HESI LPN COMPREHENSIVE EXIT EXAMINATION
2026–2027 — STUDY GUIDE | LATEST UPDATE
2026/2027 | ACTUAL EXAM PRACTICE QUESTIONS
AND ANSWERS | EXAM REVIEW | 100% CORRECT
ANSWERS | VERIFIED SOLUTIONS
1. A practical nurse is delegating tasks to an unlicensed assistive personnel
(UAP) member. Which task is appropriate for the UAP?
A) Administering an oral medication
B) Performing a sterile dressing change
C) Ambulating a stable client in the hallway
D) Teaching a client about wound care
Correct Answer: C
UAPs can ambulate stable clients. Medication administration, sterile dressing
changes, and patient teaching are responsibilities of licensed nurses.
2. A client with chronic obstructive pulmonary disease is receiving oxygen at 2
L/min via nasal cannula. The client is drowsy and has a respiratory rate of 8
breaths per minute. What is the best action?
A) Increase oxygen to 4 L/min
B) Decrease oxygen to 1 L/min and notify the registered nurse
C) Administer a bronchodilator
D) Place the client flat
Correct Answer: B
In COPD with chronic CO₂ retention, excessive oxygen can suppress the hypoxic
drive. The PN should reduce oxygen to maintain SpO₂ 88–92% and notify the RN.
Increasing oxygen worsens hypoventilation.
3. A client is prescribed warfarin for atrial fibrillation. Which statement
indicates a need for further teaching?
A) “I will take the medication at the same time every day.”
B) “I will report any unusual bruising or bleeding.”
, C) “I can take aspirin for headaches while on warfarin.”
D) “I will keep my appointments for INR checks.”
Correct Answer: C
Aspirin increases bleeding risk when taken with warfarin and should be avoided
unless prescribed. The other statements are correct.
4. A practical nurse is caring for a client prescribed digoxin. The apical pulse is
54 bpm and irregular. What should the PN do?
A) Administer the digoxin as ordered
B) Hold the digoxin and notify the registered nurse or provider
C) Give half the dose
D) Administer with an antacid
Correct Answer: B
Digoxin should be held if the apical pulse is below 60 bpm and the RN or provider
notified. Administering could worsen bradycardia. The PN cannot independently
change the dose.
5. A practical nurse is preparing to administer a subcutaneous injection of
enoxaparin. Which technique is correct?
A) Aspirate before injecting
B) Massage the site after injecting
C) Pinch a skin fold on the abdomen and inject at a 90-degree angle
D) Use a 1.5-inch needle in the deltoid muscle
Correct Answer: C
Enoxaparin is given subcutaneously into a pinched abdominal skin fold at 90
degrees. Aspiration and massage are not recommended. A 1.5-inch needle is for
intramuscular use.
6. A client is prescribed furosemide for heart failure. Which laboratory value
requires immediate notification?
A) Serum potassium 3.1 mEq/L
B) Serum sodium 138 mEq/L
, C) Serum calcium 9.0 mg/dL
D) Serum magnesium 2.0 mEq/L
Correct Answer: A
Furosemide causes potassium loss; a potassium of 3.1 mEq/L is hypokalemic and
increases risk of dysrhythmias. The RN or provider should be notified before giving
the dose.
7. A client receiving a blood transfusion develops chills, fever, flank pain, and
dark urine. What is the priority action?
A) Slow the transfusion and administer an antipyretic
B) Stop the transfusion and infuse normal saline with new tubing
C) Administer diphenhydramine and continue the transfusion
D) Document and continue to monitor
Correct Answer: B
These are signs of an acute hemolytic reaction. The transfusion must be stopped
immediately, the line maintained with normal saline using new tubing, and the
RN/provider notified.
8. A nurse is preparing to administer regular insulin and NPH insulin. Which
action is correct?
A) Draw up NPH first, then regular
B) Draw up regular first, then NPH
C) Mix the two in a vial
D) Administer both by IV push
Correct Answer: B
When mixing short-acting (regular) and intermediate-acting (NPH) insulins, draw
up regular insulin first to prevent contamination of the regular vial with NPH. They
are drawn into one syringe, not mixed in a vial, and given subcutaneously.
9. A practical nurse is teaching a client with type 2 diabetes who is prescribed
metformin. Which statement indicates a need for further teaching?
A) “I will take the medication with meals.”
B) “I will stop the medication before procedures using contrast dye.”
, C) “I will have my kidney function checked regularly.”
D) “I can drink alcohol in moderation while taking metformin.”
Correct Answer: D
Alcohol can increase the risk of lactic acidosis with metformin and should be
limited or avoided. The other statements are correct.
10.A client with a recent coronary stent placement is prescribed clopidogrel.
Which statement indicates a need for further teaching?
A) “I will report any unusual bruising or black tarry stools.”
B) “I can stop the medication after 6 months if I feel fine.”
C) “I need to tell my dentist I am taking this medication.”
D) “I should not take ibuprofen without consulting my provider.”
Correct Answer: B
Dual antiplatelet therapy must not be stopped prematurely after stent placement
due to the risk of stent thrombosis. The other statements are correct.
11.A client with bipolar disorder is taking lithium. The lithium level is 1.8
mEq/L. The client has coarse tremors, blurred vision, and ataxia. What is the
priority action?
A) Hold the next dose and notify the provider
B) Encourage fluid intake and give the dose with food
C) Reassure the client these are common side effects
D) Administer prescribed propranolol for tremors
Correct Answer: A
A lithium level of 1.8 mEq/L is toxic (therapeutic 0.6–1.2 mEq/L). Coarse tremors,
blurred vision, and ataxia are signs of toxicity. The dose must be held and provider
notified.
12.A practical nurse administers albuterol to a child with acute asthma. Which
adverse effect should the nurse monitor for immediately?
A) Hypokalemia
B) Tachycardia and nervousness
2026–2027 — STUDY GUIDE | LATEST UPDATE
2026/2027 | ACTUAL EXAM PRACTICE QUESTIONS
AND ANSWERS | EXAM REVIEW | 100% CORRECT
ANSWERS | VERIFIED SOLUTIONS
1. A practical nurse is delegating tasks to an unlicensed assistive personnel
(UAP) member. Which task is appropriate for the UAP?
A) Administering an oral medication
B) Performing a sterile dressing change
C) Ambulating a stable client in the hallway
D) Teaching a client about wound care
Correct Answer: C
UAPs can ambulate stable clients. Medication administration, sterile dressing
changes, and patient teaching are responsibilities of licensed nurses.
2. A client with chronic obstructive pulmonary disease is receiving oxygen at 2
L/min via nasal cannula. The client is drowsy and has a respiratory rate of 8
breaths per minute. What is the best action?
A) Increase oxygen to 4 L/min
B) Decrease oxygen to 1 L/min and notify the registered nurse
C) Administer a bronchodilator
D) Place the client flat
Correct Answer: B
In COPD with chronic CO₂ retention, excessive oxygen can suppress the hypoxic
drive. The PN should reduce oxygen to maintain SpO₂ 88–92% and notify the RN.
Increasing oxygen worsens hypoventilation.
3. A client is prescribed warfarin for atrial fibrillation. Which statement
indicates a need for further teaching?
A) “I will take the medication at the same time every day.”
B) “I will report any unusual bruising or bleeding.”
, C) “I can take aspirin for headaches while on warfarin.”
D) “I will keep my appointments for INR checks.”
Correct Answer: C
Aspirin increases bleeding risk when taken with warfarin and should be avoided
unless prescribed. The other statements are correct.
4. A practical nurse is caring for a client prescribed digoxin. The apical pulse is
54 bpm and irregular. What should the PN do?
A) Administer the digoxin as ordered
B) Hold the digoxin and notify the registered nurse or provider
C) Give half the dose
D) Administer with an antacid
Correct Answer: B
Digoxin should be held if the apical pulse is below 60 bpm and the RN or provider
notified. Administering could worsen bradycardia. The PN cannot independently
change the dose.
5. A practical nurse is preparing to administer a subcutaneous injection of
enoxaparin. Which technique is correct?
A) Aspirate before injecting
B) Massage the site after injecting
C) Pinch a skin fold on the abdomen and inject at a 90-degree angle
D) Use a 1.5-inch needle in the deltoid muscle
Correct Answer: C
Enoxaparin is given subcutaneously into a pinched abdominal skin fold at 90
degrees. Aspiration and massage are not recommended. A 1.5-inch needle is for
intramuscular use.
6. A client is prescribed furosemide for heart failure. Which laboratory value
requires immediate notification?
A) Serum potassium 3.1 mEq/L
B) Serum sodium 138 mEq/L
, C) Serum calcium 9.0 mg/dL
D) Serum magnesium 2.0 mEq/L
Correct Answer: A
Furosemide causes potassium loss; a potassium of 3.1 mEq/L is hypokalemic and
increases risk of dysrhythmias. The RN or provider should be notified before giving
the dose.
7. A client receiving a blood transfusion develops chills, fever, flank pain, and
dark urine. What is the priority action?
A) Slow the transfusion and administer an antipyretic
B) Stop the transfusion and infuse normal saline with new tubing
C) Administer diphenhydramine and continue the transfusion
D) Document and continue to monitor
Correct Answer: B
These are signs of an acute hemolytic reaction. The transfusion must be stopped
immediately, the line maintained with normal saline using new tubing, and the
RN/provider notified.
8. A nurse is preparing to administer regular insulin and NPH insulin. Which
action is correct?
A) Draw up NPH first, then regular
B) Draw up regular first, then NPH
C) Mix the two in a vial
D) Administer both by IV push
Correct Answer: B
When mixing short-acting (regular) and intermediate-acting (NPH) insulins, draw
up regular insulin first to prevent contamination of the regular vial with NPH. They
are drawn into one syringe, not mixed in a vial, and given subcutaneously.
9. A practical nurse is teaching a client with type 2 diabetes who is prescribed
metformin. Which statement indicates a need for further teaching?
A) “I will take the medication with meals.”
B) “I will stop the medication before procedures using contrast dye.”
, C) “I will have my kidney function checked regularly.”
D) “I can drink alcohol in moderation while taking metformin.”
Correct Answer: D
Alcohol can increase the risk of lactic acidosis with metformin and should be
limited or avoided. The other statements are correct.
10.A client with a recent coronary stent placement is prescribed clopidogrel.
Which statement indicates a need for further teaching?
A) “I will report any unusual bruising or black tarry stools.”
B) “I can stop the medication after 6 months if I feel fine.”
C) “I need to tell my dentist I am taking this medication.”
D) “I should not take ibuprofen without consulting my provider.”
Correct Answer: B
Dual antiplatelet therapy must not be stopped prematurely after stent placement
due to the risk of stent thrombosis. The other statements are correct.
11.A client with bipolar disorder is taking lithium. The lithium level is 1.8
mEq/L. The client has coarse tremors, blurred vision, and ataxia. What is the
priority action?
A) Hold the next dose and notify the provider
B) Encourage fluid intake and give the dose with food
C) Reassure the client these are common side effects
D) Administer prescribed propranolol for tremors
Correct Answer: A
A lithium level of 1.8 mEq/L is toxic (therapeutic 0.6–1.2 mEq/L). Coarse tremors,
blurred vision, and ataxia are signs of toxicity. The dose must be held and provider
notified.
12.A practical nurse administers albuterol to a child with acute asthma. Which
adverse effect should the nurse monitor for immediately?
A) Hypokalemia
B) Tachycardia and nervousness
