HESI LPN-ADN Entrance Exam 2026/2027 - Complete
Exam-Style Questions | 150 Verified Questions
HESI LPN-ADN Entrance Exam 2026-2027 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive exam prep document provides 150 verified, exam-style questions meticulously
aligned with the 2026/2027 HESI LPN-ADN Entrance Exam blueprint. Each question includes
detailed rationales and distractor explanations, ensuring thorough understanding of core nursing
concepts. Designed for LPNs seeking ADN admission, this resource covers essential content areas with
up-to-date clinical scenarios. Achieve a top score with confidence using this pass-guaranteed study
guide.
Abstract:
The 2026/2027 edition of the HESI LPN-ADN Entrance Exam study resource offers 150 verified exam-style
questions, each accompanied by comprehensive rationales and distractor analysis. This document is structured to
reflect the exam's content distribution, covering fundamentals of nursing, pharmacology, maternal-newborn care,
pediatric nursing, mental health, and medical-surgical nursing. The questions are designed to assess critical
thinking and application of knowledge in clinical scenarios, aligning with the latest evidence-based practice
guidelines. Each section's weight mirrors the actual exam to optimize preparation efficiency. The answer format
ensures learners understand not only correct choices but also why alternatives are incorrect, promoting deeper
learning. This resource is an indispensable tool for LPNs transitioning to ADN programs, aiming for a pass
guarantee and top performance.
Content Area Overview:
Content Area Questions Key Topics Weight
Fundamentals of Nursing 1-30 Infection control, vital signs, safety, 20%
legal/ethical issues
Pharmacology 31-50 Dosage calculations, medication 13%
administration, adverse effects
Maternal-Newborn Nursing 51-75 Antepartum, intrapartum, postpartum, 17%
neonatal care
Pediatric Nursing 76-100 Growth and development, common 17%
childhood illnesses, immunizations
Mental Health Nursing 101-120 Therapeutic communication, psychiatric 13%
disorders, crisis intervention
Medical-Surgical Nursing 121-150 Cardiovascular, respiratory, gastrointestinal, 20%
endocrine systems
Page 1
,Q1. A nurse reviews arterial blood gas results: pH 7.25, PaCO2 50 mm Hg, HCO3- 24 mEq/L.
Which acid-base imbalance is present, and what is the priority intervention?
A. Anticipated: Administer O2, Position high Fowler's; Nonessential: Deep breathing, Intubation;
Contraindicated: Sodium bicarbonate
B. Anticipated: Administer O2, Deep breathing; Nonessential: Intubation, High Fowler's;
Contraindicated: Sodium bicarbonate
C. Anticipated: Administer O2, Sodium bicarbonate; Nonessential: Deep breathing; Contraindicated:
Intubation, High Fowler's
D. Anticipated: All interventions; Nonessential: None; Contraindicated: None
Correct Answer: A. Anticipated: Administer O2, Position high Fowler's; Nonessential: Deep
breathing, Intubation; Contraindicated: Sodium bicarbonate
Rationale: The ABG indicates uncompensated respiratory acidosis (low pH, high PaCO2, normal
HCO3-). Anticipated interventions improve ventilation and oxygenation: O2 via non-rebreather and high
Fowler's. Deep breathing is nonessential because the problem is hypoventilation, not ineffective cough.
Intubation is not yet indicated unless patient deteriorates. Sodium bicarbonate is contraindicated because
it can cause metabolic alkalosis and is not standard for respiratory acidosis without severe acidosis.
Why Wrong:
B - Deep breathing is nonessential, not anticipated; high Fowler's is anticipated, not nonessential.
C - Sodium bicarbonate is contraindicated, not anticipated; intubation is nonessential, not
contraindicated.
D - Sodium bicarbonate is not anticipated; intubation is not anticipated at this time.
Reference: Ignatavicius, D. D. (2026). Medical-Surgical Nursing: Concepts for Interprofessional Care,
11th ed., Ch. 16.
Q2. A nurse is caring for four patients. Based on the provided report, which patient requires the
most immediate nursing intervention?
A. Patient A: 1, Patient B: 2, Patient C: 3, Patient D: 1
B. Patient A: 1, Patient B: 1, Patient C: 2, Patient D: 1
C. Patient A: 1, Patient B: 2, Patient C: 1, Patient D: 1
D. Patient A: 2, Patient B: 1, Patient C: 2, Patient D: 1
Correct Answer: C. Patient A: 1, Patient B: 2, Patient C: 1, Patient D: 1
Rationale: Patient A (critical, 1) has signs of pulmonary embolism. Patient D (critical, 1) has an allergic
transfusion reaction. Patient C (urgent, 2) has mild hypoxemia. Patient B (non-urgent, 3) shows signs of
hypovolemia but is stable. Both A and D are life-threatening, but A requires immediate attention. In this
ranking, both A and D are priority 1, C is 2, B is 3.
Why Wrong:
A - Patient C is not non-urgent; sat 91% on O2 requires intervention.
B - Patient B is not critical; hypovolemia is urgent but not as critical as PE or transfusion reaction.
D - Patient A is critical, not urgent; Patient B is non-urgent, not critical.
Reference: Harding, M. M., et al. (2026). Lewis's Medical-Surgical Nursing, 12th ed., Ch. 67.
Page 2
,Q3. A patient receiving warfarin therapy has an INR of 5.2 and is not bleeding. Which intervention
is most appropriate?
A. Administer vitamin K 1 mg orally.
B. Hold warfarin and administer fresh frozen plasma.
C. Administer protamine sulfate.
D. Continue warfarin and recheck INR in 24 hours.
Correct Answer: A. Administer vitamin K 1 mg orally.
Rationale: For a supratherapeutic INR (5-9) without bleeding, the standard intervention is to hold
warfarin and give oral vitamin K 1-2.5 mg. Fresh frozen plasma is reserved for active bleeding.
Protamine sulfate reverses heparin, not warfarin. Continuing warfarin increases bleeding risk.
Why Wrong:
B - Fresh frozen plasma is indicated only for active bleeding, not for elevated INR without bleeding.
C - Protamine sulfate reverses heparin, not warfarin.
D - Continuing warfarin with INR 5.2 risks bleeding; holding and reversing is required.
Reference: Lehne, R. A. (2026). Pharmacology for Nursing Care, 12th ed., Ch. 34.
Q4. A nurse assesses a patient with a long-arm cast for compartment syndrome. Which finding is
most indicative of early compartment syndrome?
A. Pallor of the fingers
B. Pain on passive stretch of fingers
C. Absence of radial pulse
D. Capillary refill > 3 seconds
Correct Answer: B. Pain on passive stretch of fingers
Rationale: Pain with passive stretch is the earliest and most reliable sign of compartment syndrome,
caused by ischemia of muscles and nerves. Pallor, pulselessness, and delayed capillary refill are later
signs indicating severe ischemia. Early detection is critical to prevent permanent damage.
Why Wrong:
A - Pallor is a later sign of circulatory compromise, not the earliest indicator.
C - Absence of pulse is a late sign that indicates advanced compartment syndrome.
D - Delayed capillary refill is a nonspecific sign and occurs later in the process.
Reference: Ignatavicius, D. D. (2026). Medical-Surgical Nursing, 11th ed., Ch. 66.
Page 3
, Q5. A client with a history of seizure disorder is prescribed phenytoin. Which laboratory value
requires immediate intervention?
A. Phenytoin level 15 mcg/mL
B. Phenytoin level 22 mcg/mL
C. Phenytoin level 8 mcg/mL
D. Phenytoin level 12 mcg/mL
Correct Answer: B. Phenytoin level 22 mcg/mL
Rationale: The therapeutic range for phenytoin is 10-20 mcg/mL. A level of 22 mcg/mL is above
therapeutic and may cause toxicity (nystagmus, ataxia, sedation). The nurse should notify the provider,
hold the next dose, and monitor for toxicity. Levels 8, 12, and 15 are within or below therapeutic; 8 is
subtherapeutic but not immediate danger.
Why Wrong:
A - 15 mcg/mL is within therapeutic range (10-20 mcg/mL).
C - 8 mcg/mL is below therapeutic but does not require immediate intervention; the nurse should
notify the provider for dose adjustment.
D - 12 mcg/mL is within therapeutic range.
Reference: Lehne, R. A. (2026). Pharmacology for Nursing Care, 12th ed., Ch. 17.
Q6. A nurse is reviewing fetal heart rate (FHR) monitoring. Which pattern indicates late
decelerations?
A. Deceleration that mirrors the contraction, with onset and return at peak of contraction.
B. Deceleration that starts after contraction begins and returns to baseline after contraction ends.
C. Deceleration that occurs abruptly, unrelated to contractions, and lasts less than 30 seconds.
D. Deceleration that starts at the onset of contraction and returns to baseline by the end of contraction.
Correct Answer: B. Deceleration that starts after contraction begins and returns to baseline after
contraction ends.
Rationale: Late decelerations are a sign of uteroplacental insufficiency, with the decrease in FHR
starting after the contraction begins (late onset) and returning to baseline after the contraction ends (slow
recovery). Option A describes variable decelerations (cord compression). Option C describes early
decelerations (head compression). Option D is a less descriptive version of early decelerations.
Why Wrong:
A - This describes variable decelerations, which are caused by cord compression and have a variable
shape.
C - This describes early decelerations, which are benign and mirror the contraction.
D - This is also early decelerations; late decelerations have onset after peak of contraction, not at
onset.
Reference: Lowdermilk, D. L., & Perry, S. E. (2026). Maternity & Women's Health Care, 12th ed., Ch. 15.
Page 4
Exam-Style Questions | 150 Verified Questions
HESI LPN-ADN Entrance Exam 2026-2027 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive exam prep document provides 150 verified, exam-style questions meticulously
aligned with the 2026/2027 HESI LPN-ADN Entrance Exam blueprint. Each question includes
detailed rationales and distractor explanations, ensuring thorough understanding of core nursing
concepts. Designed for LPNs seeking ADN admission, this resource covers essential content areas with
up-to-date clinical scenarios. Achieve a top score with confidence using this pass-guaranteed study
guide.
Abstract:
The 2026/2027 edition of the HESI LPN-ADN Entrance Exam study resource offers 150 verified exam-style
questions, each accompanied by comprehensive rationales and distractor analysis. This document is structured to
reflect the exam's content distribution, covering fundamentals of nursing, pharmacology, maternal-newborn care,
pediatric nursing, mental health, and medical-surgical nursing. The questions are designed to assess critical
thinking and application of knowledge in clinical scenarios, aligning with the latest evidence-based practice
guidelines. Each section's weight mirrors the actual exam to optimize preparation efficiency. The answer format
ensures learners understand not only correct choices but also why alternatives are incorrect, promoting deeper
learning. This resource is an indispensable tool for LPNs transitioning to ADN programs, aiming for a pass
guarantee and top performance.
Content Area Overview:
Content Area Questions Key Topics Weight
Fundamentals of Nursing 1-30 Infection control, vital signs, safety, 20%
legal/ethical issues
Pharmacology 31-50 Dosage calculations, medication 13%
administration, adverse effects
Maternal-Newborn Nursing 51-75 Antepartum, intrapartum, postpartum, 17%
neonatal care
Pediatric Nursing 76-100 Growth and development, common 17%
childhood illnesses, immunizations
Mental Health Nursing 101-120 Therapeutic communication, psychiatric 13%
disorders, crisis intervention
Medical-Surgical Nursing 121-150 Cardiovascular, respiratory, gastrointestinal, 20%
endocrine systems
Page 1
,Q1. A nurse reviews arterial blood gas results: pH 7.25, PaCO2 50 mm Hg, HCO3- 24 mEq/L.
Which acid-base imbalance is present, and what is the priority intervention?
A. Anticipated: Administer O2, Position high Fowler's; Nonessential: Deep breathing, Intubation;
Contraindicated: Sodium bicarbonate
B. Anticipated: Administer O2, Deep breathing; Nonessential: Intubation, High Fowler's;
Contraindicated: Sodium bicarbonate
C. Anticipated: Administer O2, Sodium bicarbonate; Nonessential: Deep breathing; Contraindicated:
Intubation, High Fowler's
D. Anticipated: All interventions; Nonessential: None; Contraindicated: None
Correct Answer: A. Anticipated: Administer O2, Position high Fowler's; Nonessential: Deep
breathing, Intubation; Contraindicated: Sodium bicarbonate
Rationale: The ABG indicates uncompensated respiratory acidosis (low pH, high PaCO2, normal
HCO3-). Anticipated interventions improve ventilation and oxygenation: O2 via non-rebreather and high
Fowler's. Deep breathing is nonessential because the problem is hypoventilation, not ineffective cough.
Intubation is not yet indicated unless patient deteriorates. Sodium bicarbonate is contraindicated because
it can cause metabolic alkalosis and is not standard for respiratory acidosis without severe acidosis.
Why Wrong:
B - Deep breathing is nonessential, not anticipated; high Fowler's is anticipated, not nonessential.
C - Sodium bicarbonate is contraindicated, not anticipated; intubation is nonessential, not
contraindicated.
D - Sodium bicarbonate is not anticipated; intubation is not anticipated at this time.
Reference: Ignatavicius, D. D. (2026). Medical-Surgical Nursing: Concepts for Interprofessional Care,
11th ed., Ch. 16.
Q2. A nurse is caring for four patients. Based on the provided report, which patient requires the
most immediate nursing intervention?
A. Patient A: 1, Patient B: 2, Patient C: 3, Patient D: 1
B. Patient A: 1, Patient B: 1, Patient C: 2, Patient D: 1
C. Patient A: 1, Patient B: 2, Patient C: 1, Patient D: 1
D. Patient A: 2, Patient B: 1, Patient C: 2, Patient D: 1
Correct Answer: C. Patient A: 1, Patient B: 2, Patient C: 1, Patient D: 1
Rationale: Patient A (critical, 1) has signs of pulmonary embolism. Patient D (critical, 1) has an allergic
transfusion reaction. Patient C (urgent, 2) has mild hypoxemia. Patient B (non-urgent, 3) shows signs of
hypovolemia but is stable. Both A and D are life-threatening, but A requires immediate attention. In this
ranking, both A and D are priority 1, C is 2, B is 3.
Why Wrong:
A - Patient C is not non-urgent; sat 91% on O2 requires intervention.
B - Patient B is not critical; hypovolemia is urgent but not as critical as PE or transfusion reaction.
D - Patient A is critical, not urgent; Patient B is non-urgent, not critical.
Reference: Harding, M. M., et al. (2026). Lewis's Medical-Surgical Nursing, 12th ed., Ch. 67.
Page 2
,Q3. A patient receiving warfarin therapy has an INR of 5.2 and is not bleeding. Which intervention
is most appropriate?
A. Administer vitamin K 1 mg orally.
B. Hold warfarin and administer fresh frozen plasma.
C. Administer protamine sulfate.
D. Continue warfarin and recheck INR in 24 hours.
Correct Answer: A. Administer vitamin K 1 mg orally.
Rationale: For a supratherapeutic INR (5-9) without bleeding, the standard intervention is to hold
warfarin and give oral vitamin K 1-2.5 mg. Fresh frozen plasma is reserved for active bleeding.
Protamine sulfate reverses heparin, not warfarin. Continuing warfarin increases bleeding risk.
Why Wrong:
B - Fresh frozen plasma is indicated only for active bleeding, not for elevated INR without bleeding.
C - Protamine sulfate reverses heparin, not warfarin.
D - Continuing warfarin with INR 5.2 risks bleeding; holding and reversing is required.
Reference: Lehne, R. A. (2026). Pharmacology for Nursing Care, 12th ed., Ch. 34.
Q4. A nurse assesses a patient with a long-arm cast for compartment syndrome. Which finding is
most indicative of early compartment syndrome?
A. Pallor of the fingers
B. Pain on passive stretch of fingers
C. Absence of radial pulse
D. Capillary refill > 3 seconds
Correct Answer: B. Pain on passive stretch of fingers
Rationale: Pain with passive stretch is the earliest and most reliable sign of compartment syndrome,
caused by ischemia of muscles and nerves. Pallor, pulselessness, and delayed capillary refill are later
signs indicating severe ischemia. Early detection is critical to prevent permanent damage.
Why Wrong:
A - Pallor is a later sign of circulatory compromise, not the earliest indicator.
C - Absence of pulse is a late sign that indicates advanced compartment syndrome.
D - Delayed capillary refill is a nonspecific sign and occurs later in the process.
Reference: Ignatavicius, D. D. (2026). Medical-Surgical Nursing, 11th ed., Ch. 66.
Page 3
, Q5. A client with a history of seizure disorder is prescribed phenytoin. Which laboratory value
requires immediate intervention?
A. Phenytoin level 15 mcg/mL
B. Phenytoin level 22 mcg/mL
C. Phenytoin level 8 mcg/mL
D. Phenytoin level 12 mcg/mL
Correct Answer: B. Phenytoin level 22 mcg/mL
Rationale: The therapeutic range for phenytoin is 10-20 mcg/mL. A level of 22 mcg/mL is above
therapeutic and may cause toxicity (nystagmus, ataxia, sedation). The nurse should notify the provider,
hold the next dose, and monitor for toxicity. Levels 8, 12, and 15 are within or below therapeutic; 8 is
subtherapeutic but not immediate danger.
Why Wrong:
A - 15 mcg/mL is within therapeutic range (10-20 mcg/mL).
C - 8 mcg/mL is below therapeutic but does not require immediate intervention; the nurse should
notify the provider for dose adjustment.
D - 12 mcg/mL is within therapeutic range.
Reference: Lehne, R. A. (2026). Pharmacology for Nursing Care, 12th ed., Ch. 17.
Q6. A nurse is reviewing fetal heart rate (FHR) monitoring. Which pattern indicates late
decelerations?
A. Deceleration that mirrors the contraction, with onset and return at peak of contraction.
B. Deceleration that starts after contraction begins and returns to baseline after contraction ends.
C. Deceleration that occurs abruptly, unrelated to contractions, and lasts less than 30 seconds.
D. Deceleration that starts at the onset of contraction and returns to baseline by the end of contraction.
Correct Answer: B. Deceleration that starts after contraction begins and returns to baseline after
contraction ends.
Rationale: Late decelerations are a sign of uteroplacental insufficiency, with the decrease in FHR
starting after the contraction begins (late onset) and returning to baseline after the contraction ends (slow
recovery). Option A describes variable decelerations (cord compression). Option C describes early
decelerations (head compression). Option D is a less descriptive version of early decelerations.
Why Wrong:
A - This describes variable decelerations, which are caused by cord compression and have a variable
shape.
C - This describes early decelerations, which are benign and mirror the contraction.
D - This is also early decelerations; late decelerations have onset after peak of contraction, not at
onset.
Reference: Lowdermilk, D. L., & Perry, S. E. (2026). Maternity & Women's Health Care, 12th ed., Ch. 15.
Page 4
