PN HESI Exit Exam V1 – Complete Practice Test
Bank (Questions 1-160)
Instructions
• Correct Answers are in Bold Italics
• Rationales are in Italic with clinical reasoning based on practical
nursing scope of practice
• Questions cover medical-surgical, pharmacology, pediatrics,
maternity, mental health, leadership, and fundamentals
1. A client who is in hospice care complains of increasing amounts of
pain. The healthcare provider prescribes an analgesic every four hours
as needed. Which action should the LPN/LVN implement?
A. Administer the analgesic only when the client requests it
B. Give the analgesic on an around-the-clock schedule
C. Wait until the client's pain is severe before administering
D. Administer half the prescribed dose to avoid oversedation
Correct Answer: B. Give the analgesic on an around-the-clock schedule.
Rationale: For clients in hospice care with increasing pain, around-the-clock
scheduled analgesics provide better pain control than PRN dosing. This
prevents pain from escalating and maintains comfort at end of life .
,2. When assessing a client with wrist restraints, the nurse observes that
the fingers on the right hand are blue. What action should the LPN
implement first?
A. Document the finding
B. Notify the healthcare provider
C. Loosen the right wrist restraint
D. Apply a warm compress to the hand
Correct Answer: C. Loosen the right wrist restraint.
Rationale: Blue fingers indicate impaired circulation, a complication of
restraint use. The restraint should be loosened immediately to restore
perfusion. This is a priority safety intervention before notifying the provider .
3. A school-age client with diabetes is placed on intermediate-acting
insulin and regular insulin before breakfast and before dinner. She will
receive a snack of milk and cereal at bedtime. What is the snack
intended to do?
A. Provide additional calories for growth
B. Prevent late night hypoglycemia
C. Enhance the effectiveness of the morning insulin
D. Satisfy hunger before sleep
Correct Answer: B. Prevent late night hypoglycemia.
Rationale: The bedtime snack provides carbohydrates to prevent
hypoglycemia during the night, especially when intermediate-acting insulin
peaks during the early morning hours .
,4. Several nurses from the medical unit access a well-known public
official's electronic medical record to obtain a status update. What is
the best response for the nurse manager to make to the nurses?
A. "You should have asked for permission first."
B. "Assessing the official's medical record is a breach of confidentiality."
C. "Only the primary nurse should access the record."
D. "You can access it if you are providing care."
*Correct Answer: B. "Assessing the official's medical record is a breach
of confidentiality." *
Rationale: Accessing a client's medical record without a need-to-know basis
violates HIPAA and confidentiality policies. Healthcare workers may only
access records for clients they are directly caring for .
5. A client with influenza is on the unit. The most effective way to
decrease the spread of microorganisms is:
A. Placing the client in isolation
B. Washing the hands frequently
C. Wearing a mask at all times
D. Using gloves for all care
Correct Answer: B. Washing the hands frequently.
Rationale: Hand hygiene is the single most effective measure to prevent the
spread of microorganisms in healthcare settings .
6. A client with a history of hypertension has been prescribed a new
antihypertensive medication and is reporting dizziness. Which is the
best way for the nurse to assess blood pressure?
, A. In the supine position only
B. In the sitting position only
C. In the supine, sitting, and standing positions
D. In the standing position only
Correct Answer: C. In the supine, sitting, and standing positions.
Rationale: Orthostatic hypotension is a common side effect of
antihypertensives. Assessing blood pressure in all three positions helps
identify drops in blood pressure with position changes that can cause
dizziness .
7. A client has a soft wrist-safety device. Which assessment finding
should the nurse investigate further?
A. Warm, pink fingers
B. Capillary refill of 2 seconds
C. Cool, pale fingers
D. Radial pulse 2+
Correct Answer: C. Cool, pale fingers.
Rationale: Cool, pale fingers indicate impaired circulation from the restraint
and require immediate investigation. Normal findings include warm pink
skin, capillary refill <3 seconds, and palpable pulses .
8. A client with anemia has been admitted to the medical-surgical unit.
Which assessment findings are characteristic of iron deficiency
anemia?
A. Nausea, vomiting, and anorexia
B. Dyspnea, tachycardia, and pallor
Bank (Questions 1-160)
Instructions
• Correct Answers are in Bold Italics
• Rationales are in Italic with clinical reasoning based on practical
nursing scope of practice
• Questions cover medical-surgical, pharmacology, pediatrics,
maternity, mental health, leadership, and fundamentals
1. A client who is in hospice care complains of increasing amounts of
pain. The healthcare provider prescribes an analgesic every four hours
as needed. Which action should the LPN/LVN implement?
A. Administer the analgesic only when the client requests it
B. Give the analgesic on an around-the-clock schedule
C. Wait until the client's pain is severe before administering
D. Administer half the prescribed dose to avoid oversedation
Correct Answer: B. Give the analgesic on an around-the-clock schedule.
Rationale: For clients in hospice care with increasing pain, around-the-clock
scheduled analgesics provide better pain control than PRN dosing. This
prevents pain from escalating and maintains comfort at end of life .
,2. When assessing a client with wrist restraints, the nurse observes that
the fingers on the right hand are blue. What action should the LPN
implement first?
A. Document the finding
B. Notify the healthcare provider
C. Loosen the right wrist restraint
D. Apply a warm compress to the hand
Correct Answer: C. Loosen the right wrist restraint.
Rationale: Blue fingers indicate impaired circulation, a complication of
restraint use. The restraint should be loosened immediately to restore
perfusion. This is a priority safety intervention before notifying the provider .
3. A school-age client with diabetes is placed on intermediate-acting
insulin and regular insulin before breakfast and before dinner. She will
receive a snack of milk and cereal at bedtime. What is the snack
intended to do?
A. Provide additional calories for growth
B. Prevent late night hypoglycemia
C. Enhance the effectiveness of the morning insulin
D. Satisfy hunger before sleep
Correct Answer: B. Prevent late night hypoglycemia.
Rationale: The bedtime snack provides carbohydrates to prevent
hypoglycemia during the night, especially when intermediate-acting insulin
peaks during the early morning hours .
,4. Several nurses from the medical unit access a well-known public
official's electronic medical record to obtain a status update. What is
the best response for the nurse manager to make to the nurses?
A. "You should have asked for permission first."
B. "Assessing the official's medical record is a breach of confidentiality."
C. "Only the primary nurse should access the record."
D. "You can access it if you are providing care."
*Correct Answer: B. "Assessing the official's medical record is a breach
of confidentiality." *
Rationale: Accessing a client's medical record without a need-to-know basis
violates HIPAA and confidentiality policies. Healthcare workers may only
access records for clients they are directly caring for .
5. A client with influenza is on the unit. The most effective way to
decrease the spread of microorganisms is:
A. Placing the client in isolation
B. Washing the hands frequently
C. Wearing a mask at all times
D. Using gloves for all care
Correct Answer: B. Washing the hands frequently.
Rationale: Hand hygiene is the single most effective measure to prevent the
spread of microorganisms in healthcare settings .
6. A client with a history of hypertension has been prescribed a new
antihypertensive medication and is reporting dizziness. Which is the
best way for the nurse to assess blood pressure?
, A. In the supine position only
B. In the sitting position only
C. In the supine, sitting, and standing positions
D. In the standing position only
Correct Answer: C. In the supine, sitting, and standing positions.
Rationale: Orthostatic hypotension is a common side effect of
antihypertensives. Assessing blood pressure in all three positions helps
identify drops in blood pressure with position changes that can cause
dizziness .
7. A client has a soft wrist-safety device. Which assessment finding
should the nurse investigate further?
A. Warm, pink fingers
B. Capillary refill of 2 seconds
C. Cool, pale fingers
D. Radial pulse 2+
Correct Answer: C. Cool, pale fingers.
Rationale: Cool, pale fingers indicate impaired circulation from the restraint
and require immediate investigation. Normal findings include warm pink
skin, capillary refill <3 seconds, and palpable pulses .
8. A client with anemia has been admitted to the medical-surgical unit.
Which assessment findings are characteristic of iron deficiency
anemia?
A. Nausea, vomiting, and anorexia
B. Dyspnea, tachycardia, and pallor
