HESI PN Exit Exam 2026-2027 | 140
Questions with Correct Verified Answers |
Graded A+ | Real Past Exam Review
This comprehensive practice test contains 140 verified questions from the HESI
PN Exit Exam (V3), covering all essential nursing domains including medical-
surgical nursing, pharmacology, maternal-newborn care, pediatrics, mental
health, fundamentals, leadership, prioritization, and clinical judgment . Designed
for LPN/LVN students preparing for graduation and NCLEX-PN success, this
resource reflects the latest 2026/2027 Elsevier HESI testing standards .
Question 1
The LPN/LVN receives the client's next scheduled bag of TPN labeled with the
additive NPH insulin. Which action should the nurse implement?
A) Hang the solution at the current rate.
B) Refrigerate the solution until needed.
C) Prepare the solution with new tubing.
D) Return the solution to the pharmacy.
Correct Answer: D) Return the solution to the pharmacy.
Rationale: Insulin should never be added to TPN solutions. The nurse should
return the solution to the pharmacy for proper preparation. Adding insulin
directly to TPN is not a standard practice and can lead to unpredictable
absorption and dosing errors .
Question 2
A male client has just undergone a laryngectomy and has a cuffed tracheostomy
tube in place. When initiating bolus tube feedings postoperatively, when should
the nurse inflate the cuff?
,A) Immediately after feeding.
B) Just prior to tube feeding.
C) Continuous inflation is required.
D) Inflation is not required.
Correct Answer: B) Just prior to tube feeding.
Rationale: The cuff should be inflated just before tube feeding to prevent
aspiration of feeding into the lungs. The cuff should be deflated between feedings
unless otherwise ordered to prevent tracheal tissue damage .
Question 3
A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid
ventricular response. Based on this finding, the nurse anticipates assisting the
physician with which treatment?
A) Administer lidocaine, 75 mg intravenous push.
B) Perform synchronized cardioversion.
C) Defibrillate the client as soon as possible.
D) Administer atropine, 0.4 mg intravenous push.
Correct Answer: B) Perform synchronized cardioversion.
Rationale: Uncontrolled atrial fibrillation with rapid ventricular response requires
synchronized cardioversion to restore normal sinus rhythm. Lidocaine is used for
ventricular arrhythmias, atropine for bradycardia, and defibrillation is for
pulseless ventricular tachycardia/fibrillation .
Question 4
A 63-year-old client with type 2 diabetes mellitus is admitted for treatment of an
ulcer on the heel of the left foot that has not healed with wound care. The nurse
observes that the entire left foot is darker in color than the right foot. Which
additional symptom should the nurse expect to find?
A) Pedal pulses will be weak or absent in the left foot.
B) The client will state that the left foot is usually warm.
,C) Flexion and extension of the left foot will be limited.
D) Capillary refill of the client's left toes will be brisk.
Correct Answer: A) Pedal pulses will be weak or absent in the left foot.
Rationale: Darker coloration of the foot indicates peripheral artery disease (PAD)
with decreased arterial blood flow. Weak or absent pedal pulses are expected.
The foot would typically be cool (not warm) due to decreased perfusion .
Question 5
A client with cirrhosis develops increasing pedal edema and ascites. Which dietary
modification is most important for the nurse to teach this client?
A) Avoid high-carbohydrate foods.
B) Decrease intake of fat-soluble vitamins.
C) Decrease caloric intake.
D) Restrict salt and fluid intake.
Correct Answer: D) Restrict salt and fluid intake.
Rationale: Fluid retention (edema and ascites) in cirrhosis is managed with
sodium and fluid restriction. Sodium restriction helps reduce fluid retention by
decreasing water retention. High-calorie, moderate-protein diets are generally
recommended .
Question 6
During report, the nurse learns that a client with tumor lysis syndrome is receiving
an IV infusion containing insulin. Which assessment should the nurse complete
first?
A) Review the client's history for diabetes mellitus.
B) Observe the extremity distal to the IV site.
C) Monitor the client's serum potassium and blood glucose levels.
D) Evaluate the client's oxygen saturation and breath sounds.
, Correct Answer: C) Monitor the client's serum potassium and blood glucose
levels.
Rationale: Tumor lysis syndrome causes release of intracellular contents, leading
to hyperkalemia, hyperuricemia, and hyperphosphatemia. Insulin infusions are
used to shift potassium into cells. Monitoring potassium and glucose is essential
to prevent complications .
Question 7
A tornado warning alarm has been activated at the local hospital. Which action
should the charge nurse working on a surgical unit implement first?
A) Instruct the nursing staff to close all window blinds and curtains in clients'
rooms.
B) Move clients and visitors into the hallways and close all doors to clients' rooms.
C) Visually confirm the location of the tornado by checking the windows on the
unit.
D) Assist all visitors with evacuation down the stairs in a calm and orderly manner.
Correct Answer: B) Move clients and visitors into the hallways and close all
doors to clients' rooms.
Rationale: During a tornado warning, clients and visitors should be moved to
interior hallways away from windows. Doors should be closed for protection.
Checking windows is unsafe during a tornado warning .
Question 8
A client with alcohol-related liver disease is admitted to the unit. Which
prescription should the nurse call the health care provider about for reverification
for this client?
A) Vitamin K1 (AquaMEPHYTON), 5 mg IM daily.
B) High-calorie, low-sodium diet.
C) Fluid restriction to 1500 mL/day.
D) Pentobarbital (Nembutal sodium) at bedtime for rest.
Questions with Correct Verified Answers |
Graded A+ | Real Past Exam Review
This comprehensive practice test contains 140 verified questions from the HESI
PN Exit Exam (V3), covering all essential nursing domains including medical-
surgical nursing, pharmacology, maternal-newborn care, pediatrics, mental
health, fundamentals, leadership, prioritization, and clinical judgment . Designed
for LPN/LVN students preparing for graduation and NCLEX-PN success, this
resource reflects the latest 2026/2027 Elsevier HESI testing standards .
Question 1
The LPN/LVN receives the client's next scheduled bag of TPN labeled with the
additive NPH insulin. Which action should the nurse implement?
A) Hang the solution at the current rate.
B) Refrigerate the solution until needed.
C) Prepare the solution with new tubing.
D) Return the solution to the pharmacy.
Correct Answer: D) Return the solution to the pharmacy.
Rationale: Insulin should never be added to TPN solutions. The nurse should
return the solution to the pharmacy for proper preparation. Adding insulin
directly to TPN is not a standard practice and can lead to unpredictable
absorption and dosing errors .
Question 2
A male client has just undergone a laryngectomy and has a cuffed tracheostomy
tube in place. When initiating bolus tube feedings postoperatively, when should
the nurse inflate the cuff?
,A) Immediately after feeding.
B) Just prior to tube feeding.
C) Continuous inflation is required.
D) Inflation is not required.
Correct Answer: B) Just prior to tube feeding.
Rationale: The cuff should be inflated just before tube feeding to prevent
aspiration of feeding into the lungs. The cuff should be deflated between feedings
unless otherwise ordered to prevent tracheal tissue damage .
Question 3
A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid
ventricular response. Based on this finding, the nurse anticipates assisting the
physician with which treatment?
A) Administer lidocaine, 75 mg intravenous push.
B) Perform synchronized cardioversion.
C) Defibrillate the client as soon as possible.
D) Administer atropine, 0.4 mg intravenous push.
Correct Answer: B) Perform synchronized cardioversion.
Rationale: Uncontrolled atrial fibrillation with rapid ventricular response requires
synchronized cardioversion to restore normal sinus rhythm. Lidocaine is used for
ventricular arrhythmias, atropine for bradycardia, and defibrillation is for
pulseless ventricular tachycardia/fibrillation .
Question 4
A 63-year-old client with type 2 diabetes mellitus is admitted for treatment of an
ulcer on the heel of the left foot that has not healed with wound care. The nurse
observes that the entire left foot is darker in color than the right foot. Which
additional symptom should the nurse expect to find?
A) Pedal pulses will be weak or absent in the left foot.
B) The client will state that the left foot is usually warm.
,C) Flexion and extension of the left foot will be limited.
D) Capillary refill of the client's left toes will be brisk.
Correct Answer: A) Pedal pulses will be weak or absent in the left foot.
Rationale: Darker coloration of the foot indicates peripheral artery disease (PAD)
with decreased arterial blood flow. Weak or absent pedal pulses are expected.
The foot would typically be cool (not warm) due to decreased perfusion .
Question 5
A client with cirrhosis develops increasing pedal edema and ascites. Which dietary
modification is most important for the nurse to teach this client?
A) Avoid high-carbohydrate foods.
B) Decrease intake of fat-soluble vitamins.
C) Decrease caloric intake.
D) Restrict salt and fluid intake.
Correct Answer: D) Restrict salt and fluid intake.
Rationale: Fluid retention (edema and ascites) in cirrhosis is managed with
sodium and fluid restriction. Sodium restriction helps reduce fluid retention by
decreasing water retention. High-calorie, moderate-protein diets are generally
recommended .
Question 6
During report, the nurse learns that a client with tumor lysis syndrome is receiving
an IV infusion containing insulin. Which assessment should the nurse complete
first?
A) Review the client's history for diabetes mellitus.
B) Observe the extremity distal to the IV site.
C) Monitor the client's serum potassium and blood glucose levels.
D) Evaluate the client's oxygen saturation and breath sounds.
, Correct Answer: C) Monitor the client's serum potassium and blood glucose
levels.
Rationale: Tumor lysis syndrome causes release of intracellular contents, leading
to hyperkalemia, hyperuricemia, and hyperphosphatemia. Insulin infusions are
used to shift potassium into cells. Monitoring potassium and glucose is essential
to prevent complications .
Question 7
A tornado warning alarm has been activated at the local hospital. Which action
should the charge nurse working on a surgical unit implement first?
A) Instruct the nursing staff to close all window blinds and curtains in clients'
rooms.
B) Move clients and visitors into the hallways and close all doors to clients' rooms.
C) Visually confirm the location of the tornado by checking the windows on the
unit.
D) Assist all visitors with evacuation down the stairs in a calm and orderly manner.
Correct Answer: B) Move clients and visitors into the hallways and close all
doors to clients' rooms.
Rationale: During a tornado warning, clients and visitors should be moved to
interior hallways away from windows. Doors should be closed for protection.
Checking windows is unsafe during a tornado warning .
Question 8
A client with alcohol-related liver disease is admitted to the unit. Which
prescription should the nurse call the health care provider about for reverification
for this client?
A) Vitamin K1 (AquaMEPHYTON), 5 mg IM daily.
B) High-calorie, low-sodium diet.
C) Fluid restriction to 1500 mL/day.
D) Pentobarbital (Nembutal sodium) at bedtime for rest.
