HESI PN ACUTE CARE 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
Question 1
A client is admitted with a diagnosis of acute pancreatitis. Which laboratory value
would the nurse expect to be significantly elevated?
A. Serum calcium
B. Serum lipase
C. Serum potassium
D. Serum sodium
Correct Answer: B. Serum lipase
Rationale: Serum lipase is the most specific and sensitive laboratory test for acute
pancreatitis. It rises within 4 to 8 hours of onset and remains elevated for longer
than serum amylase. Serum calcium may decrease, not increase, due to fat
saponification. Potassium and sodium are not specifically indicative of
pancreatitis.
,Question 2
A client with heart failure is receiving furosemide. Which assessment finding
indicates that the medication is having the desired therapeutic effect?
A. Decreased peripheral edema
B. Increased blood pressure
C. Increased heart rate
D. Decreased urine output
Correct Answer: A. Decreased peripheral edema
Rationale: Furosemide is a loop diuretic that promotes fluid excretion, reducing
preload and relieving symptoms of fluid overload such as peripheral edema,
pulmonary congestion, and dyspnea. A decrease in edema indicates the
medication is effective. Blood pressure should decrease, and urine output should
increase. Tachycardia is not a desired effect.
Question 3
The nurse is caring for a client who has just returned from the post-anesthesia
care unit (PACU) following a right total hip arthroplasty. Which action should the
nurse take first?
A. Administer prescribed pain medication
B. Assess the client's neurovascular status of the right leg
C. Apply a warm compress to the incision
D. Encourage deep breathing and coughing exercises
Correct Answer: B. Assess the client's neurovascular status of the right leg
Rationale: After hip arthroplasty, the priority is to assess for neurovascular
compromise. The nurse must check for sensation, motor function, pulses, capillary
refill, color, and temperature of the operative leg to detect early signs of nerve
damage or vascular insufficiency. Pain management, respiratory exercises, and
wound care are important but secondary to immediate neurovascular assessment.
Question 4
A client is receiving a continuous heparin infusion for a deep vein thrombosis
(DVT). Which laboratory test is primarily used to monitor the therapeutic effect of
heparin?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International normalized ratio (INR)
,D. Platelet count
Correct Answer: B. Activated partial thromboplastin time (aPTT)
Rationale: The aPTT is the primary test used to monitor unfractionated heparin
therapy. The therapeutic goal is typically 1.5 to 2.5 times the control value. PT/INR
is used to monitor warfarin therapy. Platelet counts are monitored to detect
heparin-induced thrombocytopenia but do not reflect therapeutic anticoagulation.
Question 5
The nurse is caring for a client with a chest tube connected to a three-chamber
drainage system. The nurse observes continuous bubbling in the water seal
chamber. What is the most appropriate initial nursing action?
A. Clamp the chest tube immediately
B. Document the finding as expected
C. Assess the system for an air leak
D. Increase the suction pressure
Correct Answer: C. Assess the system for an air leak
Rationale: Continuous bubbling in the water seal chamber indicates an air leak.
The nurse should first assess the system to locate the source of the leak, which
could be at the insertion site, connections, or within the drainage system.
Clamping the tube could lead to tension pneumothorax. Suction should not be
increased without investigating the cause. Intermittent bubbling is expected, but
continuous bubbling is not.
Question 6
A client with chronic kidney disease (CKD) is scheduled for hemodialysis. Which
serum electrolyte value is of greatest concern to the nurse before the procedure?
A. Sodium 138 mEq/L
B. Calcium 8.5 mg/dL
C. Potassium 6.2 mEq/L
D. Magnesium 1.8 mg/dL
Correct Answer: C. Potassium 6.2 mEq/L
Rationale: Hyperkalemia (potassium > 5.0 mEq/L) is a life-threatening
complication of CKD due to decreased renal excretion. A potassium level of 6.2
mEq/L poses a significant risk of cardiac arrhythmias. The other values are within
normal limits and not of immediate concern. Pre-dialysis potassium levels must be
carefully monitored and managed.
, Question 7
The nurse is caring for a client who is 24 hours post-operative following an
abdominal hysterectomy. Which finding would indicate a potential complication
and require immediate intervention?
A. Serosanguineous drainage on the dressing
B. Client reports pain at the incision site
C. Temperature of 101.2°F (38.4°C)
D. Client has not had a bowel movement
Correct Answer: C. Temperature of 101.2°F (38.4°C)
Rationale: A temperature of 101.2°F on the first post-operative day is above the
expected low-grade fever (up to 100.4°F) and may indicate an infection or other
complication such as atelectasis, wound infection, or urinary tract infection. This
finding requires prompt assessment and intervention. Serosanguineous drainage
and pain are expected. Bowel movement may not occur for a few days.
Question 8
A client with diabetes insipidus is receiving desmopressin acetate. Which
assessment finding indicates that the treatment is effective?
A. Blood glucose level of 110 mg/dL
B. Serum sodium of 130 mEq/L
C. Urine output decreased to 40 mL/hour
D. Specific gravity of 1.002
Correct Answer: C. Urine output decreased to 40 mL/hour
Rationale: Desmopressin is a synthetic antidiuretic hormone used to treat diabetes
insipidus by promoting water reabsorption. A decrease in urine output to normal
levels (approximately 30-60 mL/hour) indicates therapeutic effectiveness. Serum
sodium would increase toward normal (135-145 mEq/L), and urine specific gravity
would increase above 1.005. Blood glucose is not related to diabetes insipidus.
Question 9
The nurse is preparing to administer intravenous (IV) vancomycin. Which action is
most important for the nurse to take to prevent a common adverse effect
associated with this medication?
A. Administer the medication over at least 60 minutes
B. Monitor the client's temperature every 4 hours
C. Encourage the client to increase oral fluid intake
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
Question 1
A client is admitted with a diagnosis of acute pancreatitis. Which laboratory value
would the nurse expect to be significantly elevated?
A. Serum calcium
B. Serum lipase
C. Serum potassium
D. Serum sodium
Correct Answer: B. Serum lipase
Rationale: Serum lipase is the most specific and sensitive laboratory test for acute
pancreatitis. It rises within 4 to 8 hours of onset and remains elevated for longer
than serum amylase. Serum calcium may decrease, not increase, due to fat
saponification. Potassium and sodium are not specifically indicative of
pancreatitis.
,Question 2
A client with heart failure is receiving furosemide. Which assessment finding
indicates that the medication is having the desired therapeutic effect?
A. Decreased peripheral edema
B. Increased blood pressure
C. Increased heart rate
D. Decreased urine output
Correct Answer: A. Decreased peripheral edema
Rationale: Furosemide is a loop diuretic that promotes fluid excretion, reducing
preload and relieving symptoms of fluid overload such as peripheral edema,
pulmonary congestion, and dyspnea. A decrease in edema indicates the
medication is effective. Blood pressure should decrease, and urine output should
increase. Tachycardia is not a desired effect.
Question 3
The nurse is caring for a client who has just returned from the post-anesthesia
care unit (PACU) following a right total hip arthroplasty. Which action should the
nurse take first?
A. Administer prescribed pain medication
B. Assess the client's neurovascular status of the right leg
C. Apply a warm compress to the incision
D. Encourage deep breathing and coughing exercises
Correct Answer: B. Assess the client's neurovascular status of the right leg
Rationale: After hip arthroplasty, the priority is to assess for neurovascular
compromise. The nurse must check for sensation, motor function, pulses, capillary
refill, color, and temperature of the operative leg to detect early signs of nerve
damage or vascular insufficiency. Pain management, respiratory exercises, and
wound care are important but secondary to immediate neurovascular assessment.
Question 4
A client is receiving a continuous heparin infusion for a deep vein thrombosis
(DVT). Which laboratory test is primarily used to monitor the therapeutic effect of
heparin?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International normalized ratio (INR)
,D. Platelet count
Correct Answer: B. Activated partial thromboplastin time (aPTT)
Rationale: The aPTT is the primary test used to monitor unfractionated heparin
therapy. The therapeutic goal is typically 1.5 to 2.5 times the control value. PT/INR
is used to monitor warfarin therapy. Platelet counts are monitored to detect
heparin-induced thrombocytopenia but do not reflect therapeutic anticoagulation.
Question 5
The nurse is caring for a client with a chest tube connected to a three-chamber
drainage system. The nurse observes continuous bubbling in the water seal
chamber. What is the most appropriate initial nursing action?
A. Clamp the chest tube immediately
B. Document the finding as expected
C. Assess the system for an air leak
D. Increase the suction pressure
Correct Answer: C. Assess the system for an air leak
Rationale: Continuous bubbling in the water seal chamber indicates an air leak.
The nurse should first assess the system to locate the source of the leak, which
could be at the insertion site, connections, or within the drainage system.
Clamping the tube could lead to tension pneumothorax. Suction should not be
increased without investigating the cause. Intermittent bubbling is expected, but
continuous bubbling is not.
Question 6
A client with chronic kidney disease (CKD) is scheduled for hemodialysis. Which
serum electrolyte value is of greatest concern to the nurse before the procedure?
A. Sodium 138 mEq/L
B. Calcium 8.5 mg/dL
C. Potassium 6.2 mEq/L
D. Magnesium 1.8 mg/dL
Correct Answer: C. Potassium 6.2 mEq/L
Rationale: Hyperkalemia (potassium > 5.0 mEq/L) is a life-threatening
complication of CKD due to decreased renal excretion. A potassium level of 6.2
mEq/L poses a significant risk of cardiac arrhythmias. The other values are within
normal limits and not of immediate concern. Pre-dialysis potassium levels must be
carefully monitored and managed.
, Question 7
The nurse is caring for a client who is 24 hours post-operative following an
abdominal hysterectomy. Which finding would indicate a potential complication
and require immediate intervention?
A. Serosanguineous drainage on the dressing
B. Client reports pain at the incision site
C. Temperature of 101.2°F (38.4°C)
D. Client has not had a bowel movement
Correct Answer: C. Temperature of 101.2°F (38.4°C)
Rationale: A temperature of 101.2°F on the first post-operative day is above the
expected low-grade fever (up to 100.4°F) and may indicate an infection or other
complication such as atelectasis, wound infection, or urinary tract infection. This
finding requires prompt assessment and intervention. Serosanguineous drainage
and pain are expected. Bowel movement may not occur for a few days.
Question 8
A client with diabetes insipidus is receiving desmopressin acetate. Which
assessment finding indicates that the treatment is effective?
A. Blood glucose level of 110 mg/dL
B. Serum sodium of 130 mEq/L
C. Urine output decreased to 40 mL/hour
D. Specific gravity of 1.002
Correct Answer: C. Urine output decreased to 40 mL/hour
Rationale: Desmopressin is a synthetic antidiuretic hormone used to treat diabetes
insipidus by promoting water reabsorption. A decrease in urine output to normal
levels (approximately 30-60 mL/hour) indicates therapeutic effectiveness. Serum
sodium would increase toward normal (135-145 mEq/L), and urine specific gravity
would increase above 1.005. Blood glucose is not related to diabetes insipidus.
Question 9
The nurse is preparing to administer intravenous (IV) vancomycin. Which action is
most important for the nurse to take to prevent a common adverse effect
associated with this medication?
A. Administer the medication over at least 60 minutes
B. Monitor the client's temperature every 4 hours
C. Encourage the client to increase oral fluid intake
