HESI PN Exit Exam V1-7 Practice
Nursing Diploma, Vancouver Island
University (2025/2026) – Actual NGN
Format with Verified Questions and
100% Correct Answer Keys
1. The PN is caring for a client with a chest tube to water-seal drainage. The
water-seal chamber shows continuous bubbling. What should the PN do first?
A. Clamp the chest tube close to the insertion site
B. Notify the registered nurse
C. Assess the drainage system for an air leak
D. Document the finding as expected
Answer: C
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak;
first check the system from the insertion site to the collection unit for loose
connections.
2. A client 12 hours after abdominal surgery has absent bowel sounds. The PN
should:
A. Encourage warm fluids
B. Notify the surgeon immediately
C. Document and continue to monitor
D. Insert a nasogastric tube
Answer: C
Rationale: Absent bowel sounds are expected in the first 24–48 hours post-op due
,to paralytic ileus; no intervention is required unless accompanied by nausea,
vomiting, or distention.
3. A client is receiving IV furosemide for heart failure. Which finding best
indicates a therapeutic response?
A. Potassium 3.5 mEq/L
B. Clear breath sounds
C. Increased peripheral edema
D. Weight gain of 1 kg in 24 hours
Answer: B
Rationale: Clear lung sounds indicate reduction of pulmonary congestion, the
desired effect of diuretic therapy.
4. The PN observes a client with a new colostomy. The stoma is dusky blue.
What is the priority action?
A. Apply warm compresses
B. Document the finding
C. Notify the RN immediately
D. Encourage fluids
Answer: C
Rationale: A dusky, blue stoma indicates ischemia/necrosis; immediate reporting is
necessary to prevent tissue loss.
5. A client with a hip prosthesis is instructed not to cross legs. This is to
prevent:
A. Hip dislocation
B. Deep vein thrombosis
C. Wound dehiscence
D. Fat embolism
Answer: A
Rationale: Hip precautions include avoiding adduction (crossing legs), internal
rotation, and flexion >90° to prevent prosthesis dislocation.
,6. Which client should the PN see first?
A. A client with a blood pressure of 148/92
B. A client with a blood glucose of 70 mg/dL
C. A client with a respiratory rate of 8 after morphine
D. A client with a temperature of 100.2°F (37.9°C)
Answer: C
Rationale: Respiratory depression (rate 8/min) is life-threatening and requires
immediate intervention.
7. A client on warfarin has an INR of 5.0 without bleeding. What should the PN
anticipate?
A. Administer vitamin K IM
B. Continue same dose
C. Hold 1–2 doses and monitor
D. Give fresh frozen plasma
Answer: C
Rationale: For INR 4.5–10 without bleeding, the standard is to hold 1–2 doses and
reduce weekly dose; vitamin K is not routine.
8. The PN is measuring a client for anti-embolism stockings. Which
measurement is essential?
A. Length from knee to ankle
B. Calf circumference and leg length from heel to popliteal space
C. Thigh circumference only
D. Foot length
Answer: B
Rationale: Proper fit requires calf circumference and leg length to ensure correct
size and compression without constriction.
9. A client with pneumonia has a temperature of 102°F, cough with green
sputum, and crackles. Which nursing intervention is priority?
A. Obtain a sputum culture
, B. Administer antipyretic
C. Apply a cooling blanket
D. Increase fluid intake
Answer: A
Rationale: Culture should be obtained before antibiotics to identify the pathogen;
antipyretics may be given after.
10. A client with diabetic ketoacidosis (DKA) has a potassium level of 3.2
mEq/L. The PN should anticipate which order before starting insulin?
A. Sodium bicarbonate IV
B. Potassium replacement
C. Calcium gluconate
D. 50% dextrose
Answer: B
Rationale: Insulin will drive potassium into cells, worsening hypokalemia;
potassium must be replaced first to prevent dysrhythmias.
11. The PN is caring for a client in Buck’s traction. What is the primary purpose
of this traction?
A. Realign bone fragments
B. Relieve muscle spasms and immobilize the fracture
C. Provide definitive fracture treatment
D. Allow early ambulation
Answer: B
Rationale: Buck’s traction is skin traction used preoperatively to relieve muscle
spasm and prevent further injury.
12. A client with chronic kidney disease has a serum potassium of 6.8 mEq/L.
What is the priority medication?
A. Sodium polystyrene sulfonate (Kayexalate)
B. Regular insulin and 50% dextrose
C. IV calcium gluconate
Nursing Diploma, Vancouver Island
University (2025/2026) – Actual NGN
Format with Verified Questions and
100% Correct Answer Keys
1. The PN is caring for a client with a chest tube to water-seal drainage. The
water-seal chamber shows continuous bubbling. What should the PN do first?
A. Clamp the chest tube close to the insertion site
B. Notify the registered nurse
C. Assess the drainage system for an air leak
D. Document the finding as expected
Answer: C
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak;
first check the system from the insertion site to the collection unit for loose
connections.
2. A client 12 hours after abdominal surgery has absent bowel sounds. The PN
should:
A. Encourage warm fluids
B. Notify the surgeon immediately
C. Document and continue to monitor
D. Insert a nasogastric tube
Answer: C
Rationale: Absent bowel sounds are expected in the first 24–48 hours post-op due
,to paralytic ileus; no intervention is required unless accompanied by nausea,
vomiting, or distention.
3. A client is receiving IV furosemide for heart failure. Which finding best
indicates a therapeutic response?
A. Potassium 3.5 mEq/L
B. Clear breath sounds
C. Increased peripheral edema
D. Weight gain of 1 kg in 24 hours
Answer: B
Rationale: Clear lung sounds indicate reduction of pulmonary congestion, the
desired effect of diuretic therapy.
4. The PN observes a client with a new colostomy. The stoma is dusky blue.
What is the priority action?
A. Apply warm compresses
B. Document the finding
C. Notify the RN immediately
D. Encourage fluids
Answer: C
Rationale: A dusky, blue stoma indicates ischemia/necrosis; immediate reporting is
necessary to prevent tissue loss.
5. A client with a hip prosthesis is instructed not to cross legs. This is to
prevent:
A. Hip dislocation
B. Deep vein thrombosis
C. Wound dehiscence
D. Fat embolism
Answer: A
Rationale: Hip precautions include avoiding adduction (crossing legs), internal
rotation, and flexion >90° to prevent prosthesis dislocation.
,6. Which client should the PN see first?
A. A client with a blood pressure of 148/92
B. A client with a blood glucose of 70 mg/dL
C. A client with a respiratory rate of 8 after morphine
D. A client with a temperature of 100.2°F (37.9°C)
Answer: C
Rationale: Respiratory depression (rate 8/min) is life-threatening and requires
immediate intervention.
7. A client on warfarin has an INR of 5.0 without bleeding. What should the PN
anticipate?
A. Administer vitamin K IM
B. Continue same dose
C. Hold 1–2 doses and monitor
D. Give fresh frozen plasma
Answer: C
Rationale: For INR 4.5–10 without bleeding, the standard is to hold 1–2 doses and
reduce weekly dose; vitamin K is not routine.
8. The PN is measuring a client for anti-embolism stockings. Which
measurement is essential?
A. Length from knee to ankle
B. Calf circumference and leg length from heel to popliteal space
C. Thigh circumference only
D. Foot length
Answer: B
Rationale: Proper fit requires calf circumference and leg length to ensure correct
size and compression without constriction.
9. A client with pneumonia has a temperature of 102°F, cough with green
sputum, and crackles. Which nursing intervention is priority?
A. Obtain a sputum culture
, B. Administer antipyretic
C. Apply a cooling blanket
D. Increase fluid intake
Answer: A
Rationale: Culture should be obtained before antibiotics to identify the pathogen;
antipyretics may be given after.
10. A client with diabetic ketoacidosis (DKA) has a potassium level of 3.2
mEq/L. The PN should anticipate which order before starting insulin?
A. Sodium bicarbonate IV
B. Potassium replacement
C. Calcium gluconate
D. 50% dextrose
Answer: B
Rationale: Insulin will drive potassium into cells, worsening hypokalemia;
potassium must be replaced first to prevent dysrhythmias.
11. The PN is caring for a client in Buck’s traction. What is the primary purpose
of this traction?
A. Realign bone fragments
B. Relieve muscle spasms and immobilize the fracture
C. Provide definitive fracture treatment
D. Allow early ambulation
Answer: B
Rationale: Buck’s traction is skin traction used preoperatively to relieve muscle
spasm and prevent further injury.
12. A client with chronic kidney disease has a serum potassium of 6.8 mEq/L.
What is the priority medication?
A. Sodium polystyrene sulfonate (Kayexalate)
B. Regular insulin and 50% dextrose
C. IV calcium gluconate
