HESI PN COMPREHENSIVE EXAM
B 2026: REAL EXAM QUESTIONS
AND CORRECT VERIFIED
LATEST MOCK PRACTICE SET
200 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
HESI PN COMPREHENSIVE EXAM B 2026: REAL EXAM QUESTIONS AND CORRECT VERIFIED ANSWERS
| PRACTICAL NURSING HESI. It contains 200 carefully selected questions that reflect the most current exam
content and testing strategies. Each question is accompanied by a correct answer and a detailed rationale that
explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 200 Questions
Foundations - Application - HESI PN Comprehensive B 2026 REAL AND Correct Practical Nursing HESI
HESI PN Comprehensive B 2026 Undergraduate YEAR 3 Practical Nursing Program
All answers with rationales
,Table of Contents
Section A - Fundamentals OF Nursing Section B - Medical-surgical Nursing
Questions 1 to 50 Questions 51 to 100
Section C - Maternal-newborn Nursing Section D - Pediatric Nursing
Questions 101 to 150 Questions 151 to 200
,Section A - Fundamentals OF Nursing
Q1.
A patient with a history of heart failure is admitted with dyspnea and crackles in the lung
bases. Which assessment finding most reliably indicates worsening cardiac output?
A. Decreased urine output (<30 mL/hr) B. Increased heart rate (110 bpm)
C. Jugular venous distention (JVD) at 45 D. Pulsus paradoxus >10 mmHg
degrees
Correct: A - Decreased urine output (<30 mL/hr)
Rationale:Decreased urine output is a sensitive indicator of reduced renal perfusion due to
low cardiac output. Heart rate and JVD reflect compensatory mechanisms but are less
specific. Pulsus paradoxus is more indicative of cardiac tamponade.
Q2.
Which laboratory value best distinguishes prerenal from intrarenal acute kidney injury
(AKI)?
A. Serum creatinine B. Blood urea nitrogen (BUN):creatinine
ratio
C. Urine sodium concentration D. Fractional excretion of sodium (FENa)
Correct: D - Fractional excretion of sodium (FENa)
Rationale:FENa <1% suggests prerenal (intact tubules), while >2% indicates intrarenal
(tubular damage). BUN:creatinine ratio >20 supports prerenal but is less accurate. Urine
sodium alone can be affected by diuretics.
Q3.
A patient receiving IV heparin develops a platelet count drop from 250,000 to 90,000/mm³.
What is the priority nursing action?
A. Administer protamine sulfate B. Discontinue the heparin infusion
C. Obtain aPTT and INR stat D. Apply warm compresses to infusion site
Correct: B - Discontinue the heparin infusion
Rationale:A 50% drop in platelets suggests heparin-induced thrombocytopenia (HIT).
Immediate cessation of heparin is critical to prevent thrombosis. Protamine reverses
anticoagulation but not HIT; aPTT/INR confirm status but are not the priority.
Page 3
, Section A - Fundamentals OF Nursing
Q4.
Which of the following patients should be assigned to the most experienced nurse?
A. Postoperative day 1 after B. Newly diagnosed type 2 diabetes
cholecystectomy with stable vital signs requiring insulin education
C. Four days post-myocardial infarction with D. Acute asthma exacerbation with
occasional PVCs paradoxical breathing and SpO 88%
Correct: D - Acute asthma exacerbation with paradoxical breathing and SpO 88%
Rationale:Paradoxical breathing and hypoxia indicate impending respiratory failure, requiring
immediate advanced assessment and intervention. This patient is unstable and demands the
highest level of nursing expertise.
Q5.
A patient on lithium therapy has a serum level of 2.0 mEq/L. Which finding requires
immediate intervention?
A. Fine hand tremor B. Polyuria and polydipsia
C. Coarse tremors and slurred speech D. Mild nausea and diarrhea
Correct: C - Coarse tremors and slurred speech
Rationale:Lithium levels >1.5 mEq/L indicate toxicity. Coarse tremors and slurred speech
signal severe neurotoxicity requiring urgent treatment (e.g., hemodialysis). Fine tremor,
polyuria, and mild GI symptoms occur at therapeutic levels or early toxicity.
Q6.
A patient with chronic kidney disease (GFR 25 mL/min) is prescribed metformin. What is
the nurse's priority action?
A. Administer the medication as ordered B. Hold the medication and notify the
prescriber
C. Monitor blood glucose hourly D. Increase oral fluid intake
Correct: B - Hold the medication and notify the prescriber
Rationale:Metformin is contraindicated when GFR <30 mL/min due to risk of lactic acidosis.
The nurse should hold the drug and notify the prescriber for an alternative. Monitoring glucose
is important but not the priority.
Page 4
B 2026: REAL EXAM QUESTIONS
AND CORRECT VERIFIED
LATEST MOCK PRACTICE SET
200 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
HESI PN COMPREHENSIVE EXAM B 2026: REAL EXAM QUESTIONS AND CORRECT VERIFIED ANSWERS
| PRACTICAL NURSING HESI. It contains 200 carefully selected questions that reflect the most current exam
content and testing strategies. Each question is accompanied by a correct answer and a detailed rationale that
explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 200 Questions
Foundations - Application - HESI PN Comprehensive B 2026 REAL AND Correct Practical Nursing HESI
HESI PN Comprehensive B 2026 Undergraduate YEAR 3 Practical Nursing Program
All answers with rationales
,Table of Contents
Section A - Fundamentals OF Nursing Section B - Medical-surgical Nursing
Questions 1 to 50 Questions 51 to 100
Section C - Maternal-newborn Nursing Section D - Pediatric Nursing
Questions 101 to 150 Questions 151 to 200
,Section A - Fundamentals OF Nursing
Q1.
A patient with a history of heart failure is admitted with dyspnea and crackles in the lung
bases. Which assessment finding most reliably indicates worsening cardiac output?
A. Decreased urine output (<30 mL/hr) B. Increased heart rate (110 bpm)
C. Jugular venous distention (JVD) at 45 D. Pulsus paradoxus >10 mmHg
degrees
Correct: A - Decreased urine output (<30 mL/hr)
Rationale:Decreased urine output is a sensitive indicator of reduced renal perfusion due to
low cardiac output. Heart rate and JVD reflect compensatory mechanisms but are less
specific. Pulsus paradoxus is more indicative of cardiac tamponade.
Q2.
Which laboratory value best distinguishes prerenal from intrarenal acute kidney injury
(AKI)?
A. Serum creatinine B. Blood urea nitrogen (BUN):creatinine
ratio
C. Urine sodium concentration D. Fractional excretion of sodium (FENa)
Correct: D - Fractional excretion of sodium (FENa)
Rationale:FENa <1% suggests prerenal (intact tubules), while >2% indicates intrarenal
(tubular damage). BUN:creatinine ratio >20 supports prerenal but is less accurate. Urine
sodium alone can be affected by diuretics.
Q3.
A patient receiving IV heparin develops a platelet count drop from 250,000 to 90,000/mm³.
What is the priority nursing action?
A. Administer protamine sulfate B. Discontinue the heparin infusion
C. Obtain aPTT and INR stat D. Apply warm compresses to infusion site
Correct: B - Discontinue the heparin infusion
Rationale:A 50% drop in platelets suggests heparin-induced thrombocytopenia (HIT).
Immediate cessation of heparin is critical to prevent thrombosis. Protamine reverses
anticoagulation but not HIT; aPTT/INR confirm status but are not the priority.
Page 3
, Section A - Fundamentals OF Nursing
Q4.
Which of the following patients should be assigned to the most experienced nurse?
A. Postoperative day 1 after B. Newly diagnosed type 2 diabetes
cholecystectomy with stable vital signs requiring insulin education
C. Four days post-myocardial infarction with D. Acute asthma exacerbation with
occasional PVCs paradoxical breathing and SpO 88%
Correct: D - Acute asthma exacerbation with paradoxical breathing and SpO 88%
Rationale:Paradoxical breathing and hypoxia indicate impending respiratory failure, requiring
immediate advanced assessment and intervention. This patient is unstable and demands the
highest level of nursing expertise.
Q5.
A patient on lithium therapy has a serum level of 2.0 mEq/L. Which finding requires
immediate intervention?
A. Fine hand tremor B. Polyuria and polydipsia
C. Coarse tremors and slurred speech D. Mild nausea and diarrhea
Correct: C - Coarse tremors and slurred speech
Rationale:Lithium levels >1.5 mEq/L indicate toxicity. Coarse tremors and slurred speech
signal severe neurotoxicity requiring urgent treatment (e.g., hemodialysis). Fine tremor,
polyuria, and mild GI symptoms occur at therapeutic levels or early toxicity.
Q6.
A patient with chronic kidney disease (GFR 25 mL/min) is prescribed metformin. What is
the nurse's priority action?
A. Administer the medication as ordered B. Hold the medication and notify the
prescriber
C. Monitor blood glucose hourly D. Increase oral fluid intake
Correct: B - Hold the medication and notify the prescriber
Rationale:Metformin is contraindicated when GFR <30 mL/min due to risk of lactic acidosis.
The nurse should hold the drug and notify the prescriber for an alternative. Monitoring glucose
is important but not the priority.
Page 4
