, HESI LPN-ADN HESI ENTRANCE EXAM (2026/2027)
MOBILITY EXAMS
1. The LPN/LVN is preparing to assist a client who is recovering from open-heart
surgery with the first postoperative ambulation. The client reports moderate
incisional discomfort and appears hesitant to get out of bed because of pain.
Which nursing intervention should the nurse implement before ambulating the
client to help the client tolerate the activity with the least amount of
discomfort?
A. Provide the client with a walker.
B. Remove the telemetry equipment.
C. Encourage the client to cough and deep breathe.
D. Premedicate the client with an analgesic before ambulating.
Correct Answer: D. Premedicate the client with an analgesic before ambulating.
Rationale: Administering a prescribed analgesic before activity helps reduce
postoperative pain, allowing the client to participate more comfortably in ambulation
and breathe more effectively during movement. Adequate pain control also
promotes early mobility, decreases the risk of postoperative complications such as
atelectasis and venous thromboembolism, and improves overall recovery without
unnecessarily limiting activity.
2. A client wearing a continuous cardiac monitor is resting comfortably in bed
when the cardiac monitor suddenly begins to alarm at the nurse's station. The
monitor screen displays no electrocardiographic complexes, raising concern for
a potentially life-threatening rhythm disturbance. What should the nurse do
first?
A. Call a code blue.
B. Call the health care provider.
C. Check the client status and lead placement.
D. Press the recorder button on the ECG console.
,Correct Answer: C. Check the client status and lead placement.
Rationale: The nurse should first assess the client directly because monitor
abnormalities may result from loose or disconnected leads rather than true cardiac
arrest. Verifying the client's condition and equipment function prevents unnecessary
emergency responses while ensuring that any actual deterioration is recognized and
managed immediately.
3. The LPN/LVN is caring for a client admitted with heart failure. During the shift,
the client suddenly develops severe shortness of breath, tachycardia, pink
frothy sputum, and bilateral crackles throughout the lungs. After immediately
notifying the registered nurse, which interventions should the nurse expect
the provider to prescribe? Select all that apply.
A. Administering oxygen
B. Inserting a Foley catheter
C. Administering furosemide (Lasix)
D. Administering morphine sulfate intravenously
E. Transporting the client to the coronary care unit
F. Placing the client in a low-Fowler's side-lying position
Correct Answers: A, B, C, D
Rationale: Oxygen administration is a priority because pulmonary edema
significantly impairs gas exchange, and supplemental oxygen improves tissue
oxygenation while other treatments take effect. Intravenous furosemide rapidly
reduces fluid overload, morphine decreases anxiety and venous return while
reducing the work of breathing, and Foley catheter insertion allows accurate
monitoring of urine output to evaluate the effectiveness of aggressive diuretic
therapy. Placing the client in low Fowler's position would worsen breathing, and
transfer to a higher level of care may occur later but is not an immediate treatment
intervention.
, 4. A client has undergone elective synchronized cardioversion for atrial fibrillation
and has now returned to the recovery area. The nurse performs frequent
assessments to identify complications related to the procedure and sedation.
Which observation should receive the highest priority?
A. Blood pressure
B. Status of airway
C. Oxygen flow rate
D. Level of consciousness
Correct Answer: B. Status of airway.
Rationale: Airway assessment is always the highest priority because clients
receiving sedation during cardioversion are at risk for airway obstruction and
respiratory depression. Ensuring a patent airway supports adequate oxygenation and
ventilation, which are essential before addressing circulation or neurological status.
5. A client has just returned from the cardiac catheterization laboratory after
insertion of a permanent demand pacemaker through the right subclavian
vein. The nurse is providing postoperative care and wants to prevent
displacement of the newly placed pacing lead. Which intervention is most
appropriate?
A. Limiting movement and abduction of the left arm
B. Limiting movement and abduction of the right arm
C. Assisting the client to get out of bed and ambulate with a walker
D. Having the physical therapist perform active range-of-motion exercises to the right
arm
Correct Answer: B. Limiting movement and abduction of the right arm.
Rationale: Restricting movement of the arm on the side of pacemaker insertion
helps prevent displacement of the pacing lead before it becomes securely embedded
within the heart tissue. Excessive shoulder movement or arm abduction on the
affected side can interfere with lead stability and increase the risk of pacemaker
malfunction, requiring repositioning or replacement.
MOBILITY EXAMS
1. The LPN/LVN is preparing to assist a client who is recovering from open-heart
surgery with the first postoperative ambulation. The client reports moderate
incisional discomfort and appears hesitant to get out of bed because of pain.
Which nursing intervention should the nurse implement before ambulating the
client to help the client tolerate the activity with the least amount of
discomfort?
A. Provide the client with a walker.
B. Remove the telemetry equipment.
C. Encourage the client to cough and deep breathe.
D. Premedicate the client with an analgesic before ambulating.
Correct Answer: D. Premedicate the client with an analgesic before ambulating.
Rationale: Administering a prescribed analgesic before activity helps reduce
postoperative pain, allowing the client to participate more comfortably in ambulation
and breathe more effectively during movement. Adequate pain control also
promotes early mobility, decreases the risk of postoperative complications such as
atelectasis and venous thromboembolism, and improves overall recovery without
unnecessarily limiting activity.
2. A client wearing a continuous cardiac monitor is resting comfortably in bed
when the cardiac monitor suddenly begins to alarm at the nurse's station. The
monitor screen displays no electrocardiographic complexes, raising concern for
a potentially life-threatening rhythm disturbance. What should the nurse do
first?
A. Call a code blue.
B. Call the health care provider.
C. Check the client status and lead placement.
D. Press the recorder button on the ECG console.
,Correct Answer: C. Check the client status and lead placement.
Rationale: The nurse should first assess the client directly because monitor
abnormalities may result from loose or disconnected leads rather than true cardiac
arrest. Verifying the client's condition and equipment function prevents unnecessary
emergency responses while ensuring that any actual deterioration is recognized and
managed immediately.
3. The LPN/LVN is caring for a client admitted with heart failure. During the shift,
the client suddenly develops severe shortness of breath, tachycardia, pink
frothy sputum, and bilateral crackles throughout the lungs. After immediately
notifying the registered nurse, which interventions should the nurse expect
the provider to prescribe? Select all that apply.
A. Administering oxygen
B. Inserting a Foley catheter
C. Administering furosemide (Lasix)
D. Administering morphine sulfate intravenously
E. Transporting the client to the coronary care unit
F. Placing the client in a low-Fowler's side-lying position
Correct Answers: A, B, C, D
Rationale: Oxygen administration is a priority because pulmonary edema
significantly impairs gas exchange, and supplemental oxygen improves tissue
oxygenation while other treatments take effect. Intravenous furosemide rapidly
reduces fluid overload, morphine decreases anxiety and venous return while
reducing the work of breathing, and Foley catheter insertion allows accurate
monitoring of urine output to evaluate the effectiveness of aggressive diuretic
therapy. Placing the client in low Fowler's position would worsen breathing, and
transfer to a higher level of care may occur later but is not an immediate treatment
intervention.
, 4. A client has undergone elective synchronized cardioversion for atrial fibrillation
and has now returned to the recovery area. The nurse performs frequent
assessments to identify complications related to the procedure and sedation.
Which observation should receive the highest priority?
A. Blood pressure
B. Status of airway
C. Oxygen flow rate
D. Level of consciousness
Correct Answer: B. Status of airway.
Rationale: Airway assessment is always the highest priority because clients
receiving sedation during cardioversion are at risk for airway obstruction and
respiratory depression. Ensuring a patent airway supports adequate oxygenation and
ventilation, which are essential before addressing circulation or neurological status.
5. A client has just returned from the cardiac catheterization laboratory after
insertion of a permanent demand pacemaker through the right subclavian
vein. The nurse is providing postoperative care and wants to prevent
displacement of the newly placed pacing lead. Which intervention is most
appropriate?
A. Limiting movement and abduction of the left arm
B. Limiting movement and abduction of the right arm
C. Assisting the client to get out of bed and ambulate with a walker
D. Having the physical therapist perform active range-of-motion exercises to the right
arm
Correct Answer: B. Limiting movement and abduction of the right arm.
Rationale: Restricting movement of the arm on the side of pacemaker insertion
helps prevent displacement of the pacing lead before it becomes securely embedded
within the heart tissue. Excessive shoulder movement or arm abduction on the
affected side can interfere with lead stability and increase the risk of pacemaker
malfunction, requiring repositioning or replacement.
