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HESI PN Leadership Exit Exam 2026/2027 | Latest
Verified Questions and Detailed Answers
OVERVIEW DESCRIPTION:
This comprehensive set of multiple-choice questions is designed for the HESI PN
Leadership Exit Exam, a specialized assessment for practical nursing students nearing
program completion. The exam evaluates the LPN’s readiness for the NCLEX-PN and
essential management principles, focusing on delegation and supervision, prioritization
of care, ethical and legal scope of practice, safety and infection control, conflict
resolution, and quality improvement. Its structure includes multiple-choice, Select-All-
That-Apply, and Next Generation NCLEX question formats, and it is administered by
Health Education Systems, Inc. (HESI).
QUESTION 1
A practical nurse (PN) is supervising an unlicensed assistive personnel (UAP) in a long-
term care facility. Which task is most appropriate to delegate to the UAP?
A. Administering a lubricating eye drop to a resident with dry eyes
B. Feeding a resident with dysphagia who requires aspiration precautions
C. Measuring and recording intake and output on a stable resident
D. Obtaining a stool specimen for occult blood testing
CORRECT ANSWER: C. Measuring and recording intake and output on a stable resident
EXPERT RATIONALE: UAPs can measure and record I&O for stable clients because it
does not require clinical judgment. Feeding a resident with dysphagia and specimen
collection require nursing assessment skills, while medication administration is outside
UAP scope.
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QUESTION 2
The PN receives handoff report on four clients. Who should be assessed first?
A. A client with chronic obstructive pulmonary disease (COPD) who is resting quietly
B. A client with heart failure who has bilateral crackles and an SpO₂ of 90% on room air
C. A client with diabetes mellitus awaiting breakfast tray delivery
D. A client with a fractured hip who is scheduled for a shower
CORRECT ANSWER: B. A client with heart failure who has bilateral crackles and an SpO₂
of 90% on room air
EXPERT RATIONALE: This client is at risk for respiratory compromise (ABCs). Hypoxia and
crackles indicate acute decompensation requiring immediate assessment by the PN.
QUESTION 3
The PN enters a client’s room and discovers that the client has removed the nasal
cannula and oxygen is blowing into the bed. What should the PN do first?
A. Complete an incident report
B. Assess the client's respiratory status
C. Reapply the nasal cannula to the client
D. Notify the registered nurse (RN) or healthcare provider
CORRECT ANSWER: B. Assess the client's respiratory status
EXPERT RATIONALE: The priority is to assess for any immediate adverse effects from lack
of oxygen before taking corrective action. Assessment always precedes intervention.
QUESTION 4
A UAP reports that a client’s blood pressure is 190/110 mmHg. The client is
asymptomatic and resting in bed. What action should the PN take first?
A. Ask the UAP to retake the blood pressure in the other arm
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B. Instruct the UAP to keep the client flat
C. Report the finding to the RN immediately
D. Reassess the blood pressure personally
CORRECT ANSWER: D. Reassess the blood pressure personally
EXPERT RATIONALE: The PN must verify an abnormal reading before making clinical
decisions. Delegation of vital sign measurement requires follow-up validation for
abnormal values.
QUESTION 5
A client who requires a sterile dressing change is assigned to a PN. Which statement
indicates the PN understands the scope of practice?
A. “I can perform the dressing change since it is a routine sterile procedure.”
B. “I will ask the RN to change the dressing because it is sterile.”
C. “My role is to assist the RN during the dressing change.”
D. “The UAP can do the dressing change if I supervise.”
CORRECT ANSWER: A. “I can perform the dressing change since it is a routine sterile
procedure.”
EXPERT RATIONALE: LPNs/PNs are trained to perform sterile procedures such as
dressing changes. The state’s nurse practice act permits PNs to perform treatments as
prescribed.
QUESTION 6
The PN discovers that a client’s signed surgical consent form is not in the chart. The
client states the surgeon explained the procedure. What is the PN’s best action?
A. Have the client sign a new consent form
B. Ask the surgeon to come back and obtain a new consent
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C. Witness the client’s signature on a blank consent form
D. Notify the circulating nurse to proceed without the form
CORRECT ANSWER: B. Ask the surgeon to come back and obtain a new consent
EXPERT RATIONALE: The PN cannot obtain informed consent; the person performing
the procedure is responsible. The PN may verify that the consent is present and the
client’s understanding.
QUESTION 7
A PN is caring for a group of clients. Which task can be assigned to a UAP?
A. Monitoring a client receiving a blood transfusion for the first 15 minutes
B. Applying a cold compress to a client’s sprained ankle as ordered
C. Removing an indwelling urinary catheter
D. Teaching a client how to use an incentive spirometer
CORRECT ANSWER: B. Applying a cold compress to a client’s sprained ankle as ordered
EXPERT RATIONALE: Applying a non-invasive, prescribed compress is within UAP scope.
Monitoring blood transfusion, catheter removal, and teaching require nursing judgment.
QUESTION 8
The charge PN is making assignments for the shift. Which client should be assigned to
an RN rather than a PN?
A. A client newly diagnosed with diabetes requiring initial diet teaching
B. A client with stable angina needing administration of antianginal medication
C. A client with a colostomy who requires stoma site cleansing
D. A client who needs a sublingual nitroglycerin for chest pain
HESI PN Leadership Exit Exam 2026/2027 | Latest
Verified Questions and Detailed Answers
OVERVIEW DESCRIPTION:
This comprehensive set of multiple-choice questions is designed for the HESI PN
Leadership Exit Exam, a specialized assessment for practical nursing students nearing
program completion. The exam evaluates the LPN’s readiness for the NCLEX-PN and
essential management principles, focusing on delegation and supervision, prioritization
of care, ethical and legal scope of practice, safety and infection control, conflict
resolution, and quality improvement. Its structure includes multiple-choice, Select-All-
That-Apply, and Next Generation NCLEX question formats, and it is administered by
Health Education Systems, Inc. (HESI).
QUESTION 1
A practical nurse (PN) is supervising an unlicensed assistive personnel (UAP) in a long-
term care facility. Which task is most appropriate to delegate to the UAP?
A. Administering a lubricating eye drop to a resident with dry eyes
B. Feeding a resident with dysphagia who requires aspiration precautions
C. Measuring and recording intake and output on a stable resident
D. Obtaining a stool specimen for occult blood testing
CORRECT ANSWER: C. Measuring and recording intake and output on a stable resident
EXPERT RATIONALE: UAPs can measure and record I&O for stable clients because it
does not require clinical judgment. Feeding a resident with dysphagia and specimen
collection require nursing assessment skills, while medication administration is outside
UAP scope.
,2|Page
QUESTION 2
The PN receives handoff report on four clients. Who should be assessed first?
A. A client with chronic obstructive pulmonary disease (COPD) who is resting quietly
B. A client with heart failure who has bilateral crackles and an SpO₂ of 90% on room air
C. A client with diabetes mellitus awaiting breakfast tray delivery
D. A client with a fractured hip who is scheduled for a shower
CORRECT ANSWER: B. A client with heart failure who has bilateral crackles and an SpO₂
of 90% on room air
EXPERT RATIONALE: This client is at risk for respiratory compromise (ABCs). Hypoxia and
crackles indicate acute decompensation requiring immediate assessment by the PN.
QUESTION 3
The PN enters a client’s room and discovers that the client has removed the nasal
cannula and oxygen is blowing into the bed. What should the PN do first?
A. Complete an incident report
B. Assess the client's respiratory status
C. Reapply the nasal cannula to the client
D. Notify the registered nurse (RN) or healthcare provider
CORRECT ANSWER: B. Assess the client's respiratory status
EXPERT RATIONALE: The priority is to assess for any immediate adverse effects from lack
of oxygen before taking corrective action. Assessment always precedes intervention.
QUESTION 4
A UAP reports that a client’s blood pressure is 190/110 mmHg. The client is
asymptomatic and resting in bed. What action should the PN take first?
A. Ask the UAP to retake the blood pressure in the other arm
,3|Page
B. Instruct the UAP to keep the client flat
C. Report the finding to the RN immediately
D. Reassess the blood pressure personally
CORRECT ANSWER: D. Reassess the blood pressure personally
EXPERT RATIONALE: The PN must verify an abnormal reading before making clinical
decisions. Delegation of vital sign measurement requires follow-up validation for
abnormal values.
QUESTION 5
A client who requires a sterile dressing change is assigned to a PN. Which statement
indicates the PN understands the scope of practice?
A. “I can perform the dressing change since it is a routine sterile procedure.”
B. “I will ask the RN to change the dressing because it is sterile.”
C. “My role is to assist the RN during the dressing change.”
D. “The UAP can do the dressing change if I supervise.”
CORRECT ANSWER: A. “I can perform the dressing change since it is a routine sterile
procedure.”
EXPERT RATIONALE: LPNs/PNs are trained to perform sterile procedures such as
dressing changes. The state’s nurse practice act permits PNs to perform treatments as
prescribed.
QUESTION 6
The PN discovers that a client’s signed surgical consent form is not in the chart. The
client states the surgeon explained the procedure. What is the PN’s best action?
A. Have the client sign a new consent form
B. Ask the surgeon to come back and obtain a new consent
, 4|Page
C. Witness the client’s signature on a blank consent form
D. Notify the circulating nurse to proceed without the form
CORRECT ANSWER: B. Ask the surgeon to come back and obtain a new consent
EXPERT RATIONALE: The PN cannot obtain informed consent; the person performing
the procedure is responsible. The PN may verify that the consent is present and the
client’s understanding.
QUESTION 7
A PN is caring for a group of clients. Which task can be assigned to a UAP?
A. Monitoring a client receiving a blood transfusion for the first 15 minutes
B. Applying a cold compress to a client’s sprained ankle as ordered
C. Removing an indwelling urinary catheter
D. Teaching a client how to use an incentive spirometer
CORRECT ANSWER: B. Applying a cold compress to a client’s sprained ankle as ordered
EXPERT RATIONALE: Applying a non-invasive, prescribed compress is within UAP scope.
Monitoring blood transfusion, catheter removal, and teaching require nursing judgment.
QUESTION 8
The charge PN is making assignments for the shift. Which client should be assigned to
an RN rather than a PN?
A. A client newly diagnosed with diabetes requiring initial diet teaching
B. A client with stable angina needing administration of antianginal medication
C. A client with a colostomy who requires stoma site cleansing
D. A client who needs a sublingual nitroglycerin for chest pain
