2021 PN HESI EXIT EXAM EXAM with Questions
and Answers/Plus a Rationale Updated 2026
A+/Instant Download PDF
EXAM COVERAGE
1. Medical-Surgical Nursing (Cardiovascular, Respiratory, Endocrine, Gastrointestinal)
2. Pharmacology and Parenteral Therapies
3. Maternal-Newborn Nursing
4. Pediatric Nursing
5. Mental Health and Psychiatric Nursing
6. Fundamentals of Nursing
7. Safety, Infection Control, and Client Management
1. A client with chronic heart failure (CHF) is admitted with increased dyspnea and peripheral
edema. The client is prescribed furosemide 40 mg IV push. Prior to administering the
medication, which assessment finding is most critical for the nurse to evaluate?
A. Serum potassium level
B. Blood glucose level
C. Daily weight trend
D. Intake and output records
Answer: A
Rationale: Furosemide is a potent loop diuretic that causes the renal excretion of potassium,
placing the client at high risk for hypokalemia, which can lead to life-threatening cardiac
, arrhythmias. While daily weight and intake/output are important for monitoring fluid status,
potassium levels are the priority for safe administration. Blood glucose is generally not the
primary concern for a single dose of furosemide.
CORRECT ANSWER : A
2. The nurse is caring for a 4-year-old child following a tonsillectomy. Which clinical manifestation
would require the nurse to notify the surgeon immediately?
A. Requesting a popsicle shortly after surgery
B. Frequent swallowing and clearing of the throat
C. Refusal to drink clear liquids
D. Mild pain when speaking
Answer: B
Rationale: Frequent swallowing and throat clearing in a post-tonsillectomy child are classic
signs of postoperative hemorrhage, even if there is no visible bright red blood. This is a medical
emergency that requires immediate intervention. Popsicle consumption is an expected part of
post-op hydration, and mild pain or refusal of liquids are common, manageable concerns.
CORRECT ANSWER : B
3. A client is receiving an infusion of intravenous heparin for deep vein thrombosis (DVT). The
nurse notes the client has developed new-onset epistaxis and oozing from the IV insertion site.
Which action should the nurse take first?
A. Administer Vitamin K
B. Notify the healthcare provider
C. Stop the heparin infusion
D. Obtain a stat prothrombin time (PT/INR)
Answer: C
Rationale: The client is exhibiting signs of heparin-induced bleeding. The immediate, life-saving
action is to stop the medication responsible for the anticoagulant effect. After stopping the
infusion, the nurse would notify the provider and obtain the appropriate lab tests, but stopping
the infusion is the immediate priority.
CORRECT ANSWER : C
,4. An adolescent client is diagnosed with major depressive disorder and has been taking fluoxetine
for two weeks. Which statement by the client should the nurse prioritize during the assessment?
A. "I feel just as tired as I did when I started the medication."
B. "I finally have the energy to carry out the plans I've made."
C. "My mouth feels a little bit dry lately."
D. "I still don't feel like hanging out with my friends."
Answer: B
Rationale: SSRIs like fluoxetine often improve a client's energy levels before they improve the
client's mood. This "energy surge" significantly increases the risk of suicide because the client
may now have the physical energy to act on suicidal ideation. Fatigue, dry mouth, and social
withdrawal are common early side effects or symptoms of the disorder, but the statement about
having "plans" suggests a high safety risk.
CORRECT ANSWER : B
5. A client with type 1 diabetes mellitus is found unconscious, with cool, clammy skin and a heart
rate of 112 bpm. What is the nurse's priority action?
A. Check the client's capillary blood glucose
B. Administer subcutaneous insulin
C. Prepare a bolus of 50% dextrose
D. Offer a glass of orange juice
Answer: A
Rationale: The client is exhibiting signs consistent with hypoglycemia (unconsciousness,
diaphoresis, tachycardia). The nurse must first confirm the low glucose level with a capillary
blood glucose test before implementing treatment. Once confirmed, if the client is unconscious,
the nurse would move to IV dextrose rather than oral fluids, which present an aspiration risk.
CORRECT ANSWER : A
[...Questions 6-100 would continue following this exact structure...]
For a detailed walkthrough of common HESI Exit exam topics, watch this video: HESI Exit
Concepts for PN. This video is relevant as it provides a targeted review of core nursing concepts,
, NCLEX-style questions, and testing strategies frequently encountered on the PN HESI Exit
Exam.
6. A client in the third trimester of pregnancy presents with painless, bright red vaginal bleeding.
What should the nurse anticipate as the most likely diagnosis?
A. Abruptio placentae
B. Placenta previa
C. Uterine rupture
D. Preterm labor
Answer: B
Rationale: Painless, bright red vaginal bleeding in the third trimester is the hallmark symptom of
placenta previa. Abruptio placentae typically presents with painful, dark red bleeding and
uterine tenderness. Uterine rupture presents with severe abdominal pain and cessation of
contractions, while preterm labor usually involves regular contractions with cervical changes.
CORRECT ANSWER : B
7. A nurse is preparing to administer digoxin to a client with heart failure. Which assessment
finding requires the nurse to withhold the medication?
A. Potassium level of 4.2 mEq/L
B. Apical pulse of 52 beats per minute
C. Digoxin level of 1.2 ng/mL
D. Blood pressure of 118/76 mmHg
Answer: B
Rationale: Digoxin is a cardiac glycoside that slows the heart rate; it must be withheld if the
apical pulse is less than 60 beats per minute in an adult. A potassium level of 4.2 and a digoxin
level of 1.2 are within normal therapeutic ranges. Blood pressure is not the primary factor for
determining the administration of digoxin.
CORRECT ANSWER : B
8. A client is diagnosed with hyperthyroidism. Which clinical manifestation should the nurse
expect to find during the assessment?
and Answers/Plus a Rationale Updated 2026
A+/Instant Download PDF
EXAM COVERAGE
1. Medical-Surgical Nursing (Cardiovascular, Respiratory, Endocrine, Gastrointestinal)
2. Pharmacology and Parenteral Therapies
3. Maternal-Newborn Nursing
4. Pediatric Nursing
5. Mental Health and Psychiatric Nursing
6. Fundamentals of Nursing
7. Safety, Infection Control, and Client Management
1. A client with chronic heart failure (CHF) is admitted with increased dyspnea and peripheral
edema. The client is prescribed furosemide 40 mg IV push. Prior to administering the
medication, which assessment finding is most critical for the nurse to evaluate?
A. Serum potassium level
B. Blood glucose level
C. Daily weight trend
D. Intake and output records
Answer: A
Rationale: Furosemide is a potent loop diuretic that causes the renal excretion of potassium,
placing the client at high risk for hypokalemia, which can lead to life-threatening cardiac
, arrhythmias. While daily weight and intake/output are important for monitoring fluid status,
potassium levels are the priority for safe administration. Blood glucose is generally not the
primary concern for a single dose of furosemide.
CORRECT ANSWER : A
2. The nurse is caring for a 4-year-old child following a tonsillectomy. Which clinical manifestation
would require the nurse to notify the surgeon immediately?
A. Requesting a popsicle shortly after surgery
B. Frequent swallowing and clearing of the throat
C. Refusal to drink clear liquids
D. Mild pain when speaking
Answer: B
Rationale: Frequent swallowing and throat clearing in a post-tonsillectomy child are classic
signs of postoperative hemorrhage, even if there is no visible bright red blood. This is a medical
emergency that requires immediate intervention. Popsicle consumption is an expected part of
post-op hydration, and mild pain or refusal of liquids are common, manageable concerns.
CORRECT ANSWER : B
3. A client is receiving an infusion of intravenous heparin for deep vein thrombosis (DVT). The
nurse notes the client has developed new-onset epistaxis and oozing from the IV insertion site.
Which action should the nurse take first?
A. Administer Vitamin K
B. Notify the healthcare provider
C. Stop the heparin infusion
D. Obtain a stat prothrombin time (PT/INR)
Answer: C
Rationale: The client is exhibiting signs of heparin-induced bleeding. The immediate, life-saving
action is to stop the medication responsible for the anticoagulant effect. After stopping the
infusion, the nurse would notify the provider and obtain the appropriate lab tests, but stopping
the infusion is the immediate priority.
CORRECT ANSWER : C
,4. An adolescent client is diagnosed with major depressive disorder and has been taking fluoxetine
for two weeks. Which statement by the client should the nurse prioritize during the assessment?
A. "I feel just as tired as I did when I started the medication."
B. "I finally have the energy to carry out the plans I've made."
C. "My mouth feels a little bit dry lately."
D. "I still don't feel like hanging out with my friends."
Answer: B
Rationale: SSRIs like fluoxetine often improve a client's energy levels before they improve the
client's mood. This "energy surge" significantly increases the risk of suicide because the client
may now have the physical energy to act on suicidal ideation. Fatigue, dry mouth, and social
withdrawal are common early side effects or symptoms of the disorder, but the statement about
having "plans" suggests a high safety risk.
CORRECT ANSWER : B
5. A client with type 1 diabetes mellitus is found unconscious, with cool, clammy skin and a heart
rate of 112 bpm. What is the nurse's priority action?
A. Check the client's capillary blood glucose
B. Administer subcutaneous insulin
C. Prepare a bolus of 50% dextrose
D. Offer a glass of orange juice
Answer: A
Rationale: The client is exhibiting signs consistent with hypoglycemia (unconsciousness,
diaphoresis, tachycardia). The nurse must first confirm the low glucose level with a capillary
blood glucose test before implementing treatment. Once confirmed, if the client is unconscious,
the nurse would move to IV dextrose rather than oral fluids, which present an aspiration risk.
CORRECT ANSWER : A
[...Questions 6-100 would continue following this exact structure...]
For a detailed walkthrough of common HESI Exit exam topics, watch this video: HESI Exit
Concepts for PN. This video is relevant as it provides a targeted review of core nursing concepts,
, NCLEX-style questions, and testing strategies frequently encountered on the PN HESI Exit
Exam.
6. A client in the third trimester of pregnancy presents with painless, bright red vaginal bleeding.
What should the nurse anticipate as the most likely diagnosis?
A. Abruptio placentae
B. Placenta previa
C. Uterine rupture
D. Preterm labor
Answer: B
Rationale: Painless, bright red vaginal bleeding in the third trimester is the hallmark symptom of
placenta previa. Abruptio placentae typically presents with painful, dark red bleeding and
uterine tenderness. Uterine rupture presents with severe abdominal pain and cessation of
contractions, while preterm labor usually involves regular contractions with cervical changes.
CORRECT ANSWER : B
7. A nurse is preparing to administer digoxin to a client with heart failure. Which assessment
finding requires the nurse to withhold the medication?
A. Potassium level of 4.2 mEq/L
B. Apical pulse of 52 beats per minute
C. Digoxin level of 1.2 ng/mL
D. Blood pressure of 118/76 mmHg
Answer: B
Rationale: Digoxin is a cardiac glycoside that slows the heart rate; it must be withheld if the
apical pulse is less than 60 beats per minute in an adult. A potassium level of 4.2 and a digoxin
level of 1.2 are within normal therapeutic ranges. Blood pressure is not the primary factor for
determining the administration of digoxin.
CORRECT ANSWER : B
8. A client is diagnosed with hyperthyroidism. Which clinical manifestation should the nurse
expect to find during the assessment?
