HESI PN COMPREHENSIVE EXIT EXAM ACCURATE
COMPREHENSIVE PRACTICE EXAM WITH ALL
POSSIBLE APPROVED WELL ELABORATED
PRACTICE QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS WITH DETAILED RATIONALES
PLUS EXPERT ANSWER KEY (100% CORRECT
VERIFIED SOLUTIONS) 2026-2027 CURRENTLY
UPDATED VERSION Q&A GUARANTEED PASS A+
INSTANT DOWNLOAD PDF
1. A client with heart failure is prescribed furosemide. Which laboratory value
should the nurse monitor most closely?
a. Serum sodium
b. Serum potassium
c. Serum calcium
d. Serum magnesium
b. Serum potassium
*Rationale: Furosemide is a loop diuretic that causes significant potassium loss.
Hypokalemia can lead to cardiac arrhythmias, making serum potassium the
most critical value to monitor. *
2. The nurse is caring for a client with a nasogastric tube attached to low
intermittent suction. Which assessment finding indicates a potential complication?
a. Dry mucous membranes
b. Serum potassium of 3.2 mEq/L
,c. Urine output of 40 mL/hr
d. Bowel sounds present in all quadrants
b. Serum potassium of 3.2 mEq/L
*Rationale: Nasogastric suction can deplete gastric fluids and electrolytes,
particularly potassium. A potassium level of 3.2 mEq/L is below normal and
indicates hypokalemia, a common complication requiring intervention. *
3. A client with type 1 diabetes mellitus reports feeling shaky and sweaty. The
nurse obtains a blood glucose level of 55 mg/dL. What is the priority action?
a. Administer 15 grams of rapid-acting carbohydrate
b. Give 0.5 mg glucagon subcutaneously
c. Notify the healthcare provider immediately
d. Recheck blood glucose in 30 minutes
a. Administer 15 grams of rapid-acting carbohydrate
*Rationale: The client is experiencing hypoglycemia. The priority is to provide 15
grams of rapid-acting carbohydrate, such as orange juice or glucose tablets, to
raise blood glucose quickly. Rechecking is done after 15 minutes. *
4. The nurse is preparing to administer digoxin to a client with atrial fibrillation.
Which finding would cause the nurse to withhold the medication?
a. Heart rate of 92 beats per minute
b. Serum digoxin level of 1.8 ng/mL
c. Apical pulse of 52 beats per minute
d. Blood pressure of 130/85 mmHg
c. Apical pulse of 52 beats per minute
*Rationale: Digoxin slows the heart rate; a pulse below 60 beats per minute is a
common reason to withhold the drug. The nurse should assess and report
bradycardia before administration. *
5. A postoperative client reports sudden chest pain and shortness of breath. The
nurse notes tachycardia and tachypnea. What is the priority nursing action?
a. Administer prescribed pain medication
b. Place the client in a high Fowler’s position
c. Apply oxygen via nasal cannula
d. Encourage deep breathing and coughing
c. Apply oxygen via nasal cannula
,*Rationale: These symptoms suggest a pulmonary embolism. Applying oxygen is
the immediate priority to address hypoxemia. High Fowler’s position may follow
but oxygenation is critical first. *
6. The nurse is assessing a client with chronic obstructive pulmonary disease.
Which finding indicates the client is using accessory muscles to breathe?
a. Pursed-lip breathing
b. Barrel-shaped chest
c. Retraction of the intercostal spaces
d. Prolonged expiration
c. Retraction of the intercostal spaces
*Rationale: Accessory muscle use includes retraction of intercostal and
supraclavicular spaces, indicating increased work of breathing. Pursed-lip
breathing is a compensatory technique, not accessory muscle use. *
7. A client is receiving heparin infusion for deep vein thrombosis. Which laboratory
test should the nurse use to monitor therapeutic effect?
a. Prothrombin time
b. International normalized ratio
c. Activated partial thromboplastin time
d. Platelet count
c. Activated partial thromboplastin time
*Rationale: Heparin therapy is monitored using aPTT, with a therapeutic range
typically 1.5 to 2.5 times the normal control. PT and INR monitor warfarin, and
platelet count monitors for heparin-induced thrombocytopenia. *
8. The nurse is providing discharge teaching to a client with a new colostomy.
Which statement by the client indicates understanding?
a. “I will change the pouch every day to prevent infection.”
b. “I should eat foods high in fiber to thicken output.”
c. “I will notify my provider if the stoma becomes dusky or purple.”
d. “I can irrigate the colostomy to avoid using a pouch.”
c. “I will notify my provider if the stoma becomes dusky or purple.”
*Rationale: A dusky or purple stoma indicates compromised circulation, which is
a sign of necrosis. This requires immediate provider notification. Pouch changes
are generally every 3-7 days, not daily. *
, 9. A client with cirrhosis is prescribed lactulose. What is the expected therapeutic
effect?
a. Decrease serum ammonia levels
b. Increase serum bilirubin excretion
c. Reduce portal hypertension
d. Improve clotting factors
a. Decrease serum ammonia levels
*Rationale: Lactulose reduces serum ammonia by promoting its excretion in the
stool, used to treat hepatic encephalopathy. It does not directly affect bilirubin,
portal pressure, or clotting. *
10. The nurse is caring for a client with a traumatic brain injury. Which assessment
finding is most concerning?
a. Glasgow Coma Scale score of 14
b. Pupils equal and reactive to light
c. Blood pressure 150/90 mmHg
d. Vomiting without nausea
d. Vomiting without nausea
*Rationale: Vomiting without nausea can indicate increased intracranial
pressure, a serious complication. A GCS of 14 is mildly decreased but less
urgent; hypertension may also occur but is expected with ICP. *
11. The nurse is reviewing a client’s laboratory results and notes a serum
creatinine of 2.5 mg/dL. What is the priority action?
a. Administer IV fluids as prescribed
b. Assess urine output and fluid status
c. Notify the healthcare provider
d. Monitor serum potassium levels
c. Notify the healthcare provider
*Rationale: A serum creatinine of 2.5 mg/dL is significantly elevated, indicating
acute kidney injury. Immediate provider notification is required for further
evaluation and intervention, though other actions may follow. *
12. A client with pneumonia has a temperature of 103°F and is diaphoretic. Which
nursing intervention is appropriate?
a. Apply a cooling blanket
COMPREHENSIVE PRACTICE EXAM WITH ALL
POSSIBLE APPROVED WELL ELABORATED
PRACTICE QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS WITH DETAILED RATIONALES
PLUS EXPERT ANSWER KEY (100% CORRECT
VERIFIED SOLUTIONS) 2026-2027 CURRENTLY
UPDATED VERSION Q&A GUARANTEED PASS A+
INSTANT DOWNLOAD PDF
1. A client with heart failure is prescribed furosemide. Which laboratory value
should the nurse monitor most closely?
a. Serum sodium
b. Serum potassium
c. Serum calcium
d. Serum magnesium
b. Serum potassium
*Rationale: Furosemide is a loop diuretic that causes significant potassium loss.
Hypokalemia can lead to cardiac arrhythmias, making serum potassium the
most critical value to monitor. *
2. The nurse is caring for a client with a nasogastric tube attached to low
intermittent suction. Which assessment finding indicates a potential complication?
a. Dry mucous membranes
b. Serum potassium of 3.2 mEq/L
,c. Urine output of 40 mL/hr
d. Bowel sounds present in all quadrants
b. Serum potassium of 3.2 mEq/L
*Rationale: Nasogastric suction can deplete gastric fluids and electrolytes,
particularly potassium. A potassium level of 3.2 mEq/L is below normal and
indicates hypokalemia, a common complication requiring intervention. *
3. A client with type 1 diabetes mellitus reports feeling shaky and sweaty. The
nurse obtains a blood glucose level of 55 mg/dL. What is the priority action?
a. Administer 15 grams of rapid-acting carbohydrate
b. Give 0.5 mg glucagon subcutaneously
c. Notify the healthcare provider immediately
d. Recheck blood glucose in 30 minutes
a. Administer 15 grams of rapid-acting carbohydrate
*Rationale: The client is experiencing hypoglycemia. The priority is to provide 15
grams of rapid-acting carbohydrate, such as orange juice or glucose tablets, to
raise blood glucose quickly. Rechecking is done after 15 minutes. *
4. The nurse is preparing to administer digoxin to a client with atrial fibrillation.
Which finding would cause the nurse to withhold the medication?
a. Heart rate of 92 beats per minute
b. Serum digoxin level of 1.8 ng/mL
c. Apical pulse of 52 beats per minute
d. Blood pressure of 130/85 mmHg
c. Apical pulse of 52 beats per minute
*Rationale: Digoxin slows the heart rate; a pulse below 60 beats per minute is a
common reason to withhold the drug. The nurse should assess and report
bradycardia before administration. *
5. A postoperative client reports sudden chest pain and shortness of breath. The
nurse notes tachycardia and tachypnea. What is the priority nursing action?
a. Administer prescribed pain medication
b. Place the client in a high Fowler’s position
c. Apply oxygen via nasal cannula
d. Encourage deep breathing and coughing
c. Apply oxygen via nasal cannula
,*Rationale: These symptoms suggest a pulmonary embolism. Applying oxygen is
the immediate priority to address hypoxemia. High Fowler’s position may follow
but oxygenation is critical first. *
6. The nurse is assessing a client with chronic obstructive pulmonary disease.
Which finding indicates the client is using accessory muscles to breathe?
a. Pursed-lip breathing
b. Barrel-shaped chest
c. Retraction of the intercostal spaces
d. Prolonged expiration
c. Retraction of the intercostal spaces
*Rationale: Accessory muscle use includes retraction of intercostal and
supraclavicular spaces, indicating increased work of breathing. Pursed-lip
breathing is a compensatory technique, not accessory muscle use. *
7. A client is receiving heparin infusion for deep vein thrombosis. Which laboratory
test should the nurse use to monitor therapeutic effect?
a. Prothrombin time
b. International normalized ratio
c. Activated partial thromboplastin time
d. Platelet count
c. Activated partial thromboplastin time
*Rationale: Heparin therapy is monitored using aPTT, with a therapeutic range
typically 1.5 to 2.5 times the normal control. PT and INR monitor warfarin, and
platelet count monitors for heparin-induced thrombocytopenia. *
8. The nurse is providing discharge teaching to a client with a new colostomy.
Which statement by the client indicates understanding?
a. “I will change the pouch every day to prevent infection.”
b. “I should eat foods high in fiber to thicken output.”
c. “I will notify my provider if the stoma becomes dusky or purple.”
d. “I can irrigate the colostomy to avoid using a pouch.”
c. “I will notify my provider if the stoma becomes dusky or purple.”
*Rationale: A dusky or purple stoma indicates compromised circulation, which is
a sign of necrosis. This requires immediate provider notification. Pouch changes
are generally every 3-7 days, not daily. *
, 9. A client with cirrhosis is prescribed lactulose. What is the expected therapeutic
effect?
a. Decrease serum ammonia levels
b. Increase serum bilirubin excretion
c. Reduce portal hypertension
d. Improve clotting factors
a. Decrease serum ammonia levels
*Rationale: Lactulose reduces serum ammonia by promoting its excretion in the
stool, used to treat hepatic encephalopathy. It does not directly affect bilirubin,
portal pressure, or clotting. *
10. The nurse is caring for a client with a traumatic brain injury. Which assessment
finding is most concerning?
a. Glasgow Coma Scale score of 14
b. Pupils equal and reactive to light
c. Blood pressure 150/90 mmHg
d. Vomiting without nausea
d. Vomiting without nausea
*Rationale: Vomiting without nausea can indicate increased intracranial
pressure, a serious complication. A GCS of 14 is mildly decreased but less
urgent; hypertension may also occur but is expected with ICP. *
11. The nurse is reviewing a client’s laboratory results and notes a serum
creatinine of 2.5 mg/dL. What is the priority action?
a. Administer IV fluids as prescribed
b. Assess urine output and fluid status
c. Notify the healthcare provider
d. Monitor serum potassium levels
c. Notify the healthcare provider
*Rationale: A serum creatinine of 2.5 mg/dL is significantly elevated, indicating
acute kidney injury. Immediate provider notification is required for further
evaluation and intervention, though other actions may follow. *
12. A client with pneumonia has a temperature of 103°F and is diaphoretic. Which
nursing intervention is appropriate?
a. Apply a cooling blanket
