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HESI PN EXIT V4 EXAM NGN-STYLE 2026 QUESTIONS WITH
VERIFIED QUESTIONS DETAILED RATIONALES GRADED A+
HESI PN Exit V4 Exam | NGN-Style — Questions with Rationales
Summarized 10-Point Exam Coverage
Fundamentals of Nursing & Patient Safety — hand hygiene, PPE, fall precautions, restraints,
documentation, SBAR, prioritization, delegation, and scope of practice for the PN.
Medical-Surgical Nursing: Cardiovascular — heart failure, dysrhythmias, hypertension,
myocardial infarction, peripheral vascular disease, anticoagulant therapy, and digoxin
monitoring.
Medical-Surgical Nursing: Respiratory — COPD, asthma, pneumonia, tuberculosis, pulmonary
embolism, chest tubes, tracheostomy care, and mechanical ventilation.
Medical-Surgical Nursing: Gastrointestinal & Genitourinary — peptic ulcer disease,
inflammatory bowel disease, cirrhosis, pancreatitis, bowel obstruction, ostomies, acute kidney
injury, chronic kidney disease, and urinary tract infections.
Medical-Surgical Nursing: Neurological, Endocrine & Musculoskeletal — stroke, seizures,
traumatic brain injury, diabetes mellitus, DKA, thyroid disorders, fractures, and total joint
arthroplasty.
Pharmacology & Medication Administration — dosage calculations, high-alert medications,
insulin administration, anticoagulants, antibiotics, and medication reconciliation.
Maternal-Newborn Nursing — prenatal care, labor and delivery, postpartum assessment,
newborn care, and obstetric emergencies.
Pediatric Nursing — growth and development, pediatric respiratory and cardiac conditions,
immunizations, and family-centered care.
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Mental Health Nursing — therapeutic communication, depression, anxiety, suicidal ideation,
crisis intervention, and psychotropic medications.
Leadership, Management & Community Health — prioritization, delegation, conflict resolution,
quality improvement, disaster preparedness, and NGN clinical judgment (Recognize Cues,
Analyze Cues, Prioritize Hypotheses, Generate Solutions, Take Action, Evaluate Outcomes).
SECTION 1: FUNDAMENTALS OF NURSING & PATIENT SAFETY (Questions 1–35)
Q1. A practical nurse (PN) is assigned to care for four clients on a medical unit. Which client
should the PN assess first after receiving report?
A. A client with pneumonia who has a new order for IV antibiotics
B. A post-operative client who is reporting pain of 4/10
C. A client with diabetes whose blood glucose was 65 mg/dL one hour ago
D. A client who is awaiting discharge this afternoon
Correct Answer: C
Rationale: A blood glucose of 65 mg/dL indicates hypoglycemia, which requires immediate
intervention to prevent neurological damage or loss of consciousness. The PN should assess this
client first to determine if treatment is needed. Option A (new antibiotic order) is important but
not urgent—antibiotics can be administered within the prescribed timeframe. Option B (pain
4/10) requires attention but is not an emergency. Option D (discharge) is routine and can be
addressed after urgent needs are met.
Q2. A client refuses a prescribed medication. What is the PN's most appropriate response?
A. Crush the medication and hide it in the client's food
B. Document the refusal and notify the RN or charge nurse
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C. Insist that the client take the medication
D. Leave the medication at the bedside to take later
Correct Answer: B
Rationale: Clients have the legal and ethical right to refuse treatment, including medications
(autonomy principle). The PN must document the refusal according to facility policy and notify
the RN or charge nurse for further evaluation. Hiding medication in food (A) constitutes
deceptive practice and violates client rights. Insisting (C) is coercive and violates therapeutic
relationship principles. Leaving medication (D) is unsafe due to risk of diversion, accidental
ingestion by others, or improper storage.
Q3. Which of the following tasks can the PN delegate to an unlicensed assistive personnel
(UAP)?
A. Assessing a new admission
B. Administering oral medications
C. Assisting a stable client with bathing
D. Developing the plan of care
Correct Answer: C
Rationale: Assisting with activities of daily living (ADLs) such as bathing, dressing, and feeding
stable clients is within the scope of UAPs under PN/RN supervision. Assessment of new
admissions (A) requires nursing judgment and is an RN responsibility. Medication administration
(B) is within PN scope but cannot be delegated to UAPs. Care planning (D) requires nursing
diagnosis and critical thinking, which are beyond UAP scope.
Q4. The practical nurse enters a male client's room to administer routine morning
medications, but the client is on the phone. Which action is best for the PN to take?
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A. Ask another nurse to go back with the medication when the client's phone call ends
B. Wait for the client to excuse himself from the telephone conversation and observe the client
taking the medication
C. Return the medication to the client's drawer on the medication cart and document the client
refused the dose
D. Leave the medication at the bedside with a glass of water and ask the client to take it when
finished
Correct Answer: B
Rationale: The nurse must witness the client taking the medication to ensure it was taken as
prescribed. Leaving medication unattended or relying on another nurse compromises patient
safety and proper documentation. Documenting a refusal without asking the client is
inaccurate.
Q5. A Korean female exchange student admitted with acute abdominal pain answers
questions easily but looks away when asked about sexual activity. What should the PN do?
A. Omit this section of the assessment
B. Ask if she would prefer an interpreter to ask this question
C. Reword the question in case the client did not understand
D. Observe the client's response when asked different questions
Correct Answer: D
Rationale: Nonverbal cues may indicate cultural discomfort or embarrassment. Observing
reactions to other questions can help determine if discomfort is specific to sexual topics or if
further cultural sensitivity/intervention is needed. Omitting the assessment (A) compromises
care. Using an interpreter (B) may not address cultural embarrassment. Rewording (C) may not
resolve cultural discomfort.
HESI PN EXIT V4 EXAM NGN-STYLE 2026 QUESTIONS WITH
VERIFIED QUESTIONS DETAILED RATIONALES GRADED A+
HESI PN Exit V4 Exam | NGN-Style — Questions with Rationales
Summarized 10-Point Exam Coverage
Fundamentals of Nursing & Patient Safety — hand hygiene, PPE, fall precautions, restraints,
documentation, SBAR, prioritization, delegation, and scope of practice for the PN.
Medical-Surgical Nursing: Cardiovascular — heart failure, dysrhythmias, hypertension,
myocardial infarction, peripheral vascular disease, anticoagulant therapy, and digoxin
monitoring.
Medical-Surgical Nursing: Respiratory — COPD, asthma, pneumonia, tuberculosis, pulmonary
embolism, chest tubes, tracheostomy care, and mechanical ventilation.
Medical-Surgical Nursing: Gastrointestinal & Genitourinary — peptic ulcer disease,
inflammatory bowel disease, cirrhosis, pancreatitis, bowel obstruction, ostomies, acute kidney
injury, chronic kidney disease, and urinary tract infections.
Medical-Surgical Nursing: Neurological, Endocrine & Musculoskeletal — stroke, seizures,
traumatic brain injury, diabetes mellitus, DKA, thyroid disorders, fractures, and total joint
arthroplasty.
Pharmacology & Medication Administration — dosage calculations, high-alert medications,
insulin administration, anticoagulants, antibiotics, and medication reconciliation.
Maternal-Newborn Nursing — prenatal care, labor and delivery, postpartum assessment,
newborn care, and obstetric emergencies.
Pediatric Nursing — growth and development, pediatric respiratory and cardiac conditions,
immunizations, and family-centered care.
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Mental Health Nursing — therapeutic communication, depression, anxiety, suicidal ideation,
crisis intervention, and psychotropic medications.
Leadership, Management & Community Health — prioritization, delegation, conflict resolution,
quality improvement, disaster preparedness, and NGN clinical judgment (Recognize Cues,
Analyze Cues, Prioritize Hypotheses, Generate Solutions, Take Action, Evaluate Outcomes).
SECTION 1: FUNDAMENTALS OF NURSING & PATIENT SAFETY (Questions 1–35)
Q1. A practical nurse (PN) is assigned to care for four clients on a medical unit. Which client
should the PN assess first after receiving report?
A. A client with pneumonia who has a new order for IV antibiotics
B. A post-operative client who is reporting pain of 4/10
C. A client with diabetes whose blood glucose was 65 mg/dL one hour ago
D. A client who is awaiting discharge this afternoon
Correct Answer: C
Rationale: A blood glucose of 65 mg/dL indicates hypoglycemia, which requires immediate
intervention to prevent neurological damage or loss of consciousness. The PN should assess this
client first to determine if treatment is needed. Option A (new antibiotic order) is important but
not urgent—antibiotics can be administered within the prescribed timeframe. Option B (pain
4/10) requires attention but is not an emergency. Option D (discharge) is routine and can be
addressed after urgent needs are met.
Q2. A client refuses a prescribed medication. What is the PN's most appropriate response?
A. Crush the medication and hide it in the client's food
B. Document the refusal and notify the RN or charge nurse
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C. Insist that the client take the medication
D. Leave the medication at the bedside to take later
Correct Answer: B
Rationale: Clients have the legal and ethical right to refuse treatment, including medications
(autonomy principle). The PN must document the refusal according to facility policy and notify
the RN or charge nurse for further evaluation. Hiding medication in food (A) constitutes
deceptive practice and violates client rights. Insisting (C) is coercive and violates therapeutic
relationship principles. Leaving medication (D) is unsafe due to risk of diversion, accidental
ingestion by others, or improper storage.
Q3. Which of the following tasks can the PN delegate to an unlicensed assistive personnel
(UAP)?
A. Assessing a new admission
B. Administering oral medications
C. Assisting a stable client with bathing
D. Developing the plan of care
Correct Answer: C
Rationale: Assisting with activities of daily living (ADLs) such as bathing, dressing, and feeding
stable clients is within the scope of UAPs under PN/RN supervision. Assessment of new
admissions (A) requires nursing judgment and is an RN responsibility. Medication administration
(B) is within PN scope but cannot be delegated to UAPs. Care planning (D) requires nursing
diagnosis and critical thinking, which are beyond UAP scope.
Q4. The practical nurse enters a male client's room to administer routine morning
medications, but the client is on the phone. Which action is best for the PN to take?
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A. Ask another nurse to go back with the medication when the client's phone call ends
B. Wait for the client to excuse himself from the telephone conversation and observe the client
taking the medication
C. Return the medication to the client's drawer on the medication cart and document the client
refused the dose
D. Leave the medication at the bedside with a glass of water and ask the client to take it when
finished
Correct Answer: B
Rationale: The nurse must witness the client taking the medication to ensure it was taken as
prescribed. Leaving medication unattended or relying on another nurse compromises patient
safety and proper documentation. Documenting a refusal without asking the client is
inaccurate.
Q5. A Korean female exchange student admitted with acute abdominal pain answers
questions easily but looks away when asked about sexual activity. What should the PN do?
A. Omit this section of the assessment
B. Ask if she would prefer an interpreter to ask this question
C. Reword the question in case the client did not understand
D. Observe the client's response when asked different questions
Correct Answer: D
Rationale: Nonverbal cues may indicate cultural discomfort or embarrassment. Observing
reactions to other questions can help determine if discomfort is specific to sexual topics or if
further cultural sensitivity/intervention is needed. Omitting the assessment (A) compromises
care. Using an interpreter (B) may not address cultural embarrassment. Rewording (C) may not
resolve cultural discomfort.
