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This comprehensive test bank contains 750 practice questions designed specifically for
PN/LPN students preparing for the HESI Exit Exam. Questions cover all core nursing content
areas including: Medical-Surgical Nursing, Pharmacology, Maternal-Child Health, Psychiatric
Nursing, Fundamentals, Leadership, and Critical Thinking. Each question features multiple-
choice format with one correct answer and detailed, medium-length rationales explaining
why the answer is correct and why other options are incorrect. This resource helps students
identify knowledge gaps, practice test-taking strategies, and build confidence for the actual
HESI Exit Exam. Ideal for individual study or group review sessions.
1. A client receiving a blood transfusion develops chills, fever, and lower back pain. What is the
priority nursing action?
A. Slow the infusion rate
B. Administer acetaminophen
C. Stop the transfusion immediately
D. Notify the healthcare provider
Correct Answer: C
Rationale: The client is exhibiting signs of a hemolytic transfusion reaction (C). The priority
action is to stop the transfusion immediately to prevent further reaction. After stopping the
transfusion, the nurse should maintain IV access with normal saline, notify the healthcare
provider, and send the blood bag and tubing to the blood bank. Slowing the infusion (A) is
incorrect as it may worsen the reaction.
2. The nurse is teaching a client with hypertension about dietary modifications. Which
statement by the client indicates a need for further teaching?
, A. "I should avoid canned soups and processed meats."
B. "I can use herbs and spices instead of salt for flavor."
C. "I should increase my intake of fresh fruits and vegetables."
D. "I can eat as much cheese as I want because it is high in calcium."
Correct Answer: D
Rationale: Cheese is high in sodium and saturated fat, and should be limited in a heart-
healthy diet (D). The client needs further teaching about sodium restriction. (A, B, and C) 2
demonstrate understanding of a low-sodium, heart-healthy diet. Canned soups, processed
meats, and salty snacks should be avoided, and herbs/spices are acceptable alternatives to salt.
3. The nurse is preparing to administer heparin subcutaneously. Which action is correct?
A. Massage the injection site after administration
B. Aspirate before injecting the medication
C. Pinch the skin and insert the needle at a 45-degree angle
D. Administer in the deltoid muscle
Correct Answer: C
Rationale: Heparin should be administered subcutaneously with the skin pinched, using a 45
to 90-degree angle depending on client size (C). The site should not be massaged (A) as this can
cause bruising or hematoma. Aspiration (B) is not recommended for subcutaneous heparin as it
can cause tissue damage. The deltoid (D) is not used for heparin; the abdomen is the preferred
site.
4. Staff on a cardiac unit consists of an RN, two practical nurses (PNs), and one UAP. Team 1's
assignment includes two clients who are both 1 day postangioplasty and two clients with
unstable angina. Team 2's assignment includes all stable clients, but two clients are bedridden
and incontinent. Which staffing plan represents the best use of available staff?
A. Team 1: RN team leader, PN; team 2, PN team leader, UAP
B. Team 1, RN team leader, UAP; team 2, PN team leader, PN
C. Team 1, PN team leader, PN; team 2, RN team leader, UAP
, D. Team 1, PN team leader, UAP; team 2, RN team leader, PN
Correct Answer: A
Rationale: Team 1 includes high-risk clients who require a higher level of assessment and
decision making, which should be provided by an RN and PN (A). Team 2 has stable clients at
lower risk than those on team 1. Although two clients on team 2 require frequent care, the care
is routine and predictable in nature and can be managed by the PN and UAP. (B, C, and D) do
not use the expertise of the nursing staff appropriately for the high-risk clients.
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5. The nurse formulates a nursing diagnosis of pain related to muscle spasms for a client with
extreme lower back pain associated with acute lumbosacral strain. Which is the best
intervention for the nurse to implement?
A. Perform range-of-motion exercises on the lower extremities every 4 hours.
B. Place a small firm pillow under the upper back to flex the lumbar spine gently.
C. Rest in bed with the head of the bed elevated 20 degrees and flex the knees.
D. Position in reverse Trendelenburg with the feet firmly against the foot of the bed.
Correct Answer: C
Rationale: Resting in bed with the head of the bed elevated 20 degrees and flexing the knees
reduces stress on the lower back muscles (C). Range-of-motion exercises can result in
paravertebral muscle spasms and increased pain (A). Bending the knees, rather than (B),
reduces stress on the lower back. (D) places stress on the lower back and increases the client's
pain.
6. The nurse plans to evaluate the effectiveness of a bronchodilator. Which assessment datum
indicates that the desired effect of a bronchodilator has been achieved?
A. Increased oxygen saturation
B. Increased urinary output
C. Decreased apical pulse rate
D. Decreased blood pressure
Correct Answer: A
, Rationale: Bronchodilators increase the diameter of the bronchioles, resulting in improved
oxygenation, reflected by an increase in oxygen saturation (A). (B, C, and D) do not indicate the
desired effect of a bronchodilator and may represent side effects rather than therapeutic
outcomes.
7. The nurse is monitoring a client who is receiving bedside conscious sedation with midazolam
hydrochloride (Versed). In assessing the client, the nurse determines that the client has slurred
speech with diplopia. Based on this finding, what action should the nurse take? 4
A. Open the airway with a chin lift-head tilt maneuver.
B. Obtain a fingerstick glucose reading.
C. Administer flumazenil (Romazicon).
D. Continue to monitor the client.
Correct Answer: D
Rationale: The desired level III in conscious sedation includes slurred speech, glazed eyes, and
marked diplopia. Because this is the desired outcome of the medication regimen, no action is
needed but continuing to monitor the client (D). The airway is open if the client is able to talk
(A). There are no signs of hypoglycemia (B). No reversal is necessary for the benzodiazepine
(Versed) without signs of oversedation, such as respiratory depression (C).
8. The nurse is assessing a client using the Snellen chart and determines that the client's visual
acuity is the same as in a previous examination, which was recorded as 20/100. When the client
asks the meaning of this, which information should the nurse provide?
A. This visual acuity result is five times worse that of a normal finding.
B. This line should be seen clearly when the client wears corrective lenses.
C. A client with normal vision can read at 100 feet what this client reads at 20 feet.
D. This client can read at 20 feet what a person with normal vision can read at 100 feet.
Correct Answer: D
Rationale: The Snellen chart results indicate that the client can read at 20 feet what a person
with normal vision can read at 100 feet (D). The numerator is the testing distance (20 feet), and
This comprehensive test bank contains 750 practice questions designed specifically for
PN/LPN students preparing for the HESI Exit Exam. Questions cover all core nursing content
areas including: Medical-Surgical Nursing, Pharmacology, Maternal-Child Health, Psychiatric
Nursing, Fundamentals, Leadership, and Critical Thinking. Each question features multiple-
choice format with one correct answer and detailed, medium-length rationales explaining
why the answer is correct and why other options are incorrect. This resource helps students
identify knowledge gaps, practice test-taking strategies, and build confidence for the actual
HESI Exit Exam. Ideal for individual study or group review sessions.
1. A client receiving a blood transfusion develops chills, fever, and lower back pain. What is the
priority nursing action?
A. Slow the infusion rate
B. Administer acetaminophen
C. Stop the transfusion immediately
D. Notify the healthcare provider
Correct Answer: C
Rationale: The client is exhibiting signs of a hemolytic transfusion reaction (C). The priority
action is to stop the transfusion immediately to prevent further reaction. After stopping the
transfusion, the nurse should maintain IV access with normal saline, notify the healthcare
provider, and send the blood bag and tubing to the blood bank. Slowing the infusion (A) is
incorrect as it may worsen the reaction.
2. The nurse is teaching a client with hypertension about dietary modifications. Which
statement by the client indicates a need for further teaching?
, A. "I should avoid canned soups and processed meats."
B. "I can use herbs and spices instead of salt for flavor."
C. "I should increase my intake of fresh fruits and vegetables."
D. "I can eat as much cheese as I want because it is high in calcium."
Correct Answer: D
Rationale: Cheese is high in sodium and saturated fat, and should be limited in a heart-
healthy diet (D). The client needs further teaching about sodium restriction. (A, B, and C) 2
demonstrate understanding of a low-sodium, heart-healthy diet. Canned soups, processed
meats, and salty snacks should be avoided, and herbs/spices are acceptable alternatives to salt.
3. The nurse is preparing to administer heparin subcutaneously. Which action is correct?
A. Massage the injection site after administration
B. Aspirate before injecting the medication
C. Pinch the skin and insert the needle at a 45-degree angle
D. Administer in the deltoid muscle
Correct Answer: C
Rationale: Heparin should be administered subcutaneously with the skin pinched, using a 45
to 90-degree angle depending on client size (C). The site should not be massaged (A) as this can
cause bruising or hematoma. Aspiration (B) is not recommended for subcutaneous heparin as it
can cause tissue damage. The deltoid (D) is not used for heparin; the abdomen is the preferred
site.
4. Staff on a cardiac unit consists of an RN, two practical nurses (PNs), and one UAP. Team 1's
assignment includes two clients who are both 1 day postangioplasty and two clients with
unstable angina. Team 2's assignment includes all stable clients, but two clients are bedridden
and incontinent. Which staffing plan represents the best use of available staff?
A. Team 1: RN team leader, PN; team 2, PN team leader, UAP
B. Team 1, RN team leader, UAP; team 2, PN team leader, PN
C. Team 1, PN team leader, PN; team 2, RN team leader, UAP
, D. Team 1, PN team leader, UAP; team 2, RN team leader, PN
Correct Answer: A
Rationale: Team 1 includes high-risk clients who require a higher level of assessment and
decision making, which should be provided by an RN and PN (A). Team 2 has stable clients at
lower risk than those on team 1. Although two clients on team 2 require frequent care, the care
is routine and predictable in nature and can be managed by the PN and UAP. (B, C, and D) do
not use the expertise of the nursing staff appropriately for the high-risk clients.
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5. The nurse formulates a nursing diagnosis of pain related to muscle spasms for a client with
extreme lower back pain associated with acute lumbosacral strain. Which is the best
intervention for the nurse to implement?
A. Perform range-of-motion exercises on the lower extremities every 4 hours.
B. Place a small firm pillow under the upper back to flex the lumbar spine gently.
C. Rest in bed with the head of the bed elevated 20 degrees and flex the knees.
D. Position in reverse Trendelenburg with the feet firmly against the foot of the bed.
Correct Answer: C
Rationale: Resting in bed with the head of the bed elevated 20 degrees and flexing the knees
reduces stress on the lower back muscles (C). Range-of-motion exercises can result in
paravertebral muscle spasms and increased pain (A). Bending the knees, rather than (B),
reduces stress on the lower back. (D) places stress on the lower back and increases the client's
pain.
6. The nurse plans to evaluate the effectiveness of a bronchodilator. Which assessment datum
indicates that the desired effect of a bronchodilator has been achieved?
A. Increased oxygen saturation
B. Increased urinary output
C. Decreased apical pulse rate
D. Decreased blood pressure
Correct Answer: A
, Rationale: Bronchodilators increase the diameter of the bronchioles, resulting in improved
oxygenation, reflected by an increase in oxygen saturation (A). (B, C, and D) do not indicate the
desired effect of a bronchodilator and may represent side effects rather than therapeutic
outcomes.
7. The nurse is monitoring a client who is receiving bedside conscious sedation with midazolam
hydrochloride (Versed). In assessing the client, the nurse determines that the client has slurred
speech with diplopia. Based on this finding, what action should the nurse take? 4
A. Open the airway with a chin lift-head tilt maneuver.
B. Obtain a fingerstick glucose reading.
C. Administer flumazenil (Romazicon).
D. Continue to monitor the client.
Correct Answer: D
Rationale: The desired level III in conscious sedation includes slurred speech, glazed eyes, and
marked diplopia. Because this is the desired outcome of the medication regimen, no action is
needed but continuing to monitor the client (D). The airway is open if the client is able to talk
(A). There are no signs of hypoglycemia (B). No reversal is necessary for the benzodiazepine
(Versed) without signs of oversedation, such as respiratory depression (C).
8. The nurse is assessing a client using the Snellen chart and determines that the client's visual
acuity is the same as in a previous examination, which was recorded as 20/100. When the client
asks the meaning of this, which information should the nurse provide?
A. This visual acuity result is five times worse that of a normal finding.
B. This line should be seen clearly when the client wears corrective lenses.
C. A client with normal vision can read at 100 feet what this client reads at 20 feet.
D. This client can read at 20 feet what a person with normal vision can read at 100 feet.
Correct Answer: D
Rationale: The Snellen chart results indicate that the client can read at 20 feet what a person
with normal vision can read at 100 feet (D). The numerator is the testing distance (20 feet), and
