HESI PN EXIT EXAM COMPREHENSIVE
REVIEW 2026/2027 QUESTIONS AND
ANSWERS
1. A client with chronic heart failure is prescribed digoxin 0.25 mg daily. The nurse notes the
client’s potassium level is 3.2 mEq/L. Which action is most important for the nurse to take?
A. Administer the digoxin as prescribed.
B. Check the client’s blood pressure.
C. Hold the dose and notify the healthcare provider.
D. Encourage the client to eat a banana.
Answer: C
Conceptual Explanation: Hypokalemia (potassium < 3.5 mEq/L) significantly increases
the risk of digoxin toxicity. The nurse must hold the medication and notify the provider to
prevent life-threatening arrhythmias.
2. The nurse is caring for a client who is 2 hours postoperative following a thyroidectomy.
Which assessment finding requires immediate intervention?
A. Sore throat when speaking.
,B. Pain at the incision site rated 4/10.
C. Laryngeal stridor.
D. Small amount of serosanguinous drainage on the dressing.
Answer: C
Conceptual Explanation: Laryngeal stridor is a sign of airway obstruction, potentially due
to edema or tetany (hypocalcemia). It is a medical emergency requiring immediate
attention.
3. A client is admitted with a diagnosis of rule-out active tuberculosis (TB). Which type of
precautions should the nurse implement?
A. Contact precautions.
B. Droplet precautions.
C. Airborne precautions.
D. Standard precautions only.
Answer: C
Conceptual Explanation: Tuberculosis is transmitted via small droplets that remain
suspended in the air. Airborne precautions, including an N95 respirator and a negative-
pressure room, are required.
, 4. A nurse is preparing to administer regular insulin to a client with type 1 diabetes. The nurse
should expect the onset of action to occur within which timeframe?
A. 5 to 15 minutes.
B. 30 to 60 minutes.
C. 2 to 4 hours.
D. 6 to 10 hours.
Answer: B
Conceptual Explanation: Regular insulin (Short-acting) typically has an onset of 30 to 60
minutes. Rapid-acting insulin (like Lispro) has an onset of 5-15 minutes.
5. An older adult client is at risk for skin breakdown. Which intervention should the nurse
prioritize to maintain skin integrity?
A. Massage bony prominences every 2 hours.
B. Use a donut-shaped cushion when the client is sitting.
C. Reposition the client at least every 2 hours.
D. Apply powder to skin folds to keep them dry.
Answer: C
Conceptual Explanation: Frequent repositioning relieves pressure and is the standard of
care for preventing pressure injuries. Massaging bony prominences and using donut
cushions are contraindicated as they can damage tissue.
REVIEW 2026/2027 QUESTIONS AND
ANSWERS
1. A client with chronic heart failure is prescribed digoxin 0.25 mg daily. The nurse notes the
client’s potassium level is 3.2 mEq/L. Which action is most important for the nurse to take?
A. Administer the digoxin as prescribed.
B. Check the client’s blood pressure.
C. Hold the dose and notify the healthcare provider.
D. Encourage the client to eat a banana.
Answer: C
Conceptual Explanation: Hypokalemia (potassium < 3.5 mEq/L) significantly increases
the risk of digoxin toxicity. The nurse must hold the medication and notify the provider to
prevent life-threatening arrhythmias.
2. The nurse is caring for a client who is 2 hours postoperative following a thyroidectomy.
Which assessment finding requires immediate intervention?
A. Sore throat when speaking.
,B. Pain at the incision site rated 4/10.
C. Laryngeal stridor.
D. Small amount of serosanguinous drainage on the dressing.
Answer: C
Conceptual Explanation: Laryngeal stridor is a sign of airway obstruction, potentially due
to edema or tetany (hypocalcemia). It is a medical emergency requiring immediate
attention.
3. A client is admitted with a diagnosis of rule-out active tuberculosis (TB). Which type of
precautions should the nurse implement?
A. Contact precautions.
B. Droplet precautions.
C. Airborne precautions.
D. Standard precautions only.
Answer: C
Conceptual Explanation: Tuberculosis is transmitted via small droplets that remain
suspended in the air. Airborne precautions, including an N95 respirator and a negative-
pressure room, are required.
, 4. A nurse is preparing to administer regular insulin to a client with type 1 diabetes. The nurse
should expect the onset of action to occur within which timeframe?
A. 5 to 15 minutes.
B. 30 to 60 minutes.
C. 2 to 4 hours.
D. 6 to 10 hours.
Answer: B
Conceptual Explanation: Regular insulin (Short-acting) typically has an onset of 30 to 60
minutes. Rapid-acting insulin (like Lispro) has an onset of 5-15 minutes.
5. An older adult client is at risk for skin breakdown. Which intervention should the nurse
prioritize to maintain skin integrity?
A. Massage bony prominences every 2 hours.
B. Use a donut-shaped cushion when the client is sitting.
C. Reposition the client at least every 2 hours.
D. Apply powder to skin folds to keep them dry.
Answer: C
Conceptual Explanation: Frequent repositioning relieves pressure and is the standard of
care for preventing pressure injuries. Massaging bony prominences and using donut
cushions are contraindicated as they can damage tissue.
