PN HESI EXIT EXAM 200 ACTUAL QUESTIONS
AND CORRECT ANSWER WITH RATIONALE
LATEST 2026
The PN HESI Exit Exam is a comprehensive, standardized assessment used
by practical nursing programs to evaluate student readiness for the NCLEX-
PN licensure examination. This rigorous exam consists of 200 questions,
including traditional multiple-choice and Next Generation NCLEX (NGN)
unfolding case studies. It covers essential nursing content areas such as
medical-surgical nursing, maternity and pediatrics, psychiatric/mental health,
pharmacology, and fundamentals of nursing care. The exam emphasizes
clinical judgment, prioritization, and safe decision-making. With proven
predictive validity, successful completion indicates that a student possesses the
necessary knowledge, critical thinking skills, and clinical competency to
practice safely as a licensed practical nurse and pass the national licensing
exam.
Question 1
A client receiving a blood transfusion develops chills and lower back pain. What is
the practical nurse's priority action?
A) Slow the infusion rate to 50 mL/hr
B) Stop the transfusion immediately
C) Administer an antihistamine
D) Take a set of vital signs
Correct Answer: B
Rationale: Chills and back pain are classic signs of a hemolytic transfusion
reaction. The priority action is to stop the transfusion immediately to prevent
further complications, then notify the healthcare provider and hang normal saline
with new tubing.
Question 2
The PN is preparing to administer digoxin 0.125 mg PO. The client's apical pulse
is 54 beats/min. What action should the PN take?
A) Administer the medication as prescribed
B) Hold the medication and notify the healthcare provider
,C) Retake the pulse in 15 minutes
D) Administer half the prescribed dose
Correct Answer: B
Rationale: Digoxin slows AV conduction and decreases heart rate. Standard
practice is to hold digoxin if the apical pulse is below 60 beats/min in adults and
notify the provider. Administering with a pulse of 54 could cause severe
bradycardia or heart block.
Question 3
An older adult client with metastatic breast cancer and bilateral pneumonia is
experiencing shortness of breath. The family requests hospice care. Which
information should the PN reinforce?
A) Instructions for care should be included in the living will
B) Hospice care can only be provided in hospital settings
C) Hospice care focuses on curing the disease
D) Hospice care focuses on comfort, dignity, and emotional support
Correct Answer: D
Rationale: Hospice care emphasizes comfort measures rather than curative
treatment. It can be provided wherever the client resides and focuses on dignity
and psychosocial support.
Question 4
The PN is caring for a client with a urinary catheter. Which finding indicates a
possible urinary tract infection?
A) Clear yellow urine
B) Foul-smelling urine
C) Output of 50 mL/hour
D) Client reports thirst
Correct Answer: B
Rationale: Foul-smelling urine, along with cloudy appearance or sediment,
indicates possible urinary tract infection. Other signs include fever, flank pain, and
changes in vital signs.
Question 5
A client with dementia becomes agitated and tries to leave the unit. Which
intervention should the practical nurse implement first?
A) Apply a vest restraint
,B) Administer a prescribed PRN sedative
C) Redirect the client to a safe, quiet activity
D) Notify the provider of the client's behavior
Correct Answer: C
Rationale: Redirection is the least restrictive intervention for managing agitation in
a client with dementia. Restraints should only be used as a last resort when less
restrictive measures have failed and the client is at immediate risk of harm.
Question 6
A client is 2 hours post-liver biopsy. In which position should the PN place the
client to reduce the risk of bleeding?
A) Supine
B) Right lateral decubitus
C) Left lateral decubitus
D) Semi-Fowler's
Correct Answer: B
Rationale: After a liver biopsy, the client should be placed in the right lateral
decubitus position to apply pressure to the biopsy site and reduce the risk of
bleeding.
Question 7
The PN notes that a client's oxygen saturation is 88% on room air 4 hours post-
surgery. What action should the PN take?
A) Continue to monitor and document the finding
B) Apply oxygen via nasal cannula and notify the healthcare provider
C) Increase the client's activity to improve ventilation
D) Encourage the client to take deep breaths and cough
Correct Answer: B
Rationale: An oxygen saturation of 88% is below the normal range (94-100%) and
indicates hypoxemia requiring intervention. The PN should apply supplemental
oxygen and notify the healthcare provider.
Question 8
A client with a new colostomy asks about stoma care. Which statement by the
client indicates a correct understanding?
A) I will change the pouch every day
B) I will cut the skin barrier one inch larger than my stoma
, C) I will empty the pouch when it is one-third to one-half full
D) I will apply powder to the stoma to keep it dry
Correct Answer: C
Rationale: The pouch should be emptied when it is one-third to one-half full to
prevent leakage and skin breakdown. The skin barrier should be cut to the exact
size of the stoma, not larger, to protect the peristomal skin.
Question 9
A client with heart failure is prescribed furosemide 40 mg IV. Which laboratory
value should the PN monitor closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss in the urine.
Hypokalemia is a significant side effect that can lead to cardiac arrhythmias,
especially in clients also taking digoxin.
Question 10
The PN is providing discharge teaching to a client with a new prescription for
warfarin. Which statement by the client indicates a need for further teaching?
A) I will avoid drinking alcohol while taking this medication
B) I will use a soft-bristled toothbrush
C) I will eat plenty of green leafy vegetables every day
D) I will report any unusual bruising or bleeding
Correct Answer: C
Rationale: Green leafy vegetables are high in vitamin K, which antagonizes the
effects of warfarin and reduces its anticoagulant effect. Clients should maintain a
consistent intake of vitamin K rather than increasing it.
Question 11
A client who is 1 day post-op from a total hip replacement reports sudden
shortness of breath and chest pain. What is the PN's priority action?
A) Administer oxygen via nasal cannula
B) Check the client's oxygen saturation
C) Notify the healthcare provider immediately
AND CORRECT ANSWER WITH RATIONALE
LATEST 2026
The PN HESI Exit Exam is a comprehensive, standardized assessment used
by practical nursing programs to evaluate student readiness for the NCLEX-
PN licensure examination. This rigorous exam consists of 200 questions,
including traditional multiple-choice and Next Generation NCLEX (NGN)
unfolding case studies. It covers essential nursing content areas such as
medical-surgical nursing, maternity and pediatrics, psychiatric/mental health,
pharmacology, and fundamentals of nursing care. The exam emphasizes
clinical judgment, prioritization, and safe decision-making. With proven
predictive validity, successful completion indicates that a student possesses the
necessary knowledge, critical thinking skills, and clinical competency to
practice safely as a licensed practical nurse and pass the national licensing
exam.
Question 1
A client receiving a blood transfusion develops chills and lower back pain. What is
the practical nurse's priority action?
A) Slow the infusion rate to 50 mL/hr
B) Stop the transfusion immediately
C) Administer an antihistamine
D) Take a set of vital signs
Correct Answer: B
Rationale: Chills and back pain are classic signs of a hemolytic transfusion
reaction. The priority action is to stop the transfusion immediately to prevent
further complications, then notify the healthcare provider and hang normal saline
with new tubing.
Question 2
The PN is preparing to administer digoxin 0.125 mg PO. The client's apical pulse
is 54 beats/min. What action should the PN take?
A) Administer the medication as prescribed
B) Hold the medication and notify the healthcare provider
,C) Retake the pulse in 15 minutes
D) Administer half the prescribed dose
Correct Answer: B
Rationale: Digoxin slows AV conduction and decreases heart rate. Standard
practice is to hold digoxin if the apical pulse is below 60 beats/min in adults and
notify the provider. Administering with a pulse of 54 could cause severe
bradycardia or heart block.
Question 3
An older adult client with metastatic breast cancer and bilateral pneumonia is
experiencing shortness of breath. The family requests hospice care. Which
information should the PN reinforce?
A) Instructions for care should be included in the living will
B) Hospice care can only be provided in hospital settings
C) Hospice care focuses on curing the disease
D) Hospice care focuses on comfort, dignity, and emotional support
Correct Answer: D
Rationale: Hospice care emphasizes comfort measures rather than curative
treatment. It can be provided wherever the client resides and focuses on dignity
and psychosocial support.
Question 4
The PN is caring for a client with a urinary catheter. Which finding indicates a
possible urinary tract infection?
A) Clear yellow urine
B) Foul-smelling urine
C) Output of 50 mL/hour
D) Client reports thirst
Correct Answer: B
Rationale: Foul-smelling urine, along with cloudy appearance or sediment,
indicates possible urinary tract infection. Other signs include fever, flank pain, and
changes in vital signs.
Question 5
A client with dementia becomes agitated and tries to leave the unit. Which
intervention should the practical nurse implement first?
A) Apply a vest restraint
,B) Administer a prescribed PRN sedative
C) Redirect the client to a safe, quiet activity
D) Notify the provider of the client's behavior
Correct Answer: C
Rationale: Redirection is the least restrictive intervention for managing agitation in
a client with dementia. Restraints should only be used as a last resort when less
restrictive measures have failed and the client is at immediate risk of harm.
Question 6
A client is 2 hours post-liver biopsy. In which position should the PN place the
client to reduce the risk of bleeding?
A) Supine
B) Right lateral decubitus
C) Left lateral decubitus
D) Semi-Fowler's
Correct Answer: B
Rationale: After a liver biopsy, the client should be placed in the right lateral
decubitus position to apply pressure to the biopsy site and reduce the risk of
bleeding.
Question 7
The PN notes that a client's oxygen saturation is 88% on room air 4 hours post-
surgery. What action should the PN take?
A) Continue to monitor and document the finding
B) Apply oxygen via nasal cannula and notify the healthcare provider
C) Increase the client's activity to improve ventilation
D) Encourage the client to take deep breaths and cough
Correct Answer: B
Rationale: An oxygen saturation of 88% is below the normal range (94-100%) and
indicates hypoxemia requiring intervention. The PN should apply supplemental
oxygen and notify the healthcare provider.
Question 8
A client with a new colostomy asks about stoma care. Which statement by the
client indicates a correct understanding?
A) I will change the pouch every day
B) I will cut the skin barrier one inch larger than my stoma
, C) I will empty the pouch when it is one-third to one-half full
D) I will apply powder to the stoma to keep it dry
Correct Answer: C
Rationale: The pouch should be emptied when it is one-third to one-half full to
prevent leakage and skin breakdown. The skin barrier should be cut to the exact
size of the stoma, not larger, to protect the peristomal skin.
Question 9
A client with heart failure is prescribed furosemide 40 mg IV. Which laboratory
value should the PN monitor closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss in the urine.
Hypokalemia is a significant side effect that can lead to cardiac arrhythmias,
especially in clients also taking digoxin.
Question 10
The PN is providing discharge teaching to a client with a new prescription for
warfarin. Which statement by the client indicates a need for further teaching?
A) I will avoid drinking alcohol while taking this medication
B) I will use a soft-bristled toothbrush
C) I will eat plenty of green leafy vegetables every day
D) I will report any unusual bruising or bleeding
Correct Answer: C
Rationale: Green leafy vegetables are high in vitamin K, which antagonizes the
effects of warfarin and reduces its anticoagulant effect. Clients should maintain a
consistent intake of vitamin K rather than increasing it.
Question 11
A client who is 1 day post-op from a total hip replacement reports sudden
shortness of breath and chest pain. What is the PN's priority action?
A) Administer oxygen via nasal cannula
B) Check the client's oxygen saturation
C) Notify the healthcare provider immediately
