HESI LPN COMPREHENSIVE EXIT EXAMINATION –
STUDY GUIDE | LATEST UPDATE 2026/2027 | ACTUAL
EXAM | PRACTICE QUESTIONS AND ANSWERS |
EXAM REVIEW | 100% CORRECT ANSWERS |
VERIFIED SOLUTIONS
1. The practical nurse is caring for a client who is on a clear liquid diet. Which
item on the client’s tray should the nurse remove?
A) Apple juice
B) Chicken broth
C) Coffee with cream
D) Gelatin
Correct Answer: C
Coffee with cream is not a clear liquid; cream is opaque and contains fat, which is
not allowed on a clear liquid diet. Apple juice, broth, and gelatin are clear liquids.
The LPN should remove the coffee with cream and clarify the order if needed.
2. A client is receiving continuous enteral feedings via a gastrostomy tube.
Which action is most important to prevent aspiration?
A) Flush the tube with 30 mL of water every 4 hours.
B) Keep the head of the bed elevated at least 30 to 45 degrees during and
after feeding.
C) Check residual volume every 8 hours only.
D) Change the feeding bag every 72 hours.
Correct Answer: B
Elevating the head of the bed during and after feedings is the most effective
measure to prevent aspiration. Checking residual volume is important but
elevation is the primary preventive measure. Flushing maintains patency;
changing the bag prevents bacterial growth but not aspiration.
, 3. The LPN is measuring a client’s blood pressure manually. Which action is
correct?
A) Deflate the cuff rapidly to avoid discomfort.
B) Place the stethoscope over the cuff to keep it in place.
C) Inflate the cuff 30 mm Hg above the point where the radial pulse
disappears.
D) Use a cuff with a bladder that covers 60% of the arm circumference.
Correct Answer: C
The cuff should be inflated until the pulse disappears, then an additional 30 mm
Hg to ensure accurate systolic reading. The cuff should be deflated slowly. The
stethoscope is placed over the brachial artery, not under the cuff. The bladder
width should be 40% and length 80% of arm circumference.
4. A client with a nasogastric tube to low intermittent suction is at risk for
which acid-base imbalance?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: B
Loss of gastric acid through NG suction leads to loss of hydrogen ions, resulting in
metabolic alkalosis. Metabolic acidosis would occur with severe diarrhea.
Respiratory imbalances are related to ventilation problems.
5. The LPN is providing oral care to an unconscious client. Which action is
most important to prevent aspiration?
A) Use a hard-bristle toothbrush to clean the teeth.
B) Turn the client’s head to the side and have suction available.
C) Use lemon glycerin swabs for oral care.
D) Place the client in a supine position for access.
Correct Answer: B
Turning the head to the side and having suction ready prevents aspiration of
,secretions. Hard-bristle brushes can damage gums; lemon glycerin swabs are
drying; supine positioning increases aspiration risk.
6. A client is on a low-sodium diet. Which food selection indicates a need for
further teaching?
A) Fresh apple slices
B) Baked chicken with herbs
C) Canned vegetable soup
D) Steamed brown rice
Correct Answer: C
Canned soups are often high in sodium. Fresh fruit, fresh meats, and plain grains
are low in sodium. The client needs further teaching to identify hidden sodium in
processed foods.
7. The LPN is preparing to administer an intramuscular injection to an adult
with a body mass index of 40. Which needle is most appropriate?
A) ½-inch needle at 90 degrees
B) 1-inch needle at 45 degrees
C) 1½-inch needle at 90 degrees
D) ⅝-inch needle at 45 degrees
Correct Answer: C
For obese clients, a longer needle (1½ to 2 inches) is needed to reach the muscle
through the subcutaneous tissue. The injection is given at a 90-degree angle.
Shorter needles may deposit medication in subcutaneous tissue rather than
muscle.
8. A client with Clostridioides difficile infection requires which type of
precautions?
A) Airborne precautions
B) Droplet precautions
C) Contact precautions
D) Standard precautions only
, Correct Answer: C
C. diff is transmitted by direct contact with spores. Contact precautions, including
gown and gloves, and hand hygiene with soap and water are required.
Alcohol-based sanitizers are not effective against C. diff spores.
9. The LPN is caring for a client with a stage 2 pressure injury. Which
intervention should be included in the plan of care?
A) Massage the area around the wound.
B) Clean the wound with hydrogen peroxide.
C) Apply a hydrocolloid dressing.
D) Keep the wound open to air.
Correct Answer: C
Hydrocolloid dressings maintain a moist wound environment and protect the
wound from contamination. Massaging can damage tissue; hydrogen peroxide is
cytotoxic; keeping the wound open to air delays healing.
10.A client with a new permanent pacemaker is being discharged. Which
instruction should the nurse include?
A) “You may have an MRI scan if needed.”
B) “Avoid using a cellular phone on the same side as the pacemaker.”
C) “You can return to contact sports in 2 weeks.”
D) “The pacemaker will need to be replaced every year.”
Correct Answer: B
Cellular phones should be kept at least 6 inches away from the pacemaker and
used on the opposite side to avoid electromagnetic interference. MRI is often
contraindicated unless the device is MRI-conditional. Contact sports should be
avoided. Pacemakers do not need annual replacement; battery life varies.
11.A client is receiving warfarin. Which statement indicates understanding?
A) “I will take aspirin for headaches.”
B) “I should use an electric razor for shaving.”
C) “I will increase my intake of green leafy vegetables.”
D) “I will have my aPTT checked regularly.”
STUDY GUIDE | LATEST UPDATE 2026/2027 | ACTUAL
EXAM | PRACTICE QUESTIONS AND ANSWERS |
EXAM REVIEW | 100% CORRECT ANSWERS |
VERIFIED SOLUTIONS
1. The practical nurse is caring for a client who is on a clear liquid diet. Which
item on the client’s tray should the nurse remove?
A) Apple juice
B) Chicken broth
C) Coffee with cream
D) Gelatin
Correct Answer: C
Coffee with cream is not a clear liquid; cream is opaque and contains fat, which is
not allowed on a clear liquid diet. Apple juice, broth, and gelatin are clear liquids.
The LPN should remove the coffee with cream and clarify the order if needed.
2. A client is receiving continuous enteral feedings via a gastrostomy tube.
Which action is most important to prevent aspiration?
A) Flush the tube with 30 mL of water every 4 hours.
B) Keep the head of the bed elevated at least 30 to 45 degrees during and
after feeding.
C) Check residual volume every 8 hours only.
D) Change the feeding bag every 72 hours.
Correct Answer: B
Elevating the head of the bed during and after feedings is the most effective
measure to prevent aspiration. Checking residual volume is important but
elevation is the primary preventive measure. Flushing maintains patency;
changing the bag prevents bacterial growth but not aspiration.
, 3. The LPN is measuring a client’s blood pressure manually. Which action is
correct?
A) Deflate the cuff rapidly to avoid discomfort.
B) Place the stethoscope over the cuff to keep it in place.
C) Inflate the cuff 30 mm Hg above the point where the radial pulse
disappears.
D) Use a cuff with a bladder that covers 60% of the arm circumference.
Correct Answer: C
The cuff should be inflated until the pulse disappears, then an additional 30 mm
Hg to ensure accurate systolic reading. The cuff should be deflated slowly. The
stethoscope is placed over the brachial artery, not under the cuff. The bladder
width should be 40% and length 80% of arm circumference.
4. A client with a nasogastric tube to low intermittent suction is at risk for
which acid-base imbalance?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: B
Loss of gastric acid through NG suction leads to loss of hydrogen ions, resulting in
metabolic alkalosis. Metabolic acidosis would occur with severe diarrhea.
Respiratory imbalances are related to ventilation problems.
5. The LPN is providing oral care to an unconscious client. Which action is
most important to prevent aspiration?
A) Use a hard-bristle toothbrush to clean the teeth.
B) Turn the client’s head to the side and have suction available.
C) Use lemon glycerin swabs for oral care.
D) Place the client in a supine position for access.
Correct Answer: B
Turning the head to the side and having suction ready prevents aspiration of
,secretions. Hard-bristle brushes can damage gums; lemon glycerin swabs are
drying; supine positioning increases aspiration risk.
6. A client is on a low-sodium diet. Which food selection indicates a need for
further teaching?
A) Fresh apple slices
B) Baked chicken with herbs
C) Canned vegetable soup
D) Steamed brown rice
Correct Answer: C
Canned soups are often high in sodium. Fresh fruit, fresh meats, and plain grains
are low in sodium. The client needs further teaching to identify hidden sodium in
processed foods.
7. The LPN is preparing to administer an intramuscular injection to an adult
with a body mass index of 40. Which needle is most appropriate?
A) ½-inch needle at 90 degrees
B) 1-inch needle at 45 degrees
C) 1½-inch needle at 90 degrees
D) ⅝-inch needle at 45 degrees
Correct Answer: C
For obese clients, a longer needle (1½ to 2 inches) is needed to reach the muscle
through the subcutaneous tissue. The injection is given at a 90-degree angle.
Shorter needles may deposit medication in subcutaneous tissue rather than
muscle.
8. A client with Clostridioides difficile infection requires which type of
precautions?
A) Airborne precautions
B) Droplet precautions
C) Contact precautions
D) Standard precautions only
, Correct Answer: C
C. diff is transmitted by direct contact with spores. Contact precautions, including
gown and gloves, and hand hygiene with soap and water are required.
Alcohol-based sanitizers are not effective against C. diff spores.
9. The LPN is caring for a client with a stage 2 pressure injury. Which
intervention should be included in the plan of care?
A) Massage the area around the wound.
B) Clean the wound with hydrogen peroxide.
C) Apply a hydrocolloid dressing.
D) Keep the wound open to air.
Correct Answer: C
Hydrocolloid dressings maintain a moist wound environment and protect the
wound from contamination. Massaging can damage tissue; hydrogen peroxide is
cytotoxic; keeping the wound open to air delays healing.
10.A client with a new permanent pacemaker is being discharged. Which
instruction should the nurse include?
A) “You may have an MRI scan if needed.”
B) “Avoid using a cellular phone on the same side as the pacemaker.”
C) “You can return to contact sports in 2 weeks.”
D) “The pacemaker will need to be replaced every year.”
Correct Answer: B
Cellular phones should be kept at least 6 inches away from the pacemaker and
used on the opposite side to avoid electromagnetic interference. MRI is often
contraindicated unless the device is MRI-conditional. Contact sports should be
avoided. Pacemakers do not need annual replacement; battery life varies.
11.A client is receiving warfarin. Which statement indicates understanding?
A) “I will take aspirin for headaches.”
B) “I should use an electric razor for shaving.”
C) “I will increase my intake of green leafy vegetables.”
D) “I will have my aPTT checked regularly.”
