HESI PN Exit Exam 2026 | Versions 1 & 2 Bundle |
398 Questions and Correct Answers | Practical
Nursing HESI Exit Exam.
1. The PN is teaching a client about gastroesophageal reflux disease (GERD).
Which statement by the client indicates a need for further teaching?
• A. "I will eat three large meals a day instead of snacking."
• B. "I should avoid lying down for at least two hours after eating."
• C. "I will elevate the head of my bed on blocks."
• D. "I will limit my intake of chocolate and caffeine."
Correct Answer: A
Rationale: Eating large meals can increase intra-abdominal pressure and worsen
GERD. Small, frequent meals are recommended. The other options are all
appropriate interventions to reduce reflux.
2. A client receiving a blood transfusion develops chills, flank pain, and dark
urine. What type of transfusion reaction does the nurse suspect?
• A. Febrile nonhemolytic reaction
• B. Acute hemolytic reaction
• C. Allergic reaction
• D. Transfusion-associated circulatory overload
Correct Answer: B
Rationale: Chills, flank pain, and dark urine (hemoglobinuria) are classic signs of
an acute hemolytic transfusion reaction. This is a medical emergency. The priority
is to stop the transfusion immediately, maintain IV access with normal saline, and
monitor renal function.
,3. The practical nurse is caring for a client immediately following a cardiac
catheterization via the femoral artery. Which finding is most concerning?
• A. Client reports mild discomfort at the insertion site
• B. Small amount of blood on the pressure dressing
• C. Decreased pedal pulse on the affected extremity
• D. Heart rate of 88 beats per minute
Correct Answer: C
Rationale: A decreased or absent pedal pulse following femoral catheterization
may indicate arterial occlusion, thrombosis, or a hematoma compressing the
artery, compromising limb perfusion. This is a critical finding requiring immediate
reporting.
4. The PN is caring for a client with a stage 3 pressure ulcer. Which type of
dressing is most appropriate for this wound?
• A. Dry gauze dressing.
• B. Wet-to-damp saline dressing.
• C. Hydrocolloid dressing.
• D. Transparent film dressing.
Correct Answer: B
Rationale: A stage 3 ulcer involves full-thickness tissue loss. A wet-to-damp
dressing provides a moist environment that promotes autolytic debridement and
granulation tissue formation.
5. The PN is preparing to suction a client's tracheostomy. What should the PN do
first?
• A. Apply sterile gloves
• B. Hyperoxygenate the client
• C. Insert the catheter into the tracheostomy
, • D. Set the suction pressure to 150 mmHg
Correct Answer: B
Rationale: Hyperoxygenation before suctioning prevents hypoxia during the
procedure. Suction pressure should be 100–120 mmHg for adults, not 150 mmHg.
6. A client is 24 hours post-operative following a total hip replacement. Which
finding is most concerning and requires immediate action?
• A. Pain score of 6 out of 10 at the surgical site
• B. Mild erythema and warmth around the incision
• C. Pulse oximetry reading of 88% on room air
• D. Urinary output of 60 mL over the last 2 hours
Correct Answer: C
Rationale: A pulse oximetry reading of 88% indicates significant hypoxemia and is
a critical finding. Post-operative clients, especially after hip surgery, are at high risk
for a pulmonary embolism. This is a life-threatening situation that requires
immediate intervention. The other findings are expected or require monitoring
but are not immediately life-threatening.
7. A client with major depressive disorder is started on phenelzine, an MAOI.
Which dietary instruction is most important?
• A. Avoid foods high in tyramine
• B. Increase intake of green leafy vegetables
• C. Drink at least 2 liters of water daily
• D. Eat small, frequent meals
Correct Answer: A
Rationale: Monoamine Oxidase Inhibitors (MAOIs) like phenelzine can cause a
life-threatening hypertensive crisis if taken with foods containing tyramine. Clients
must avoid aged cheeses, cured meats, red wine, and other tyramine-rich foods.
, 8. A client with asthma is prescribed albuterol via inhaler. The PN should assess
the client for which common side effect?
• A. Bradycardia
• B. Tremors
• C. Hypotension
• D. Drowsiness
Correct Answer: B
Rationale: Albuterol is a beta-2 adrenergic agonist. Common side effects are
related to its action on the sympathetic nervous system and include tachycardia
(not bradycardia), palpitations, and fine muscle tremors.
9. A client with schizophrenia says, "The birds are flying in the sky to steal my
thoughts." How should the PN respond?
• A. "Don't worry, birds cannot steal your thoughts."
• B. "I understand you are frightened, but I don't see any birds here."
• C. "You are experiencing a delusion; it is not real."
• D. "Let's go inside so the birds cannot get you."
Correct Answer: B
Rationale: The best response uses therapeutic communication by acknowledging
the client's feelings (fear) and gently presenting reality without arguing with or
validating the delusion.
10. The PN is caring for a client in the active phase of labor. The client suddenly
becomes short of breath, cyanotic, and collapses. What should the PN suspect?
• A. Placenta previa.
• B. Amniotic fluid embolism.
• C. Uterine rupture.
• D. Eclampsia.
398 Questions and Correct Answers | Practical
Nursing HESI Exit Exam.
1. The PN is teaching a client about gastroesophageal reflux disease (GERD).
Which statement by the client indicates a need for further teaching?
• A. "I will eat three large meals a day instead of snacking."
• B. "I should avoid lying down for at least two hours after eating."
• C. "I will elevate the head of my bed on blocks."
• D. "I will limit my intake of chocolate and caffeine."
Correct Answer: A
Rationale: Eating large meals can increase intra-abdominal pressure and worsen
GERD. Small, frequent meals are recommended. The other options are all
appropriate interventions to reduce reflux.
2. A client receiving a blood transfusion develops chills, flank pain, and dark
urine. What type of transfusion reaction does the nurse suspect?
• A. Febrile nonhemolytic reaction
• B. Acute hemolytic reaction
• C. Allergic reaction
• D. Transfusion-associated circulatory overload
Correct Answer: B
Rationale: Chills, flank pain, and dark urine (hemoglobinuria) are classic signs of
an acute hemolytic transfusion reaction. This is a medical emergency. The priority
is to stop the transfusion immediately, maintain IV access with normal saline, and
monitor renal function.
,3. The practical nurse is caring for a client immediately following a cardiac
catheterization via the femoral artery. Which finding is most concerning?
• A. Client reports mild discomfort at the insertion site
• B. Small amount of blood on the pressure dressing
• C. Decreased pedal pulse on the affected extremity
• D. Heart rate of 88 beats per minute
Correct Answer: C
Rationale: A decreased or absent pedal pulse following femoral catheterization
may indicate arterial occlusion, thrombosis, or a hematoma compressing the
artery, compromising limb perfusion. This is a critical finding requiring immediate
reporting.
4. The PN is caring for a client with a stage 3 pressure ulcer. Which type of
dressing is most appropriate for this wound?
• A. Dry gauze dressing.
• B. Wet-to-damp saline dressing.
• C. Hydrocolloid dressing.
• D. Transparent film dressing.
Correct Answer: B
Rationale: A stage 3 ulcer involves full-thickness tissue loss. A wet-to-damp
dressing provides a moist environment that promotes autolytic debridement and
granulation tissue formation.
5. The PN is preparing to suction a client's tracheostomy. What should the PN do
first?
• A. Apply sterile gloves
• B. Hyperoxygenate the client
• C. Insert the catheter into the tracheostomy
, • D. Set the suction pressure to 150 mmHg
Correct Answer: B
Rationale: Hyperoxygenation before suctioning prevents hypoxia during the
procedure. Suction pressure should be 100–120 mmHg for adults, not 150 mmHg.
6. A client is 24 hours post-operative following a total hip replacement. Which
finding is most concerning and requires immediate action?
• A. Pain score of 6 out of 10 at the surgical site
• B. Mild erythema and warmth around the incision
• C. Pulse oximetry reading of 88% on room air
• D. Urinary output of 60 mL over the last 2 hours
Correct Answer: C
Rationale: A pulse oximetry reading of 88% indicates significant hypoxemia and is
a critical finding. Post-operative clients, especially after hip surgery, are at high risk
for a pulmonary embolism. This is a life-threatening situation that requires
immediate intervention. The other findings are expected or require monitoring
but are not immediately life-threatening.
7. A client with major depressive disorder is started on phenelzine, an MAOI.
Which dietary instruction is most important?
• A. Avoid foods high in tyramine
• B. Increase intake of green leafy vegetables
• C. Drink at least 2 liters of water daily
• D. Eat small, frequent meals
Correct Answer: A
Rationale: Monoamine Oxidase Inhibitors (MAOIs) like phenelzine can cause a
life-threatening hypertensive crisis if taken with foods containing tyramine. Clients
must avoid aged cheeses, cured meats, red wine, and other tyramine-rich foods.
, 8. A client with asthma is prescribed albuterol via inhaler. The PN should assess
the client for which common side effect?
• A. Bradycardia
• B. Tremors
• C. Hypotension
• D. Drowsiness
Correct Answer: B
Rationale: Albuterol is a beta-2 adrenergic agonist. Common side effects are
related to its action on the sympathetic nervous system and include tachycardia
(not bradycardia), palpitations, and fine muscle tremors.
9. A client with schizophrenia says, "The birds are flying in the sky to steal my
thoughts." How should the PN respond?
• A. "Don't worry, birds cannot steal your thoughts."
• B. "I understand you are frightened, but I don't see any birds here."
• C. "You are experiencing a delusion; it is not real."
• D. "Let's go inside so the birds cannot get you."
Correct Answer: B
Rationale: The best response uses therapeutic communication by acknowledging
the client's feelings (fear) and gently presenting reality without arguing with or
validating the delusion.
10. The PN is caring for a client in the active phase of labor. The client suddenly
becomes short of breath, cyanotic, and collapses. What should the PN suspect?
• A. Placenta previa.
• B. Amniotic fluid embolism.
• C. Uterine rupture.
• D. Eclampsia.
