessment finding is most concerning in a client receiving morphine by
intravenous route?
A. Respiratory rate of 8 breaths/minute.
B. Mild nausea after administration.
C. Blood pressure of 132/78 mmHg.
D. Drowsiness while watching television.
Correct Answer: A. Respiratory rate of 8 breaths/minute.
Explanation: Respiratory depression is the most serious adverse effect of opioid
therapy and requires immediate intervention. Mild sedation and nausea are
common side effects, while the blood pressure is within an acceptable range.
────────────────────────────────────────
QUESTION 7.
EXAM PREPARATION | COMPREHENSIVE PRACTICE EXAM | LATEST UPDATE
2026/2027 | ADVANCED REVIEW
Examiner:
HESI (Health Education Systems, Inc.)
TABLE OF CONTENTS
1. Adult Medical-Surgical Nursing
2. Pharmacology and Medication Administration
3. Fundamentals of Nursing
4. Maternal-Newborn Nursing
5. Pediatric Nursing
6. Mental Health Nursing
7. Leadership, Delegation, and Management of Care
8. Infection Prevention and Safety
9. Clinical Judgment and Prioritization
10. Ethical and Legal Nursing Practice
PN HESI EXIT || MEDICAL-SURGICAL NURSING || PHARMACOLOGY ||
FUNDAMENTALS || MATERNAL-NEWBORN || PEDIATRICS || MENTAL HEALTH ||
LEADERSHIP || DELEGATION || PRIORITIZATION || SAFETY || INFECTION CONTROL
|| CLINICAL JUDGMENT || THERAPEUTIC COMMUNICATION || ETHICS || LEGAL
RESPONSIBILITIES || EVIDENCE-BASED PRACTICE || MEDICATION SAFETY ||
PATIENT EDUCATION || QUALITY IMPROVEMENT || NCLEX-STYLE REASONING ||
ADVANCED REVIEW
QUESTION 1.
A practical nursing student is caring for four clients during a clinical capstone. Which
client should the student recommend the supervising nurse assess first?
A. A client with chronic heart failure who reports increasing orthopnea and has an
oxygen saturation of 88% on room air.
B. A client with osteoarthritis requesting PRN analgesia before physical therapy.
,C. A client with type 2 diabetes whose pre-lunch blood glucose is 218 mg/dL.
D. A client awaiting discharge who needs reinforcement of wound care instructions.
Correct Answer: A. A client with chronic heart failure who reports increasing
orthopnea and has an oxygen saturation of 88% on room air.
Explanation: Airway, breathing, and oxygenation problems require the highest
priority. Progressive orthopnea with hypoxemia suggests worsening pulmonary
congestion that may rapidly deteriorate. The remaining clients have needs that are
important but not immediately life-threatening.
────────────────────────────────────────
QUESTION 2.
A nurse administers regular insulin at 0730. At what time should the nurse anticipate
the greatest risk for hypoglycemia related to the medication's peak action?
A. 0800
B. 1000
C. 1400
D. 1800
Correct Answer: B. 1000
Explanation: Regular insulin generally peaks approximately 2 to 4 hours after
administration, making mid-morning the period of greatest hypoglycemia risk. The
other times either precede the expected peak or occur after the peak effect has
declined.
────────────────────────────────────────
QUESTION 3.
A client with chronic kidney disease has a serum potassium level of 6.5 mEq/L and
develops peaked T waves on the cardiac monitor. Which prescribed intervention
should the nurse implement first?
,A. Restrict dietary potassium.
B. Administer sodium polystyrene sulfonate.
C. Administer IV calcium gluconate.
D. Schedule hemodialysis.
Correct Answer: C. Administer IV calcium gluconate.
Explanation: Calcium gluconate stabilizes the myocardial membrane and is the
priority intervention when ECG changes accompany severe hyperkalemia. Dietary
restriction, potassium removal, and dialysis are important but do not immediately
reduce the risk of fatal dysrhythmias.
────────────────────────────────────────
QUESTION 4.
A postoperative client suddenly becomes restless, tachycardic, and reports shortness
of breath. Which nursing action has the highest priority?
A. Elevate the legs above heart level.
B. Encourage coughing and deep breathing.
C. Administer prescribed oral analgesics.
D. Assess oxygenation and apply supplemental oxygen while notifying the provider.
Correct Answer: D. Assess oxygenation and apply supplemental oxygen while
notifying the provider.
Explanation: Acute respiratory compromise requires immediate assessment and
intervention. Oxygen administration while initiating further evaluation helps
address hypoxia. The remaining interventions fail to address the potentially life-
threatening condition promptly.
────────────────────────────────────────
QUESTION 5.
, A nurse is teaching a client prescribed warfarin therapy. Which statement by the
client indicates correct understanding?
A. "I should report unusual bleeding or black, tarry stools immediately."
B. "I can safely double my dose if I miss one."
C. "I should stop taking the medication before any dental procedure without
notifying my provider."
D. "I do not need routine laboratory monitoring."
Correct Answer: A. "I should report unusual bleeding or black, tarry stools
immediately."
Explanation: Bleeding is the major complication of warfarin therapy and requires
prompt reporting. Missed doses should not be doubled, procedures require provider
guidance, and routine coagulation monitoring remains essential.
────────────────────────────────────────
QUESTION 6.
Which assessment finding is most concerning in a client receiving morphine by
intravenous route?
A. Respiratory rate of 8 breaths/minute.
B. Mild nausea after administration.
C. Blood pressure of 132/78 mmHg.
D. Drowsiness while watching television.
Correct Answer: A. Respiratory rate of 8 breaths/minute.
Explanation: Respiratory depression is the most serious adverse effect of opioid
therapy and requires immediate intervention. Mild sedation and nausea are
common side effects, while the blood pressure is within an acceptable range.
────────────────────────────────────────
QUESTION 7.
