HESI PN EXIT EXAM 2026/2027 – 300
PRACTICE QUESTIONS AND ANSWERS
|VERIFIED ANSWERS PLUS RATIONALES |
ALREADY GRADED A+ /GUARANTEED
PASS /MOST RECENT
Question 1
The practical nurse (PN) is preparing to ambulate a postoperative client after cardiac
surgery. Which action is most important to ensure client safety?
• A) Place the bed in the highest position
• B) Ensure the client has non-skid footwear
• C) Position the bedside table directly in front of the client
• D) Raise all four side rails before ambulating
Correct Answer: B
Rationale: Non-skid footwear reduces the risk of slipping and falling during
ambulation. The bed should be in the lowest position to prevent falls from height .
Question 2
The PN enters a client's room and finds the client unresponsive. What is the first
action?
• A) Call the family
• B) Check for a pulse
• C) Start chest compressions
• D) Notify the healthcare provider
Correct Answer: B
Rationale: Checking for a pulse determines whether CPR is needed. This follows the
ABC (Airway, Breathing, Circulation) approach to emergency assessment .
Question 3
A client receiving a blood transfusion develops chills and back pain. What is the PN's
priority action?
• A) Slow the transfusion rate
• B) Stop the transfusion immediately
• C) Administer acetaminophen as ordered
• D) Notify the healthcare provider
,Correct Answer: B
Rationale: Chills and back pain are signs of a possible hemolytic transfusion reaction.
The transfusion must be stopped immediately; then notify the provider and maintain
IV access with normal saline .
Question 4
A client with a tracheostomy requires suctioning. What should the PN do first?
• A) Apply suction while inserting the catheter
• B) Hyperoxygenate the client
• C) Insert the catheter gently
• D) Suction for 20 seconds
Correct Answer: B
Rationale: Hyperoxygenating the client before suctioning helps prevent hypoxia
during the procedure. Suction should only be applied during withdrawal .
Question 5
A confused resident in a long-term care facility has no ID band or picture. What is the
best action for the PN before administering medications?
• A) Ask a regular staff member to confirm the resident's identity
• B) Hold the medication until a family member arrives
• C) Reorient the resident to name, place, and situation
• D) Confirm the room and bed number match the medication record
Correct Answer: D
Rationale: Confirming multiple identifiers, including room and bed number, per
facility policy is essential to ensure patient safety before medication administration.
Reliance solely on staff or family confirmation risks error .
Question 6
The PN observes a newly hired PN who is preparing to administer a liquid medication
via a client's feeding tube system using the wrong procedure. What action should the
PN take?
• A) Demonstrate how to administer medication via a feeding tube
• B) Confirm that the medication is only administered once daily
• C) Determine if the medication is compatible with the solution
• D) Offer to assist in calculating the rate of flow for the mixture
Correct Answer: A
Rationale: The PN should demonstrate the correct procedure to ensure safe
medication administration and proper staff training .
,Question 7
The PN is caring for a client with a new colostomy. Which statement indicates that
the client understands the discharge teaching?
• A) "I will change the pouch every day."
• B) "I will empty the pouch when it is about one-third to one-half full."
• C) "I will apply lotion to the skin around the stoma."
• D) "I will eat foods that will cause gas to help the stoma work."
Correct Answer: B
Rationale: Emptying the pouch when it is one-third to one-half full prevents leakage
and skin breakdown. The skin around the stoma should be cleaned with mild soap
and water .
Question 8
An adult client weighing 150 pounds with 40% total body surface area burns has
been admitted. Which finding requires immediate reporting?
• A) Poor appetite and refusal to eat
• B) Systolic blood pressure of 102 mmHg
• C) Painful moaning and crying
• D) Urine output of 20 ml/hr
Correct Answer: D
Rationale: Adequate urine output (>30 ml/hr) is a key indicator of adequate renal
perfusion and fluid status after burns. Output of 20 ml/hr signals hypovolemia/shock
and requires immediate intervention .
Question 9
A 12-year-old child begins a blood transfusion with an infusion pump. Fifteen
minutes after starting, he complains of itchy skin and appears flushed. What is the
PN's first action?
• A) Apply lotion to the skin
• B) Stop the transfusion immediately
• C) Inspect the infusion site
• D) Obtain vital signs
Correct Answer: B
Rationale: Signs of allergic or hemolytic transfusion reactions require immediate
cessation of the transfusion to prevent worsening complications. Further assessment
follows .
, Question 10
The PN is reinforcing teaching for a client prescribed warfarin (Coumadin). Which
statement by the client indicates a need for further teaching?
• A) "I will use a soft toothbrush."
• B) "I will report any unusual bleeding."
• C) "I will take ibuprofen for my headaches."
• D) "I will have my blood tested regularly."
Correct Answer: C
Rationale: "I will take ibuprofen for my headaches" indicates a need for further
teaching, as NSAIDs like ibuprofen increase the risk of bleeding when taken with
warfarin. Acetaminophen is a safer alternative for pain .
Question 11
While taking the vital signs of an older male client who takes psychotropic
medications, the PN notes uncontrollable hand movements and excessive blinking of
the eyes. Which information in the client's medical record should the PN review?
• A) Prescription for lorazepam
• B) History of Parkinson's disease
• C) Screening for tardive dyskinesia
• D) Recent urine drug screen report
Correct Answer: C
Rationale: Tardive dyskinesia is a movement disorder caused by long-term use of
psychotropic medications. Reviewing prior screenings helps assess risk and plan
care .
Question 12
A client with chronic kidney disease stage 4 is admitted with hyperkalemia (K+ 6.2
mEq/L). The nurse reviews the electronic health record and notes the client is
scheduled for dialysis tomorrow. Which intervention should the nurse implement
first?
• A) Administer sodium polystyrene sulfonate orally.
• B) Prepare for immediate hemodialysis.
• C) Administer intravenous calcium gluconate.
• D) Administer albuterol via nebulizer.
Correct Answer: C
Rationale: Intravenous calcium gluconate is given first to protect the heart from life-
threatening arrhythmias by stabilizing the myocardial membrane. Sodium
polystyrene sulfonate works slowly, dialysis is not immediate, and albuterol is a
temporary measure to shift potassium into cells but does not protect the heart .
PRACTICE QUESTIONS AND ANSWERS
|VERIFIED ANSWERS PLUS RATIONALES |
ALREADY GRADED A+ /GUARANTEED
PASS /MOST RECENT
Question 1
The practical nurse (PN) is preparing to ambulate a postoperative client after cardiac
surgery. Which action is most important to ensure client safety?
• A) Place the bed in the highest position
• B) Ensure the client has non-skid footwear
• C) Position the bedside table directly in front of the client
• D) Raise all four side rails before ambulating
Correct Answer: B
Rationale: Non-skid footwear reduces the risk of slipping and falling during
ambulation. The bed should be in the lowest position to prevent falls from height .
Question 2
The PN enters a client's room and finds the client unresponsive. What is the first
action?
• A) Call the family
• B) Check for a pulse
• C) Start chest compressions
• D) Notify the healthcare provider
Correct Answer: B
Rationale: Checking for a pulse determines whether CPR is needed. This follows the
ABC (Airway, Breathing, Circulation) approach to emergency assessment .
Question 3
A client receiving a blood transfusion develops chills and back pain. What is the PN's
priority action?
• A) Slow the transfusion rate
• B) Stop the transfusion immediately
• C) Administer acetaminophen as ordered
• D) Notify the healthcare provider
,Correct Answer: B
Rationale: Chills and back pain are signs of a possible hemolytic transfusion reaction.
The transfusion must be stopped immediately; then notify the provider and maintain
IV access with normal saline .
Question 4
A client with a tracheostomy requires suctioning. What should the PN do first?
• A) Apply suction while inserting the catheter
• B) Hyperoxygenate the client
• C) Insert the catheter gently
• D) Suction for 20 seconds
Correct Answer: B
Rationale: Hyperoxygenating the client before suctioning helps prevent hypoxia
during the procedure. Suction should only be applied during withdrawal .
Question 5
A confused resident in a long-term care facility has no ID band or picture. What is the
best action for the PN before administering medications?
• A) Ask a regular staff member to confirm the resident's identity
• B) Hold the medication until a family member arrives
• C) Reorient the resident to name, place, and situation
• D) Confirm the room and bed number match the medication record
Correct Answer: D
Rationale: Confirming multiple identifiers, including room and bed number, per
facility policy is essential to ensure patient safety before medication administration.
Reliance solely on staff or family confirmation risks error .
Question 6
The PN observes a newly hired PN who is preparing to administer a liquid medication
via a client's feeding tube system using the wrong procedure. What action should the
PN take?
• A) Demonstrate how to administer medication via a feeding tube
• B) Confirm that the medication is only administered once daily
• C) Determine if the medication is compatible with the solution
• D) Offer to assist in calculating the rate of flow for the mixture
Correct Answer: A
Rationale: The PN should demonstrate the correct procedure to ensure safe
medication administration and proper staff training .
,Question 7
The PN is caring for a client with a new colostomy. Which statement indicates that
the client understands the discharge teaching?
• A) "I will change the pouch every day."
• B) "I will empty the pouch when it is about one-third to one-half full."
• C) "I will apply lotion to the skin around the stoma."
• D) "I will eat foods that will cause gas to help the stoma work."
Correct Answer: B
Rationale: Emptying the pouch when it is one-third to one-half full prevents leakage
and skin breakdown. The skin around the stoma should be cleaned with mild soap
and water .
Question 8
An adult client weighing 150 pounds with 40% total body surface area burns has
been admitted. Which finding requires immediate reporting?
• A) Poor appetite and refusal to eat
• B) Systolic blood pressure of 102 mmHg
• C) Painful moaning and crying
• D) Urine output of 20 ml/hr
Correct Answer: D
Rationale: Adequate urine output (>30 ml/hr) is a key indicator of adequate renal
perfusion and fluid status after burns. Output of 20 ml/hr signals hypovolemia/shock
and requires immediate intervention .
Question 9
A 12-year-old child begins a blood transfusion with an infusion pump. Fifteen
minutes after starting, he complains of itchy skin and appears flushed. What is the
PN's first action?
• A) Apply lotion to the skin
• B) Stop the transfusion immediately
• C) Inspect the infusion site
• D) Obtain vital signs
Correct Answer: B
Rationale: Signs of allergic or hemolytic transfusion reactions require immediate
cessation of the transfusion to prevent worsening complications. Further assessment
follows .
, Question 10
The PN is reinforcing teaching for a client prescribed warfarin (Coumadin). Which
statement by the client indicates a need for further teaching?
• A) "I will use a soft toothbrush."
• B) "I will report any unusual bleeding."
• C) "I will take ibuprofen for my headaches."
• D) "I will have my blood tested regularly."
Correct Answer: C
Rationale: "I will take ibuprofen for my headaches" indicates a need for further
teaching, as NSAIDs like ibuprofen increase the risk of bleeding when taken with
warfarin. Acetaminophen is a safer alternative for pain .
Question 11
While taking the vital signs of an older male client who takes psychotropic
medications, the PN notes uncontrollable hand movements and excessive blinking of
the eyes. Which information in the client's medical record should the PN review?
• A) Prescription for lorazepam
• B) History of Parkinson's disease
• C) Screening for tardive dyskinesia
• D) Recent urine drug screen report
Correct Answer: C
Rationale: Tardive dyskinesia is a movement disorder caused by long-term use of
psychotropic medications. Reviewing prior screenings helps assess risk and plan
care .
Question 12
A client with chronic kidney disease stage 4 is admitted with hyperkalemia (K+ 6.2
mEq/L). The nurse reviews the electronic health record and notes the client is
scheduled for dialysis tomorrow. Which intervention should the nurse implement
first?
• A) Administer sodium polystyrene sulfonate orally.
• B) Prepare for immediate hemodialysis.
• C) Administer intravenous calcium gluconate.
• D) Administer albuterol via nebulizer.
Correct Answer: C
Rationale: Intravenous calcium gluconate is given first to protect the heart from life-
threatening arrhythmias by stabilizing the myocardial membrane. Sodium
polystyrene sulfonate works slowly, dialysis is not immediate, and albuterol is a
temporary measure to shift potassium into cells but does not protect the heart .
