This comprehensive practice exam contains 200 multiple-choice questions designed to
simulate the actual LPN/LVN HESI Exit Exam. It covers all core nursing content areas including
medical-surgical nursing, pharmacology, psychiatric nursing, maternal-child health, and
fundamentals. Each question includes the correct answer and a detailed, medium-length
rationale explaining the clinical reasoning. The exam follows NCLEX-style question formats
with select-all-that-apply items. Perfect for final exam preparation, this resource helps
identify knowledge gaps, reinforce critical thinking, and build test-taking confidence. All
answers are verified and graded A+ standard for accurate self-assessment.
1) The LPN/LVN is caring for a client with a nasogastric tube attached to low continuous suction.
The nurse notes that the client's serum potassium level is 3.2 mEq/L. Which finding is most
consistent with this laboratory value?
1. Muscle weakness
2. Increased urine output
3. Positive Chvostek's sign
4. Hyperactive bowel sounds
Correct Answer: 1. Muscle weakness
Rationale: A potassium level of 3.2 mEq/L is below the normal range (3.5-5.0 mEq/L), indicating
hypokalemia. Nasogastric suctioning can cause potassium loss through gastric fluids.
Hypokalemia presents with muscle weakness, fatigue, leg cramps, and cardiac dysrhythmias.
Increased urine output is not typical. Chvostek's sign is associated with hypocalcemia.
Hyperactive bowel sounds are associated with hyperkalemia or other conditions.
Page | 1
,2) A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min via
nasal cannula. The LPN/LVN understands that the reason for this low oxygen flow rate is which?
1. To prevent oxygen toxicity
2. To prevent drying of mucous membranes
3. To maintain the hypoxic drive to breathe
4. To reduce the risk of carbon dioxide narcosis
Correct Answer: 3. To maintain the hypoxic drive to breathe
Rationale: In clients with COPD, the respiratory drive may be stimulated by low oxygen levels
(hypoxic drive) rather than by high carbon dioxide levels. Administering high-flow oxygen can
suppress this hypoxic drive and lead to respiratory depression and apnea. Low-flow oxygen
maintains oxygenation without eliminating the hypoxic stimulus. While oxygen toxicity and
drying are concerns, the primary reason for low flow is to maintain the hypoxic drive.
3) The LPN/LVN is caring for a client who is 2 days post-operative following a total hip
replacement. Which action should the nurse take to prevent dislocation of the new joint?
1. Place a pillow between the client's legs when turning
2. Position the client in a low-Fowler's position for meals
3. Have the client perform straight leg raises every 2 hours
4. Encourage the client to cross the legs at the ankles while sitting
Correct Answer: 1. Place a pillow between the client's legs when turning
Rationale: After total hip replacement, the hip must be kept in abduction to prevent
dislocation. Placing a pillow between the legs when turning maintains the hip in abduction and
prevents adduction past midline. Low-Fowler's position is acceptable. Straight leg raises can
stress the joint. Crossing legs at the ankles is contraindicated as it can lead to adduction and
dislocation.
4) The nurse is monitoring a client following cardioversion. Which observations should be of
highest priority to the nurse?
1. Blood pressure
2. Status of airway
Page | 2
,3. Oxygen flow rate
4. Level of consciousness
Correct Answer: 2. Status of airway
Rationale: After cardioversion, the priority is maintaining a patent airway because the client
may have received sedative medications and may have decreased respiratory effort. Airway
obstruction or respiratory depression can lead to hypoxia and cardiac arrest. While blood
pressure, oxygen flow rate, and level of consciousness are important, airway patency is always
the first priority in the ABCs (Airway, Breathing, Circulation).
5) The nurse is assisting in caring for the client immediately after insertion of a permanent
demand pacemaker via the right subclavian vein. The nurse prevents dislodgement of the
pacing catheter by implementing which intervention?
1. Limiting movement and abduction of the left arm
2. Limiting movement and abduction of the right arm
3. Assisting the client to get out of bed and ambulate with a walker
4. Having the physical therapist do active range of motion to the right arm
Correct Answer: 2. Limiting movement and abduction of the right arm
Rationale: The pacing catheter is inserted through the right subclavian vein, so limiting
movement and abduction of the right arm prevents dislodgement of the catheter tip from the
ventricular wall. The left arm is not involved. Ambulation with a walker would involve arm
movement and is contraindicated immediately post-procedure. Active range of motion to the
right arm could dislodge the catheter.
6) A client diagnosed with thrombophlebitis 1 day ago suddenly complains of chest pain and
shortness of breath, and the client is visibly anxious. The LPN/LVN understands that a life-
threatening complication of this condition is which?
1. Pneumonia
2. Pulmonary edema
3. Pulmonary embolism
4. Myocardial infarction
Page | 3
, Correct Answer: 3. Pulmonary embolism
Rationale: Thrombophlebitis involves inflammation and clot formation in a vein. A deep vein
thrombus can dislodge and travel to the pulmonary vasculature, causing a pulmonary
embolism. Symptoms include sudden chest pain, dyspnea, tachypnea, tachycardia, and anxiety.
This is a life-threatening emergency. Pneumonia, pulmonary edema, and myocardial infarction
may present with similar symptoms but are not the classic complication of thrombophlebitis.
7) A 24-year-old man seeks medical attention for complaints of claudication in the arch of the
foot. The nurse also notes superficial thrombophlebitis of the lower leg. The nurse should check
the client for which next?
1. Smoking history
2. Recent exposure to allergens
3. History of recent insect bites
4. Familial tendency toward peripheral vascular disease
Correct Answer: 1. Smoking history
Rationale: Claudication in a young adult combined with thrombophlebitis is highly suggestive of
Buerger's disease (thromboangiitis obliterans). This condition is strongly associated with
tobacco use, especially in young men. Smoking causes vasospasm and inflammation of small
and medium-sized arteries and veins. Allergens, insect bites, and family history are not the
primary risk factors for this presentation.
8) The nurse has reinforced instructions to the client with Raynaud's disease about self-
management of the disease process. The nurse determines that the client needs further
teaching if the client states which?
1. "Smoking cessation is very important."
2. "Moving to a warmer climate should help."
3. "Sources of caffeine should be eliminated from the diet."
4. "Taking nifedipine (Procardia) as prescribed will decrease vessel spasm."
Correct Answer: 2. "Moving to a warmer climate should help."
Page | 4
simulate the actual LPN/LVN HESI Exit Exam. It covers all core nursing content areas including
medical-surgical nursing, pharmacology, psychiatric nursing, maternal-child health, and
fundamentals. Each question includes the correct answer and a detailed, medium-length
rationale explaining the clinical reasoning. The exam follows NCLEX-style question formats
with select-all-that-apply items. Perfect for final exam preparation, this resource helps
identify knowledge gaps, reinforce critical thinking, and build test-taking confidence. All
answers are verified and graded A+ standard for accurate self-assessment.
1) The LPN/LVN is caring for a client with a nasogastric tube attached to low continuous suction.
The nurse notes that the client's serum potassium level is 3.2 mEq/L. Which finding is most
consistent with this laboratory value?
1. Muscle weakness
2. Increased urine output
3. Positive Chvostek's sign
4. Hyperactive bowel sounds
Correct Answer: 1. Muscle weakness
Rationale: A potassium level of 3.2 mEq/L is below the normal range (3.5-5.0 mEq/L), indicating
hypokalemia. Nasogastric suctioning can cause potassium loss through gastric fluids.
Hypokalemia presents with muscle weakness, fatigue, leg cramps, and cardiac dysrhythmias.
Increased urine output is not typical. Chvostek's sign is associated with hypocalcemia.
Hyperactive bowel sounds are associated with hyperkalemia or other conditions.
Page | 1
,2) A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min via
nasal cannula. The LPN/LVN understands that the reason for this low oxygen flow rate is which?
1. To prevent oxygen toxicity
2. To prevent drying of mucous membranes
3. To maintain the hypoxic drive to breathe
4. To reduce the risk of carbon dioxide narcosis
Correct Answer: 3. To maintain the hypoxic drive to breathe
Rationale: In clients with COPD, the respiratory drive may be stimulated by low oxygen levels
(hypoxic drive) rather than by high carbon dioxide levels. Administering high-flow oxygen can
suppress this hypoxic drive and lead to respiratory depression and apnea. Low-flow oxygen
maintains oxygenation without eliminating the hypoxic stimulus. While oxygen toxicity and
drying are concerns, the primary reason for low flow is to maintain the hypoxic drive.
3) The LPN/LVN is caring for a client who is 2 days post-operative following a total hip
replacement. Which action should the nurse take to prevent dislocation of the new joint?
1. Place a pillow between the client's legs when turning
2. Position the client in a low-Fowler's position for meals
3. Have the client perform straight leg raises every 2 hours
4. Encourage the client to cross the legs at the ankles while sitting
Correct Answer: 1. Place a pillow between the client's legs when turning
Rationale: After total hip replacement, the hip must be kept in abduction to prevent
dislocation. Placing a pillow between the legs when turning maintains the hip in abduction and
prevents adduction past midline. Low-Fowler's position is acceptable. Straight leg raises can
stress the joint. Crossing legs at the ankles is contraindicated as it can lead to adduction and
dislocation.
4) The nurse is monitoring a client following cardioversion. Which observations should be of
highest priority to the nurse?
1. Blood pressure
2. Status of airway
Page | 2
,3. Oxygen flow rate
4. Level of consciousness
Correct Answer: 2. Status of airway
Rationale: After cardioversion, the priority is maintaining a patent airway because the client
may have received sedative medications and may have decreased respiratory effort. Airway
obstruction or respiratory depression can lead to hypoxia and cardiac arrest. While blood
pressure, oxygen flow rate, and level of consciousness are important, airway patency is always
the first priority in the ABCs (Airway, Breathing, Circulation).
5) The nurse is assisting in caring for the client immediately after insertion of a permanent
demand pacemaker via the right subclavian vein. The nurse prevents dislodgement of the
pacing catheter by implementing which intervention?
1. Limiting movement and abduction of the left arm
2. Limiting movement and abduction of the right arm
3. Assisting the client to get out of bed and ambulate with a walker
4. Having the physical therapist do active range of motion to the right arm
Correct Answer: 2. Limiting movement and abduction of the right arm
Rationale: The pacing catheter is inserted through the right subclavian vein, so limiting
movement and abduction of the right arm prevents dislodgement of the catheter tip from the
ventricular wall. The left arm is not involved. Ambulation with a walker would involve arm
movement and is contraindicated immediately post-procedure. Active range of motion to the
right arm could dislodge the catheter.
6) A client diagnosed with thrombophlebitis 1 day ago suddenly complains of chest pain and
shortness of breath, and the client is visibly anxious. The LPN/LVN understands that a life-
threatening complication of this condition is which?
1. Pneumonia
2. Pulmonary edema
3. Pulmonary embolism
4. Myocardial infarction
Page | 3
, Correct Answer: 3. Pulmonary embolism
Rationale: Thrombophlebitis involves inflammation and clot formation in a vein. A deep vein
thrombus can dislodge and travel to the pulmonary vasculature, causing a pulmonary
embolism. Symptoms include sudden chest pain, dyspnea, tachypnea, tachycardia, and anxiety.
This is a life-threatening emergency. Pneumonia, pulmonary edema, and myocardial infarction
may present with similar symptoms but are not the classic complication of thrombophlebitis.
7) A 24-year-old man seeks medical attention for complaints of claudication in the arch of the
foot. The nurse also notes superficial thrombophlebitis of the lower leg. The nurse should check
the client for which next?
1. Smoking history
2. Recent exposure to allergens
3. History of recent insect bites
4. Familial tendency toward peripheral vascular disease
Correct Answer: 1. Smoking history
Rationale: Claudication in a young adult combined with thrombophlebitis is highly suggestive of
Buerger's disease (thromboangiitis obliterans). This condition is strongly associated with
tobacco use, especially in young men. Smoking causes vasospasm and inflammation of small
and medium-sized arteries and veins. Allergens, insect bites, and family history are not the
primary risk factors for this presentation.
8) The nurse has reinforced instructions to the client with Raynaud's disease about self-
management of the disease process. The nurse determines that the client needs further
teaching if the client states which?
1. "Smoking cessation is very important."
2. "Moving to a warmer climate should help."
3. "Sources of caffeine should be eliminated from the diet."
4. "Taking nifedipine (Procardia) as prescribed will decrease vessel spasm."
Correct Answer: 2. "Moving to a warmer climate should help."
Page | 4
