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PN HESI EXIT EXAM VERSIONS V1-V10 EXAM LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
PN HESI EXIT EXAM VERSIONS V1-V10
Complete Exam Bank: 250 Questions with Detailed Rationales
Based on Practical Nursing HESI Exit Exam Blueprint
SECTION 1: SAFETY AND INFECTION CONTROL (Questions 1-25)
Question 1
A practical nurse is caring for a client with a wound infection. Which action is most
important to prevent the spread of infection to other clients?
A) Wearing gloves when changing the wound dressing
B) Placing the client in a private room
C) Using sterile technique for wound care
D) Performing hand hygiene before and after client contact
Answer: D
Rationale: Hand hygiene is the single most important measure to prevent the spread of
infection. While all actions are important for infection control, hand hygiene is the most
effective and fundamental intervention. Gloves should be worn for contact with blood,
body fluids, or contaminated surfaces, and sterile technique is needed for wound care,
but hand hygiene is the priority .
Question 2
A client is placed on airborne precautions for active tuberculosis. Which type of
personal protective equipment (PPE) is required for the nurse entering the room?
A) Surgical mask and gloves
B) N95 respirator and gloves
C) Gown and gloves
D) Face shield and gloves
Answer: B
Rationale: Airborne precautions require an N95 respirator (or higher level) to filter
airborne particles. Gloves are also needed for contact with the client or contaminated
surfaces. A surgical mask is not sufficient for airborne precautions. The client should
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also be placed in a negative pressure room. TB is transmitted via airborne particles, and
an N95 respirator provides adequate filtration. Some facilities use a PAPR (Powered Air-
Purifying Respirator) for added protection .
Question 3
The PN is preparing to administer an intramuscular (IM) injection. Which needle
length is appropriate for a 150-pound adult with normal muscle mass?
A) 5/8 inch
B) 1 inch
C) 1.5 inch
D) 2 inch
Answer: C
Rationale: For a 150-pound adult with normal muscle mass, a 1.5-inch needle is
typically appropriate for an IM injection to ensure the medication reaches the muscle.
The choice of needle length depends on the client's size, the injection site, and the
amount of adipose tissue. The ventrogluteal site is recommended for adults, and a 1.5-
inch needle is usually sufficient for a person of this size. For a smaller adult, a 1-inch
needle may be used. For children or thin adults, a 1-inch needle may suffice. A 5/8-inch
needle is used for subcutaneous injections or intradermal injections .
Question 4
Which site is considered the safest for IM injections due to the absence of major
nerves and blood vessels?
A) Deltoid
B) Dorsogluteal
C) Ventrogluteal
D) Vastus lateralis
Answer: C
Rationale: The ventrogluteal site is considered the safest for IM injections because it is
free from major nerves and blood vessels. It provides a large muscle mass, is relatively
painless, and has a low risk of injury to the sciatic nerve. The dorsogluteal site is
associated with risk of sciatic nerve injury. The deltoid is used for small volumes. The
vastus lateralis is commonly used in infants and children .
Question 5
A client has a prescription for a blood transfusion. Before starting the transfusion,
which action should the PN take first?
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A) Verify the client's identity using two identifiers
B) Prime the blood tubing with normal saline
C) Check the client's vital signs
D) Document the transfusion start time
Answer: A
Rationale: Verifying the client's identity using two identifiers (e.g., name and date of
birth) is the first and most important action before initiating a blood transfusion. This
must be verified against the blood product label. Checking vital signs, priming the
tubing, and documentation are also important but occur after verification. The blood
product label should be checked with another licensed nurse, and the client's identity
should be confirmed before starting the transfusion .
Question 6
The PN is caring for a client who is at risk for falls. Which intervention is most
appropriate?
A) Place the bed in the lowest position
B) Keep the side rails up at all times
C) Apply a vest restraint at night
D) Encourage the client to remain in bed
Answer: A
Rationale: Placing the bed in the lowest position is a key fall prevention intervention.
Side rails should be used appropriately (not as a restraint). Restraints should be
avoided. Encouraging bed rest is not appropriate; the client should be encouraged to
ambulate with assistance. Bed alarms, non-skid socks, and frequent toileting are also
helpful . Restraints should only be used as a last resort and require a provider's order.
The bed should be in the lowest position to prevent injury if the client attempts to get
out of bed independently. The call light should be within reach. Non-skid footwear
should be used.
Question 7
A client is receiving enteral feedings via a nasogastric (NG) tube. Which action is
most important to prevent aspiration?
A) Flush the tube with water before and after feedings
B) Elevate the head of the bed to 30-45 degrees
C) Check tube placement before each feeding
D) Administer the feeding at room temperature
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Answer: B
Rationale: Elevating the head of the bed to 30-45 degrees is the most important
intervention to prevent aspiration during enteral feedings. Checking tube placement
and flushing are also important, but maintaining the head of the bed elevation is critical
for preventing reflux and aspiration. Tube placement should be verified before each
feeding and at regular intervals using pH testing or X-ray. The head of the bed should
remain elevated for 30-60 minutes after the feeding is completed to further reduce
aspiration risk .
Question 8
Which action by the PN is most effective in preventing catheter-associated urinary
tract infections (CAUTIs)?
A) Changing the catheter every 48 hours
B) Using sterile technique during insertion
C) Irrigating the catheter daily with normal saline
D) Collecting urine samples from the drainage bag
Answer: B
Rationale: The most effective way to prevent CAUTIs is to use sterile technique during
insertion. Catheters should be changed only when necessary, not routinely. Irrigation is
not recommended and can introduce infection. Urine samples should not be collected
from the drainage bag due to the risk of contamination; they should be collected from
the catheter port. Other measures include maintaining a closed drainage system,
securing the catheter to prevent movement, and maintaining unobstructed urine flow.
The catheter should be removed as soon as possible to reduce infection risk .
Question 9
A client is prescribed an opioid analgesic. Which adverse effect is most important
for the PN to monitor?
A) Constipation
B) Respiratory depression
C) Nausea
D) Sedation
Answer: B
Rationale: Respiratory depression is the most serious adverse effect of opioid
analgesics and requires immediate intervention. Constipation, nausea, and sedation
are also common side effects but are not life-threatening. The PN should monitor the
client's respiratory rate and depth, and oxygen saturation. Naloxone should be available
as an antidote for respiratory depression. Monitoring for respiratory depression is
PN HESI EXIT EXAM VERSIONS V1-V10 EXAM LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
PN HESI EXIT EXAM VERSIONS V1-V10
Complete Exam Bank: 250 Questions with Detailed Rationales
Based on Practical Nursing HESI Exit Exam Blueprint
SECTION 1: SAFETY AND INFECTION CONTROL (Questions 1-25)
Question 1
A practical nurse is caring for a client with a wound infection. Which action is most
important to prevent the spread of infection to other clients?
A) Wearing gloves when changing the wound dressing
B) Placing the client in a private room
C) Using sterile technique for wound care
D) Performing hand hygiene before and after client contact
Answer: D
Rationale: Hand hygiene is the single most important measure to prevent the spread of
infection. While all actions are important for infection control, hand hygiene is the most
effective and fundamental intervention. Gloves should be worn for contact with blood,
body fluids, or contaminated surfaces, and sterile technique is needed for wound care,
but hand hygiene is the priority .
Question 2
A client is placed on airborne precautions for active tuberculosis. Which type of
personal protective equipment (PPE) is required for the nurse entering the room?
A) Surgical mask and gloves
B) N95 respirator and gloves
C) Gown and gloves
D) Face shield and gloves
Answer: B
Rationale: Airborne precautions require an N95 respirator (or higher level) to filter
airborne particles. Gloves are also needed for contact with the client or contaminated
surfaces. A surgical mask is not sufficient for airborne precautions. The client should
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also be placed in a negative pressure room. TB is transmitted via airborne particles, and
an N95 respirator provides adequate filtration. Some facilities use a PAPR (Powered Air-
Purifying Respirator) for added protection .
Question 3
The PN is preparing to administer an intramuscular (IM) injection. Which needle
length is appropriate for a 150-pound adult with normal muscle mass?
A) 5/8 inch
B) 1 inch
C) 1.5 inch
D) 2 inch
Answer: C
Rationale: For a 150-pound adult with normal muscle mass, a 1.5-inch needle is
typically appropriate for an IM injection to ensure the medication reaches the muscle.
The choice of needle length depends on the client's size, the injection site, and the
amount of adipose tissue. The ventrogluteal site is recommended for adults, and a 1.5-
inch needle is usually sufficient for a person of this size. For a smaller adult, a 1-inch
needle may be used. For children or thin adults, a 1-inch needle may suffice. A 5/8-inch
needle is used for subcutaneous injections or intradermal injections .
Question 4
Which site is considered the safest for IM injections due to the absence of major
nerves and blood vessels?
A) Deltoid
B) Dorsogluteal
C) Ventrogluteal
D) Vastus lateralis
Answer: C
Rationale: The ventrogluteal site is considered the safest for IM injections because it is
free from major nerves and blood vessels. It provides a large muscle mass, is relatively
painless, and has a low risk of injury to the sciatic nerve. The dorsogluteal site is
associated with risk of sciatic nerve injury. The deltoid is used for small volumes. The
vastus lateralis is commonly used in infants and children .
Question 5
A client has a prescription for a blood transfusion. Before starting the transfusion,
which action should the PN take first?
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A) Verify the client's identity using two identifiers
B) Prime the blood tubing with normal saline
C) Check the client's vital signs
D) Document the transfusion start time
Answer: A
Rationale: Verifying the client's identity using two identifiers (e.g., name and date of
birth) is the first and most important action before initiating a blood transfusion. This
must be verified against the blood product label. Checking vital signs, priming the
tubing, and documentation are also important but occur after verification. The blood
product label should be checked with another licensed nurse, and the client's identity
should be confirmed before starting the transfusion .
Question 6
The PN is caring for a client who is at risk for falls. Which intervention is most
appropriate?
A) Place the bed in the lowest position
B) Keep the side rails up at all times
C) Apply a vest restraint at night
D) Encourage the client to remain in bed
Answer: A
Rationale: Placing the bed in the lowest position is a key fall prevention intervention.
Side rails should be used appropriately (not as a restraint). Restraints should be
avoided. Encouraging bed rest is not appropriate; the client should be encouraged to
ambulate with assistance. Bed alarms, non-skid socks, and frequent toileting are also
helpful . Restraints should only be used as a last resort and require a provider's order.
The bed should be in the lowest position to prevent injury if the client attempts to get
out of bed independently. The call light should be within reach. Non-skid footwear
should be used.
Question 7
A client is receiving enteral feedings via a nasogastric (NG) tube. Which action is
most important to prevent aspiration?
A) Flush the tube with water before and after feedings
B) Elevate the head of the bed to 30-45 degrees
C) Check tube placement before each feeding
D) Administer the feeding at room temperature
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Answer: B
Rationale: Elevating the head of the bed to 30-45 degrees is the most important
intervention to prevent aspiration during enteral feedings. Checking tube placement
and flushing are also important, but maintaining the head of the bed elevation is critical
for preventing reflux and aspiration. Tube placement should be verified before each
feeding and at regular intervals using pH testing or X-ray. The head of the bed should
remain elevated for 30-60 minutes after the feeding is completed to further reduce
aspiration risk .
Question 8
Which action by the PN is most effective in preventing catheter-associated urinary
tract infections (CAUTIs)?
A) Changing the catheter every 48 hours
B) Using sterile technique during insertion
C) Irrigating the catheter daily with normal saline
D) Collecting urine samples from the drainage bag
Answer: B
Rationale: The most effective way to prevent CAUTIs is to use sterile technique during
insertion. Catheters should be changed only when necessary, not routinely. Irrigation is
not recommended and can introduce infection. Urine samples should not be collected
from the drainage bag due to the risk of contamination; they should be collected from
the catheter port. Other measures include maintaining a closed drainage system,
securing the catheter to prevent movement, and maintaining unobstructed urine flow.
The catheter should be removed as soon as possible to reduce infection risk .
Question 9
A client is prescribed an opioid analgesic. Which adverse effect is most important
for the PN to monitor?
A) Constipation
B) Respiratory depression
C) Nausea
D) Sedation
Answer: B
Rationale: Respiratory depression is the most serious adverse effect of opioid
analgesics and requires immediate intervention. Constipation, nausea, and sedation
are also common side effects but are not life-threatening. The PN should monitor the
client's respiratory rate and depth, and oxygen saturation. Naloxone should be available
as an antidote for respiratory depression. Monitoring for respiratory depression is
