HESI PN EXIT EXAM PRACTICE
2026/2027 QUESTIONS AND ANSWERS
1. A patient with heart failure is receiving digoxin. Which of the following laboratory values
would most likely increase the risk of digoxin toxicity?
A. Sodium 138 mEq/L
B. Potassium 3.2 mEq/L
C. Calcium 9.5 mg/dL
D. Magnesium 2.0 mEq/L
Answer: B
Conceptual Explanation: Hypokalemia (low potassium) significantly increases the risk of
digoxin toxicity because digoxin and potassium compete for the same binding sites on the
sodium-potassium ATPase pump.
2. A nurse is caring for a client who is post-operative following a thyroidectomy. Which
assessment finding is the priority to report to the provider?
A. Moderate pain at the incision site
B. Hoarseness when speaking
,C. Small amount of serosanguinous drainage
D. Laryngeal stridor
Answer: D
Conceptual Explanation: Laryngeal stridor is a sign of upper airway obstruction and is a
medical emergency that requires immediate intervention.
3. Which of the following medications is considered the antidote for heparin overdose?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Glucagon
Answer: B
Conceptual Explanation: Protamine sulfate is the specific antagonist used to reverse the
anticoagulant effects of heparin.
4. An older adult client is admitted with a diagnosis of dehydration. Which of the following
findings should the nurse expect?
A. Bradycardia
B. Distended neck veins
C. Increased skin turgor
, D. Hypotension
Answer: D
Conceptual Explanation: Dehydration leads to decreased circulating blood volume
(hypovolemia), which typically results in hypotension and tachycardia.
5. A nurse is preparing to administer regular insulin to a client. When should the nurse expect
the insulin to reach its peak effect?
A. 15 to 30 minutes
B. 2 to 4 hours
C. 6 to 8 hours
D. 10 to 12 hours
Answer: B
Conceptual Explanation: Regular insulin (short-acting) has an onset of 30-60 minutes and
reaches its peak effect in 2 to 4 hours.
6. Which of the following findings indicates that a client might be experiencing a hemolytic
transfusion reaction?
A. Urticaria and itching
B. Low back pain and hemoglobinuria
C. Fever and chills
D. Distended neck veins and cough
2026/2027 QUESTIONS AND ANSWERS
1. A patient with heart failure is receiving digoxin. Which of the following laboratory values
would most likely increase the risk of digoxin toxicity?
A. Sodium 138 mEq/L
B. Potassium 3.2 mEq/L
C. Calcium 9.5 mg/dL
D. Magnesium 2.0 mEq/L
Answer: B
Conceptual Explanation: Hypokalemia (low potassium) significantly increases the risk of
digoxin toxicity because digoxin and potassium compete for the same binding sites on the
sodium-potassium ATPase pump.
2. A nurse is caring for a client who is post-operative following a thyroidectomy. Which
assessment finding is the priority to report to the provider?
A. Moderate pain at the incision site
B. Hoarseness when speaking
,C. Small amount of serosanguinous drainage
D. Laryngeal stridor
Answer: D
Conceptual Explanation: Laryngeal stridor is a sign of upper airway obstruction and is a
medical emergency that requires immediate intervention.
3. Which of the following medications is considered the antidote for heparin overdose?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Glucagon
Answer: B
Conceptual Explanation: Protamine sulfate is the specific antagonist used to reverse the
anticoagulant effects of heparin.
4. An older adult client is admitted with a diagnosis of dehydration. Which of the following
findings should the nurse expect?
A. Bradycardia
B. Distended neck veins
C. Increased skin turgor
, D. Hypotension
Answer: D
Conceptual Explanation: Dehydration leads to decreased circulating blood volume
(hypovolemia), which typically results in hypotension and tachycardia.
5. A nurse is preparing to administer regular insulin to a client. When should the nurse expect
the insulin to reach its peak effect?
A. 15 to 30 minutes
B. 2 to 4 hours
C. 6 to 8 hours
D. 10 to 12 hours
Answer: B
Conceptual Explanation: Regular insulin (short-acting) has an onset of 30-60 minutes and
reaches its peak effect in 2 to 4 hours.
6. Which of the following findings indicates that a client might be experiencing a hemolytic
transfusion reaction?
A. Urticaria and itching
B. Low back pain and hemoglobinuria
C. Fever and chills
D. Distended neck veins and cough
